This story reports on a retrospective study looking at a form of massage therapy that is designed to treat infertility, with the claim that it is an alternative to surgery or in-vitro fertilization (IVF) in dealing with blocked fallopian tubes. The theory is that massage may help remove adhesions— scar tissue that forms after surgery, infection or trauma and can block fallopian tubes, preventing pregnancy. This concept may have appeal for women who wish to avoid invasive treatment. The story earns points for including a valuable comment from an infertility expert, who rightfully points to some of the many limitations in the study used to back the claim that massage therapy is effective for tubal infertility. However, its quantification of benefits, which doesn’t factor in the high number of women who were never contacted for follow-up on their results, will likely leave readers with an inflated sense of the effectiveness of this approach.
Couples who experience infertility are sometimes desperate for solutions, so having an alternative, less invasive form of treatment is very attractive. If massage works to increase fertility — and it’s not clear that this report of a study can adequately conclude that — it could be a safer and less expensive option than traditional surgery or IVF treatments. The story rightfully identified some of the key problems with this study — that it was retrospective, didn’t control for confounding factors, and was entirely conducted by the company marketing its brand of massage therapy — all elements which may tend to inappropriately raise expectations of effectiveness. Female infertility is a serious problem that can be costly in its emotional toll as well as the expense of treatment. Readers deserve responsible reporting of results of research on infertility; anything less adds to the burden of suffering.
The story tells us that the Clear Passage Therapy costs $6,000, takes about 20 hours of massage, and may be covered by some insurers.
The report tells us that the massage treatment of 1,392 infertile women showed a “60 percent success rate in opening at least one fallopian tube and a 57 percent pregnancy rate for women whose tubes have opened.” Those numbers seem compelling but we aren’t told what the alternatives (IVF or surgery) produce. The major problem with the 60% or 57% number is that the study had a very high dropout rate, something that’s not obvious from the published paper, but which the story could have identified with a little digging. There were 680 women with blocked fallopian tubes, yet only 235 were ‘followed up’. What that means is two thirds of the women in the study couldn’t be contacted at the end of the study to see if they managed to get pregnant or not. Of the 235 who were contacted, 143 had managed to clear blocked fallopian tubes. What should be the denominator here, 235 or 680? If you think it’s the 680 women with the blocked fallopian tubes, the success rate is 143/680= 21%. If you consider only the women they were able to contact, 235, then the success rate looks much larger, 143/235= 60%. Women who had success with the treatment were probably more inclined to respond to a questionnaire from the company, so this latter number is likely skewed in favor of success.
It seems reasonable on the face of it that there is little harm from massage therapy. But when the treatment is described thus: “we’ll hold that stretch until the tissues and adhesions start to deform and give way,” it is not unreasonable to expect some consideration of potential harms. We’ll give the benefit of the doubt.
This study had important limitations including a retrospective design and high dropout rate. So it was very good that a source unconnected to the trial could weigh in with quality criticisms on the state of the science. Dr. Joel Batzofin, a fertility expert said: “The results were good in some sections, but it’s not scientific in the sense of a prospective, randomized, controlled study.” The story could have riffed on that comment and reminded the readers that some studies are better than others, and a retrospective study, with only about 30% follow-up may have serious biases which can skew the results.
The impact of the problem of infertility was not exaggerated.
The main thing that saved this story from being an advertisement for Clear Passage Massage therapy was the inclusion of Dr. Joel Batzofin, a fertility specialist at New York Fertility Services. He clearly laid out some of the key factors that could influence the results of this type of research:“They [the patients] were not stratified by disease type, by age, by duration of infertility, by body weight, smokers versus non-smokers, ever pregnant versus never pregnant, male factors— these are all things that have a profound bearing on results.”
The actual study that this story is based on compared the massage therapy against national rates of success of IVF and surgery. Including those numbers in the story was very important because the curious reader is going to ask: if this massage therapy is effective, then how effective is it compared to what? We don’t learn about this vital information from FoxNews.
There was no mention of the availability of Clear Passage massage. How many clinics do they have and where are they located? Do they operate nationwide?
We don’t think the story is exaggerating the nature of the ‘newness’ of the massage therapy. The story seems to have been prompted by the publication of the referenced study.
The story clearly represents the views of the staff of the clinic offering the service, and the positive results obtained by one patient, which suggested there might be a news release behind this. The addition of an unconnected scientist weighing in on the study is good evidence the journalist went beyond any such news release.