How Infertility Made Me a Skeptic
Part One: Acupuncture & Wheatgrass
It happened again recently that I ran into an acquaintance who was doing acupuncture to help fertility. This happens all the time in LA, really, where many people believe in acupuncture, and where many, many women (at least in my circle) have put off having children until their late 30s or early 40s. I admit that I tried acupuncture myself, at a time when I was diagnosed with serious fertility problems. I spent a couple hundred dollars on sessions with needles and some pills with herbs. I never did take the pills, because I started some actual, medical fertility treatments and didn’t want to combine the medicine I was taking with an unknown element. And then, I decided the acupuncture was silly, so I stopped going.
My travails with infertility pretty much sealed the deal on my becoming a skeptic (or you could say a critical thinker, rational mom, or what have you), because I was embittered by my encounter with alternative medicine and supplements. I was, at one point, imbibing a two-ounce “shot” of wheatgrass every day, because I heard that this was supposed to help fertility. In fact, I heard that wheatgrass was supposed to contain all of the nutrients in a full pound of vegetables. All it took to prove the falseness of this claim was a quick glance at the back of a package of frozen wheatgrass, where the nutritional information is listed. Two ounces of wheatgrass really doesn’t contain the nutrients of even one vegetable, let alone a whole pound—of anything.
Steven Novella does a great job of breaking down the reasons to be skeptical of acupuncture here.
Essentially, it just doesn’t work, and there’s really no evidence that it’s ever worked. Yet, I know plenty of well-educated, well-spoken, intelligent people who will say, without any irony, “Oh, acupuncture is supposed to be great for fertility!” So how do smart people fall for this stuff? What’s the hook, and why do some of us bite? Why do we drink wheatgrass, take supplements, do yoga for fertility, or any number of other “treatments” whose efficacy is unproven?
Here are some thoughts.
1. My friends don’t lie. Word of mouth is powerful. I have no reason to doubt that my friends are honest people who mean well. If someone tells me she’s heard wheatgrass is effective, why would I think she’s offering a bogus waste of money?
2. I’m no doctor. I have only the smallest inkling of how ibuprofen works, but I know that it does. The explanation of chi and meridians might sound a little mystical, because we can’t see those things. But we can’t see germs, either. For those of us who are not doctors or scientists, a lot of things can sound plausible.
3. Desperation is a big motivator. I remember when I was singing the praises of wheatgrass, my mother, a medical professional, said something that fell on somewhat deaf ears: “Anecdotal evidence doesn’t really count.” In truth, there’s really not even good anecdotal evidence that wheatgrass helps fertility. But I read about it in a Chinese medicine book I bought. (So add that to the total money I wasted on Chinese medicine.) Wheatgrass is also discussed in Julia Indichnova’s book Inconceivable. She tries the entire spectrum of “natural” cures—juicing, yoga, acupuncture, wheatgrass, colon cleansing. Eventually, in spite of high FSH diagnosis (this was my diagnosis, and it’s not an easy one), she conceives naturally, and she attributes this conception to her change in lifestyle. So many women I know with high FSH read this book like it’s the Bible. It’s a lifeline for them. When you are desperate, anecdotal evidence is hope, and it’s tough to hear otherwise.
4. The proponents are louder than the critics. When I’ve come clean with friends, or on discussion boards, about my skepticism regarding acupuncture, it’s like people come out of the woodwork to agree. But it takes a lot to get out on that skeptic dance floor alone and start the party. People who don’t believe in this stuff know better than to join the conversation. People who are embarrassed that they spent a lot of money tend to keep quiet. The default position, in polite conversation, is to nod and smile.
5. Fertility clinics pair up with acupuncture clinics. There are often brochures for local acupuncture and Chinese medicine clinics in reputable fertility clinics. This gives the impression that doctors endorse these treatments. And actually, some doctors do endorse them, which I find problematic and misleading. The fact that many women who are seeking alternative treatment are simultaneously using assisted reproductive technology just confuses the issue. A typical word of mouth endorsement from the louder proponents goes something along the lines of, “I tried three rounds of IVF, but the one with the acupuncture took!”
I actually have been tinkering with this post for a while, and in the meantime, I found Stephen Barrett’s list of reasons that people may become vulnerable to “quackery.” It looks pretty similar to mine.
He also has a nice article on “Why Quakery Persists.”
Steven Novella recently wrote a great piece on how Evidence Based Medicine is losing the battle against complementary and alternative medicine.
These two and others have been writing about skepticism for much longer than I have, and well, they’re doctors. I feel that my place in this whole affair is as a regular person, not a scientist, just trying to get the word out to other parents. It may be that quackery persists all over the country and the world, but somehow, living in Los Angeles, I just feel surrounded by it. I can’t go to any gathering of friends without hearing about some pseudoscientific treatment and having to simply be as polite as I can about it.
