from the book How to Have a Baby: Overcoming
Infertility
by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani,
MD.
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Rights of the Infertile Couple - and What Society
Needs to Do About Them
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Table of Contents
Why
are some couples unhappy with modern infertility treatment
?
What
can alternative medicine offer infertile couples ?
How
can you protect yourself from quacks ?
How
can you use alternative medicine intelligently ?
There is no doubt that modern medicine
inspires awe. IVF laboratories and sophisticated ultrasound
scanning machines appear very impressive and reassuring
when you are infertile. However, paradoxically, even
though the effectiveness of reproductive technology
has improved dramatically, more infertile patients than
ever before have become dissatisfied with their medical
care today. This situation has resulted in a move towards
'alternative' medicine, which has become increasingly
popular all over the world. Even in the United States
of America (the bastion of high-tech scientific medicine),
more than 20 per cent of infertile couples have consulted
an alternative medicine practitioner, mainly because
they were unhappy with modern medical care.
Why
are some couples unhappy with modern infertility treatment
?
There are many reasons for this unhappiness
with modern medicine. Patients increasingly feel that
medicine has become too commercial and that doctors
are too busy to spend time with them. They are unhappy
with the impersonal nature of modern medicine, especially
when the doctor spends more time looking at their lab
reports and ultrasound scans, rather than with them.
While it is true that patients need technology, they
also need tender, loving care; after all, doctors need
to look after not only their medical problems, but also
their emotional needs!
What
can alternative medicine offer infertile couples ?
Alternative medicine, on the other hand,
offers a markedly different perspective. Rather than
focussing on the infertility in isolation, alternative
medicine treats the patient as a whole; hence the popular
term, holistic medicine. Doctors practicing alternative
medicine sit down and talk to the patient; they touch
and feel him and ask many questions. And such attention
feels good, in refreshing contrast to the modern doctor
who rarely has even 15 minutes to spend with the patient.
(Often, tender loving care and personal attention are
all that alternative medicine practitioners have to
offer, but they offer it very well indeed!) There is
no doubt of the efficacy of the placebo effect, and
even the simple act of touching the patient, can have
a therapeutic effect. Also, alternative medicine doctors
are very good at reassuring patients, as contrasted
with the coldly scientific approach of western medicine.
Many patients (usually those with unexplained
infertility or with ovulatory disorders) do conceive
when they use alternative medicine. However, the practice
of alternative medicine in India today leaves a lot
to be desired. For one, such medicine does not have
a universally accepted scientific basis; hence, it is
difficult to rigorously analyze its claims. Since there
is no need for formal publication or peer review in
alternative systems of medicine, there is little scientific
documentation available about their efficacy or side-effects,
so that it becomes difficult to confirm claims or dispute
them. Consequently, one has to blindly trust the doctor.
Authoritative journals or texts are
difficult to find; and most publications use little
scientific rigour, being based mostly on anecdotal case
reports, with little documentation or proof. Moreover,
since there is no official monitoring of the practitioners
of alternative medicine, anyone can make tall claims
and get away with them! Also, since there are few formal
training requirements, anyone can practice alternative
medicine, with minimal skills or qualifications. Unfortunately,
unscrupulous practitioners have mushroomed, who are
out to make a quick buck, and malpractices and quackery
flourish, which is why most infertility specialists
distrust alternative medicine practitioners today.
How can you protect
yourself from quacks ?
How can you protect yourself from quacks
? Remember that quackery is not an all-or-nothing phenomenon.
Some products can be useful for some purposes, but worthless
for others. For example, while certain ayurvedic herbs
can be very useful, often the mass-manufactured ayurvedic
medicines available in chemists’ shops are completely
useless, because they do not contain what they are supposed
to! While there is no doubt that homoeopathic medicines
can be helpful, the concept of a standard homoeopathic
remedy for common illnesses such as headaches and colds
flouts a basic homoeopathic principle, which states
that remedies need to be tailor made for a particular
person and only a skilled homoeopathic physician can
identify the required medicines properly.
Unproven methods are not necessarily
quackery. Those consistent with scientific concepts
may be considered to be experimental, but legitimate
practitioners do not go around promoting unproven procedures
in the marketplace. Instead, they engage in responsible,
properly designed research studies to prove or disprove
their claims.
Quackery can harm individuals in many
ways. First, is the loss of a tremendous amount of money
which patients invest in pursuing this treatment, and
many unscrupulous practitioners can bleed patients and
their relatives dry — a little at a time. Also, many
of the quack therapies can cause direct harm. It is
a common misconception that ‘natural medicines’ have
no harmful side- effects — but anything which can have
an effect, by definition, also has the potential to
cause harmful effects (after all, the desired effects
of a medicine are what we call its therapeutic action
and undesirable effects are labeled ‘side-effects’!).
The indirect harm they cause can also be enormous: for
example, patients may pursue ‘alternative medicine’
for treating their infertility and may deprive themselves
of the opportunity of getting effective state-of-the-art
medical treatment.
Quackery flourishes even in the USA
where people are much more sophisticated, and the US
Food and Drug Administration (FDA) provides effective
policing. Therefore, it is hardly surprising that in
India this menace is rampant, and there are far more
quacks than regular medical practitioners. Faith healing,
for example, is an integral part of Indian traditions,
especially in villages where educated priests take advantage
of people’s ignorance and blind faith.
How can you save yourself from being
quacked? Here are some useful pointers by Dr. Stephen
Barrett from his Quackwatch Web site (at http://www.quackwatch.com/.)
