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Zdzisław Krasnodębski: “In vitro does not cure infertility.” We explain

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The removal of the citizens’ bill “Yes to in vitro” from the parliamentary freezer has renewed the discussion on the in vitro method. As part of it, PiS MP Professor Zdzisław Krasnodębski stated that “in vitro does not cure infertility.” The expert explains why this statement is “immature and a form of manipulation.”

In the Sejm of the new term from November 22 work in progress on the citizens’ bill “Yes to in vitro”, which proposes a return to government financing of the in vitro procedure for couples struggling with infertility (such a program operated in Poland in 2013-2016). In connection with this project, there is a renewed discussion about the in vitro method – its effectiveness or moral objections to its use. The speeches included Zdzisław Krasnodębski, PiS MEP and professor of sociology. November 22 he wrote on x.com (formerly Twitter): “IVF does not cure infertility. Couples remain infertile after using this method.” The next day, he devoted several posts to the topic of “a large industrial sector, generating huge profits, producing people to order and experimenting on human embryos.” His entry from November 22 gained over 420,000 likes. views.

Post on the profile of MEP Zdzisław Krasnodębski from November 22, 2023 x.com

“No drugs will cure cystic fibrosis. Should we ban the treatment?”

The post of the PiS MEP sparked reactions from Internet users, many of them were outraged. “Just as the medications that the Professor takes for high blood pressure do not cure high blood pressure… when will you stop taking them?”; “but they give you the opportunity to have your dream, long-awaited child. And what do you think about in vitro?” – commented (original spelling of all posts). But some supported the professor, mocking, for example: “Left-wing MPs argue on TV that he heals.”

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Some time after the publication of the quoted post, the administrator of the MEP’s account blocked the possibility of posting comments. Many users therefore referred to the post by sharing it. “The stupidest argument I’ve ever heard”; “When will older men finally stop dealing with topics on which they have nothing intelligent to say?”; “The definition shows that the basic feature of infertility is the inability to get pregnant and have children. If medical procedures are used that change this state of affairs and lead to the birth of a child, they can undoubtedly be considered treatment,” they wrote.

Some Internet users noted that some diseases cannot be cured, but treatment is possible. They wrote sarcastically: “Insulin does not cure diabetes. After using insulin, diabetics still remain diabetics”; “Dialysis does not cure kidney failure, after dialysis, people with kidney failure remain people with kidney failure”; “Transplantation does not cure the diseased organ. Prohibit it!”; “No drugs will cure cystic fibrosis. I understand that we should ban the treatment?”

Some, sharing the post of the PiS MEP, shared stories about their experiences with in vitro: “From my own backyard, I know people who, after several years of trying to use in vitro, now have a child – other methods did not work (also the natural one, in which many people died ). Then they came in with the second child – but somehow it helped in this case”; “My friend, after many years of trying, got pregnant only using in vitro fertilization. The next pregnancy, less than a year after the birth of her daughter, she became pregnant normally and this is a true story.”

Still others pointed out the mistake made by prof. Krasnodębski. “Infertility and infertility. Find the differences” – he stated journalist of “Gazeta Wyborcza” Paweł Wroński. “In vitro is a method of fighting infertility, not infertility. These are two different things. It cannot treat infertility” – he noticed Michał Protaziuk from onet.pl.

Does the available medical knowledge and doctors confirm the PiS MEP’s claim?

Infertility and infertility. What is wrong with the PiS MEP?

First, let’s explain: “infertility” is a medical term describing a disease entity. According to definition World Health Organization (WHO) included in the International Classification of Diseases (IDC 11) infertility is a disease of the male or female reproductive system characterized by the inability to get pregnant within 12 months of regular unprotected intercourse.

However, infertility, which was written by prof. Krasnodębski is not a medical term – this word functions in everyday language; by some it is used interchangeably with the term infertility.

“Infertility and infertility are two similar terms, often used interchangeably in everyday language. However, this is a mistake because, although both refer to problems with conceiving a child by a couple, infertility, unlike infertility, is an incurable condition” – explain Bocian infertility treatment clinic. Similarly distinguishes these two concepts Invicta infertility treatment clinic: “we talk about infertility when you are unable to father a child”, while infertility “is most often a problem that is subject to treatment”. We talk about the latter “when pregnancy does not occur within a year of regular intercourse between the couple without the use of contraceptives.”

In an interview with Konkret24, the differences between infertility and sterility are explained by gynecologist and obstetrician Dr. Hab. n. med. Rafał Kurzawa, president Polish Society of Reproductive Medicine and Embryology (PTMRiE). Professor Kurzawa deals with infertility treatment and gynecological surgery.

– The distinction between infertility and infertility does not really exist in the world’s scientific literature. The disease of infertility has its own ICD code and we should use this medical term. However, it is customary to divide the Polish language into infertility, i.e. a reduced chance of getting pregnant and giving birth to a child, and infertility, where this concept is completely binary, i.e. the couple has no chance of getting pregnant naturally – explains Prof. Snowstorm. According to him, in each of these variants – infertility and infertility – you can try to treat the couple in such a way as to restore fertility, or you can treat them in such a way as to increase fertility (in the case of infertility) or use a method that will help you bypass infertility. – We use all these methods depending on the patient’s situation. In both cases, we use methods that are unrelated to in vitro, but in the case of absolute infertility (i.e. infertility), we have a smaller arsenal of options for using conservative methods and we more often use methods related to medically assisted reproduction – explains the expert.

