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While modern infertility treatment has become very effective, the sad fact is that there are still many dangerous infertility treatments to which patients are needlessly subjected. These treatments not only waste time and energy, they can actually reduce your fertility !
More Harm than Good
Some of the treatments recommended for infertility can do more harm than good. Here's a list of what we feel are dangerous treatments which you should be aware of. First take a look at why there are so many harmful and ineffective treatments still around. Patients would expect that all good doctors would offer only safe and effective treatment - so why should useless and ineffective treatments still exist ?
The reason for this is that infertility is a complex area, and there is still a lot of confusion about the best treatment option for many common problems even amongst doctors . When doctors disagree amongst themselves, how is a patient to make sense of all the options ?
The Doctor's Judgment
Most doctors take pride in their own personal experience , and trust their own clinical judgment. They prefer doing treatments which have worked in their hands, and this causes them to become biased. Even though there is no proof that the treatments are actually helpful, they remember patients who conceived after taking that treatment.
This is called "anecdotal " experience, and create a bias in each individual doctor's mind. Few doctors are broad minded enough to study the scientific literature critically, and few have the objectivity to practice evidence-based medicine.
It's easy to get "fooled by randomness" in infertility medicine, because there are so many variables, and many patients will get pregnant even inspite of the doctor's "treatment" ! Of course, the doctor will take credit for the pregnancy - and patients too are quite happy to share the credit with their doctor.
Read more- Bad IVF doctors and how to protect yourself
High Success Rates?
The best way to explain this bias is to consider the example of a doctor who has performed varicocele surgery for 10 men with a low sperm count. Of these, only one succeeds in getting his wife pregnant. ( This success was not because the surgery helped, but because his sperm count was not really low in the first place, since it was done at an unreliable laboratory).
This means that the pregnancy rate for varicocele surgery in this doctor's hand is only 10%, and he should his advise his patients accordingly. However, in real life, what happens is that the other nine patients who fail to conceive get fed up , and change their doctor.
They are "lost to follow-up", and the doctor only remembers the one patient who did get his wife pregnant ( since he comes back with a big smile and a box of chocolates !) Therefore, he continues to imagine that pregnancy rates after varicocele surgery in "his clinical experience" are very high.
The second way doctors often delude themselves ( and their patients) is that even if their patients don't get pregnant after the surgery, they still feel the surgery was justified because the sperm count increased. Thus, they use an increase in the sperm count as a "surrogate marker" for success in gauging the effectiveness of their infertility treatment.
Read more- Expert patients versus doctors
However, since it's well known that sperm counts fluctuate considerably in any case, it's hard to credit the surgery with the increase in the sperm count. Also, men don't want an increased sperm count - they want a baby, and from the couple's point of view, the surgery is still a failure ( even though the sperm count did increase !)
The other complicating factor in assessing the effectiveness of a treatment is the gullibility of patients, and their desperation. Infertile couples are so happy to clutch at straws, that they are willing to pursue any path which offers a glimmer of hope. Here's a list of what we feel are dangerous treatments of which patients should beware !
- Varicocele Surgery-The fact that doctors are still uncertain about the efficacy of varicocele surgery after so many years is itself is a telling commentary on how unhelpful this surgery is. While the surgery may improve sperm counts in some men, objective trials have shown that it is no better than just watchful waiting
- Medical Therapy for Low Sperm Counts- This is another one of those areas where fashions come and go. The current rage is "antioxidants" and dietary supplements such as Proxeed. Since they do not need a medical prescription, they can be sold directly to unwary patients, but no study has documented an increase in pregnancy rates after any of these treatments.
- Surgery for Fibroids- Fibroids are very common benign tumours found in the uterus of many young women. Some of these women who have fibroids will also have the misfortune of being infertile, and some of them will then end up falling in the hands of an enthusiastic knife-happy surgeon who will advise them to get the fibroids removed. However, most fibroids are silent bystanders in an infertile woman's uterus, and do not need to be removed.
- Surgery for Removing an Ovarian Cyst- Ovarian cysts are very common in young women, which is why they are very common in infertile women. Because of the frequent use of ultrasound scanning in treating infertile women, many of these small ovarian cysts are diagnosed and reported by the sonographer. Once an infertile woman knows she has an ovarian cyst ( a term she may never have heard of before), her mind starts playing tricks with her, and she feels that it is the cyst which is responsible for her infertility.
- Hysteroscopic Metroplasty- This has become a very popular operation in some parts of India. While doing a hysteroscopy, some over-enthusiastic surgeons will make cuts on the lateral walls of the uterus, to "broaden" the uterine cavity. The truth is that fertile uterine cavities come in various shapes and sizes, and there is no need to change the shape of the cavity. Not a single study in the medical literature has been published which shows this procedure helps , and this gratuitous surgery can often cause intrauterine adhesions and damage the uterus ! Beware of trigger happy surgeons out to make money
- D&C for Pregnancy Termination - Many doctors still perform a surgical evacuation of the uterine cavity when a patient suffers a missed abortion. This used to be a standard surgical treatment in the past, but leads to intrauterine adhesions in some women. It is far safer and better to medically terminate this pregnancy using RU-486 ( mifegest) and prostaglandins, as this leaves the uterine cavity intact
- Medical Therapy for Endometriosis- A diagnosis of endometriosis is very commonly made in infertile women when a laparoscopy is performed for them. In fact, the chances of finding minimal endometriosis are as high as 60%, depending upon how carefully the doctor looks ! Of course, once the endometriosis is found, this is then labeled to be the "cause" for the infertility, when often it is just an innocent "red herring" of no clinical importance. The damage really starts when doctors treat the endometriosis by trying to suppress it with Danazol or GnRH agonists. Medical therapy of endometriosis has been shown to be useless, and just wastes time and money because you cannot conceive while you are taking this "treatment"
- Immune Therapy for Repeated Pregnancy Losses-Patients who suffer repeated pregnancy losses present one of reproductive medicine's most frustrating problems. We usually cannot pinpoint the reason for the miscarriage, which means that patients are often desperate in their search for solutions. They are emotionally very vulnerable, and are willing to try anything under the sun, in the hope that it will work for them. They intuitively believe that their body is "rejecting" their embryos, which is why immune therapy for these patients has become so popular and fashionable. Unfortunately, not only is it extremely expensive, there is no evidence to show it helps.
- Physical Therapy and Massage Therapy- "Clear passage" at www.clearpassage.com claims to achieve excellent success rates with "site-specific" massage, which they believe "decreases adhesions and increases function of the organs." This is an excellent example of quack therapy ( to learn how to identify quackery read www.quackwatch.com). However, it's all just clever marketing ( what a lovely name they have selected !) . Their claims that their "medical studies " were "recently honored with induction into the US Library of Medicine" will unfortunately mislead naive patients into believing that this therapy works, when every surgeon know that it's impossible to remove adhesions without surgery - after all, scar tissue does not melt because you knead it !
Not only do all these treatments waste time, money and energy, they also cause patients to get fed up and frustrated, so that they end up losing confidence in doctors - and in themselves ! The worst kind of hope is false hope - and these treatment offer unsuspecting patients just that, and nothing else. The only antidote against this is information and education, so you can protect yourself from such harmful treatments.
Some of the treatments recommended for infertility can do more harm than good. It's important that you opt for treatments only after conducting a certain amount of research.
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