In medical school, I was taught to first ask patients about the symptoms that brought them in (i.e. chief complaint and review of systems). Instead, the approach of the infertility industry (also called Assisted Reproductive Technology or ART) often focuses on which cash-pay procedure the patient can afford. Here are the words many couples hear when they walk into an REI clinic (Reproductive Endocrinology and Infertility Specialist):<\/p>\n
\u201cYou haven\u2019t been able to get pregnant. Well, we could go straight to IVF or you could try IUI (intrauterine insemination) first to get a discounted rate on IVF.\u201d<\/p>\n
\u201cLook at this chart of how your egg number is drastically declining with age.\u201d<\/p>\n
Urgency, fear of one\u2019s inadequacy and need for a quick solution rush over the woman who has held one negative pregnancy test after another. The REI physician will likely explain the IVF procedure within a 30-minute appointment.<\/p>\n
These couples who go with the program will soon be faced with discarding \u201cpoor quality\u201d embryos and hearing about embryos dying in the petri dish. The doctor will need to decide how many embryos and on what days he will perform the embryo transfer in the procedure room. The husband is separated completely from the creation of the new life while the woman is alone in the procedure room. The couple will then need to decide to either freeze or destroy the extra embryos.<\/p>\n
The high pregnancy complication rate is generally glossed over. The idea of the actual pregnancy seems intangible at that moment. The hard questions are forgotten. What if they get triplets? They risk losing all three babies. They may be advised to selectively reduce the pregnancy (aborting one child to decrease the risk of losing all three children).<\/p>\n
But on the forefront of the woman\u2019s mind as she walks into the clinic is the fear of the loss of the family she has dreamed of. She is wondering, \u201cWhy is this happening to me? Why am I failing at something that most, including me at one time, take for granted?\u201d<\/em><\/p>\n My goal in this article is not to judge the couples who have used these methods, nor the intentions of some of the medical professionals involved. Instead, I want to educate you regarding the risks of this approach and the poor medical evidence for it, along with the possible risks of poor pregnancy outcomes. Additionally, I would like to offer a better treatment approach that treats the underlying cause of infertility, cooperates with the women’s natural reproductive system, and offers couples healing, both emotionally and physically.<\/p>\n Infertility is a symptom that there is something else medically wrong. The approach of IVF is to bypass the underlying cause of infertility.<\/p>\n IVF is done by overriding the body\u2019s own hormones with high dose hormone injections, over- stimulating the ovaries (causing from mild discomfort to life threatening ovarian hyperstimulation syndrome), harvesting multiple eggs from the woman, and collecting the man\u2019s semen after masturbation. The semen is spun down (concentrated by centrifugation) and the egg and sperm are combined out of the body (\u201cin vitro\u201d). The embryos are then inspected. If they meet criteria, one or multiple embryos are placed in the uterus of the woman.\u00a0 If the embryos don\u2019t meet criteria, sometimes based on gender or eye color, they are discarded.<\/p>\n So, instead of implementing more medical treatment to fix the underlying cause of infertility, IVF circumvents this step. The cause of infertility (for example, endometriosis) often causes other issues, such as inflammation and low hormones. Chronic inflammation and inflammatory markers or low progesterone can lead to adverse pregnancy outcomes such as miscarriage and preterm birth. The IVF procedure itself doesn\u2019t treat these problems.<\/p>\n It is also well known in the medical community that pregnancy complications are increased with IVF, from preeclampsia<\/a> to ectopic pregnancy<\/a> and multiple gestations<\/a> to gestational diabetes<\/a>. It can even increase the incidence of hysterectomy<\/a> at time of delivery.<\/p>\n Babies conceived via IVF are more likely to be stillborn<\/a>, born too early<\/a>, and have low birthweight<\/a>. Babies born specifically from frozen embryo transfer IVF are more likely to not grow properly<\/a> (intrauterine growth restriction). Women with infertility struggle not only physically but emotionally. Setting them or their babies up for a higher risk of adverse pregnancy outcomes, to me, is heartbreaking.<\/p>\n A couple I know spent over $200,000 on IVF. Round after round failed. They are still getting bills to this day. They have no baby. They have no money left for adoption.<\/p>\n Take Jessica Hepburn. Now a well-known activist<\/a>, she lost her sanity and her marriage to 11 cycles of IVF. She ended up with six pregnancy losses. She even had a life-threatening ectopic pregnancy. She also refinanced her mortgage and went into massive debt spending tens of thousands of dollars. If couples end up spending all of their life savings, it had better be a proven system.<\/p>\n These women are desperate. They are willing to shell out enormous sums (Forbes estimates<\/a> $15,000-$20,000 per cycle) for a chance to hold a child in their arms. Oftentimes, patients do not know the numbers. The actual success rates are not widely known.