Natural Conception after Adoption and Assisted Reproduction Treatment

Today at work I was putting together a presentation on “What is correlation?” (I know, my work is full of excitement and such geekery 😎 ), and I came across an interesting example of ‘illusory correlation’ from the infertility world that I thought I would share with you all.  I was about using it as an example in my presentation.

Have you ever heard someone say

“Adoption increases the chance of an infertile couple getting pregnant naturally?”

Many people have heard or say this, and many can tell you a story of someone they know/know of that this happened to.  The rationale behind this can be hypothesised as:

Once the pressure is off and the couple is less anxious, it will happen naturally.

But how true is that?

Apparently it turns out there is NO empirical evidence to support such a hypothesis.  Research (from Resolve) has shown that the percentage of women who become pregnant without adopting is no different to the percentage of women who become pregnant without adopting.  What this means is that, while a small percentage of people who were having difficulty getting pregnant do not get pregnant after adopting a child, these are likely the same people who would have gotten pregnant after having difficulty, even without the adoption.  It has nothing to do with the adoption.

So why do so many people believe this myth?  Because many people can tell you of a story of someone they know that this happened to.  But the thing is, most people can only tell you ONE story.  And they don’t tell you all the stories they know about the infertile couples that adopted a child and didn’t get pregnant naturally afterward.  The examples of where it did happen are salient to them, perhaps because they remember thinking to themselves “This couple is going to have two babies within a few months of age of each other!”  What happens when something is salient – or when it produces a vivid memory – is that people tend to overemphasize the likelihood of its occurrence.  And they give it a lot of attention.

This is known as vividness bias.

The vividness bias is supported by what’s often referred to as an illusory correlation – the impression that two variables are related when in fact they are not.  In this example, because of one or two very salient or vivid examples, many people believe that there is a relationship between adoption and getting pregnant, when in reality, there is not.

(Extracted from: Intentional Interruption: Breaking Down Learning Barriers to Transform By Steven Katz and Lisa Ain Dack)

Similar to the case made for getting pregnant naturally after adoption, you may have heard a similar argument for couples who stop assisted reproduction and get pregnant naturally afterwards.  There is research that was published in 2012 that found that 17% of women who became pregnant, and gave birth, from IVF treatment, became pregnant again naturally (NB….within 6 years!).  For those women who were unsuccessful with IVF, 24% became pregnant naturally after stopping infertility treatment.

Other recent research has found that 16% of infertile women conceive naturally after stopping treatment (within 13 years!).  And by the way, let us not forget that a fertile couple’s chance of conception is 20-24% for every menstrual cycle!  So that 16% statistic still SUCKS.  In addition, the original cause of a woman’s infertility made a difference as to the chance of achieving a successful natural pregnancy after IVF – if the infertility was due to uterine, cervical or ovarian problems, endometriosis or infertility in their male partners, the women had a significantly greater chance of achieving a successful natural pregnancy after stopping IVF.  However in comparison, if the couple’s infertility was ‘unexplained’ or the problem was with tubal pathology, her chances of a natural pregnancy decreased 😦

So there are many illusory correlations out there in the infertility world.  And now you know how to respond to people that say to you:

“ohhh you will get pregnant naturally after adopting/stopping treatment, that happened to my friend/friend of friend”

you can reply

“……the evidence is contrary, my dear, and you are suffering from vividness bias”

It’s a whole lot politer, and factual, than – “F*#$ you”.

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Why can’t we make a baby? #NIAW

Why?  Why me?  Why can’t I make a baby like all my other friends and family? I have so many questions about why after almost 2.5 years of trying to conceive and failing miserably, month after month.  What have I done to cause this?  Why won’t my body just get pregnant? What am I doing wrong?

It’s human nature to want to know why things happen.  But these are the type of questions that run through my head round and round, continuously ever since we decided to grow our family.  I have yet to answer any of these questions.  It is exhausting.

Chris and I are 1 in 8 couples of child bearing age in the US that struggle with the disease that is infertility.  We tried the good old fashioned way – sex – for 11 months before we went to seek specialist help from a reproductive endocrinologist doctor after we discovered that Chris’s testosterone levels were “below normal”.  It turned out for us that testosterone levels do not actually matter that much when it comes to fertility.  Chris actually had super sperm, and lots of them!  But it did lead us to start the typical tests for diagnosing infertility.

