Fertility Industry Evokes Glengarry Glen Ross

The fertility industry mantra today seems to come straight out of Glengarry Glen Ross: Always Be Closing

In a powerful new essay, Questioning the Cult of Repro Tech, health advocate and author Miriam Zoll reveals little publicized details behind today’s now seemingly ubiquitous fertility procedure: in vitro fertilization (IVF). Her research and writing make for a compelling read that raises important questions about bioethics and the way fertility medicine is marketed and dispensed.

Among the takeaways: from its earliest days the scientists and developers of fertility medicine have systematically downplayed health risks. In more recent years the fertility industry has sought to cultivate a caring, reassuring narrative. However they also obfuscate and mislead patient/consumers at their most vulnerable.

It is not unusual for IVF commercials featuring cuddly babies or instant chat windows to pop up on the screen, inviting distraught couples to click just once to enter the Promised Land.

It’s queasiness-inducing to behold the slick marketing and sales lead generation efforts routinely employed by clinics eager to sign up new, usually overwhelmed customers. At this week’s American Society for Reproductive Medicine (ASRM) 2015 Annual Meeting there were many expo hall snapshots and tweets.

In this Tweet the emphasis is on IVF patient traffic.

Increase your IVF patients 15–30%, guaranteed. Be sure to stop by #ASRM booth number 411! pic.twitter.com/Oj8nEAcVue
— Vanguard (@MedMarketLink) October 19, 2015

Such overtures to ‘grow your bottom line’ from the business expo raises questions about the underlying interests of the ASRM and its members. It’s hard to reconcile the call for greater IVF traffic depicted in the Twitter image with this quote from ASRM Vice President Richard Paulson: “I think it is important that people understand that infertility is not just a cosmetic disease.”

When entrepreneurial business focus takes priority over evidence-based medicine one can conclude we’re living with an untenable system where the ‘do no harm’ mission no longer applies.

One doesn’t have to look far to see how difficult it is for consumers to truly assess the safety and efficacy of fertility procedures. Informed consent is hard to achieve if comprehensive well-documented, peer-reviewed research is hard to come by.

As Zoll stated so succinctly:

When you marry misinformation and the aggressive marketing tactics of the industry with the psychological profile of a woman who is nervous and fearful about her natural reproductive capacity, you begin to understand how new customers are being reeled into the waiting rooms of an estimated 2,300 repro tech clinics operating in 56 countries today.

Not to tar and feather all who make a living selling fertility procedures, some doctors do seem genuinely interested in patient care. In response to a report this week on ovarian cancer risk from IVF, reporter Sarah Knapton of The Telegraph sought industry comment.

The Telegraph headline October 20, 2015

“This study, from a huge database, suggests that women who have IVF with certain conditions, such as endometriosis, may be at increased risk of developing ovarian cancer,” said Dr Adam Balen. “The question remains as to whether women who have received IVF treatment should be offered surveillance/screening and, if so, how often and by what means. I think we need to call for a policy on this.”

Meanwhile Professor Geeta Nargund, Medical Director of Create Fertility, which has five clinics in the UK, said that the findings were concerning.

“Not enough has been done to safeguard the health and safety of women undergoing IVF in the UK,” she said.

“IVF should be used only when it is really needed. What we do not want is our interventions to put women’s health at risk. We should be moving towards milder stimulation and fewer drugs in IVF.”

Now if only we had some way of holding clinics accountable to ensure that they aren’t putting women’s health at risk. Maybe, some 37 years after IVF was first made commercially available it’s time there was an industry standard and better expectation setting on the type of screening, drug protocols and fertility procedures dispensed?

We also need more forthright disclosures about the physical and emotional risks associated with undergoing fertility treatment. In an essay, published in The Guardian, titled “I had my eggs frozen. I wish someone had told me how difficult it was,” the writer candidly notes:

“Honestly, though, I wish someone would have told me straight about how shit I might feel…I wish I’d know that the risk of ovarian hyperstimulation syndrome (OHSS), for which I was admitted to hospital, isn’t as rare as we’re lead to believe. In terms of egg production, I knew that quantity didn’t mean quality and that producing 18 eggs (“fabulous,” said the embryologist down the phone) might mean only two were mature enough in the end to use.”

Something to consider, fertility industry entrepreneurs, instead of focusing on new ways to increase IVF traffic. Surely there must be more to fertility medicine than simply locking down that Cadillac or steak knives.

Pamela Mahoney Tsigdinos is the author of the award-winning book Silent Sorority. Her latest ebook is Finally Heard: A Silent Sorority Finds Its Voice.