Professor Robert Winston, who helped pioneer IVF for childless people in the UK has written a new book and an article in the Daily Mail, in which he strongly criticises the money making machine that IVF has become. He questions whether IVF is the right step for many people seeking to conceive and feels they may be rushed into it and encouraged to have costly private treatments that may be unnecessary.
Although Professor Winston also questions whether support services including acupuncture have been robustly researched, I share some of his concerns that people can be rushed into IVF. We see too many women who have have not been investigated fully. We see men whom after one sperm analysis are told they have a sperm issue and require ICSI with IVF. We see many couples who have conceived before and either already have a child or have suffered miscarriage so we know they are capable of achieving pregnancy. Seldom is a full investigation offered. This means that issues such as those highlighted in the article such as having a fibroid that may preclude conception are missed. Lifestyle advice is seldom given to either men or women and we know so much can be changed with diet, weight loss, alcohol use etc.
As the waiting list for NHS IVF has shortened, many people we see can feel rushed into IVF. There is no ‘inbetween’. We used to see more women being offered interventions such as monitored cycles to check whether ovulation was taking place, clomiphene (‘clomid’) to induce ovulation and IUI. Some couples may have only been trying to conceive for 6-12 months before being referred for IVF. Although we do not want couples who will be found to have underlying fertility issues to wait longer than necessary, there is a balance to be had in giving a couple time enough to get pregnant. One couple we saw told us they had been trying to get pregnant for 18 months. Upon further questioning we worked out that as they both worked away, they had only really had ‘babymaking’ sex during her fertile time, twice within that time. With a few tweaks to their schedules, they managed to get pregnant within two months, avoiding the IVF that they had already been recommended.
Part of what we offer to those trying to get pregnant, is the space to talk through their fertility. We ask about lifestyle, diet and ways of eating, supplements, how do people relax, stress levels and so forth. This is because acupuncture is a holistic medicine and we cannot judge a person only on their sperm analysis or their record of conceiving. We need to look at the bigger picture. So although IVF is a wonderful treatment for some, it is not the only way forward for those who are struggling to conceive and I hope that mainstream fertility services will, as Professor Winston argues, move towards more individualised fertility planning with more treatment options than just IVF.