Follow-up after 6 years

"Sir, this patient is married for six months. She has amenorrhea for three months." It was my outpatient clinic. My Registrar wanted my advice. "Is she pregnant?" I asked. "No. Actually she has been menstruating regularly for last six years with cyclical medroxy progesterone therapy. She has not taken that drug for the last three months because she thought it might interfere with her chances of conceiving. You had seen her six years ago and advised her that. You had also told her to see you after she got married." I looked at the patient's face. I could not remember seeing her six years ago, but that advice rang a bell. "Why do you think I called her to see me after she got married?" I asked. I must have told the patient the reason, but either she had forgotten it, or my Registrar had forgotten to ask her the reason. The Registrar shook her head. "Think what the reason could be" I encouraged. "May be to see if she got pregnant" she guessed. Bad guess. I suppressed a smile and asked her, "what will you do for her now?" "I will regularize her period with hormones" she said. I wanted to say 'Oh God!' but did not. "She wants a pregnancy, does she not?" I asked. "Yes sir." "So you will induce progesterone withdrawal bleeding and then you will induce ovulation with clomiphene citrate" I said. "I had called her after her marriage for ovulation induction in case her menstruation had not become regular by that time." I hoped she got the thought process correctly. That was what would make good gynecologist out of her.