IVF and the Media

21 June 2016

Several months ago I was approached by Four Corners to appear on it regarding IVF success rates and what patients understand.  I am always cautious of these invitations, especially from national groups as there is often an underlying agenda with a risk for things not to go the way that you plan.  After talking to Sarah Dingle and laying down boundaries about which I was prepared to be quoted, I agreed to a TV interview which was done on Tuesday 3rd May at Fertility SA.

In it I was asked about our work on weight and weight loss and how lifestyle intervention seems to make a big difference to the outcomes of IVF by reducing insulin resistance and improving wellbeing.  Unfortunately in the editing, none of this came out but I was quoted that a proportion of patients do not need IVF because of changes in lifestyle or simpler forms of treatment.

It is interesting how you can spend several hours being interviewed and end up with no more than two or three quotes out of that!  However I gather that the Four Corners team can spend up to a month on a program for it to be edited down to around about forty minutes, so this is common to all TV and film making.

Other doctors who appeared on the program were made to appear more controversial and were under more attack than I was.  I received lots of compliments from non-fertility colleagues and the community about appearing on the program and I felt that it was worthwhile.  However I have received very little news from my fertility colleagues and I suspect that some of the may not be entirely happy with my views about seeking to avoid IVF where possible.

My basic philosophy in Fertility SA, as in the previous organisations that I have served, is that we are here to help people have a baby the most natural and inexpensive way that can be found, and this is best done by appropriate diagnosis, investigations and seeking simple, non-invasive management above that of high technology.  However when technology has to be used, it has to be of the very highest quality, informed by the best evidence that we have available, and highly trained staff.

During the course of my media interview I was asked to produce five questions that you should ask your IVF specialist, and these are as follows:

1. Are you a recognised specialist spending the majority of your time in the fertility area, and what is your experience and reputation?
Some doctors claim to be fertility specialists but are not qualified gynaecologists or physicians. Some do fertility work as a very minor part of their interest, some doctors are gynaecologists with a strong expertise in fertility and some doctors are subspecialists, with reproductive endocrinology and infertility (CREI) training in addition to being gynaecologists.

2. Will you fully investigate us to see if a cause can be found for our infertility that might avoid complicated treatment and advise us on whether waiting longer has a good chance of working?
Some doctors move straight to treatment without adequate investigations, including ultrasound, radiology, surgery or blood testing. Many couples will become pregnant naturally by waiting if no infertility cause is found.

3. What options are open to us other than IVF, and what can we do to avoid treatment or maximise our chances of success?
These sometimes include waiting longer, changing diet, optimising weight, stopping smoking or drugs, timing intercourse, and offering other treatments, including ovulation induction and intrauterine insemination.

4. If we undergo IVF, what are our chances of having a single healthy baby from one started treatment cycle?
Ask for results based on your age, your diagnosis, and that clinic’s actual results declared to a central reporting body rather than a generic figure for all their clinics and all ages. Make sure you understand you are not quoted a “cumulative” figure, which includes all frozen embryos over several additional cycles. Ask what your chance is of getting an embryo transferred, because many couples may not get to have an embryo that is normal.

5. What will the real financial and emotional costs be if I undergo treatment?
There may be undeclared add-ons, such as additional costs for intracytoplasmic sperm injection (ICSI), pre-implantation diagnosis, freezing of embryos, certain laboratory procedures, or anaesthetic charges. A few people find the treatment very difficult for their emotional wellbeing and ability to work well.

I have been used to being exposed in the media a lot for nearly 25 years and I guess one never knows what to expect after being interviewed.  Local media are usually very positive and want to promote South Australian achievements, but national and international media are more critical of your contributions and often come in with a preset agenda.  Fertility units either use the media to promote their facilities or have to respond to the media seeking to score points off them.

I have enjoyed being in the media in the areas of my knowledge, but I am very grateful that I don’t work professionally full time as a media commentator or star!

Professor Robert Norman

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