<\/p>\n Since IVF\u2019s inception in 1978, there has been time and money for research. Since then, the improvement in live birth rate per cycle has gone from 22.3% in 1995, 33% in 2003, and 31% in 2015, according to CDC data. Every IVF clinic is mandated to report to the CDC.<\/p>\n I went to a trusted source in medicine for further research studies. Cochrane<\/a> is “an international network with headquarters in the UK, a registered\u00a0not-for-profit organization, and a member of the UK\u00a0National Council for Voluntary Organizations. Cochrane produces systematic reviews, published in the\u00a0Cochrane Library, to help people make informed health decisions.” Systematic reviews<\/a> “are a way of reviewing all the data and results from research about a particular question in a standardized, systematic way.”<\/p>\n The Cochrane database relies on high quality evidence, such as randomized control trials or RCTs. RCTs represent the gold standard in developing clinical evidence, especially in this day and age focused on providing \u201cevidence based medicine.\u201d<\/p>\n Cochrane reports that one-third of infertile couples have \u201cno identifiable cause for their inability to conceive.\u201d\u00a0 They explain that IVF \u201cis a widely accepted treatment,” but one that is “invasive and expensive and is associated with risks.\u201d<\/p>\n Cochrane Database reports that, in women with unexplained infertility, \u201cIVF may be associated with higher live birth rates than expectant management, but there is insufficient evidence to draw firm conclusions.\u201d “Expectant management” means literally doing nothing compared to IVF. That means the studies fail to find an improvement with IVF as compared to no treatment at all.<\/p>\n What about diagnosed infertility? I looked for randomized control trials on IVF for PCOS and endometriosis, some of the most common causes of infertility. I found none.<\/p>\n What about male infertility? A 2016 systematic review<\/a> in the Cochrane database compared regular timed intercourse using an ovulation prediction kit, IUI (intrauterine insemination), IVF and ICSI (Intracytoplasmic Sperm Injection). They reported “no evidence” of a difference in live birth or pregnancy rates between treatments. There were 10 randomized controlled trials and 757 patients studied, but “the quality of the evidence was low or very low for all comparisons,” primarily due to “failure to describe study methods, serious imprecision and inconsistency.” The authors wrote, \u201cWe found insufficient evidence to determine whether there was any difference in safety and effectiveness between different treatments for male subfertility.”<\/p>\n Again, this study shows regular timed intercourse with an ovulation prediction kit is equal to IVF, IUI, or ICSI (where the sperm is injected directly into the egg instead of floating in a dish as with IVF)[i]<\/a>.<\/p>\n In the US, between 2015 and 2019, 8.5% of married women aged 15-49 were infertile<\/a>, according to the CDC. During that same timeframe, 2.2% of all women aged 15-49 reported having ever undergone artificial insemination (1.7%) or IVF (0.5%).<\/p>\n These numbers demonstrate that a significant population of women don\u2019t have access to IVF, perhaps due to the high costs, fear of the invasiveness or side effects, or moral opposition to sacrificing their own embryos for a chance of pregnancy. As a medical profession, we need to do more. And we can.<\/p>\n NaProTechnology simply uses modern medicine to find the cause of infertility and treat it, instead of bypassing that process. Over 1400 medical scholarly articles are the foundation the system\u2019s textbook, The Medical & Surgical Practice of NaProTECHNOLOGY<\/em>.<\/p>\n NaProTechnology works by diagnosing and treating ovulation defects that are completely ignored by IVF. NaProTechnology has developed surgical techniques to fix endometriosis with excellent results published in the Journal of Gynecologic Surgery<\/em><\/a> in 2010: \u201cNear Adhesion-Free Reconstructive Pelvic Surgery: Three Distinct Phases of Progress Over 23 Years.\u201d<\/p>\n Even if women don\u2019t get pregnant, nearly every patient achieves an improvement in her health in the process whether it be pelvic pain from endometriosis, PMS from a hormone deficiency, or the closest thing we have to a cure of PCOS with a wedge resection surgery. If a couple does get pregnant, they don\u2019t face as many complications of high risk pregnancies from IVF, aren\u2019t told their embryos are dying in a petri dish, nor risk increased chances of birth defects or watching their triplets die after delivering early at 22 weeks, as I have seen as results of IVF pregnancies. If it\u2019s their desire, a couple will be more likely to still have money left to adopt after NaProTechnology treatments.<\/p>\n Even if they have suffered through failed IVF cycles, I don\u2019t want another woman to suffer but heal emotionally and physically with the breakthroughs of NaProTechnology.<\/p>\nWhat IVF does and doesn\u2019t<\/h3>\n
What IVF does to women (and couples)<\/h3>\n
What does the medical evidence suggest?<\/h3>\n
Most women are not getting help<\/h3>\n
The NaProTechnology answer.<\/h3>\n