How do you measure if a treatment is successful?

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Every week I see couples who are trying to conceive. Prior to seeing me, they have consulted widely as to what strategies supposedly lead to success. There is no shortage of “expertise” out there! Sometimes it’s your know-all friend in the tea room, or a natural therapy person, or a GP, or Doctor Google. I’m always amazed when a particular treatment or strategy is billed as having a “100 percent success rate”. How could anyone believe that?? How can the people that write that stuff expect anyone to believe them? If they were right, no-one would have to do anything else!

Another one of my favorites is “I have seen hundreds of couples over the years and once they took xxxx, they got pregnant.” This kind of statement is generally the basis for segments on popular current affairs TV shows, or articles in popular magazines. But did the potion in question lead to pregnancy, or would it have happened anyway?

So let me ask you some simple (?) questions:

  1. How do you (or serious researchers) work out whether a particular strategy led to pregnancy, or whether it was a coincidence – that is, it would have happened anyway?
  2. How would you decide whether an “expert” is really an expert in the area they profess to be?
  3. How would you define a treatment as “successful” anyway?

HINT: the answers are NOT things like “my friend knew someone who took it, and it worked” or “they were interviewed in the national media, so they must be an expert”.

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