Thursday, November 13, 2008

Book Review: "Infertility for Dummies"

"Infertility for Dummies"
Sharon Perkins, RN, and Jackie Meyers-Thompson
2007, 362 pages

Before reading this, I should warn you that it is written from my strongly pro-life position. Okay, you've been warned.

I decided to pick up a basic book on infertility simply because so many of my friends are dealing with this. In fact, out of the six young married couples in our church with whom we hang out, four have dealt or are dealing with infertility. I didn't want to leave such a widespread issue out of my reading, so I picked up this book. I'm definitely going to read more books on the subject to develop my understanding further.

I wasn't that crazy about this book, both informationally and ethically. I'll deal with those issues in a minute. First, what I liked:

Like all the dummies books, this book is clear, concise, humorous, well-organized and easily accessible. The language and the explanations were clear, and I learned a lot (though the hormonal interchanges of the fertility cycle are still largely beyond me!). I think that this would be a good reference book (it's really easy to find specific information that you might need at a time) and as a basic primer.

The two things I didn't like: information problems and ethics.

Starting with the book's information:

I can't speak to the later chapters, because I was reading much of this information for the first time. However, though I am not overly conversant with reproductive technologies and the ins and outs of infertility, I am fairly knowledgeable about basic female fertility and especially natural family planning. When I was reading these sections, I kept finding errors - lots of them, some tiny, some not so tiny. But that made me wonder just how accurate the following chapters were. Now, don't get me wrong. Most of these errors were really tiny and wouldn't make a big difference to the reader. But they are errors that wouldn't be written by a truly knowledgeable author and which shouldn't have made it to print. Here are a few examples:

Text: "The cervix... keeps the baby from falling out of the uterus when you're pregnant because it's a tight, muscle-like tissue." (p. 23)
Correction: The cervix is not muscle-like, it IS a muscle (being part of the uterus, which is a muscle).

Text: ""But the most consistent thing about your menstrual cycle should be that ovulation occurs 14 days before your period begins. So if your cycles are 28 days, you ovulate on day 14. But if your cycles are short, say 25 days, you're actually ovulating on day 11..." (p. 29)
Correction: This was a big one. In fact, I can't believe they included this simplistic of an explanation of female fertility, because it is vastly misleading. While the average fertile luteal phase is assumed to be 14, it can range anywhere from 10 to 16 days (some docs say 12 is the lower limit, but many babies have been carried to term with mums who have 10/11 day luteal phases). Thus, timing sex to be just before [average period length - 14 days] is extremely inaccurate and misleading. The authors do acknowledge different luteal phase lengths, but in their directions on "how to get pregnant," they just tell you to subtract 14 from your average cycle length to get your ovulation date.

Text: In reference to charting: "Look for a subtle drop in temperature, followed by a sustained rise in temperature.... at least 0.5 degrees" (p. 70)
Correction: #1 - It's 0.4 degrees, not 0.5 degrees; #2 - They completely ignore the fact that many women "stair-step" with their temperatures - you may see your temperature rise gradually to the high temperature level rather than just one big jump. #3 - They also fail to tell anything of the official natural family planning rules, such as "3 over 6," etc. It's not so much that it's wrong as that it's incomplete. #4 - Not every woman gets the "pre-ovulation dip;" in fact, most don't. Thus to depend on the dip as a predictor of ovulation is not a reliable method.

Enough on that.... I will just say that these little errors made me slightly distrustful of the book's reliability.

Onto ethics...

This is a hard subject, because it really depends on your beliefs. I am dissatisfied with the book's ethics because of my pro-life and Christian beliefs, but you, gentle reader, may not be. So read on, and make of it what you will.

Basically, my position: I believe that a new life begins at the moment of conception. In other words, Sperm + Egg = Baby. This is regardless of whether the embryo is one cell or ten or a hundred or a hundred million - I believe that it is a unique individual, created by God. Thus, to "discard embryos" is, to me, the same thing as an abortion. This is not a popular view, but it is my honest belief.

IVF (in-vitro fertilization), thus, is rife with ethical dilemmas for those of us who believe this way, because "extra embryos" are generally part of the process. Many couples try to transfer all of their embryos, but usually this is impossible, as the number of embryos is usually far greater than the average woman's ability to bear children. Some couples purposely try to ensure that a small number of embryos is created so that they will have the ability to transfer all of them. A very small number put their extra embryos up for adoption (or, in a less formal process them, "donate" them - since the state regards embryos as property rather than persons, the legal adoption process is optional and therefore generally used only by parents who want to respect the personhood of their babies). However, most extra embryos are eventually discarded. As I believe that embryos are babies, and not "genetic material for making babies," the practice of embryo disposal is ethically unacceptable.

There is also the issue of pre-implantation genetic diagnosis, in which embryos are tested for gender and genetic conditions - those with characteristics the parents want are kept, those with unfavorable or unwanted characteristics (wrong gender, genetic conditions) are discarded. Ethically, this is the same thing as an aborting a baby with health defects. (Not to mention that embryos are often injured in the process of testing them, with some data showing that these babies have a higher incidence of birth defects, possibly resulting from the testing itself.)

Thus, for me, there are many deep, deep problems with the reproductive technologies industry. However, this book is completely dismissive of these issues. Besides stating that "there are ethical issues under debate with such-and-such procedure" or "some people have problems with this," they are somewhat contemptuously dismissive of all ethical considerations. The book is filled with statements such as the following: "Many people with frozen embryos would like to see something positive done with embryos that they donate for research, and would rather have them used for stem cell development than just be destroyed." (p. 324) Furthermore, in referring to embryos, the authors refuse to call them more than "potential life," which is an easy way to dismiss the personhood of embryos.

Lastly, here is one corker that made me really angry, and also made me wonder if the authors have the emotional maturity to be even writing a book, let alone one on infertility. In the chapter on adoption, there is one teensy-weensy section on adopting special-needs kiddos, and the main jist of the section is to discourage adoptive parents from doing so. Let's hear this choice morsel from the authors:

"Sometimes, people are tempted to adopt special-needs children because they're more easily available. Other couples are drawn by a picture of a child... Sharon (one of the authors) remembers thinking seriously about adopting a child with handicaps while her family was waiting for their referral... every one of the pictures appealed to her. However, she realized that her family wasn't really emotionally prepared to handle a child with serious problems. Although it's easy to be caught up emotionally in the idea of raising a special-needs child, look realistically at your lifestyle and personalities before making a decision." (pp. 312-313)

In other words, "Stop and get ahold of yourself before you do something stupd."


Do I recommend this book? It gets a "whatever" kind of rating. The information is okay, the ethics are (in my opinion) absolutely deplorable. Next time, I'm going to look for a book with a conscience.

1 comment:

  1. I don't know if the authors wrote this in the section on testing embryos before implanting them, but I've read of studies that show that when parents do this, they actually reduce their rate of successful pregnancies. It would seem to be the other way around -- that when you're "sure" that the embryo is genetically healthy, etc., that you're more likely to have a successful pregnancy. I'm assuming that something about the testing process weakens the embryos somehow.



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