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a blog by Rachel Gurevich, April 27, 2011

If I could pick one infertility myth that grates on every nerve of my body, one myth that I would eradicate if I had the power, it would be the myth that there is a particular program, book, drug, herb or diet that can cure infertility.

Let me tell you something: There is no one “cure” for infertility. There is no “program” or schedule or diet that will cure every person’s infertility. It is a lie.

You know what the worst aspect of this myth is? That infertility friendly websites, organizations and books promote this myth. That there are some wonderful doctors and otherwise helpful people spreading this idea of a cure. I can think of some great fertility books that include either the word “cure” right in the title, or promise other impossible promises.

This infuriates me even further.

I know there are a few people out there getting ready to leave a comment either to honestly debate me on this or share their affiliate-link to a cure program they just swear works. Please. Spare me.

Saying there is a “cure for infertility” is like saying there is one cure for world peace, or one cure for dizziness. There cannot be one cure to world peace, when the world’s conflicts are varied. Each issue needs a focused, unique plan.

Likewise, there’s no one cure for dizziness because dizziness can be caused by a number of things, including low blood sugar, emotional upset, low blood pressure and so on.

I’ve seen many programs promising a cure for ovulation-based infertility. Sometimes I wonder if they go after that one because:

women are more likely to try out crazy programs than men (not because women are gullible, but because men can be a bit lazy), and
it’s easier to sell a “cure” for an infertility problem that’s a bit esoteric.
Of course, promising one specific cure for ovulatory infertility is just as ridiculous as promising a cure for infertility. There are many different causes for ovulation trouble, including polycystic ovarian syndrome (PCOS), premature ovarian failure (POF), obesity, hypothalamic amenorrhea, hyperprolactinemia, poor ovarian reserve and more. To promise a cure through a diet, a program, a juice fast, whatever — it’s silly. And wrong.

To those looking for that one cure: I’m sorry, it’s not out there. But there’s so much reason for hope! According to the American Society for Reproductive Medicine (ASRM), 85 percent of couples dealing with infertility do achieve pregnancy with fertility treatment or lifestyle changes (if appropriate). Your cure probably won’t come from a magic herb or crazy diet, but that doesn’t mean potential success is not out there.

To those selling these cures or selling reasonable, research-backed help under the “cure” promise: Stop it. Just stop. If you really believe your program or diet is the one cure to infertility, then you’re delusional. Think for a moment about what you’re promising. And if you know your cure isn’t foolproof, stop labeling it a cure. It’s wrong. It’s unethical. And it’s a lie.

Thoughts? Please share in the comments. (Unless you want to convince me of your cure ... I’d rather not hear about that.)

Endometriosis: When Women Aren't Taken Seriously

by Rachel Gurevich, March 17, 2011

March is National Endometriosis Awareness Month, and I’m thinking about all those women who live with endometriosis every day. My heart today, however, is especially focused on those women who have endometriosis, but don’t know it yet. Could that woman be you?

According to Endometriosis.org, a survey in 2005 found that it takes an average of eight years for a woman to get a diagnosis of endometriosis. Eight years! Of these women, 65 percent get a misdiagnosis first, and up to 50 percent of women need to see five or more medical professionals before they get the care they need.

That is just … crazy!

Why Does It Take So Long to Get an Endometriosis Diagnosis?

The question I’m asking myself today is why? Why does it take so long to get diagnosed? And why do they need to see so many different doctors before something is done?
I’d like to say that it’s due to the complicated nature of endometriosis diagnosis, which can only officially be done through laparoscopy. Unfortunately, I don’t think that is the main problem.

I suspect the issue is that women are not being taken seriously.

The main symptom for most women with endometriosis, besides infertility, is painful menstrual cramps. Pain is a symptom that doctors are willing to take seriously if they can explain it easily, but if not, is often written off quickly as psychosomatic (ie, it’s all in your head) or not as bad as the patient is describing.

Women Not Take Seriously with Other Diseases, Too

A good example of women's pain not being taken seriously is with heart disease. According to womenshealth.gov, when compared to men, women experiencing heart attack symptoms are twice as likely to be sent home and not have their heart attack symptoms taken seriously. This makes women more likely to die from a heart attack than men.

It’s not hard to see how a woman complaining of cramps might be told to take it easy and use a hot water bottle, and then be written off as being a hypochondriac.

And how many times have women not been taken seriously when it comes to infertility? I have heard numerous stories, especially from younger women, about women going to their doctor with concerns about irregular cycles or trouble conceiving, only to be told to go home and keep trying — despite the fact that they have tried plenty long enough!

I say it’s time women are taken seriously. Medical care professionals, are you up for the challenge to listen?

And readers, what do you think? Have your symptoms of infertility or another medical condition not been taken seriously? What did you do? How did you get the help and care you needed? (Or didn’t you?) I’d love to read about your experience in the comments.

Overweight Women and Fertility Treatment

by Rachel Gurevich, June 29, 2010

A few weeks ago, yet another study came out showing that being overweight can lead to fertility woes. In this study, women who had a BMI over 25 had a higher risk of miscarriage than women with a BMI under 25. Also, there are many previous studies that have shown high BMI to raise the risk of infertility.