- Forget about ‘secret cures’. True
scientists share their knowledge as part of the process
of scientific development. Quacks often keep their
methods secret to prevent others from decisively demonstrating
that they don’t work. No one who actually discovered
a cure for infertility would have reason to keep it
secret. If a method really works, the discoverer would
gain enormous fame, fortune and personal satisfaction
by sharing the discovery with others.
- Remember that quackery often garbs
itself in a cloak of pseudo-scientific respectability
and its promoters often use scientific terms and quote
(or misquote) from scientific references. Be equally
wary of pseudo-medical jargon. Instead of offering
to treat your infertility, some quacks will promise
to ‘detoxify’ your body, ‘balance’ its chemistry,
release its ‘nerve energy’ or ‘bring it in harmony
with nature’. The use of concepts that are impossible
to measure or quantify enables success to be claimed
even though nothing has actually been accomplished.
- Ignore any practitioner who says
that infertility is caused by faulty nutrition or
can be remedied by taking supplements. Although some
diseases are related to diet, most are not. Moreover,
in most cases where diet actually is a factor in a
person’s health problem, the solution is not to take
vitamins but to alter the diet.
- Be wary of catchy anecdotes and testimonials.
If someone claims to have conceived after using an
unorthodox remedy, there is often a rational explanation.
Some patients with long-standing unexplained infertility
do get pregnant on their own – and they may erroneously
give credit to the treatment. Some testimonials, of
course, are complete fabrications!
- Don’t let desperation cloud
your judgement! It is true that infertile couples
are very susceptible to being quacked, but if you
feel that your doctor isn’t doing enough to help you,
don’t stray from scientific health care in a desperate
attempt to find a solution. Instead, discuss your
feelings with your doctor and consider a consultation
with a recognized expert.
The best way you can protect yourself
from being taken for a ride, is to make sure you are
well informed about your infertility. The ‘take-home
message’ is simple: if it sounds too good to be true,
it probably isn’t!
Unfortunately, because of widespread
quackery in the field of alternative medicine, most
infertility specialists today have a poor opinion of
what alternative medicine can offer their patients.
This often means that doctors end up throwing the baby
out with the bath water! There are many areas for which
Western medicine today has little to offer the patient.
Examples include: medical treatment for a low sperm
count, or treatment for a thin endometrial lining. It
is possible that alternative medical systems may have
effective techniques for treating these conditions –
and if we research these, and show that they are effective,
we may be able to make significant progress in our ability
to help infertile couples.
How can
you use alternative medicine intelligently ?
Amongst the various options available,
acupuncture has become quite popular, and the theory
behind this is that it can re-balance the bioenergy
of the body that runs in the Meridian pathways, and
this helps to improve tissue function. The "scientific"
explanation is that it changes levels of neurotransmitters,
the chemicals that nerve cells use to communicate. Herbalists
may recommended ginseng as a "tonic" for men and women
; and a combination of false unicorn root (helonias)
and vitex tinctures for women. This realm of herbal
practice is probably for experts only, as we still do
not know all the side effects of these herbs. In general,
it's best to take as little medication as possible when
you are trying to get pregnant. Nutritionist therapists
suggest using supplements which contain arginine, beta
carotene, zinc, and Vitamin C and Vitamin E. Aromatherapists
may give a clary sage oil massage which is said to improve
estrogen levels; and rosemary, tea tree, lavendar and
other anti-infective oils for an abdominal massage.
An important area to consider is the
mind/body connection. There are now clinics in the USA
that claim to have good pregnancy results with meditation,
yoga, relaxation and visualization techniques. Again,
solid documentation of these results is lacking, but
you may want to try these out.
For options like ayurveda and homeopathy,
it is important that you go to a reliable practitioner,
because these are complex sciences, and you need expert
guidance to achieve the best results. We feel that diverse
modalities such as massage, Reiki, yoga, ayurveda, acupressure,
acupuncture, hypnosis, homeopathy, naturopathy and many
others can work in conjunction with each other as part
of a unified team rather than in competition.
We need to learn to combine the best
of both worlds – high technology with high touch – and
this is called integrative medicine, as pioneered by
Dr Andrew Weil of the USA. Integrative medicine neither
rejects conventional medicine nor embraces alternative
medicine uncritically – just because most alternative
medicine systems are ‘natural’ does not automatically
make them better! The most important requirement is
that you need to find a good doctor, no matter what
system of medicine you choose to follow.
It is equally important that you understand
the limits and the rationale of the system, so that
you are not taken for a ride. Thus, if you have blocked
tubes, remember that it is very unlikely that herbal
medicine will help you open them. Also, do remember
that infertility is a heterogeneous problem – and some
modes of therapy may be better for treating certain
problems, rather than others! A good doctor will be
able to guide you, so that you are aware of the strengths
and limitations of each approach.
As a patient, you should feel free to
explore all possible options – remember that they are
not competitive, and should be seen to be complementary
to each other – after all, the goal for all of them
is to help you to have a baby! Thus, if you find that
Reiki helps you, you can combine Reiki treatment with
IVF if you so desire! There is no harm in going to an
alternative medicine doctor – but do let your infertility
specialist know what other treatments you are taking.
The combined knowledge of both old and new healing modalities
is ultimately superior than a single-model approach
– and you can learn to combine the best of both worlds!
Next page: Making
Decisions about Treatment
Previous page:
Rights of the Infertile Couple - and What Society
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