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A new study calls into question whether two popular fertility treatments really work. But some researchers have questions about the study itself.
Studies show infertility affects nearly one out of seven couples. Many of these couples appear to have nothing wrong with them, or at least no obvious symptoms showing why they can't have a baby.
University of Utah Reproductive Endocrinology Department Director Dr. Mark Gibson said, "The people we call ‘unexplained,' it doesn't mean nothing's wrong. It means we don't know how to figure out what's wrong."
Two very common treatments for unexplained infertility are artificial insemination and a drug called clomid, or clomifene citrate, which stimulates ovulation. A new Scottish report says these treatments, by themselves, do not increase the odds of having a baby. Gibson says he's seen similar studies.
"Studies existing in literature show such small benefits for either artificial insemination or clomid in couples whose evaluation is normal that they don't really seem worth the cost," he said.
Five centers in Europe no longer offer these treatments, saying they're just a leap of faith. So, why are they still being offered in the U.S.? Gibson says these treatments may not be effective on their own, but he says, "Combine clomid and insemination, there is good evidence that couples with unexplained infertility do benefit."
Reproductive Care Center Reproductive Endocrinologist Keith Blauer said, "Adding clomifene citrate and intra-uterine insemination together probably about doubles that chance of pregnancy."
Blauer says the study is good overall, but it has some flaws.
"When you're doing treatment for unexplained infertility, you use a higher dose of clomifene citrate. They use 50 milligrams and, in fact, cut it to 25 milligrams if they were responding too well, but that higher response is exactly what you're looking for," he said.
Plus, he says they didn't study clomifene citrate the way it's normally used in the U.S. He says if a woman just takes it by itself, it actually makes conception more difficult.
"It makes the cervical mucus thicker. It, often times, makes if more difficult for sperm to get through, and you can overcome that by doing artificial insemination," he said.
Some researchers say women ask their doctors to prescribe clomid if they're not getting pregnant, which is not necessarily a good idea.
E-mail: pnelson@ksl.com