We thanked our lucky stars that all our test results came back normal – there was nothing seriously wrong with either of us.  In fact, we passed all our tests with flying colours, we were top of the class!  But this put us into the category that 20% of infertile couples are diagnosed with – unexplained infertility.  This meant that the doctors could not tell us why we hadn’t been successful so far in trying to conceive the way they teach you at school.  We were about to embark on a journey that was going to take us beyond what they taught us at school – we were going to try to get pregnant with medical assistance.  We were heading into the world of the unknown.  We knew little to nothing about infertility.

At first it was difficult to explain to our friends and family why we were seeking treatment, because there was nothing ‘technically’ wrong with us.  The infertility was inexplicable!  It was embarrassing, it was awkward to explain.  So this is why I started this blog, to help us get over this difficulty in explaining what we were doing and why, as well as helping to explain our feelings about our disease in general.

Unexplained infertility in someways has been a good thing – there is always hope that this treatment will work.  But ultimately it is difficult to accept that there is just no known reason that this isn’t working for us.  In some cases, going through medically assisted treatment for infertility can reveal the explanation of a couple’s infertility.  But in our case, after 3 IUIs (Artificial Insemination) and 3 cycles of IVF (In-Vitro Fertilisation), 1 suspected ectopic pregnancy,  and over $90k of medical bills we are none the wiser as to why we do not have a baby in our arms yet.

Conception is a wondrous act of nature, but it is also an incredibly complex process  – there have to be many stars in line for a healthy baby to be born.  For something that is the very basis of our human race’s existence, we still know very little about the disease that prevents us from growing our families.  It’s incredible, right?

I am currently in the dreaded two week wait of our third (and final) IVF cycle.  If this cycle fails, apart from being devastated, I do not know how we will ever be able to move forward without knowing why this has happened, why medical treatment didn’t work for us.  Our infertility will never leave us.

For National Infertility Awareness Week (NIAW), the national non-profit infertility organisation Resolve is promoting this year’s theme #StartAsking.  The theme is about promoting the questions that we want to be answered, whether this is asking for our Employers to provide insurance coverage, asking for legislation that supports family building options or asking our friends and family to support us.  For me, the one question I have and want to raise more awareness about is to:

 #StartAsking for more targeted research on unexplained infertility.

Perhaps if we can understand more about how or why some couples are infertile, then better focused medical interventions can be developed to defeat infertility.

I want answers!!!! But we won’t ever get answers if we don’t talk about infertility and unexplained infertility.  It shouldn’t be a secret.  We can do this by speaking openly about infertility, by getting organisations like Resolve to help raise our community’s voice and build awareness.

If you would like to know more about infertility, please visit Resolve.org.

If you would like to help, you can contribute by fundraising or donating for Resolve.  Or just comment below with your questions and thoughts to join in the discussion!

wishniaw.png

Average number of blastocysts per IVF cycle

It’s a really simple question – what is the average number of blastocysts per IVF cycle?  After our failed IVF cycle I posted a status update in my local resolve support group’s facebook page, I explained what had happened with our cycle: 14 eggs retrieved, 11 mature, 11 fertilised, 2x 5 Day blastocysts transferred (5BB & 5CC) on Day 5, 9 still alive on day 5, but 0 were of sufficient quality for cryopreservation.   Some ladies commented how they had similar results with 0 embryos making it to the freezer, and one lady posed the very good question how common is it to have 0 make it to the freezer? Perhaps it is more common than we think?  So it got me thinking…at no point has my doctor said what a typical number of eggs, embryos or blastocysts she would expect out of a cycle for us – the only stats we were ever told was all about our likelihood of a successful pregnancy from 1 cycle of IVF, and ultimately, a live birth.  And of course, that is the only statistic we only really care about, right?  This holds true, until you get a Big Fat Negative (BFN), then the other statistics start to matter and grind at you.

So I looked into it, and asked google – what is the average number of blastocysts per IVF cycle?  But I couldn’t find an easy answer, or at least one that I held great confidence in.  I’m the kind of person who needs to see the supporting evidence, and not just some seemingly arbitrary numbers some random person has posted on a website.  But although I didn’t find any national statistics per se, what I did find, made me feel a whole lot better about our last cycle.

