CHR - Press Relations
Blog topic: "Making Babies" the Eastern or Western Way
Our New York colleague Sami S. David, MD has recently been making the rounds on the TV circuit, likely promoted by the P.R. machine of Little, Brown and Company, the publisher of his new book (with co-author Jill Blakeway). "Making Babies" (Hachette Book Group) is advertised as "promoting a proven 3-months program for achieving maximal fertility" and as "employing the very best practices of Eastern and Western medicine." Concomitantly, Dr. David's website also announces the impending opening of a new Center for Integrative Fertility, dedicated to the same goals.
We have known Dr. David for a long time. CHR's founder, Norbert Gleicher, MD, indeed, shared for a short time office space with Dr. David, when both were, decades ago, as young Assistant Professors, on the faculty of Mount Sinai School of Medicine. Though removed from main stream infertility practice because of his refusal to offer in vitro fertilization (IVF) services, Dr. David over the years successfully maintained an "alternative" infertility practice, promoting a "low-tech" approach to infertility.
Though we, because we never were able to find data-driven support, disagreed with many aspects of his approach, we always respected it as an honest attempt at offering selected patients what they were seeking and, in the process, giving them at least some success.
In promoting his book (and new infertility center), and making the rounds on TV, Dr. David, however, for the first time, appears to endanger the integrity that used to be a hallmark of his practice style: His major message in book and appearances is that there are "too many test tube babies" (CNN, American Morning), "that alternative approaches [which he offers] are safer and cheaper" (FOX and Friends) and "that Eastern alternative treatments have established values (FOX)."
None of this, of course, is true and/or established or based on reasonable research data. Indeed, since infertility in the U.S. is mostly an uninsured benefit and patients, therefore, end up paying for much of their care out of pocket, they usually vet their options carefully [President Obama, an example that may be worthwhile looking at when considering cost reductions in our medical system!]. A principal reason why IVF cycle utilization in the U.S. (and elsewhere in the world) has been steadily increasing is the safety of the process and its cost-effectiveness.
Nothing in this world is, of course perfect! This means that even the safest medical procedures have risks and potential complications. Errors can happen in IVF like with any other medical procedure. FOX, indeed, interviewed Dr. David under the heading "Embryo mix-up in IVF," reporting on a recently reported case, where a patient erroneously received the embryos of another patient. While Dr. David did point out that such an occurrence, of course, reflected an inadvertent occurrence, he failed to stress the rarity of such events, considering how many hundreds of thousands embryos are handled every year in IVF laboratories around the world. He also failed to note that, were it not for the sophisticated quality assurance processes nowadays mandatory in IVF laboratories, such an error may never even have been recognized.
In short, IVF is at least as safe as flying, driving a car or any other activities we pursue out of free choice on a daily basis and much safer than many other medical treatments in routine use.
IVF has also proven, in most cases of infertility, as the most cost-effective treatment. It is, of course, true that an IVF cycle will be more costly than one of the "natural" cycles Dr. David often promotes, but that is really an inappropriate comparison. The question is not how costs between different treatment cycles compare. The real question is how total costs compare to have a baby at home. And if infertility treatments are assessed in such a way, IVF, nowadays, beats almost all alternatives,- both in cost and time to pregnancy.
Finally, a word about Eastern alternative treatments: As we just pointed out recently in the September 2009 CHR-Update [LINK], we have nothing against acupuncture and/or Chinese herbs. The value of acupuncture has, however, remained very questionable even after quite a number of studies, though it at least does not appear to harm. This stands in contrast to unproven and untested herbs, which, as recently reported (Boivin and Schmidt, Human Reproduction 2009; 24:1626-31), appear to reduce pregnancy rates with IVF by approximately 30%.
Since acupuncture does not harm, we, therefore, have no objections to infertility patients using the procedure. Not harming the ultimate goal of any infertility patient, to conceive, should, however, be the priority of any approach towards infertility. We, therefore, caution about the use of untested and unstudied herbs, widely propagated in Eastern medicine.
Finally, a word about the concept of a 3-months program to achieve maximal fertility: This, of course, is a highly attractive marketing slogan for a book (and, maybe, later also for a new infertility center). It, however, should be recognized as only such, and not taken seriously. We really have no tool to measure "fertility" except, of course, by pregnancy. What this concept, therefore, would suggest is a 3-months program to achieve pregnancy. If Dr. David (and associates), indeed, can achieve pregnancy in 3 months by whatever means, we are all for it!
We, however, suggest for all of those who have not conceived by that time that they seriously consider a switch to state-of-the-art Western infertility care.
Media contact: 212-994-4400 x.4491
