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In medicine, it is traditional for the doctor to do tests in order to come to the right diagnosis . He needs to identify what your problems are, so that he can then suggest the right treatment. This seems very logical and makes a lot of sense. After all, if the doctor cannot identify the problem, how can he suggest a solution?

In medicine, it is traditional for the doctor to do tests in order to come to the right diagnosis . He needs to identify what your problems are, so that he can then suggest the right treatment. This seems very logical and makes a lot of sense. After all, if the doctor cannot identify the problem, how can he suggest a solution ? However infertility medicine is completely different. Unlike other branches of medicine , it is not a problem oriented - it is solution oriented. Patients don't come to a doctor and say - Please open my blocked tubes - they come to a doctor and say - I want to have a baby !

For older patients, the final common treatment pathway which most doctors will advice is IVF , because it maximizes their chances of getting pregnant. This is true , no matter what their medical diagnosis is - whether it is unexplained infertility ; or blocked tubes ; or a low sperm count. It really doesn't matter what the problem is - what we're trying to do is to bypass the problem, rather than waste time trying to identify it ! This means that if an older woman comes to me , I will tell her that the only reasonable solution for her would be IVF treatment. Now , it's only she's willing to do the IVF treatment would it make sense for me to do medical tests for her , so that I can formulate a treatment plan which is tailored to her particular diagnosis. However , if she's not willing to do IVF , there's really no point in my doing any tests at all, because it's not going change any recommendation I can make for.

Actually, this is true in some other conditions as well . Let's take the case of a man with an advanced prostate cancer who has metastases in the lungs. There's little point in doing repeated CTs of the chest, if he does not want any medical intervention for this. The Golden rule in medicine is simple - you should only do tests if it changes your treatment options !

 

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