The statistics that the Pacific Fertility Center in Canada are claiming are [1]:

11 – Average number of eggs retrieved

9 – Average number of mature eggs

7 – Average number of eggs that fertilise (approximately 80%)

7 – Average number of fertilised eggs that will form embryos (98%)

7 – Average number of embryos on Day 3 of culture

3.5 – Average number of blastocycts on Day 5/6 (50% of good quality day 3 embryos make it to blastocyst)

It was not clear if this was their clinic’s statistics or where the source of this data came from.  So my confidence is not high in it, I don’t know over how many cycles or patients this average is calculated.  But at least it gives you a flavour of what numbers to expect.  Note, it does not mention average number of blastocysts making it to cryopreservation!

Another clinic, Advanced Fertility Center of Chicago, provides a nice pretty chart of their own statistics, broken down by age for the period of 2003-2005.  First of all my first alarm bell is that is over 10 years old now!  Has anything changed in Assisted Reproductive Technologies in the last 10 years? Hmmmmm.  Anyway, here it is….

ivf-eggs-embryos-babies

Advanced Fertility Center of Chicago’s average number of eggs, mature eggs, fertilised eggs, 8 cell embryos and Day 5 blasts [2]

Their numbers are slightly lower than the Canadian clinic’s…but there could be many reasons for this because, again, there is no clue as to how many cycles/patients this average is calculated over.  This clinic does publish their statistic of how many blastocysts make it to cryopreservation.  And here is the money shot statistic people!!!!

number-embryos-frozen-age

Advanced Fertility Center of Chicago’s average number of blastocysts frozen per cycle in 2010-2011 [3]

Just look at how low these numbers are! An average of 1.7 for women younger than 35 years old.  And this statistic is a little bit more up to date than the ones above – this was for cycles from 2010-2011.

So what is the point of this post?  The point is that we didn’t have any blastocysts that made it to cryopreservation, but we did have 2 blasts that were transferred and 1 that could have been frozen, but they decided it might not survive the thaw.  For our first cycle we had one blast make it to the freezer.  The point is, we had high expectations for more to make it to the freezer, when in actual fact the reality is, we were better than average to have so many good Day 3 embryos and we were typically average with transferring 2 on Day 5. Yes, IVF cycle 2 was a failure, but we were pretty average with our second cycle!!! This doesn’t mean we are less likely to succeed with cycle 3, rather the odds ARE in our favour.

Happy dance Dani!!!

stay the path

[1] Source: http://www.pacificfertility.ca/our-resources/guide-to-ivf-lab-results/

[2] Source: http://www.advancedfertility.com/ivf.htm

[3] Source: http://www.advancedfertility.com/cryo.htm

 

 

How to get the most out of your doctor

It took me about 24hrs after it was confirmed that I am pregnant to realise I do not know how to be pregnant.  This might seem very weird considering we have been talking about this moment for more than two years now.  Once we started trying to conceive I just of buried my head in the sand.  I didn’t want to jinx our chances by buying a book about it, and I started to avoid all pregnancy related websites and apps after 6 months of failing to succeed in our quest to make a baby.  I know the basics, like smoking is a big no-no, drugs are dangerous, avoid raw meat and reduce caffeine, but really, that is the limits of my knowledge.  So yesterday we went to the book store and bought two books on pregnancy.  One was the standard text book “Great expectations: Your all in one resource for pregnancy”, and the second was “Expecting Better”, beautifully demonstrated in this picture by Sushi:

Sushi, my book keeper

Sushi, my book keeper

This second book interested me because I have always wondered whether Japanese women stop eating sushi, or French women stop eating brie when they are pregnant.  Really?  I don’t think so.  I hope that this book will enlighten me to what the conventional wisdom really means.  But when I started reading the first chapter I didn’t need to go much further with it to be completely satisfied with my purchase.  Why?  Well the author, Emily Oster, is not so different from me, she was not happy with what her doctor was telling her.  I realised that my experience with my fertility clinic’s doctors and the feeling I had that there was a poor lack of communication.  All of this was because I was not asking the right questions.  I didn’t know I needed to ask them.  And this is silly because all along I had the key questions in the back of my mind…I use them everyday at work!!!

