Wednesday, October 20, 2010

Experimental versus Unproven treatments in infertility

There are many areas in reproductive medicine in which our ignorance is still phenomenal. While we are very good at fertilising eggs in the lab, we still do not know what causes a low sperm count; and we do not have much to offer the patient with poor ovarian reserve.

When these patients come to IVF specialists, they often end up getting very disheartened. Honest experts will explain to them what the limits of our technology are , to help them make a well-informed decision. While many are willing to accept these limits , others are quite unhappy and will want to explore alternative options.

While many IVF specialists will pooh-pooh these options, I encourage patients to explore them. After all, the options I am offering will continue to be available - and if they feel they'd be better off trying something else, then they should do so. This way they have peace of mind they did their best - and I am always by their side to hand hold them, if they need this.

I explain to them that these are uncharted territories; and we do not have much evidence whether these alternative options are of any use or not. They can be considered to be unproven - or experimental - depending upon what your worldview is. It's fine to try these out, using yourself as a guinea pig ( you can think of this as being a self-funded personal clinical trial ). I will be happy to help you check if the treatment is helping or not. If it does , that's great - we've all learnt something and I can then recommend this option to other patients as well ( even though one swallow does not make a summer, anecdotal evidence is still helpful ). If it does not, then we can move on to Plan B !

The point is that doctors and patients are all on the same side - irrespective of which "system of medicine" we use to achieve our goal . Let's treat them all with equal respect - and let the proof of the pudding be in the eating !

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