Often friends couch the suggestion to try alternative treatments in terms of thinking positively, implying that skepticism about acupuncture is tantamount to a lack of effort or open mindedness. And really, one could ask, what’s the harm of trying wheatgrass or acupuncture? They might not work, but could they hurt? And aren’t we all free to do what we like? If these things make us feel good, then what’s the problem?
If these treatments take the place of actual treatment, the big problem is that patients who are desperate to have children are actually doing nothing to further that goal. That is tragic, considering that often for women, fertility is a time sensitive issue, and time wasted on ineffective treatments means less time available for effective ones.
If women seek actual treatment in tandem with alternative treatments, the main problem is that they are wasting money that could be better spent on college funds, car payments, or even new wardrobes.
The most pernicious effect may simply be the continued persistence of the prevalence of these kinds of treatments, in spite of much evidence that they do not work. Because I believe that I wasted my money, I now speak up on the subject of acupuncture or wheatgrass, or many other alternative infertility treatments. It takes a gentle touch to do this, when talking about infertility, which is emotional issue for those enduring it. However, I sincerely believe that in addition to dealing with the hardship of infertility, women should not have to deal with the hardship of an empty bank account.
As it turned out, I conceived naturally and went on to have the world’s most perfect baby. It may have been that my brush with infertility was the result of a misdiagnosis. (I’ll try to cover this in another post.) Still, I was an older mom, and I got very lucky. I certainly have a continued empathy for anyone who is facing problems conceiving, which is why I believe it’s important to let women know that acupuncture and wheatgrass, along with many other supposed cures, are just a waste of time and cash.
molly Said,
February 3, 2009 @ 8:28 am
any disease or condition for which there’s no good treatment or cure is like a big fat open door with a sign that says “Exploit For Profit!!” If the condition is not well understood, or has an iffy diagnosis, even better.
Stacy McKenna Seip Said,
February 3, 2009 @ 10:11 am
While I don’t use alternative medicine of any sort (not even chiropracty) despite a great many of my friends engaging in alternative therapies or healing techniques (Chinese medicine, Reiki, you name it) there is something to be said for the peace of mind factor. If it makes them feel better, more hopeful, less stressed about the situation to have those treatments, then bully for them! A great many conditions (including fertility) are aggravated by stress, so I don’t necessarily consider it wasted money if their “western medicine” treatment makes something biologically feasible, but their alternative medicine relieves their stress enough to help “make it stick”. It’s all about priorities with money – if their peace of mind, the thought that they’re doing *everything possible*, is worth that much money to them, so be it. For us skeptics, it’s highly unlikely it’d be worth it. But I most certainly always recommend using alternative medicine as a supplement, not a primary treatment.
Melissa Said,
February 3, 2009 @ 5:31 pm
I understand that all medical procedures, alternative or mainstream, carry some sort of risk, but I know of someone’s experience with acupuncture that makes me certain I will never try it. I am a classical musician, and I play a stringed instrument, so my hands are my most valuable possession. A well known violinist, performer and pedagogue, Pamela Frank, engaged in acupuncture several years ago to alleviate some tendonitis issues, and emerged with all of the nerves in her left hand semi-paralyzed – she can do day-to-day activities such as opening doors or writing a short note, but she can’t repeatedly move her fingers for more than 5 minutes. She’s well-regarded as a teacher these days, but when she plays, only for 5 minutes at a time, it’s the saddest thing in the world – agonizingly beautiful, but short-lived. Her performing career is dead.
The problem with acupuncture is that it’s not sufficiently regulated – any old hack can claim proficiency, and that strikes me as dangerous.
Jeff Said,
February 4, 2009 @ 4:43 pm
Thanks for this post. It was well written and handles several delicate subjects with due care.
My wife and I are both self-identifying skeptics, and struggled with infertility ourselves a few years back. We are both stronger skeptics today than we were then, but she’s a PhD in molecular biology and I’ve been a closet science geek since high school, so we’re both fairly up on the scientific method. Nevertheless, the difficult challenge of infertility eventually found us in the living room of a new-age acquaintance and woo-woo practitioner, beating drums and dousing over herbal supplements in our hands to determine what our bodies “needed”. We both privately thought it was a little weird, and even discussed afterwards what additional control tests she could have added to the magical dousing efforts. Despite this, we continued to pay for this magic every week for a few months, and neither of us actually raised the question with the other that we might be wasting our time and money.
