Yet, in today’s era of easy access to information, patients—especially women trying to conceive—can conveniently obtain a wealth of medical knowledge. They bear not only the fear of diseases but also profound anxiety intertwined with concerns about fertility and family future, and the issues involved are often highly private. The fragmentation and one-sidedness of online information tend to amplify these anxieties, transforming doctors from absolute authorities into advisors who need to compete with "online voices."
Therefore, obstetricians and gynecologists not only need to possess exquisite medical skills but also master the art of effective communication, translating professional medical judgments into treatment plans that patients can understand and trust. Communication strategies must go beyond mere medical explanations, incorporating profound empathy for fertility anxiety and strict respect for privacy to build an unshakable doctor-patient trust.
Case Sharing
A 28-year-old female patient (trying to conceive) was found to have a 4cm-diameter ovarian cyst during a physical examination. Ultrasound showed a smooth cyst wall and uniform contents, suggesting a high possibility of a functional cyst. The doctor recommended a follow-up ultrasound in the early phase after menstruation (3 months later) without immediate intervention.
After returning home, the patient remained extremely worried and searched online for topics such as "how to treat ovarian cysts." She encountered alarming headlines like "ovarian cysts affect ovulation," "endometriomas cause infertility," "ovarian cysts must be surgically removed," and "ovarian cysts can become cancerous," as well as numerous shared experiences from netizens stating that "laparoscopic surgery should be performed immediately upon discovery." Comparing these with the doctor’s recommendation of "observation," she felt deeply anxious and confused, convinced that the doctor had underestimated the severity of her condition, which might delay the optimal treatment window and even ruin her fertility plans.
The next day, she returned to the clinic with a stack of printed materials, accusing the doctor’s observation plan of "delaying treatment" and emotionally demanding an "effective treatment plan" immediately.
Handling Methods
Faced with the patient’s anxiety and skepticism, the doctor adopted the following layered communication strategy ☟:
Step 1: Empathize and Accept – First Soothe Emotions to Build a Trust Foundation
Instead of directly refuting or dismissing the patient’s concerns, the doctor first expressed understanding (using affirmative language to soothe emotions and avoid escalating conflicts).
"I fully understand your worries and exactly why you’re so anxious. You and your family are doing everything you can to conceive, so any slight change feels like a huge obstacle—I’m well aware of this pressure. Additionally, there’s an overwhelming amount of conflicting information online, which can indeed make people more anxious the more they read."
Step 2: Professional Interpretation – Screen Information Using Gynecology-Specific "Language"
After the patient’s emotions stabilized, the doctor explained using gynecology-specific metaphors and authoritative guidelines.
1. Specialized Metaphors for Intuitive Understanding
"Your ovaries are like a 'garden' that works diligently every month. This cyst is like a small 'blister' (follicle or corpus luteum) temporarily filled with fluid in the garden—it’s usually part of the normal physiological process of ovulation. In the vast majority of cases, once your period arrives next month or the month after, the 'blister' will be absorbed and disappear on its own. Our recommendation to observe is to give this 'small blister' a chance to resolve naturally."
"Surgery is like digging up the soil in the garden. No matter how advanced the technology is, it’s inevitable to damage some of the good 'soil' (ovarian tissue). For a 'blister' that’s likely to disappear on its own, our top priority is to 'protect the soil' and avoid any unnecessary harm, as ovarian reserve is crucial for conception."
2. Citing Authoritative Gynecological Guidelines for Accurate Science Popularization
The authoritative Chinese Expert Consensus on the Diagnosis and Treatment of Ovarian Cysts (2022 Edition) in our field states: Asymptomatic ovarian cysts in premenopausal women are mostly functional cysts, which can regress spontaneously or remain unchanged without treatment. Those with a diameter <10cm can be observed; if the cyst does not disappear or continues to grow after observation, and physiological cysts are ruled out, surgery may be considered as appropriate. Unilateral, unilocular cysts with a diameter <5cm—especially those without solid or papillary components—have a malignant risk of <1%. More than half can regress spontaneously within 3 months. Regular follow-up with serum CA125 testing and ultrasound is recommended, with an interval of 2–3 months. For your case—a newly discovered, simple cyst <5cm in diameter confirmed by ultrasound—the preferred initial management is short-term (2–3 menstrual cycles) observation and follow-up. The cases you read online about 'immediate laparoscopic surgery upon discovery' likely involve cysts that are too large or have complex features such as solid components, which do not apply to your situation."
Step 3: Reach a Plan Consensus – Collaboratively Develop a Personalized Fertility-Friendly Plan
Transform the patient from a passive information recipient into an active decision-maker (role shift to involve the patient, granting them a sense of control and security).
"Our feelings and goals are completely aligned: to help you conceive smoothly while ensuring your health, using the method that has the least impact on your fertility. So, we can develop a plan together: come for a follow-up ultrasound 3–5 days after your next period ends—this is the most accurate time to observe the cyst. If you’re still really worried, we can do a blood test for CA125 today. If the result is normal, you can feel at ease with the observation. If you experience sudden severe abdominal pain during the observation period, please seek medical attention immediately so we can rule out other conditions. What do you think—can you accept this plan?"
Outcome
After the communication, the patient’s anxiety was significantly alleviated, and she agreed to the jointly developed monitoring plan. A follow-up examination 3 months later showed that the cyst had regressed spontaneously, and she expressed sincere gratitude to the doctor.
In the obstetric and gynecological clinical setting intertwined with fertility anxiety and fragmented online information, a doctor’s empathetic acceptance of the patient’s emotions, accessible interpretation based on professional guidelines, and collaborative goal-setting communication style can not only effectively resolve skepticism triggered by "online opinions" but also build a doctor-patient bond centered on trust.
This type of communication, which balances medical professionalism with humanistic care, respects the patient’s profound expectations for fertility and health while safeguarding the scientific nature and safety of diagnosis and treatment. Ultimately, it helps patients achieve positive health outcomes in a reassuring environment, and provides a practical direction for obstetrics and gynecology to address special communication challenges and achieve high-quality doctor-patient interaction.
Author Information
Editor-in-Charge: Lily