In my job I help leaders make decisions every day…I do this by presenting the evidence, the facts – for and against a decision – I do some analysis on the data that supports the decision, I try to be unbiased and objective in my analysis, and then I present a recommendation to the leader on the best course of action.  The leader doesn’t always go with my recommendation, but I have presented them with the facts and figures to make their own mind up.  Sometimes I feel a bit hurt, but then I remember, I am not the one taking the risk.  So when it comes to our healthcare and doctors, WE are the decision makers.  We need to be presented with the arguments for and against, and be told what the supporting evidence is.  WE are unique in many different ways and the decisions we make will be unique, blanket guidelines are not always appropriate for everyone.

I think a good example of this is when we were told we should do ‘ICSI’ because of our unexplained infertility.  We didn’t ask the questions:  What are the pros of ICSI?  What are the cons of ICSI?  What are the improved success rates with people like us? (i.e. what’s the supporting evidence/data?)   We were not armed to make a decision, we just went with what the doctor said, and in the back of my mind I felt like I had not been given a chance to make a decision.  I did actually do a lot of this research myself, but it would have been better if my doctor would have told me – after all I am not the medical professional, I just have the fortunate ability to interpret statistics from studies and experiments.  So although I was finally happy with the decision to do ICSI after my research, something inside me was niggling about our doctor’s communication.

Another example is when it came to our embryo transfer.  We were told that it is the standard practice at the clinic to transfer 2 embryos on day 3, unless there were over 6 fertilised embryos then maybe we would be a candidate for waiting to Day 5 to transfer 2 blastocysts.  We did not ask the questions: what are the pros of us waiting to Day 5? What are the cons of us waiting to Day 5?  What are our personal chance of success with 4 fertilised embryos compared to if we had had 6? (i.e. what’s the supporting evidence/data?).  Again, I did a lot of this research myself.

I could go on with other opportunities throughout our infertility treatment where I could have asked these three simple questions that would have revealed the knowledge I needed to feel like I was in control of making a decision.  We rely on doctors to make the decisions for us…and most of the time I am happy with that fact, but there were times that I felt like we should hold that responsibility for a decision.  When it comes to my pregnancy I want to be able to ask these questions to my doctors and nurses so I can take the responsibility for making some of the big decisions such as prenatal testing or birthing plans.

Emily Oster suggests reading the book “Our medical mind: How to decide what is right for you” by Jerome Groopman and Pamela Hartzband.  I think I might try it, and I’ll let you know how it goes.  Has anyone read this one?

In the meantime my friends, next time you are in a consult with your doctor, remember these three simple questions to help you make the best decision, for you, and get the most out of your doctor….

  • What are the pros (for me)?
  • What are the cons (for me)?
  • What is the evidence/what are the chances (for me in particular)?

Fertilomat.com – an experiment

At first I wasn’t  sure how I felt about this website: Fertilomat.com Initially, I was mad about it.  I was mad because I believe it was just targeting vulnerable women who are concerned about their level of infertility.  But then I thought, well it appears to be combining a whole bunch of medical research and turning it into a user friendly format for women to interact with, that’s got to be a good thing.  This website has developed a ‘predictive’ model that combines data from various research areas into fertility, such as effect of BMI, alcohol and caffeine.  But the big problem I have with this website is that they are not transparent with how the model is developed or what the potential error is.  This makes me suspicious.

Plus their business model sucks.  They charge women 19 Euros to view a two page personal report based on 23 questions about lifestyle.  The questions are very simple, such as weight, height, age, alcohol intake, caffeine etc. Although I can see that this model may have taken many hours of research and cost them a bit of money to develop, I feel conned because the research that they do cite is free to download anyway.  I also wonder how the authors of all the various research reports being used feel about their data being used to make money from women in this manner?  The website could have chosen a different approach and made money in other ways, by advertising on their website, or charging medical practitioners to use their model.  Maybe I am just biased…

So as a matter of interest I paid for the two page personal report providing me with my fertility score.  Quite frankly I was very disappointed.  First of all because for some reason the form I filled in reset to my height as 4ft and weight as 55lbs.  I am 5’8″ and 130lbs, so the output was useless anyway.  Here are the two charts that were included in my 19 Euro report…

Depressing...

