When your gynecologist can be a threat to your infertility
Gynecologists are trained to do a basic infertility workup and to treat simple infertility problems. While most gynecologists will do a good job with handling simple infertility problems, the truth is that sometimes your gynecologist can actually prove to be an impediment in your quest have a baby.
Gynecologists are trained to provide healthcare for women and are usually the primary care physicians for most women. When a couple has a fertility problem, it's usually the woman who seeks medical advice, and her first point of contact is usually her gynecologist. Gynecologists are trained to do a basic infertility workup and to treat simple infertility problems, so that they can make the right diagnosis and institute treatment is appropriate. While most gynecologists will do a good job with handling simple infertility problems, the truth is that sometimes your gynecologist can actually prove to be an impediment in your quest have a baby.
This is because gynecologists often do not have any special interest, training or experience in taking care of infertile women. This is why they often cannot provide a well-defined treatment protocol, as a result of which they often end up doing treatment on an ad hoc basis every month, which wastes a lot of time.
Thus, most gynecologists have no idea what to do in case the man has a problem. The knee-jerk response is to refer the man to an andrologist, but this then means that care starts getting fragmented, as a result of which the treatment of the infertile couple gets compromised.
Sadly, most gynecologists are not very efficient in taking care of the older infertile woman. Because they're so used to delivering babies, and since they see older women who get pregnant in their own bedroom all the time, they often do not realize the deleterious effect which the passage of time can have on the ovarian reserve of the older infertile woman . As a result of this blond spot, they will often Institute ineffective treatment options such as clomid for ovulation induction or IUI for older women, thus causing them to lose valuable time, which can never be replaced.
Some gynecologists are still quite reluctant to refer patients for IVF to infertility specialists because they want to retain control over the treatment of what they consider to be their patient. This is why they will often repeat the same treatment ad nauseum, even when these have no therapeutic benefit whatsoever. Many of them will insist that the patient remove small fibroids or small endometriotic cysts - even though this surgery does not improve fertility - and can actually reduce it, by creating adhesions and reducing ovarian reserve.
Few doctors today do D&Cs for infertile women - but older gynecologists still resort to obsolete procedures such as hydrotubation to "open blocked tubes". This just wastes time ! Even worse, the patient starts losing confidence in doctors - and just gives up on infertility treatment all together, because they are fed up; and have run out of time, patience and money !
Even worse when a new patient comes to them, even if the patient has received treatment from another gynecologist, they will often end up repeating the laparoscopy or repeating the IUI treatments, even though there is no logical basis to doing so.
Gynecologists don't have a holistic perspective when dealing with the infertile couple. They don't have any training in handling the infertile man with an abnormal sperm count; and they tend to underestimate the emotional consequences of infertility. They will often adopt an ultra conservative approach to these women, which can end up harming their fertility potential.
This often means that the poor patient just gets plain fed up of the same tired ineffective treatment options - and will then seek out an IVF specialist, because she wants to move on with her treatment. However, the waste of time is irretrievable, and often results in older women losing their best shot at getting the right infertility treatment for themselves.