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Infertility Advice

Update at the Bottom

I recently sent along an episode of Reply All to Noemi because it spoke about money.  I had paused it midway through the episode when I got out of the car in the morning, and returned to it in the afternoon.  In between, I sent the email.  I would have still sent the email, but now hearing the end of the episode, I would have written a very different message.

The episode was about people listing their financial transactions online.  You can listen to the episode, if you want, below.  The part that gave me pause came at 13:45.  The woman is talking to someone who charges others to give them advice.  She asks him a question about PCOS.

The situation is that she was diagnosed with PCOS two years ago.  She is now in a committed relationship.  She tells the advice giver that having PCOS means that she is infertile and will be unable to have children.  She asks him if she should tell her boyfriend now that children aren’t in their future.


Hold up.

Who told her that PCOS equals infertility?  PCOS is a common diagnosis for infertility — about a third of all infertility diagnoses are PCOS-related — but not all women who are diagnosed with PCOS will be infertile.

It’s also an issue that has possible solutions.  If you look at the various reasons for female factor infertility (missing or blocked fallopian tube, endometriosis, uterine anomaly, etc), it’s a problem usually solved with less invasive treatments such as oral medications.  It’s a diagnosis that many times allows doctors to ramp up slowly to IVF instead of heading straight to embryo creation without passing go.

I’m not minimizing PCOS, but a PCOS-diagnosis is not a single lane road to infertility.

The advice giver tells her to be upfront and tell her boyfriend.  It’s not terrible advice — I’m all for openness in relationships and she should tell her partner her known medical history — but it’s uninformed advice.  He doesn’t point out that she should still be careful about having unprotected sex unless she wants to have children because she is fertile until proven otherwise when it comes to PCOS.  He doesn’t point out that PCOS is often treated successfully with Clomid and Metformin.  That the average 20 – 24 year old has a 20% chance of getting pregnant, lower than the success rates of Clomid/Metformin or IUIs for women with PCOS.

I only knew this was uninformed advice because I knew generally about PCOS.  Which made me wonder: How many other advice columns do I read and nod along with, believing it to be good advice because I don’t know better.  Whereas someone, somewhere else, is cringing as they read the advice, knowing that it’s just… wrong.  Or even when it’s right, it’s uninformed, a shot in the dark.

This advice thing is serious business, especially because we are so open to gathering the thoughts and feelings of other people when we’re struggling to make sense of our lives.  What else is the comment section except a receptacle to catch all the advice and feedback that floats out of the reader’s mind as they read the post?

It definitely gave me pause.

And it totally wasn’t what the episode was about.

Update: I think it makes a strong case for why situation-specific advice columns work and general advice columns are hit-or-miss.  I feel safer asking for advice and accepting advice from someone who is speaking from experience vs. someone outside of the situation.  I don’t need the person to have gone through the exact same thing, but… I mean, would an 80-year-old woman want advice on how to deal with an age-specific situation from a 20-year-old?  Probably not.  So why should a woman with PCOS take advice from a random man?

Side note: Tomorrow is #Microblog Monday.  Get writing.


1 Amel { 07.05.15 at 10:48 am }

Hmmm…food for thought about not knowing better.

I have a friend with PCOS who managed to get pregnant and have a child. Even from her teenage years, her period was really random and rare in between, so she knew from the start that she had some trouble. She went on medication and now she’s got a 5-year-old. Another friend was diagnosed with PCOS much later in life. Went on medication, but it only made her bleed, so she stopped it, but she’s still hoping to be able to get pregnant naturally someday.

2 KeAnne { 07.05.15 at 1:24 pm }

You make really great points. I read “Dear Prudence” weekly and while I generally think Yoffe does a great job and consults others when needed, she isn’t an expert and who is it say those she consults are as knowledgeable as they should be too.

3 Cristy { 07.05.15 at 3:00 pm }

Lori and I had a similar conversation following a Dear Abby post about an adoptee struggling with the knowledge of her adoption. Abby’s advice was terribly wrong and I’m glad Lori responded. But it’s made me realize that advice columnists can often be wrong. Part of this is handled in the comments section, but I believe another beauty of the online community is that there’s the potential to address the bad advice. Still, I agree with you.

4 Queenie { 07.05.15 at 3:09 pm }

For that reason, when I am looking for advice, I try to seek it out from multiple viewpoints. Because with anything in life, mileage may vary, right? It doesn’t freak me out that I or others may be “wrong” in giving or taking advice– it’s no less valid because it may be different than my acTual experience.

5 torthuil { 07.05.15 at 5:18 pm }

I would never take advice from someone unless I know they have expertise on the subject (that includes expertise on me, lol). And people can know a lot about one thing without knowing much about something else. For example our birth doula did a wonderful job of giving support and advice during labour, and I would certainly recommend her and/or hire her again if needed. But afterwards we connected on Facebook, and I learned that outside of the birth world she has a lot of ideas I don’t agree with. I respect her right to have her own opinion, but outside of labour and birth I won’t be asking her advice on most things!

6 Lori Lavender Luz { 07.05.15 at 5:43 pm }

Ruh roh. As someone who is now writing an advice column (what *I* would do given a situation), this is a reminder to be very clear about facts and opinions. And to check facts.

7 ANDMom { 07.05.15 at 6:11 pm }

I think especially when it comes to uncomfortable or personal subjects, there is more bad and wrong info out there than good. In the past 18 years, I have found very little reliable information about endometriosis – even from “reliable” sources (including actual practicing physicians). Which makes me know that my family and friends only get the bad information and have zero comprehension of what the disease actually is to me. (Which, granted, mine is on the very extreme end of things, but still.)

I do often wonder about people who write to advice columns – do they really sit around not taking action waiting to see if someone responds?

8 Working mom of 2 { 07.06.15 at 12:08 am }

Yikes. I would hope the woman who was seeking relationship advice would go elsewhere for medical advice.

As to why anyone would seek a columnist’s advice…well, I have considered it before. There is an unusual problem/ situation in my family that I have considered writing to someone about. It makes more sense for unusual situations where there’s not a lot of (or any) support groups or therapists specializing in the problem.

9 Stephanie (Travelcraft Journal) { 07.06.15 at 10:41 pm }

Did you end up commenting on the episode? I always wonder what to do in those situations. Should you (I) say something? Or trust they’ll figure it out some other way?

10 Lisa { 07.09.15 at 11:31 am }

Last year our office was par of an international news story. It was a good uplifting story, not a scandal or anything, but definitely medical. I was ASTOUNDED at 1) the misinformation that the media put out there all over the darned WORLD and b) the way that people interpreted said misinformation. I reacted the same way you did to this advice giver. If this is what I’m hearing about a subject I KNOW about, what kinds of junk am I taking home from a subject I’m learning about on TV/the internet/the radio/a podcast? I do a lot more dissecting of “all the things” now.

(c) 2006 Melissa S. Ford
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