Depressing…

Of the two pages of My ‘personal’ report, I actually received 1 1/2 pages of report. 1/2 page was dedicated to repeating back my answers to the 23 questions, the other 1/2 page were the two charts above.  Then the last 1/2 was some text pointing out that my BMI was far too low (of course it was because the interface was CRAP and assumed I was 4ft and 55lbs) and my fertility score is below average, and next year it will decline.  It also told me that it was good that I was avoiding alcohol because 1 litre of wine in a week can decrease fertility by 60% (thanks, I read that in the free research report you cited).  It told me: ‘the fact that you don’t smoke increases your chances of getting pregnant’.  Ummmm no that’s not how it works!!!!  Then the last paragraph filled up space telling me that If I want to know more about my fertility I should see a doctor/gynaecologist to check for further tests such as ultrasounds.  And that was it!!!!

Simply put people, and as I suspected, this is a CON: Fertilomat.com But I am glad I spent the 19 Euros because hopefully now I can share this so other women won’t!

Beer, Beer and more Beer!! Wait – should you really be drinking beer?

Beer – the cool, refreshing, golden nectar.  My first beer was admittedly at a young age of 13.  I hated it, but that’s what everyone else was drinking, so beer it was.  As my palette has grown accustomed to the varieties and tastes I have become a distant admirer of certain beers.  Particularly German Hefeweizen beers.  So during my 2WW it was difficult to come all the way to Germany and avoid the stuff…..so……here I am – two beers in hand!!!

Hofbrauhaus in Munich. Mmmm Beer!

Hofbrauhaus in Munich. Mmmm Beer!

Officially, Chris and I both gave up alcohol almost 17 months ago.  I say ‘officially’ because we have both had alcohol in these months as we have caved on occasion.  However, we have significantly reduced our intake of alcohol to maybe one or two beers/glasses of wine a month, if at all.  The reason?  Because ‘they’ tell us alcohol affects both fertility and the development of the foetus in the early stages.

It is logical, after all, if alcohol is capable of making you do silly things with your mind, then surely it can affect other things too.  I have no qualms in giving up alcohol, plus it saves on the purse, and reduces the calorie intake (never hurts).  There are many conflicting views about the impact of alcohol on fertility.

The UK Government suggests a pregnant woman, or a woman who is trying to conceive should drink no more than 1-2 units once or twice a week (ie one small glass of wine).  Their drink aware campaign (www.drinkaware.co.uk) website is quite informative about alcohol and fertility for both men and women.

One interesting bit of research I read about from Harvard University found that couples undergoing IVF found that women who drank more than six units per week were 18% less likely to conceive, while men were 14% less likely*.  Although this statistic sounds quite high you will only need to drink 3 times a week or more, that is quite a lot.  LAst time I drank that much was at University!!  Generally, I go with the school of thought that one small drink every once in while is unlikely to have any significant impact.  But as the stakes grow higher and more money is invested in our treatment, the more cautious I am about alcohol intake.

So what about that picture above with me holding two beers from Friday night?  Well they actually are not mine, they are the beers of my new colleagues.  BUT! I did enjoy three non-alcoholic Weizen beers!  Obviously the fact that I had three meant I must have enjoyed them.  It was only after one of my German students told me that he was taking a case of the non-alcoholic stuff back to Rome with him that I thought I should give it a go.  Usually, non-alcoholic beers remind me of the bitter taste of Beck’s non-alcoholic that was served when I was on my tours of duty in Afghanistan.  Beggars can’t be choosers, but that stuff put me off it all for several years.  Well at least until now that is.

The non-alcoholic beer definitely doesn’t give you that light headed happiness feeling you would ordinarily experience with the alcoholic version.  But throughout the night I realized that I felt comfortable drinking with my new friends without the pressure of feeling like I had to drink.  In fact near the end of the evening, one of my friends pointed to my glass and said to the waiter “I’ll have what she’s having”, I quickly pointed out it was non-alcoholic.  Obviously he immediately changed his mind, and looked disappointed at me.  He was disappointed because all along he thought I was keeping up with the lads without getting pissed and I was drinking them under the table!  But it was quickly laughed off and nothing more was said.

I think I will try these non-alcoholic options more.  In fact, a fellow blogger (the longest journey) came up with a cracking idea….to put some juice/fizz in a wine glass to give the impression of drinking wine.  Psychologically, that surely has to have the same effect as a non-alcoholic beer.  Well I’m going to try it and let you know 😉

At the top of Kofel in Oberammergau.

Bye Bye Bavaria!  Thank you for the beer discovery!

