Do medical providers knowingly place unsuspecting infertile women at risk through the drugs and treatment they administer and knowingly mislead the public by overstating their success rates and understating the risk associated with infertility treatments?

The assertion is valid that accountability and verifiability in the reporting of In Vitro Fertilization (IVF) outcome statistics is lacking. It is also a fact that currently, reported data by the Society for Assisted reproductive Technology (SART) on their web site is self-verified by the clinics and not independently verified (http://www.ivfauthority.com/2009/06/ivf-success-rates-sart-cdc-reporting.html )

When it comes to fertility drugs (e.g. gonadotropins such as Follistim, Gonal F, Bravelle, Repronex, Lupron, etc.) used in IVF, claims that there are long-term serious side effects have been grossly overstated. While indiscriminately overdosing a woman who is inordinately sensitive to gonadotropins (a “high responder”) does increase the incidence of multiple pregnancies and can precipitate the serious complications associated with Severe Ovarian Hyperstimulation Syndrome (OHSS), the risk of these can be minimized or avoided through judicious and individualized approaches to their use.

More than a decade ago, following the tragic diagnosis of ovarian cancer in the Saturday Night Live celebrity, Gilda Radner (who had received prior gonadotropin therapy), many began to suggest the existence of a “cause-and-effect” relationship. A retrospective study that was hastily performed raised further alarm. However, all subsequent, well-controlled prospective studies have since refuted the connection. The fact is that infertility itself is associated with an overall increase in the risk of ovarian (and breast) cancer. Childless women who have never used gonadotropins develop ovarian cancer with the same frequency as those that have. It should also be pointed out that ovarian cancer cells do not even have follicle stimulating hormone (FSH) surface receptors. Thus, the suggestion that such gonadotropins would promote the proliferation of ovarian cancer cells is ridiculous.

Lupron and other similar drugs are among the safest short-term medications in the infertility arena. Though their prolonged usage can lead to osteoporosis (bone loss), this can be avoided through the concomitant administration of low dose estrogen.

What should be considered is the fact that any intervention carries with it both an upside and a downside….whether it is driving a car, discharging a firearm or taking medication. Obviously the level of such risk is directly proportionate to competency, skill and intent It follows that when it comes to fertility treatments, it is incumbent upon the doctor and patient to assess the cost-benefit ratio, and in so doing to base their judgment on fact rather than emotion.