researchotaku (researchotaku) wrote in little_details,

Concealing a husband's infertility in America and/or Japan

Time: Modern day but the main action for the situation in question is early 2000s.

Place: An alternative universe United States that was conquered by Japan at the end of World War II (because Japan managed to develop the atomic bomb first and dropped it on Akron and Detroit).

Technology level: Relatively the same as this universe.

My main character, Shinji, desperately wants children. His wife, Kyoko, is subconsciously against having children (because then party time's over) but she goes along with this because she feels like that, well, having children is What Married People Do (and babies are great status symbols, aren't they?). After a year of trying (they are in their mid-twenties), there are no babies so they go get fertility tests.

Kyoko is pretty sure that the problem isn't with her since she had an "oopsie" with another man while Shinji was on his tour of duty in another country (I haven't decided whether she miscarried or aborted the child but it's irrelevant for this question) so when they do the fertility tests, Kyoko doesn't want Shinji to find out the truth.

First question: Is it possible for a doctor to discuss a person's fertility status to that person's spouse without the person being present? I'm aware of the United States' HIPAA laws that say you can't discuss someone's medical information with anyone except that person unless they give express permission that you can (and I can say that Shinji said it was okay). But would a doctor be willing to do this?

Search used: can a doctor tell a wife about her husband's infertility but not the husband?

Second question: The problem is with poor Shinji. The problem is that he has low sperm motility (so his sperm spin around in circles mostly). I've come up with two ways Kyoko can react:

a. Kyoko thanks the doctor for his time and vows to tell Shinji at home to let him down easy. Of course, she lies to him and says the problem is with her. The doctor never finds out that Kyoko lied to Shinji (until Shinji calls him up years later, demanding to know the truth).

b. Kyoko thanks the doctor for his time but requests that the doctor not tell Shinji that it's him because "it would destroy him" if he knew the truth. Kyoko tells the doctor that she will tell Shinji that it's her to save his ego. She has already decided that she has no desire to go through the artifical fertilization procedures so either way, the point is moot. The doctor says he won't say anything unless Shinji comes in and asks himself (which he does, years later). I'm only considering this option because, from what I've seen of Lost, this happened to the Korean couple so this makes me think that this is a possibility (but then again, TV Land doesn't operate with the same rules as the real world).

Either option is in character for Kyoko but I'm not sure about what the doctor can do in this situation. It is vital to the story that Shinji not know he's infertile until Kyoko tells him eight years later.

I'd love other ways to conceal Shinji's infertility from him if neither of these options make any sense.

Search used: Same search as above but the closest answer I found was to a search that doesn't quite match this question which was "Can a doctor tell a wife about her husband's medical condition?" One hit I got posed the question of a husband being HIV positive and whether the doctor should tell the wife if the husband forbids it. Apparently, at least in Texas, it is up to the doctor whether or not to tell the wife. But HIV is different than infertility so I'm not sure which way to go on this one.

Third question: Shinji has low sperm motility and because Kyoko lied to him, he never did anything to counteract it. Kyoko never underwent any sort of fertility treatment (because she was perfectly fine). They end up adopting instead so the heat was off, babymaking-wise. In fact, she went on the Pill for years (she claimed it was to regulate her periods but it was really because she was having an affair). Years later, Kyoko ends up pregnant (they are now in their early thirties).

At this point, Shinji knows he has low sperm motility but has not told Kyoko that he knows. The real reason she's pregnant is because she's having an affair (and the condom broke). Shinji suspects that she's having an affair but isn't 100% sure. I'd like him to call up our old friend the fertility doctor and ask what are the chances that someone with his kind of low sperm motility can conceive a child without any sort of assistance?

I've tried searching using the phrase "low sperm motility + chances of getting pregnant" and while I get results that tell me it's "low", I'd really like a number. I'd also like to know whether Kyoko ending up pregnant without Shinji getting any sort of treatment would raise an expert's eyebrows (ie is it pretty obvious that Kyoko must be stepping out on Shinji?). I mean, it's obvious to me because I'm the writer and I know Kyoko is having an affair and that Shinji's chances of conceiving naturally are pretty much zero (even if he took supplements and all that. Only IVF and the like would work for him) but would it be obvious in the "real world"?

Since in this world Japan conquered America, I would appreciate tips from either country's medical practices. I do a lot of hybrid type things in order to move my plot (in other words, I go with whatever way will let me do what I want within reason) so if Japanese system works better than the American system or vice versa, I'll go with that.

I appreciate any help (or search terms) you can provide!

Tags: japan (misc), japan: health care and hospitals, ~medicine: reproduction

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