Recently, a nationally known magazine published an article detailing the perceived dangers of infertility treatment. The article was alarmist and inaccurate, and my fear is that someone may read that article and decide not to pursue infertility treatment. Let's be real; none of us are happy that we have to take drugs and go through procedures to conceive. We all wish that we could get pregnant by having sex with our partners. But, for a lot of infertile women, that just isn't going to happen. So, we must research, learn, and make informed decisions about the direction of our treatment. In this article, I hope to dispel some of the fears that surround the treatment of infertility.
Myth: "Infertility drugs are dangerous. If you use them, you will develop ovarian cancer."
The truth is, this just isn't an accurate statement. The American Cancer Society believes there are several risk factors for ovarian cancer, including age and a family history of ovarian, breast, or colorectal cancer. Women who start their periods at an early age or women who have no children or who have their first child after age 30 may have a slightly increased risk of ovarian cancer. Scientists believe the risk of ovarian cancer increases with the number of uninterrupted menstrual cycles a woman has in her life, which would explain why the risk of ovarian cancer could increase if a woman never becomes pregnant.
In some early studies, it appeared that there was a link between prolonged use of Clomid and the increased risk of ovarian cancer, especially if the woman never became pregnant. A January 2002 study from the University of Pittsburgh Graduate School of Public Health questions this link, but the jury is still out on the long-term safety of Clomid. My suggestion would be to speak with your doctor about all of the risks, and consider limiting Clomid to a total of six cycles. Remember, the research showing a possible link between Clomid and ovarian cancer was done on women who took Clomid for at least 12 consecutive months. Using Clomid for a couple of months likely won't increase your risk. In addition, the ovarian tumors seen in Clomid patients are slow developing and have low malignant potential.
Scientists do believe that infertility itself can raise a woman's chance of developing ovarian cancer. A 10 year study of over 12,000 women showed that women who spent more than 5 years trying to conceive were at a 2.7-fold higher risk for ovarian cancer than were those who tried for less than one year. Women who used fertility drugs were not more likely to develop ovarian cancer than those who had never used fertility drugs. In general, the increased ovarian cancer rates were seen in women whose infertility was unexplained, or when the infertility was caused by endometriosis. However, the risk of ovarian cancer actually dropped with each pregnancy.
What's the bottom line? You should always question the medical care you receive, and you should always take an active role in your own health. Don't take medication just because your doctor tells you to. If Clomid hasn't worked for you after a couple of cycles, consider moving to the injectable gonadotropins. But most of all, don't panic and assume that seeking help for your infertility has doomed you to a future of ovarian cancer. That simply isn't true. In addition, the best thing you can do to protect yourself from any level of harm from the fertility drugs is to get pregnant - and that's a cure we could all love.
Myth: "I'm going to get breast cancer because I used fertility drugs."
You might develop breast cancer in the future, but the greatest risk factor for developing breast cancer is being female. Neither the American Cancer Society nor the Susan G. Komen Breast Cancer Foundation list fertility drug usage as a risk factor for breast cancer. However, never being pregnant and never breastfeeding are considered to be risk factors.
The overwhelming scientific evidence suggests that you will not develop cancer solely because of your use of fertility drugs. Ultimately, all medications come with some sort of risk. The payoff from fertility drugs, however, must exceed the benefits of any other type of pharmaceutical.
Myth: Fertility doctors are all just out to make a buck. They make decisions that put my life in danger, and they aren't accountable to anyone.
The field of reproductive endocrinology is one of the only medical specialties that self-regulates. The Society for Assisted Reproductive Technology is comprised of 370 practice members, comprising approximately 95% of all reproductive endocrinology practices in the country. SART's functions include:
- developing patient selection criteria
- working to decrease the incidents of multiple birth
- serving as a watchdog over the profession. Importantly, this function also works to decrease governmental intrusion into medical decisionmaking
- providing guidelines for quality practice in order to increase the caliber of patient care
- initiating practice, laboratory, and advertising guidelines
The American Society for Reproductive Medicine works closely with SART in order to both broaden available technology and create guidelines that keep pace with the advancement of science.
Make sure that your clinic or physician is a SART member. This can easily be done through the group's website. Choosing a physician affiliated with SART means that you have a physician committed to upholding the highest standards of care. The notion that doctors can run reproductive endocrinology clinics out of their basements is absurd. Instead, reproductive endocrinologists have an excellent track record for self-policing as well as working to better the state of the science as a whole.
Don't believe everything that you read, especially if the information is geared towards spreading ignorance and fear. With just a little bit of diligence, a few questions, and some time on the Internet you can become an informed patient and an active advocate for your own care. The team of professionals treating you are working very hard to help you realize your dream of becoming pregnant. Good luck!
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