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Words are powerful; just ask anyone who has recently heard the word "infertile" applied to their personal situation. Confusion surrounds medical terminology in many arenas, and reproductive medicine is no different. In the New England Journal of Medicine, several letters to the editor took issue with a study published in the January 1999 edition. The large clinical study, Efficacy of Superovulation and Intrauterine Insemination in the Treatment of Infertility (Guzick DS, Carson SA, Coutifaris C, et al. N Engl J Med 1999;340:177-83. ), compared commonly-used fertility drugs and procedures in regards to the conclusive occurrence of pregnancy.
Letters called for attention by the study's authors (and other practitioners), recommending careful consideration be made regarding the use of certain terms when referring to or speaking with patients who are having trouble conceiving. Such consideration would lead to better understanding by patients of their own conditions and situations, thereby enhancing relationships between patient and practitioner.
As the letters to the editor indicate, there can be cultural differences in the use of words or terms, differences which may have powerful impact. In the United States, where this website is published, the word "infertility" is used often intermittently with "subfertility" and "sterility"; however, each has its own subtle and sometimes dramatic distinction.
According to the study authors in their response to the criticism, "In the United States, infertility is usually defined as the inability to conceive after one year of unprotected intercourse." Add to that the further definition of recurrent miscarriage as infertility, plus the inability to conceive again after one successful conception (secondary infertility). However, the authors go on to note that in many other countries and even among the general public in America, "infertility" and "sterility" are used synonomously. The impact of such word use is obvious, not only in the disciphering of study results, but also in the lives of people who are directly affected by the labels.
© Tracy Morris