Eventually, we decided that this was silly and we should end our “treatments”. Being ripped off by a friend adds another layer of complexity as you risk offending the person and causing problems among your shared group of friends, but fortunately for us this problem solved itself the week before we were going to confront her and terminate our sessions. She flaked on us and her family, moved to the Pacific coast (it was “calling to her” or some such thing) and vanished. Problem solved.
So why would two educated, rational and science-savvy people engage in what was clearly pseudoscience nonsense? For us, being fairly type-A people with a strong need to feel in control of situations, I think this gave us a small measure of comfort that at least we were doing *something* about it. Also, we might have ended it much sooner, but I think neither of us wanted to call it quits if our partner was getting even a small psychological benefit out of it.
Flash forward a few years, and we have recently adopted the worlds most perfect baby (sorry, Julie) and look back on the experience with an embarrassed chuckle.
molly Said,
February 4, 2009 @ 10:16 pm
If it were the case that acupuncture relieves stress, and that relieving stress improves outcomes–then would there not be a measurable improvement in disease outcomes for the punctured? Since quality studies have never shown such improved outcomes, it seems far-fetched.
Julie Said,
February 5, 2009 @ 11:01 am
Jeff, what a great comment. I’m so glad you adopted a perfect baby!
I think it’s a very good point, and one I didn’t cover, that it’s that need to feel like you’re doing *something* that drives some of us to woo. I remember feeling like I had just been diagnosed with this horrible problem, and I didn’t want to waste any time. I wanted to do everything I could do and not miss a single opportunity to help myself.
I remember when I became more skeptical of acupuncture, yet another friend recommended it to me. I said that I was just trying medical treatments. My friend said brightly, “Try everything!” Again, she said it with that spirit of positive energy and open mindedness, implying that somehow being open to the cure would bring the cure. This attitude of being open and non critical of alternative medicine is pervasive among my friends, and it takes too long to counter it in normal conversation. So…Jessie and I started a blog instead!
Nancy Said,
February 5, 2009 @ 8:01 pm
I lost five pregnancies before I had my sons. I did not go in for quackery but I did begin to feel like the world’s most unlucky woman and fell into superstition – fearing to repeat anything I associated with a pregnancy loss – things like carrying groceries lest I bring down the wrath of the fates.
I was fortunate to have a perinatologist with a love of his work and the arrogance to think that even if there wasn’t an obvious cause for my miscarriages that eventually we would figure it out. I owe my children to the hubris of this man who declared “there’s always a reason”, who used every new test that came out, who monitored my uterus and placenta weekly and who finally was able to diagnose a then virtually unknown (but actually fairly common) genetic thrombophilia called MTHFR. I went on, with the help of Lovenox and baby aspirin, to have two relatively normal pregnancies.
When I hear women request help with fertiltiy that is “non medical” I think of all the time I wasted and the additional child I might have had if I’d gone to a doctor in the first place. I’m not sure why women don’t go, but I think it could have something to do with fear, that is, being afraid of what you might learn.
I didn’t name my child Prometheus but I was tempted. If infertility taught me anything, it’s that the truth really does set you free, even if it’s bad news and that hubris, and arrogance in the face of nature is something to celebrate.
Grandma Said,
February 12, 2009 @ 2:48 pm
I burst with pride when I read these amazing posts my grown up perfect baby brings into the world.
Another vital step is to always get a second opinion from another physician when there is very bad news. As as Healthcare professional, I can tell you with certainty that doctor’s make mistakes, as do labs, x-ray techs, and everyone in entire industry.
It’s difficult for many people, especially women who are given the diagnosis of infertility and who are extremely vulnerable to take this step. I think it’s such a daunting task because there is time pressure..but doesn’t it make more sense then turning to accupunture, aroma therapy, and the dousing of various herbal supplements over the hands (by the way Jeff, I actually had someone convince me to agree to this), and in the middle of it all, I just started laughing. My situation was different, of course…but even health care rationalists look for alternative treatment options when all else has failed.
I know that many have probably gone to several doctors, and gotten several opions….but many don’t, and that’s tragic.
Martin Baby Blog » Diaper Daily News - 2/13/09 Said,
February 13, 2009 @ 9:31 am
[...] How Infertility Made Me a Skeptic (Rational Moms) [...]
Dana Said,
February 14, 2009 @ 7:02 am
Great post, Julie. A little off the subject, but along the same idea – when Jake first had all his ear infection problems (10 in the space of 5 months) we read somewhere that a chiropractor could help. We took him to a local one a few times and was told, “Fluids gone! He should be fine!” Two weeks later, another ear infection. We quickly canned the treatments and had the tubes put in. (Knock on Wood) He never had another ear infection.
colon Said,
March 31, 2009 @ 5:36 am
This is right here, in the present, not the future.