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The workup should not stop when a single problem is discovered - it is still important to complete the testing, since it is possible that infertile couples may have multiple problems. Remember also that many diseases, such as pelvic inflammatory disease (PID) which can cause the tubes to get blocked, can be "silent", so that the patient may have absolutely no signs or symptoms.
A single test abnormality does not necessarily mean that a problem exists and the test may need to be repeated, to confirm that it is a persistent problem.
Sometimes it can be difficult for patients to come to terms with the fact that there is a major problem which presents a significant hurdle to getting pregnant. The truth can be bitter, but it's far better to face up to it and deal with it, rather than live in a fool's paradise! With today's advanced reproductive technology, we can always find a solution, no matter what the problem - but remember that unless you can intelligently identify the problem, you cannot find a solution!
Unfortunately, it is very common to find that tests are done piecemeal - or sometimes, not done at all, so that often treatment is started before coming to a diagnosis. Conversely, some doctors take so long to do the tests that patients get fed up - after all, they want treatment! It is also common to find that doctors will insist on repeating the tests a previous doctor has performed - and this can be a waste of valuable time and money.
The couple must be seen together, and the first test which should be done is a semen analysis. Sadly, sometimes the wife will have undergone innumerable tests (sometimes repeatedly!); and the husband's semen analysis (where the problem lies) has not been done even once.
It is only after the workup has been completed that a treatment plan can be formulated - and you will then need to make decisions about treatment options.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
