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Searching for Fertility

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On the internet, there's an abundance of information just a few keystrokes away for people struggling with fertility issues. But how do you know what information you can really trust?

 

Simply typing in "fertility" in a Google search seems a good place to start for information, but in reality, the first page of results is riddled with potential landmines of [mis?]information, and there's over 10 million more results on the pages that follow.

 

In this blog I will examine just the top ten results that come up from this search, and help distinguish between the good and the not-so-good.

 

To understand what's useful and what's not, it's helpful to categorize this information according to the type of site it comes from. For example, FertilityStories.com would also fit into the category of "user-generated support," and sadly, because it relies on individual experiences, is probably the least reliable source of information in the group. Trusting individuals' experiences can be misleading at best and dangerous at worst. While there may not be anything factually wrong with the information provided, it almost certainly isn't applicable to you. At the very least, their anecdotes lack context. For example, a patient writing a fertility story might say that because they tried a common fertility medication like Clomid ten times without success, they recommend that other patients not try Clomid. That's a dangerous tale because it might turn you off to the very product that you need, because your body and your experiences are going to be very different from theirs.

 

Another category of site would be product-based websites, places of commerce that sell a variety of products or treatments.  FertilityFriend, TheBabyCorner, and FertilityBlend are examples of sites that have various products, from ovulation calendars to elixirs, that may or may not be helpful. The problem with trying to gather helpful information here is that while the sites may provide information that's factual, it may not be pertinent to you, and the focus is naturally going to be on selling a product rather than providing unbiased information that might lead a viewer to a competing product or treatment.

 

A third category of information would be "compilation sites" like Wikipedia and MedicalNewsToday would fall under. These sites may well have factual information, and very interesting articles, but without context, without an idea of how reputable or thorough the information is, they may confuse a patient more than help them or worse, cause them to fret about something completely unrelated to their particular case.

 

The best source of information available through this type of search would be actual medical providers, like WebMd and the American Fertility Association (AFA). These sites have much useful information and also allow patients to directly contact a specialist in the treatment of infertility, someone who put the pieces of your particular infertility puzzle together.

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Is There Really an App for That?

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4304520308_436f175a58_o.jpgYou can use your iPhone, one frequently hears, to accomplish almost anything. Whatever your problem, "there's an app for that." Well, being a long-time, loyal iPhone user, I decided to look at the quality and usefulness of the three applications available for people suffering from infertility (as of June 4, 2010).
 
The "Fertility Affirmations" App ($2.99) is a set of 40 phrases that the publisher describes as "positive, uplifting, and inspiring thoughts." Infertile women are to focus on these thoughts based on the notion that "thoughts create your own reality and can change your life." Based on a past life as a cognitive behavioral psychologist, I have no doubt that our thoughts, particularly our interpretations of the events we experience, can profoundly affect us psychologically and physically. However, there is no evidence that simply "focusing" on rather generic phrases like "My body is designed to conceive" will enhance a woman's chance of becoming pregnant. I cannot recommend this App.
 
The "Boost Fertility" App ($0.99) consists of information that the publisher describes as "ways that you can help to improve your fertility naturally." These items are groups into three categories: "Diet," "Supplements," and "Herbs." Dietary recommendations include consuming what is essentially a standard well-balanced diet (with the exception of a recommended increased intake of "oily food"), avoidance of any alcohol or caffeine intake for 3 months prior to attempts to conceive, and discontinuation of smoking. Among the "Supplements" recommended for couples are folic acid, vitamin E, and vitamin C. The "Herb" category includes information about a single herb - Agnus Castus - which it states is most helpful for women with a luteal phase defect and those with a high prolactin level. Although there are natural, common sense ways to improve fertility naturally, only a few of them are included in this App. Many of the recommendations for supplement use are highly controversial given conflicting research on the value of a variety of supplements on fertility. Although research suggests that Agnus Castus may be helpful with a subgroup of women who do not ovulate, it is certainly not a treatment of choice for either luteal phase defect or women with a high prolactin levels. This App provides minimal useful information while characterizing opinions as facts. I cannot recommend this App either.
 
The "Infertility Glossary" App ($0.99) provides short definitions for words related to the diagnosis and treatment of infertility. An internet search revealed that these definitions are the same as those on the InterNational Council on Infertility Information Dissemination (INCIID) website's glossary.
 
INCIID is a well-regarded nonprofit organization that provides information and support for the infertility community. The definitions are a little stale (last updated in 2004) and many are presuppose substantial pre-existing knowledge and so are not patient friendly. For example, "assisted hatching" is defined as "Thinning out the zona pellucida prior to transferring the embryo into the uterus." This definition doesn't explain what the "zona pellucida" is and doesn't explain why anyone would want to thin it out, or whether it's an effective procedure.
 
We also have a glossary page on this website. Its definition for assisted hatching is "A micromanipulation technique in which the shell around the egg (the zona pellucida) is opened or thinned to facilitate the embryo hatching process and subsequent implantation." It also provides a link that provides substantially more detail about purpose and effectiveness for those that want more information.
 
Of even greater concern about the definitions are inaccurate or misleading definitions. The definition of Zygote Intrafallopian Transfer (ZIFT) indicates that it involves a "minor surgical procedure," when, in fact it involves an invasive procedure, laparscopy, that requires general anesthesia. The definition of "X Chromosome" includes the comment that "when two X chromosomes combine, the baby will be a girl." In females, the X chromosomes do not combine; instead, they exist as two independent copies of the X chromosome.
 
I cannot recommend this App which contains definitions of very limited value to patients, ones that are available free on the internet for those with more advanced knowledge of fertility procedures.
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