(Quick note, for those who don’t know: BMI, or body mass index, considers your height and weight togetherto help you gauge whether you are at a normal weight. A BMI over 25 is considered to be overweight.)

Advice to Lose Weight

Every time one of these studies on weight comes out, there’s talk about strongly advising overweight women to lose the weight before they receive fertility treatment. In the harsher opinion pieces, it’s been said that women should be refused treatment if they are overweight.
Also, it’s no secret in the fertility community that women who have higher BMIs are often told by doctors to go lose weight, and then come back if they still can't get pregnant. Or, when treatments fail, women are told the reason is their weight, and that they should lose it to solve the problems.

Sometimes, weight is brought up when it’s not even that high. I had my gynecologist tell me the reason I stopped ovulating and was miscarrying was related to my weight. Except in my case, I was only five pounds overweight — weight I gained from all the miscarriages! (A reproductive endocrinologist, later told me that my weight had nothing to do with my infertility. Plus, I later lost that weight. It didn't help.)

I understand why doctors would want to encourage a couple to drop some pounds. (They should advise men AND women to lose weight, in my opinion). Not just because of the increased fertility risks, but also the increased risks of pregnancy complications and general health concerns.

But refusing treatment doesn’t seem right to me. In fact, simply telling a woman or man that they should go home and come back when they are thinner is downright stupid.

Why Fertility Treatment Shouldn’t Be Refused

Losing weight is not easy. Because losing weight requires support, information and sometimes medical help if the weight is connected to an untreated health issue. (Thyroid problems, for example.)

Instead of just telling a woman she should drop a few pounds, what if clinics offered weight loss as a treatment? Maybe they would have a dietitian on staff who would speak to couples, help them look into what they can change to improve their health, and support them along the way.

There would be screening for undiagnosed medical problems that may lead to weight problems. They would also screen for age-related infertility, so they can advise a couple whether or not they have time to try weight loss first.

What if clinics offered weight loss support groups? They could be led by a psychologist or social worker who is versed in infertility, but also in eating disorders, including emotional eating (something many women coping with infertility deal with.)

I still think that if the woman so chooses, she should get standard fertility treatment as she wishes, even before she loses the weight.

But for those who do want to give weight loss a try, it’s cruel to just tell them to go lose the weight without any support or help.

These are my thoughts. What are yours? Do you think women should have to lose weight before receiving fertility treatments? Do you think clinics offering weight loss support are a good or bad idea? Share your thoughts and experiences in the comments, I’d love to hear from you!

How Old Is Too Old to Have a Baby?

by Rachel Gurevich, June 29, 2010

You may have read or heard the news about a 66 year old woman who gave birth to triplets in India. The new mother has never had a child before, and was eager to become a mother.

Meanwhile, Rajo Devi Lohan, the oldest woman to ever give birth, is dying at age 70, just 18 months after having her daughter. The news story said she is dying of complications from her IVF pregnancy, which she has been unable to overcome.

These stories together have my heart and mind churning over when is it too old to have a baby.

And I don’t mean when is it too old for IVF to be successful, or how old can you get pregnant without fertility treatments. I mean simply when -- ethically and morally -- should pregnancy be considered no longer an option.

I’ll be honest with you and say I’m not sure what I believe on this issue. In fact, I’m confused. I argue with myself.

On the one hand, I want to say that if medical science allows us to have children at a ripe old age, then why shouldn’t we?

Can you imagine how silly it would be to turn down, for example, medical treatment after age 60 because at one time, 60 years old was considered to be old age? “Nope, sorry, don’t treat any of my illnesses anymore. I’m old, and statistically, it’s time for me to die.”

That would be crazy!

On the other hand, I want to say that it’s unfair to have a child when you won’t be around to raise him or her. Why should the child become an orphan at 18 months old, or 5 years old, or even 10 years old, just because you wanted to become a mother or father?

My not-yet-firm opinion is that 55 should be the upper limit. My argument is that with today’s life expectancies, the child has a good chance of being mothered or fathered until they are 20 years old.

I spoke about this with my husband, and he totally disagrees with me. “Why 55? How do you know that a 60 year old mother might not live until 90? A 50 year old father might live only until age 60? You never know.”

“Yes, but that’d be unusual. You can look at unusual circumstances like that.”

“Then let me ask you this,” he said, with that look he gets when he knows he’s about to argue me into a corner. “Let’s say the parents in question live in a third-world country where the life expectancy is only 40 years old. If a mother there gets pregnant at age 35, is she wrong? Should she not have children just because she will likely die in five years and leave orphans?”

What could I say to that?

Of course I believe that the 35-year old mother should be allowed to have a child, if she wants, regardless of whether or not the life expectancy of her country is just 40 years old.

So you see? I’m not sure what I think.

What do you think? Please share your thoughts in the comments below. I’d love to hear from you!

[Read "When Is a Woman Too Old to Have a Baby?" Watch "Ask the Expert: How Does Age Impact Fertility?"]