Fertility Massage: an Unethical Practice?

Abstract

Infertility is defined as not being able to get pregnant after one year of unprotected intercourse (or six months if a woman is 35 or older).(1-3) Women who can get pregnant but are unable to stay pregnant may also be infertile.(1-3) Reported prevalence of infertility rates vary, but most are around15% of couples after one year of unprotected intercourse.(2,3) Fertility decreases with age for both men and women, declining around 35 years.(3) For women, by the age of 40 their fertility has decreased significantly and some report this as falling by half.(3) Pregnancy success rates (or conception rates) can be reported by cycle (e.g., the rate per month) or cumulatively (chances of conceiving over a period of time). These rates are very different, and care needs to be taken to ensure clear reporting of rates so that confusion does not occur. Rates are also different for natural conceptions and assisted reproductive conceptions (e.g., in vitro fertilization (IVF)). Reported cumulative natural conception rates are used less in the literature and are based on having vaginal intercourse each month over a 12-month period. Both forms of reporting for natural and assisted conceptions show a similar trend, whereby younger women have a greater chance of conceiving and older women have less chance.(1,2) Infertility can affect the couples’ psychological well-being and sexual relationship(4) and cause significant personal anguish.(2) The overwhelming desire to conceive and the psychological stress that accompanies infertility mean that these couples/ individuals are a vulnerable group and, as such, there is an ethical, moral, and legal requirement for professional, open, and truthful promotion, marketing, and advertising about the benefits of infertility treatments. This includes the potential role of massage for the treatment of infertility. Massage specialization seems to be increasing as massage therapists hone their skills in a particular area and as they distinguish themselves from their competitors. One area of specialization is infertility massage. The aim of this commentary is to discuss the evidence, or lack thereof, for infertility massage, the implications for treatment, and the risks and ethical issues associated with the promotion, advertising, and treatment of fertility massage. Massage aND PsyChOlOgICal sTRessINDUCeD INfeRTIlITy