Long established medical interventions to help couples with infertility problems do not seem to improve fertility, according to a study published on BMJ online. These findings challenge current practice in the UK and national guidelines should be reviewed in the light of this evidence, say the authors.
One in seven couples in the UK experience infertility. Unexplained infertility affects a quarter of these couples and common interventions to help them have been used for many years in line with fertility guidelines issued by the National Institute for Health and Clinical Excellence (NICE).
A team of researchers led by the University of Aberdeen compared the effectiveness of two specific interventions with expectant management (no treatment).
They recruited 580 women who had experienced unexplained infertility for more than two years from four teaching hospitals and a district general hospital in Scotland. The women were randomised into three groups-one group of women were encouraged to try naturally for a pregnancy and had no medical interventions; one took oral clomiphene citrate (CC) which is believed to correct subtle ovulatory dysfunction; and the other had unstimulated intra-uterine insemination (IUI) of sperm.
Overall, 101 women became pregnant and had a live birth during the course of the study.
The researchers found that women who had no interventions had a live birth rate of 17%, the group taking oral CC had a birth rate of 14%, and the group having unstimulated IUI had a birth rate of 23%.
They point out that to have a meaningful and significant improvement in the live birth rate, the difference in live births between unstimulated IUI and no intervention would have to be much higher than the 6% reported in this trial.
Side effects for women including abdominal pain, bloating, hot flushes, nausea and headaches were highest in women taking oral CC, affecting 10% of women. (GR comment: And this does not take into consideration the potential long term negative effects of the drug).
Interestingly, women on active treatments (CC and IUI) were reassured by the process of treatment while women who had no interventions were less satisfied, despite it being equally effective.
The researchers conclude: "These interventions, which have been in use for many years, are unlikely to be more effective than no treatment. These results challenge current practice, as endorsed by a national guideline in the UK."
In an accompanying editorial, Tarek El-Toukhy and Yacoub Khalaf from the Assisted Conception Unit at Guy's and St Thomas' NHS Foundation Trust, say: "As a direct result of the lack of evidence, many couples with unexplained infertility endure (and even request) expensive, potentially hazardous, and often unnecessary treatments."
They call for high quality clinical trials to guide policymakers and to inform patients about the best treatments, and the cost effectiveness and the adverse effects associated with these interventions.
In addition, they suggest that current NICE guidelines, which endorse the use of up to six cycles of IUI without ovarian stimulation in couples with unexplained infertility, be reviewed in the light of current evidence.
Source: BMJ-British Medical Journal
Author's Comments:
Drug therapy for treatment of infertility like clomiphene has been around for a while, yet its efficacy just like other assisted reproductive methods is questionable. And it's no wonder since on their own (i.e. without natural and holistic support) their aim seems to treat individual body parts as opposed to a bigger whole.
I am not in anyway against assisted reproductive technologies, in fact I believe it has its place and sometimes even refer patients who truly cannot fall pregnant any other way. In addition, I support a lot of couples going through IVF with natural methods. However I believe couples in general are equivocally led to believe science is more effective than their own body's wisdom. They lose faith in the fact that their body can heal and change and adapt to create the baby of their dreams--even in cases where all hope had previously been lost.
How can I be so sure? I've seen this happen too many times to doubt it. My patients often experience miracles in the eyes of those who simply don't understand or believe in the unchangeable laws of nature. What they experience are not miracles because nature never deviates from its established laws. Our bodies have immense wisdom, ability and regeneration power--given the right circumstances and the right sort of encouragement--optimum fertility can be restored. It is just a matter of time.
The right amount of time required for optimum results is at least 120 days of what I like to call pristine living--because this is approximately how long it takes for the egg to mature and the sperm to form and if the sex cells are developing in the best possible environment the chances of a healthy conception are at the very least doubled. Pristine living is easier than you think but it does require that you do the absolute best you can day in, day out.
Eating a healthy diet on its own it not enough, you need to avoid all toxins (environmental, dietary and recreational), ensure you dose up on your good quality nutrients, get enough sleep, exercise and relaxation; naturally balance your hormones, emotions and priorities. When you and our partner do these things you automatically put yourselves in the best possible position to ensure your chances of a live birth are increased beyond the 17% in the above mentioned study. Foresight, the Association for Preconceptual Health Care in the UK shows at least 78% increase in the numbers of babies being taken home by "previously infertile" couples who follow such an approach.
Take back your power and start making better choices for yourself and the long term health and wellbeing of your family now. You all deserve it!
Copyright (c) 2008 Gabriela Rosa and Natural Fertility and Health Solutions P/L.
