Simplicity in Medicine

Nowadays, more than in previous times, a doctor notices an array of complicated and perplexing protocols used in management of different illnesses and syndromes. In my specialty, many women who complain of infertility are frequently subjected to such dizzying pharmaceutical formulae, with frequently disturbing complications: hyper­ovulation, twinning, triplets, quadruplets and upwards… with ensuing questionable, if not really worse, results. In our daily practice, one frequently faces cases of infertility that are treated with pell-mell piles of highly effective medications, with disappointing results, most of the time. If one looks close to such cases, one discovers that they are newly married couples who are pressed by the surrounding family and/or tribe and that only a month or two would have elapsed after their marriage, without signs of a long­awaited cyesis. Looking closer at such cases, which really are merely cases of short delay of conception, one would discover that the miserable young woman is under heavy psychological stress that has caused in her a form of anovulation. All what would be needed is to re-assure her that everything is fine and encourage the young submissive husband to stop, or ease, the nagging of the mother-in-law. It should not surprise anyone if the young woman would return to you in the following month saying she missed her period. A colleague might disagree with such an appeal for simplification and argue that most cases of infertility are caused by multiple factors like tubal occlusion and polycystic ovaries etc. However, the majority has much simpler etiologies.