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Asking the right questions about infertility will save you valuable time and effort. Finding the 'why' will lead you faster to the 'how'.

A Case 

I recently saw an infertile patient who had over 3 thick files bulging with medical tests and reports. They must have visited over 10 infertility specialists who had done every possible test under the world to try to find out what their problem was.

The Condition 

She had been tested for antisperm antibodies, NK cells , hostile cervical mucus, tuberculosis, chlamydia, sperm DNA fragmentation; you name it, and she had had the test done. Each doctor had repeated test after test, but each result was normal. They were at their wit's end. "Why can't I get pregnant , doctor , if everything is normal ?" was her plaintive cry.

Patient's Expectations 

I was amazed at how little she had learnt after visiting so many doctors. Instead of learning from her experience, she was still asking the wrong question ! She expected me to order some more tests, or use some newer machine to probe her insides and pinpoint the elusive problem.

I had to remind her that the quality of the answer we get depends upon the quality of the question we ask. No one cares about problems - people only care about solutions. Rather than keep on asking "What's the problem ? Why aren't I getting pregnant ?", she should instead be asking , "What can I do in order to get pregnant ?"

About Questions and Answers 

Ask a better question , and you get a better answer ! This was a totally new perspective for her, and I had to walk her through this viewpoint. As I explained to her, it hardly mattered what the reason for her infertility was - the only thing which mattered was how we could fix the problem.

Everyone knows: GIGO - garbage in, garbage out. If you keep on asking "What's the problem ?" you will end up wasting a lot of time, money and energy in trying to identify it. Unfortunately, many of these diagnostic labels are inaccurate, unreliable or even completely wrong.

For example, a few years ago, many patients were diagnosed as having an "inadequate luteal phase" - and even treated for this problem ! We now realize, with hindsight, that there is no such condition, and we did a major disservice to our patients by coining this term and making such a (mis)diagnosis.

Read more- The quality of a doctor's answers depend upon the quality of a patient's questions

It breaks my heart when I see how much time and money infertile patients have wasted in pursuing a diagnosis. Is it the end, doc? Could I be having antisperm antibodies ? These are all the wrong questions , but we see this all the time.

The First Question 

Thus, after a failed IVF cycle , the first question patients ask is - Why didn't I get pregnant ? ( Interestingly, patients who get pregnant after IVF (In Vitro Fertilization) never ask - Why did I get pregnant ? The fact is that we cannot answer either of these questions - and often it's just a matter of chance ! )

The Right Question 

The right question patients should be asking after a failed IVF cycle is - What do I do next ? Often, the best option is to repeat the IVF (In Vitro Fertilization) cycle. It's a lot like buying a lottery ticket - there's no compulsion to do so , but if you don't buy, you don't win ! And the oftener you buy, the better your chances of winning !

This is why, for most infertile patients, it's better to look forwards rather than to look backwards. The best question is - What's the next step ? It's a good idea to make a list of all possible treatment options - ranging from: stopping treatment and remaining child-free; adopting; repeating the IVF cycle; doing the IVF cycle at a new clinic; or using third party reproduction.

You can then eliminate the options which you are not willing to consider, so that you are then left with the alternatives you are willing to explore. You then need to focus on each of these, till you find the one which is best for you.

Often, if you use this approach, you may find that the absence of alternatives makes decision making easy , and you can plan your next step and navigate your path through the infertility maze with much greater ease !

Be a Well-Informed Patient - Visit HELP- the Health Education Library for People


Asking the right questions about infertility will save you valuable time and effort. Finding the 'why' will lead you faster to the 'how'.

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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