Wednesday, May 02, 2007

Issues with reproductive technology

There's an interesting article at Slate about a couple of new books on the problems with assisted reproduction (IVF and other techniques).

The main current problem: the number of embryos which are often implanted has lead to a large rise in the number of multiple births, which tend to be bad for everyone (mothers, children and society.) There are also higher rates in IVF children of other odd medical conditions, and no one yet understands why.

The situation in Australia is summarised in a fairly recent Medical Journal of Australia article. It would seem that maybe only 30% of women here try a single embryo implant, and the rest go for double embryo transfer. This is despite the very significant health risks of having twins.

(The Slate article indicates that in America, some clinics may offer to implant 3 or even 4 embryos, which is pretty crazy really.)

I love technology, but have old fashioned views when it comes to reproduction. I can't quite reconcile how a country like Australia can have both an abortion rate of perhaps 80,000 or so per year, and around 5,000 births through IVF. There are clearly thousands of healthy embryos going to waste, while at the same time a relatively small proportion of women are going through expensive, painful and potentially dangerous treatment to have a child that stands a higher rate of illness than a naturally conceived one.

One final, slightly off the wall, point to make. I hope people have not forgotten about the 2001 study which indicated a very strong positive relationship between third party prayers and the success of IVF.

I had wondered why such a startling result was not the subject of follow up studies. However, it seems that the paper was pursued hard by a group associated with the Skeptical Inquirer, who pointed out the generally fraudulent activities of one of the authors. The skeptics attack is explained here. It is worth noting that it is based on guilt by association, rather than establishing how any fraud may actually have been done. (The skeptic's report seems also wrong where it indicates that the Journal of Reproductive Medicine removed the report from its website. It still seems to be there now, as shown by my link above.)

The skeptics also get a bit silly, I think, when they say that the head doctor of the study:

...was investigated by the U.S. Department of Health and Human Services Office for Human Subject Protections, because the researchers never got informed consent from the patients in the trial. Such misconduct is a serious violation of medical ethics and federal rules that were adopted to prevent the kind of atrocities that occurred in Nazi Germany and in the United States during the infamous Tuskeegee Syphilis Study.

Oh come on. What they were studying was something that could only have positive results if successful. Unless skeptics think that there is a risk that God punishes those hopeful women who were being prayed for, this is a pretty trivial issue, isn't it?

I would like to know if anyone else is going to do a similar study, but Googling has not brought up any quick answer to that.

If it was confirmed, it would certainly indicate that, if nothing else, God seems to like babies.

4 comments:

Caz said...

A very large study, not so long ago (results during the last year or so?) found zip, zero, zilch, nadda, happening - good or bad - with the power of prayer, no matter the medical condition.

It was a properly designed controlled study. Needless to say, there was very little media coverage.

The IVF techniques in Australia have improved considerably, thus allowing doctors to use only one or two embryos at a time. This is really only in the last, say, five years (?). Prior, it was entirely common for all women to have multiple embryos used for each cycle tried, that is, 3 or 4, such that many clinics obviously still do overseas. They're using different techniques, that's all.

Don't forget, the majority of IVF attempts do fail, so it's not as though there are lots of women having triplets or quads.

Caz said...

It was only on heart patients -

Here 'tis -
http://tinyurl.com/2g9yck

I guess you'll argue that illness and trying to have a medically assisted baby aren't the same? :-D

"... a significantly higher number of patients who knew they were being prayed for - 59 per cent - suffered complications, compared with 51 per cent who were uncertain. The authors left open the possibility this was a chance finding. But they said being aware of the strangers' prayers may also have caused some patients a kind of performance anxiety.

The study also found more patients in the prayer group - 18 per cent - suffered major complications, like heart attack or stroke, compared with 13 per cent in the group that did not receive prayers.

In their report, the researchers suggested that this finding might also be a result of chance.

One of the authors of the findings, Reverend Dean Marek, director of chaplain services at the Mayo Clinic in Minnesota, added: "Our study was never intended to address the existence of God or the presence or absence of intelligent design in the universe."

Steve said...

Caz, yes I was quite aware of the recent study negative study, and didn't mention it because I assume most readers were aware of it. The IVF study was remarkable because it indicated a really clear and strong result. I think the earlier studies of prayer for illnesses which had also shown a positive effect were no where near as strong.

From a Christian/philosophical of view, I am actually very symapathetic to the view that prayer, or God, is not testable this way. Again, that was why the IVF study was so surprising.

The most likely explanation is that it was a fraud, but wouldn't it be good to try to replicate it so we know whether it was a one off?

Caz said...

Are you being a bit flip by suggesting that "most people" would have known about last year's study results? This was something that took TEN YEARS and I only saw that one very brief article. Not that I'm on the look out for prayer research, it was only by chance. On that basis, pretty much no one would know about this study! My thought on it ... :-D

The IVF study was only over a period of 4 months, and done 6 years ago.

You'd want to see those results replicated in quite a few more, and more robust, studies before getting too excited.

Don't know how you'd control for improved techniques since 2001 though.