“Some things are treated in such a way that the risks and consequences of a given condition are reduced”

MEP Krasnodębski stated that “in vitro does not cure” because “after using this method, couples still remain infertile.”

However, in vitro is presented as a method of treating infertility. This is how it is presented by those operating in: Poland clinics treatment infertility offering in vitro. The Invicta clinic’s website claims that “IVF does not cure infertility” presented as a myth. “In medicine, depending on the disease entity, causal or symptomatic treatment is used,” we read in the arguments of the specialists of this facility. “There are many diseases in which it is impossible to remove the source of health problems, but their effects can be effectively eliminated. This is the case, for example, in people with kidney disease who require dialysis, diabetics who need external insulin supply, or patients with heart defects who artificial valves are implanted. Medical treatment solves the problem, but does not make the organs suddenly healthy. However, no one questions the fact that patients undergo treatment,” explains the clinic. The authors of this explanation argue that in the case of a disease such as infertility, “the use of medical procedures that change this state of affairs and lead to the birth of a child can undoubtedly be considered treatment.”

American Mayo Clinicthe best hospital in the world in 2023 by ranking the American “Newsweek”, informs in its materials that in vitro “is a method of treating infertility”. British National Health Service (NHS) stands out the three main types of infertility treatment: medications, surgery and assisted conception – including intrauterine insemination and in vitro fertilization.

“Infertility can be treated with medicine, surgery, intrauterine insemination or assisted reproductive methods” – explain in turn, the American agency Centers for Disease Control and Prevention (CDC). He mentions in vitro as one of the methods of assisted reproduction.

Of course, in the medical community itself there are voices against the idea of ​​in vitro treatment of infertility. When the portal reader Practical Medicine asked the editorial office: “why the in vitro fertilization method is referred to as infertility treatment”, the answer was provided by prof. Violetta Skrzypulec-Plinta, MD, PhD, obstetrician-gynecologist, vice-rector Medical University of Silesia in Katowice. First, she explained what in vitro fertilization was, then added: “The use of in vitro does not increase the fertility of either partner, so calling it an infertility treatment method in this sense is not entirely correct. However, this name is used colloquially, because it often enables couples who have not been able to conceive and give birth to a child despite using other methods, which is the main goal of these couples.”

We asked Professor Rafał Kurzawa, president of PTMRiE, whether in vitro is a method of treating infertility. He answers with an example: – Let’s imagine that we have a patient with a urinary tract infection. She is given antibiotics: she is treated, there is no urinary tract infection – she is cured. We also have a patient who has anovulatory menstrual cycles, we administer the drug, restore ovulatory cycles, and the patient becomes pregnant. We stopped the medications and she started having anovulatory cycles again, and she got pregnant naturally. Did this treatment cure her of her anovulatory cycles? NO. Another example: we have a patient with diabetes. This patient must receive insulin in order to function properly and avoid atherosclerosis and other complications of diabetes. Does insulin treat her diabetes? NO. Insulin enables it to function normally. When we stop taking insulin, all the dangerous consequences of diabetes can occur.

Then he explains: – There are many therapies in medicine that are replacement therapies or specific bypasses that bypass the problem and allow people to function normally. It’s exactly the same with in vitro. If a woman has blocked fallopian tubes or no fallopian tubes at all because they were removed for some reason (for example, she had two ectopic pregnancies in both fallopian tubes), how else can she get pregnant if not through in vitro fertilization? Currently, no one has yet invented a method of tubal transplantation in such a way that the patient could get pregnant naturally. When an egg is naturally fertilized, the first stages of embryonic development take place in the fallopian tube. How else will such a patient get pregnant if not through in vitro fertilization? There is no alternative to it today – says prof. Snowstorm. – So either she decides to be childless or adopt, or she undergoes treatment using the in vitro method, which is a medical procedure with proven effectiveness, incidentally the highest of all those used today, and thanks to which she will have a chance to have a child – she adds.

Professor Kurzawa assesses MEP Krasnodębski’s claim as follows: – This is a statement that, in my opinion, is immature and is a form of manipulation. The question is whether this is intentional manipulation or ignorance? It is also a bit thoughtless, because if the MEP thought about what treatment is all about, he would notice that some things can be cured, some things cannot be cured and they are treated in such a way that the risks and consequences of a given condition are limited, giving the patient a chance to live in comfort or to live at all.

– The aim of currently used therapies – this applies to all diseases, taking into account the fact that medicine has its limitations – is to improve the quality of life of a sick person. Likewise, medically assisted reproduction methods, in the vast majority of cases, actually replace the process of natural conception in the laboratory, which, for various reasons, cannot take place in a woman’s body – concludes Prof. Snowstorm.

Main photo source: Piotr Nowak/PAP/x.com

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