Monday, May 09, 2005

as my erstwhile employer's opinion editor says this was "good" but they'd run enough on IVF lately, I may as well air it here.

In an article on this page last Friday, Dr Amin Abboud is certain to
have made many infertile couples' blood boil – including, I admit,
mine, with this advice – "They just needed to relax and do what is
naturally necessary to conceive."
"Just relax" is the most common, and most infuriating, piece of advice
suffered by infertile people, and in most cases, as useless as it
He suggests that IVF in Australia needs a review going beyond the
financially-driven reforms mooted, then sent off to an expert panel,
by the Federal Government recently.
Dr Abboud says that one third of infertile couples whose condition is
"unexplained" would become pregnant without IVF if they pursued "other
treatment options."
But can he tell us which third? And does he really expect women in
their late thirties who have been waiting years on the "natural"
platform to pass up the IVF train when it arrives, and agree to wait
another couple of years, by which time their chances of motherhood
will have shrunk even further?
He doesn't specify those other treatment options, but they would
certainly include fertility drugs, with associated risks of multiple
births, and alternative treatments such as acupuncture, lifestyle
changes and herbal or naturopathic assistance – most of which can be
pursued at the same time as IVF treatment.
Technically speaking, when I underwent IVF 2 ½ years ago, I was in
that third of patients whose infertility was "unexplained", not having
fallen pregnant after a year of carefully timed natural attempts. But
the fact that two attempts had managed to get not even a drop of fluid
to traverse my fallopian tubes gave me a clue which way I should jump,
and our success on the second embryo transfer, shows that for many
"unexplained" patients, IVF is a shortcut well worth risking.
Dr Abboud suggests that the "general pattern" of IVF treatment in
Australia is similar to the "vicious" and unregulated competition in
the United States. I don't know what kind of Australian IVF doctors
he's met, but the fine, caring and extremely cautious medical staff
who worked with me during my treatment showed no signs of any of the
sins of the US system, most particularly the push to transfer
excessive numbers of embryos, risking high order multiple births.
As an aside, if IVF in Australia were to be restricted by number of
cycles, I believe many would-be parents would be more likely to risk
twins and even triplets to get the most out of their allocated
chances, resulting in more premature births, among the many problems
with multiple births.
Dr Abboud quotes a Sydney IVF clinic director as saying that in the
future, sex will be for fun and IVF will be for babies. He – Dr Abboud
- hints that issues such as sex selection will help push this supposed
Dr Abboud has clearly never undergone weeks of hormonal pummelling of
his body, mind and emotions, weeks of injections, followed by painful
egg pickup and invasive embryo transfer procedures. Any woman who
would choose IVF over the fun path, even or particularly to choose a
child's gender is, I believe, in need of counselling. It hurts, it's
unpleasant and no one in their right mind would choose it if they
didn't need to.
His called-for "scientific review" would presumably come up with
suggestions like "relax and wait" – I can feel my blood warming up
In his article, Dr Abboud pointed out that the Access Infertility
Network, an advocate of easy access to IVF, is funded by the IVF
industry. Fair enough. But before taking Dr Abboud's suggestions on
board, we should look at his background. In 2002 he was quoted on the
Australian Catholic Weekly's web site as saying "good science is
ethical science" as he criticised stem cell research.
In 2003, he was acknowledged as helping Reverend the Hon. Dr Gordon
Moyes of the NSW Parliament write a speech opposing embryonic stem
cell research, and he has made his stand against that research clear
in numerous other forums. Would it be cynical of me to detect the
anti-IVF bias that often accompanies opposition to non-reproductive
uses of embryos?
In a submission to a federal senate inquiry on human cloning – and I'm
not going into that issue here – Dr Abboud said: "Inadequate research
has been done on the development of the human when conceived and born
out of what has been traditionally understood as family dynamics."
Would that be the good old missionary position, Dr Abboud?

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