One in seven couples in the UK experience infertility. Unexplained infertility affects a quarter of these couples and common interventions to help them have been used for many years in line with fertility guidelines issued by the National Institute for Health and Clinical Excellence (NICE).
A team of researchers led by the University of Aberdeen compared the effectiveness of two specific interventions with expectant management (no treatment).
They recruited 580 women who had experienced unexplained infertility for more than two years from four teaching hospitals and a district general hospital in Scotland. The women were randomised into three groups-one group of women were encouraged to try naturally for a pregnancy and had no medical interventions; one took oral clomiphene citrate (CC) which is believed to correct subtle ovulatory dysfunction; and the other had unstimulated intra-uterine insemination (IUI) of sperm.
Overall, 101 women became pregnant and had a live birth during the course of the study.
The researchers found that women who had no interventions had a live birth rate of 17%, the group taking oral CC had a birth rate of 14%, and the group having unstimulated IUI had a birth rate of 23%.
They point out that to have a meaningful and significant improvement in the live birth rate, the difference in live births between unstimulated IUI and no intervention would have to be much higher than the 6% reported in this trial.
Side effects for women including abdominal pain, bloating, hot flushes, nausea and headaches were highest in women taking oral CC, affecting 10% of women. (GR comment: And this does not take into consideration the potential long term negative effects of the drug).
Interestingly, women on active treatments (CC and IUI) were reassured by the process of treatment while women who had no interventions were less satisfied, despite it being equally effective.
The researchers conclude: "These interventions, which have been in use for many years, are unlikely to be more effective than no treatment. These results challenge current practice, as endorsed by a national guideline in the UK."
In an accompanying editorial, Tarek El-Toukhy and Yacoub Khalaf from the Assisted Conception Unit at Guy's and St Thomas' NHS Foundation Trust, say: "As a direct result of the lack of evidence, many couples with unexplained infertility endure (and even request) expensive, potentially hazardous, and often unnecessary treatments."
They call for high quality clinical trials to guide policymakers and to inform patients about the best treatments, and the cost effectiveness and the adverse effects associated with these interventions.
In addition, they suggest that current NICE guidelines, which endorse the use of up to six cycles of IUI without ovarian stimulation in couples with unexplained infertility, be reviewed in the light of current evidence.
Source: BMJ-British Medical Journal
Author's Comments:
Drug therapy for treatment of infertility like clomiphene has been around for a while, yet its efficacy just like other assisted reproductive methods is questionable. And it's no wonder since on their own (i.e. without natural and holistic support) their aim seems to treat individual body parts as opposed to a bigger whole.
I am not in anyway against assisted reproductive technologies, in fact I believe it has its place and sometimes even refer patients who truly cannot fall pregnant any other way. In addition, I support a lot of couples going through IVF with natural methods. However I believe couples in general are equivocally led to believe science is more effective than their own body's wisdom. They lose faith in the fact that their body can heal and change and adapt to create the baby of their dreams--even in cases where all hope had previously been lost.
How can I be so sure? I've seen this happen too many times to doubt it. My patients often experience miracles in the eyes of those who simply don't understand or believe in the unchangeable laws of nature. What they experience are not miracles because nature never deviates from its established laws. Our bodies have immense wisdom, ability and regeneration power--given the right circumstances and the right sort of encouragement--optimum fertility can be restored. It is just a matter of time.
The right amount of time required for optimum results is at least 120 days of what I like to call pristine living--because this is approximately how long it takes for the egg to mature and the sperm to form and if the sex cells are developing in the best possible environment the chances of a healthy conception are at the very least doubled. Pristine living is easier than you think but it does require that you do the absolute best you can day in, day out.
Eating a healthy diet on its own it not enough, you need to avoid all toxins (environmental, dietary and recreational), ensure you dose up on your good quality nutrients, get enough sleep, exercise and relaxation; naturally balance your hormones, emotions and priorities. When you and our partner do these things you automatically put yourselves in the best possible position to ensure your chances of a live birth are increased beyond the 17% in the above mentioned study. Foresight, the Association for Preconceptual Health Care in the UK shows at least 78% increase in the numbers of babies being taken home by "previously infertile" couples who follow such an approach.
Take back your power and start making better choices for yourself and the long term health and wellbeing of your family now. You all deserve it!
Copyright (c) 2008 Gabriela Rosa and Natural Fertility and Health Solutions P/L.
Information about the Author:
Leading Sydney natural fertility specialist, researcher and author Gabriela Rosa is devoted to helping bring healthy babies into the world. For free fertility advice and your FREE Natural Fertility Booster subscription visit boostyourfertilitynow.com
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