EBM and BBM

As an IVF specialist, I often need to give bad news to patients. A particularly frustrating problem is telling patients with poor ovarian reserve that they have a poor chance of getting pregnant. This condition is called oopause; and many of these patients need donor eggs in order to achieve a pregnancy.

However, it can be hard to come to terms with this, and many will search for options and alternatives as to what they can do to improve their ovarian response. There is a lot of anecdotal information about what other women with high FSH levels have done to have a baby with their own eggs, including options such as alternative medicine, such as herbs, acupuncture and yoga. In fact, there are many Bulletin Boards, Forums and websites put up by patients, which discuss these options.

I encourage my patients to explore these options, since Western medicine has little to offer them women who are poor ovarian responders ( except for the option of using donor eggs, which has a very high success rate, but may not be acceptable to everyone). However, I also emphasise that while it's fine for them to explore these options on their own, it's hard for me to recommend any particular approach, as there is no evidence to show that they help.

As an IVF specialist, I need to practise EBM or Evidence Based Medicine. However, patients can always practise BBM ( Bulletin Board Medicine) on their own !