She has signed a form declaring that she was aware that the treatment was unproven and unlicensed for use in pregnancy; and that steroids have potential side-effects ranging from psychosis to liver failure. Yet, she sits there – out of desperation – hoping that the unproven treatment will protect her twins that she has been carrying.
After years of infertility and a miscarriage, Sophie decided to put her faith in reproductive immunology – a field that could be promising or utterly bogus, according to critics. But with advocates such as women who have had a healthy baby after four or five losses, Sophie figured she had nothing to lose. After all, she was constantly told to just try again.
A long standing problem since antiquity
Infertility has always been a human, medical and social problem since the beginning of human existence. Since the first records of treatment of gynaecological disorders in the Egyptian society in 1900B.C., conception was not considered divine punishment but an illness to be diagnosed and treated.
But even with a longstanding interest in fertility issues, there is still a caveat in the understanding of the causes of infertility fully.
A renewed interest in infertility began in 1965, when it was realised that the baby boom generation began to come of age and there were delays in childbearing. Scientific advancements and technology to assist infertile couples to bear children propelled.
With the birth of Louise Brown in 1978, the first “test tube baby”, conception techniques received the much deserved interest.
But fast forward 39 years, infertility issues are still not as understood as experts thought it would be.
The field that is reproductive immunology
Up to one in four pregnancies end in miscarriages and one in 20 women experience two losses. One in 100 suffers from recurrent miscarriage: three, four or even 10 failed pregnancies.
American physician Dr Alan Beer attempted to provide an explanation to the rates by popularising the idea that a woman’s own immune system might be responsible for miscarriages, infertility and failed IVF cycles.
He argued that natural killer cells, which usually destroy cancer cells and viruses, could get out of control and target the pregnancy.
“Effectively, women become serial killers of their own babies,” he said.
He then prescribed steroids to suppress the immune system and injecting women with new antibodies derived from donor blood before drip-feeding them intralipids, which are thought to bind with NK cells and prevent the release of toxins.
There is some scepticism behind Beer's theory as NK cells are naturally found in the bloodstream and during the first trimester – when most miscarriages occur - there is no blood circulating in the early placenta to supply the baby.
But studies still show steroids boost the chances of having a baby by 20%.
For Sophie, she suffered from Hashimoto’s thyroiditis and once she was put on steroids, she naturally conceived twins after the first month.
Such is the strange landscape of the fertility industry: doctors are prescribing steroids to pregnant women, but sceptics are too doubtful to back a study into their effects. Meanwhile, the patients trapped in between are making extreme medical decisions guided by private clinics and online fertility forums.
Numbers versus emotions
Scepticism for such a treatment is normal. But Dr George Ndukwe, one of the pioneers of Beer’s methods in the UK said that the proof was in the outcome – the treatment increased the chances of having a baby by five times.
“It does not matter what people say. If what you’re doing is working, there are more babies. If it’s not working, there are no babies. There’s no half-baby, no quarter-baby, only a full baby,” he said. He has also claimed to have 2,000 babies born under his immune treatments.
A few weeks after her intralipid infusion, Sophie miscarried her twins. A follow-up scan revealed an empty womb. But despite her grief, Sophie was not ready to give up. She started on another round of steroids and became easily pregnant again.
She received another infusion of intralipids and thought about the pregnancy as little as possible.
In November last year, Sophie managed to pass the first trimester with no problems. But it still proves nothing about steroids or the intralipid infusion.
Perhaps the reality is that scientists and patients have fundamentally different views on what makes a treatment worthwhile – while scientists think in numbers, patients think with emotions. MIMS
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