*Harvard University Website. Alcohol hinders having a baby through IVF, couples warned.

Accessed from: http://news.harvard.edu/gazette/story/2009/10/alcohol-hinders-having-a-baby-through-ivf-couples-warned/

Work in Progress…ARTApp

I successfully completed another module in my Data Science course! Woohoo!! Eight modules down, one to go. Now I have one week off of study, then onto the home straight.  I can’t wait to finish it.

Part of my final project was to develop an online web App; I decided to develop an App that uses the data provided by the CDC on Assisted Reproductive Technology and presents the data in more user friendly way.  I bit off more than I could chew for this project because the data the CDC provides is a bit messy and required some cleaning up in order that I could manipulate it easily.  Now I have ‘cleaned’ the data, I need to spend a bit more time making the visualisation useful.  I got 100% for my project so I passed with flying colours, but I have a lot more to do before I share it with a wider online community.  You can have a sneak preview!

You can see my ARTapp here.  It was supposed to look a bit more like this…

Screen shot of my ARTApp

Screen shot of my ARTApp so far

My idea is that someone can select a state they are interested in, it shows all the fertility clinics in that given state, then the user can select a fertility statistic they are interested in comparing their clinic against the state wide average.  There is also a map of the states that shows the statistic average for each state. This is just a prototype for now, I will keep working at it and include all data available from CDC, not just data for fresh embryos.  Also add in some more interactive charts for looking at ART data over time.

Now, wouldn’t it be good to know what the IUI stats are like too?

View the latest U.S. Fertility Clinic Data

What is the probability of IUI success?

Our Doctor told us that we have a 20% chance of success with our IUI treatment (Letrozole Day 3-7, Ovidrel trigger 36 hours before IUI procedure and progesterone suppositories (50mg) for two weeks after IUI).  After three rounds, that would be a cumulative chance of success of 60%.  But this probability is a calculated estimate based on many factors that our doctor knows about us.  For example, if you were diagnosed with unexplained infertility the probabilities of success are lower than if you have been diagnosed with an ovulation related dysfunction.  Age, number of years trying to conceive and sperm quality are all examples of other factors that will influence your probability of success.

Success rates for IUI?

Success rates for IUI?

There are many predictive models out there to determine likelihood of success of IUI.  Each model seems to be slightly different, but in general they tend to range between 9-23% success for unexplained infertility, and the important factors that determine this success also seem to vary from model to model.  This is probably the real reason why that if you were to google ‘the probability of IUI success’, you won’t find much of a straight or clear answer.

Why do I care?  The difference between 10% (a one in ten chance) compared to 20% (a one in five chance), is psychologically different and I’d like to prepare myself for these seemingly different odds!  I trust my doctor, but I want to know more about why it’s 20%.

I spent several hours trying to find something useful that explained the most recent stats.  But the website with the most useful statistics explaining the different probabilities is www.advancedfertility.com.  However, the website is confusing, statistics are hidden away in text paragraphs that require reading several times, multiple hyperlinks to different pages that break up ease of understanding, how recent is this information and it is not always clear where their statistics have come from.

If you google ‘the probability of IVF success’ there is a plethora of useful information and supporting data (because the govt mandates the data is collected by clinics), also there is a really good resource, Society for Assisted Reproductive Technologies (http://www.sart.org/) who summaries the most recent data at the clinic level and the national level.  They even have a patient level ‘Predict my success’ interactive tool.

So, I herby call for greater transparency and clarity on IUI success rates, similar to what can be found online for IVF success rates.  I’m not looking for exactness, just more openness.

If you know of good resources to help understand success rates of IUI, please comment below and share!

Research shows that age is not correlated with fertility…um OK

I’m back on my data hunt for my course project to develop a web app…and I came across a research paper that explored factors associated with fertility in a small district in India*.  The abstract of the paper begins with:

“This paper focuses on the cause and effect relations on human fertility. Here fertility is used as the number of children ever born for a woman….”

