How to Make a Family: The Blog

Nothing New, But Stay Tuned

A New York Times piece, Racing to Beat the Maternal Clock, was published on December 12, under the section head Frontline Report.

With my own daily existence being rather mired in the topic, I can no longer provide the perspective of a newcomer to the infertility world. But really -- a NYT article on how reproductive biology is still trumping science? This is still news?

Right. Lots of people are buying into the heavy-duty marketing by the industry that nearly claims the ability to get anyone pregnant at any time. At least, that's how desperate minds can translate what they read. The relationship between provider and receiver of family-building help is a two-way street.

The instinctual drive to have a baby can be for some a cause of near insanity. Otherwise reasonable people will literally hear and read what they long for the most -- that their dilemma can be resolved by the experts. Fertility experts are often happy to oblige.

My face is overtaken by a grin when I read (in Leslie Berger's NYT article) how Dr Bradley Van Voorhis of the University of Iowa School of Medicine referred to the older patients crowding fertility clinics' doors as "otherwise highly educated..."

One quote in the same article did catch my eye, with the same sort of zing that I recall when finding out about PGD back in the mid-90's. Sherman Silber, a doc in St Louis who's made history in the field a few times, announced his opinion that egg-freezing "will emancipate women as much as the birth control pill did in 1960." That's a keeper for posterity.

Not all fertility docs are as quotable as Zev Rosenwaks. Berger's interview of him, Turning Points on the Road to Conception, is more informative than the 'maternal clock' piece. Still, even he, the Director of The Center for Reproductive Medicine and Infertility at New York-Presbyterian Hospital, says "Today, we help most of our patients depending on their age. Depending on how far couples are willing to go, we can treat them pretty successfully 90 percent of the time." This near the end of the interview in which he started by saying that the sometimes-reported "higher" rates of infertility are really just a product, especially in the U.S., of people trying to conceive later in life.

While he 'hopes' that people will take what we know about the biological clock into consideration when they're planning families, Rosenwaks and others stand by, waiting to offer the best they can to those of us who pursue life as if our unborn children are angels in the wings who will enter on cue. 

"It's marketing"

Thanks to Tara Parker-Pope and Dr. Jamie Grifo for their NYT commentary on the latest book being hyped, The Fertility Diet.

The book isn't the first to try and draw easy conclusions about connections between what we eat and how well our bodies procreate. This one, though, is getting tons of press because it came out of Harvard and a large national study.

Like any well done research, the Nurses' Health Study contains both believable science and points to be proven (or not) later. When stuff comes out of Harvard, readers get excited. Algorithmic how-to answers to our dilemmas always go down easier than complex systems integration. Even just writing that last sentence is no fun.

So Tara called it like it is, and Jamie Grifo chimed in -- readers be wary of book titles.

Reminds me of a few years ago when a respected colleague worked long and hard to come out with a book that pointed to the benefits of traditional Chinese medicine for fertility enhancement... I was privileged to read the pre-publication galley and interview my friend, the TCM physician-cum-author, for a review. While she certainly has her professional biases, she also has the wisdom to understand the grey areas of medical diagnosis and treatment, that there is no One Answer for all. She confided that her book's title, The Infertility Cure, had been a point of discomfort for her, having been proposed by the publisher as the right label in order to get her message out. She felt it was misleading yet in the end, resigned to follow the advice of those with book-selling experience.

It was a wise business choice -- the book was a huge success. The author wound up on TV, radio, the Web, and in print magazines. Numerous books in the same vein followed. Her business is thriving.

It is a good book. She is a respected physician. The moral of the story is not to develop a wall of distrust toward all writings put forth as answers. Rather, readers will do well to simply remember that books (and websites, etc.) are creations not only of ethical professionals who mean only goodwill toward readers, but also of publishing businesses that mean primarily to sell books.

Counting Heads

This could be good news. I think.

From the Yale Daily News:
The NIH has awarded $12.4 million to a team of Yale scientists to oversee the collection of data on the causes and treatments of infertility and other reproductive diseases and disorders.

The researchers, headed by Heping Zhang, professor of biostatistics and director of the Yale Collaborative Center for Statistics in Science, make up the Data Coordinating Center as part of the NIH’s Reproductive Medicine Network. [RMN]

They will oversee a network of seven other clinical centers to monitor study design, data management and analysis.

Here's what I'm hoping... Can we get an updated estimate on how many people are coping/struggling/dealing with, battling, journeying though, seeking help/treatment for... infertility?

This money's going toward some particularly large-scale studies. Lots and lots of subjects. Might be an opportunity for counting heads.

For a full decade now, when I write about the incidence of infertility, I have no other number to quote from all the best sources than that darn "6.1 million individuals."

Here ya go, straight from the American Society for Reproductive Medicine:

Infertility affects about 6.1 million women and their partners in the U.S.  -- about ten percent of the reproductive-age population (Source: National Survey of Family Growth, CDC 1995).

Now... I  know that there have been follow-ups to the NSFG, because I was one of the field data gatherers for it in 2002-2003. So, let's go check on those numbers to see if a change has been charted.

And what we find, on the CDC website regarding the 2002 NSFG is this:

1. How many people in the United States have infertility problems? The latest data on infertility available to the Centers for Disease Control and Prevention (CDC) are from the 2002 National Survey of Family Growth. Of the approximately 62 million women of reproductive age in 2002, about 1.2 million, or 2%, had had an infertility-related medical appointment within the previous year and an additional 10% had received infertility services at some time in their lives. (Infertility services include medical tests to diagnose infertility, medical advice and treatments to help a woman become pregnant, and services other than routine prenatal care to prevent miscarriage.)   Additionally, 7% of married couples in which the woman was of reproductive age (2.1  million couples) reported that they had not used contraception for 12 months and the woman had not become pregnant.