Monday, July 27, 2009

Alternatives to IVF

Some of this sounds like quackery but it is undoubtedly true that deciphering the cause of a person's infertility should be the first thing tried before rushing into IVF. And even quackery can have a useful placebo effect

It’s a sad fact of life that one in six couples will have difficulty conceiving. Those praying for a miracle will often try anything, from the estimated 75% who experiment with alternative therapies, to the 1 in 80 women who will eventually give birth to an IVF baby in the UK each year. Now, two leading fertility specialists have decided to bridge the gap between conventional and complementary medicine, and offer an alternative to rushing into IVF. “I estimate that 50% of women on IVF don’t need it,” says Dr Sami David, a doctor involved with the first-ever successful IVF procedure in New York 30 years ago. “They could get pregnant naturally.”

David has turned his back on what has become a multimillion-pound industry with a vested interest in rushing women into assisted conception. “Infertility is a symptom, not a disease,” he says, “yet most fertility doctors are only interested in giving a woman drugs and getting her on a course of expensive, and stressful, IVF as soon as possible. I’m not against IVF — far from it,” he continues. “But it shouldn’t be the first thing we turn to as doctors. Putting a woman on aggressive drugs to stimulate egg production is a waste of time if, in fact, she is failing to get pregnant because her partner has a low sperm count, or she has an infection.”

David claims that most specialists have little interest in doing the necessary detective work to establish why a couple aren’t conceiving. Together with Jill Blakeway, an alternative-health practitioner who moved from the UK to America 20 years ago, he has written The Fertility Plan, a three-month scheme that helps women overcome common blocks to pregnancy. The book offers targeted advice according to five different “types” of people. “The types are loosely based on Chinese medicine, combined with Dr David’s clinical experience,” says Blakeway, who has such a high success rate that The New York Times dubbed her “the fertility goddess”. “I didn’t want to bog people down with the more esoteric aspects of eastern philosophy,” she adds, “so I’ve kept it simple.” The five types are: stuck, pale, waterlogged, dry and tired; there are quizzes and guidelines to help identify your type and what to do in each case. It’s all refreshingly simple.

“IVF is part of our quick-fix society, particularly in New York,” says Blakeway. “We are used to life being convenient, to having stuff delivered on demand, so a woman might think: ‘When the time comes, I can always go for IVF.’ Making babies is a much more mysterious thing — you can’t think like that.” She is also keen to remind women that IVF still has a relatively poor success rate. “At one of the most renowned New York clinics, figures indicate that among women under 35, the success rate is still only 47%.”

In the book, the duo present a range of common factors that can inhibit fertility, but which doctors don’t always raise. “There are issues from hormones being thrown out of balance by yo-yo dieting, to women who exercise too much, which could lower levels of oestrogen and progesterone,” David says. “Or infertility can arise from a diminished flow of blood to the uterus, which can be dramatically helped by acupuncture.”

Another common cause of infertility is bacterial infection, which has prompted David to remark that antibiotics are his favourite fertility drug. “A lot of doctors specialise in scaring the patient,” he says. “They’ll tell a woman of 37 she’s left it too late and her only option is IVF. But they’re measuring everyone by the same yardstick. Every woman has time to take a three- or four-month evaluation of what’s going on with her body.” Blakeway agrees that the emotional rollercoaster of trying to become pregnant can extract a heavy toll on would-be mothers. “The last thing we wanted to do was make women feel stressed out about not getting pregnant. If it’s not happening for you yet, it’s comforting to bear in mind that there is an enormous amount you can do for yourself.”


Update: A medical correspondent says it is ALL quackery above and says that of course doctors do all they can to identify the problem first. That may be so in the USA but it is not so in the UK, where NHS doctors are notoriously slow to order diagnostic tests. So the warning above (which appeared in a British paper) may be timely for some Brits.

Daily pill may cure blood cancer

BLOOD cancer patients could soon take a daily pill to treat the condition which has traditionally given sufferers a survival time of just a few years. Cancer specialists are meeting in Melbourne this weekend to discuss the future direction of treating myeloma - an incurable blood cancer which effects thousands of Australians.

"We are seeing a major advance in the treatment of multiple myeloma,'' Royal Melbourne Hospital oncologist Professor Jeffrey Szer said in a statement. "In the past five years for instance, myeloma patient survival, which has traditionally been three to four years, has been significantly extended with the availability of innovative new medicines.'' One such medicine, Revlimid, will be discussed at the meeting as a possible oral treatment for the condition.

"We are seeing a significant improvement in quality of life and cancer survival rates,'' Prof Szer said. "There are a number of new treatment strategies that clinicians are adopting to enable them to achieve these outcomes.

"Revlimid is an example of an innovative new medicine that has a unique mechanism of action to kill cancer cells and prolong the patient's life. Compelling Revlimid clinical trail data is being discussed at (the) medical symposium this weekend with local and international experts, coinciding with the Leukaemia Foundation's public lecture.''

Some 1500 people are diagnosed with myeloma in Australia each year. The cancer, which develops in the bone marrow, inhibits the production of normal blood cells and causes symptoms such as anaemia, fatigue and infections.


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