Alarm bells rang as soon as I see ’cause and effect….’.  But I was intrigued, so I read on.  The factors that this study looked at were ‘natural factors’ (including age of woman, age of woman at marriage, religion and type of family) ‘economic factors’ (including employment of woman and spouse, income of woman and spouse) and ‘knowledge factors’ (including education of woman and spouse).  I should now mention that this is clearly NOT a piece of medical research, rather came from a journal of anthropology.  Studies that look at non-medical factors can be revealing never-the-less, so here we go…
I loved the result that the more educated a woman and her spouse were the fertility rate lowered.  Basically you can possibly turn this around and say that the less educated you were the more likely you were to have children.  I think we can guess why.  But it is the way that the report concludes which makes it sound rather amusing…
“Conclusion: Higher employment, higher income of both husband and wife and nuclear family system could bring the reduction in the fertility level of the women in Kanyakumari district”

CORRELATION DOES NOT EQUAL CAUSATION – BAHHHHHH

I know that this research paper was probably trying to assess what causes the high birth rate in this particular district, but I think the translation and the way the conclusions have been made make this a paper a funny read if you are into that kind of geekery.  So Ladies – lose the jobs, dumb up your brain cells and knock a few out of your husband too, and don’t worry, age is not correlated with fertility, that is if we want to learn some lessons from Kanyakumari district!

Oh yes and here is another one of my favourite xkcds.

Cancer Causes Cell Phones – Duh!

* K. Senthamarai Kannan* and V. Nagarajan, “Factor and Multiple Regression Analysis for Human Fertility in Kanyakumari District“. Available at: http://www.krepublishers.com/02-Journals/T-Anth/Anth-10-0-000-08-Web/Anth-10-3-000-08-Abst-PDF/Anth-10-3-211-08-416-Kannan-K-S/Anth-10-3-211-08-416-Kannan-K-S-Tt.pdf

Statistics statistics – infertility and treatment – who to believe?

Did you know?? Over 1% of all infants born in the US are conceived using Assisted Reproductive Technology*.

Luckily I am an analyst by trade, so I am quite aware of the lies, damn lies and statistics.  I am quite skeptical when it comes to stats that don’t explain the data source.  A lot of websites quote stats and don’t tell you either where the data originated, how it was collected or how it was analysed.  So which stats can you believe?

I am undertaking a small project for an online course in data science – part of my project is to develop an online app.  The app can be anything I like, but it has to be an interactive tool using data.  Seeing as I have been looking at lots of statistics online about fertility treatments, I thought, why not design my own web app that allows a user to interact with all that data out there?  Hmmmm perhaps I am being ambitious.  But I have a couple of weeks to complete it – so lets see!  In the mean time, I have been doing some research on potential data sources…

The most up to date fertility treatment data I have found so far is from the Centers for Disease Control and Prevention (CDC).  (Ha! I didn’t expect to find the data here!!)  Apparently there is an Act that mandates all clinics performing Assisted Reproductive Technology to provide annual data to the CDC.  I think this data is THE most comprehensive (or certainly largest) source of data to understand the factors that contribute to a successful birth when using Assisted Reproductive Technology*.  The CDC has been collecting data since 1995.  All their data is freely available to download along with reports and interactive tables.  The most recent data released is from 2012, collected from 256 clinics with in the US.

When I was reading the CDC 2012 report that was published in 2014 I found an interesting stat that surprised me – In 2010 about 7.4 million women aged 15-44 received infertility services at some time in their lives.  That makes it about one in ten women of that age group.   If I look at all my friends and family on my facebook in that age group, that could be 12 of my friends affected somehow.  Woah.

Anyway, the data provided by the CDC gives stats on almost 98% of clinics in the US.  The link below (provided by the CDC website) takes you to an interactive tool that allows you to see the data for your fertility clinic – they probably report it on their website.  But you have to be careful when you look at the numbers and what they all mean.  I’d highly recommend reading the whole report to help understand it all.  I did not see this data before we decided which clinic to use.  To be honest the number of choices for us weren’t particularly big, but we did have a choice.

The data looks good for my project, I just need some ideas on how to make a useful app out of it.  If anyone has any suggestions on what they think would be a useful way to see the data I’d be interested to hear from you.  I’ll keep you updated on my stats research as I come across it…

Ps. Hope this post wasn’t too geeky!! I can be quite geeky sometimes.

View the latest U.S. Fertility Clinic Data

*Note. The CDC define Artificial Reproductive technology as a procedure that involves surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning then to the woman’s body or donating them to another woman.  They do NOT include treatments in which only sperm are handled (ie. IUI) or procedures in which woman takes drugs only to stimulate egg production without the intention of having eggs surgically retrieved.