Alice Domar, Ph.D, Harvard Medical School's Comments
Jul 20, 2007 | comments: 7
Alice Domar, Ph.D, Harvard Medical School Jul 24, 2007, 12:09pm EDT
Dear Mary,

You do not run on at all. Your points were good ones and I appreciate your sharing your story.
In a properly run placebo controlled study, the person or persons administering the entity (either the active one or the placebo) do not know which one is being administered. So that any results which come from the study can be attributed solely to the difference between the two, not the impact of the person or persons administering it. I totally agree that if a kind person administers one, and a harried or unkind person administers the other, any difference can not be attributed solely to the entity being studied.

I myself wonder if the contradictory evidence we are now seeing in terms of the impact of acupuncture on IVF outcome may result from the skill and personality of the acupuncturist him or herself. In my center, we are seeing a very clear preference for female acupuncturists, so one might wonder about the impact of a study which only used male ones.

And you are right in that we can never truly study the impact of yoga or other modalities for which there is no placebo. But those who do them, and benefit, are all the evidence many of us need.

Ali
Jun 21, 2007 | comments: 25
J-

My hat is off to you for two reasons. One- for recognizing that you didn't want children and thus didn't have any. I wish more people would be honest with their feelings. And two, for being able to be supportive to your friends who are going through infertility, even though you may not necessarily relate to their situation. You are a good friend.

Ali
Jun 21, 2007 | comments: 25
Dear Les,

I agree with a lot of your points, especially the one about the difference in stress levels between the 1950's and now. In terms of your comments about health habits, women in those days tended to start trying to get pregnant when they were far younger than women do today. A 22 year old who has borderline health habits is more likely to get pregnant than a 32 year old with comparable health habits. So the women of today, who are older, do need to take their health habits into account. And there was infertility in those days as well. My mother took years to get pregnant and looking back, there were several couples in the neighborhood where I grew up who never had kids so I am guessing that they had infertility. The prevalence has not changed; the only difference is that women are older and treatments are far more successful, so we hear about it more.
make sense?
Ali
Jun 21, 2007 | comments: 25
Dear Debbie,
It seems to me that "getting everything removed" is a pretty drastic step, especially as you so clearly want a child. Your husband's refusal to be tested is obviously a huge issue. There is a new product, called Fertell (I was on the advisory board so I actually know a fair amount about it) where he can test himself at home. Not ideal as far as your doctor is concerned, but if the test is normal your doctor might be willing to proceed with treatment. Any way your husband would be willing to go talk to a therapist with you to see how he might be more helpful in this journey? This is not an easy process, especially alone.
I wish you the best of luck.
Ali
Jun 21, 2007 | comments: 25
Alice Domar, Ph.D, Harvard Medical School Jun 26, 2007, 12:25pm EDT
Dear Suzi,
Good idea but it is beyond my area of expertise!
Ali
Jun 21, 2007 | comments: 25
Alice Domar, Ph.D, Harvard Medical School Jun 26, 2007, 12:24pm EDT
Dear Jeannie,
I am so sorry about your loss. I have a list of snappy comeback lines which I give to my patients since people's comments never cease to amaze me with their stupidity. Think of a few good ones, memorize them, to protect yourself for the next time.
Did you ever receive a diagnosis for your infertility?
Ali
Jun 21, 2007 | comments: 25
Alice Domar, Ph.D, Harvard Medical School Jun 26, 2007, 12:23pm EDT
Dear Heather,
I am not an expert on the impact of smoking on fertility per se but my guess would be that getting away from smoke would get you (and your eggs?) healthier pretty quickly. I know that IVF programs wants smokers to stop at least a few months before cycling, which suggests that one can clear the nicotine. I don't know of any connection between PCO and smoking. But be aware that although smoking lowers your chances somewhat, think about the birth rates in the 1950's and 1960's (think baby boom) when many women smoked. Nothing is absolute.
ok?
Ali
Jun 21, 2007 | comments: 25
Alice Domar, Ph.D, Harvard Medical School Jun 26, 2007, 12:21pm EDT
Dear Lisa,
I am always careful to tell patients at the beginning of the program that the only way that this approach can positively impact fertility is to undo the potential harmful impact of stress and lifestyle factors. My impression of unexplained is that it is actually often "not yet diagnosed". If someone goes through the mind/body program and follows the recommendations and does not conceive, she can always know that she did everything in her control to increase the chance. And although our stats show half conceive within six months, about 95% become moms within two years, someway.
Ali
Jun 21, 2007 | comments: 25
Alice Domar, Ph.D, Harvard Medical School Jun 26, 2007, 12:14pm EDT
Dear Connie,
It is interesting to see how life comes full circle. My parents went through infertility (both primary and then secondary) before having my sister and I am sure that my mother's traumatic experience influenced me in in my decision to go into this field. When I first started the mind/body program almost 20 years ago, she said the same thing as you. But I have to tell you that when I did start researching the stress/infertility connection, I was subject to a lot of criticism so 26 years ago it would have been even harder.
Ali
May 25, 2007 | comments: 10
Dalal,
Infertility can strain even the happiest of marriages and ten years is too long to suffer. I hope that after your cousin reads the article, she will find a way to sit down with her husband and figure out a way to move on and perhaps build their family in a different way. It might be helpful for them to sit down with an infertility counselor who can carefully explain what their options are, such as adoption or egg or sperm donation. They are a family already but they need to be able to make decisions together in order to enlarge it. I wish them the best of luck.
May 25, 2007 | comments: 10
Kristen,
I am glad for you that you have not gone through infertility and commend you for reading it anyway. Unfortunately, in the future someone you love, or several someones, will indeed probably have a difficult time getting pregnant. And you are now better informed and can be a good listener and friend.
May 25, 2007 | comments: 10
Leah,
Congrats to you on two fronts. First, for recognizing that you and your partner don't want to have a baby at this time, rather than feeling pressure to have one for all the wrong reasons. And also for having the kind of relationship where you are able to talk and work through a crisis. Being able to communicate during a crisis is the sign of a truly healthy relationship. Keep up the good work!
 
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