Cindy_bookcoverbaby_3 I have been asked to review a new infertility book. It is “Having a Baby… When the Old-Fashioned Way Isn’t Working,” by Cindy Margolis. I was contacted by Megan Swartz, apparently a publicity type of person at Penguin Books; Ms. Swartz tells me that “you are the audience that Cindy wrote this book for.”

I’m not sure Ms. Swartz is correct here. We infertility bloggers are a very tough crowd, and by the time we start blogging, I think most of us have done more than our share of research. We’re also a tough crowd because many of us started blogging or reading blogs because our experiences have been unusual. We turn to the internet for information about our unusual outcomes, puzzling or lacking diagnoses, or difficult circumstances and so while a basic primer on infertility has an audience, I believe that we are not it.

So. The first thing you encounter when opening this book is Cindy Margolis herself. I must admit that I had never heard of Cindy and am immune to her fame. According to her own website:

Cindy Margolis (http://www.cindymargolis.com/) is the perfect celebrity spokesperson for RESOLVE and to be the ‘Face of Infertility’ as she has the attention of such a wide variety of audiences and markets all over the world. She is loved and respected for her leadership, beauty, Internet feats and passionate infertility awareness, education and support. A true American success story, the most popular celebrity on the Internet, Cindy is also an accomplished Supermodel, Actress and Author.

(Rampant capitalizations not mine). Apparently, Cindy Margolis had a popular website in the mid-90’s and she now claims to be the “most downloaded woman” on the internet. I’m not sure how much she can take credit for her, uh, downloadability, since it seems to correlate with her state of undress. I encountered Cindy naked and paired with keywords like “w.et pa.nties” when I did a quick Google search. So the “internet feats” sound a little bit ridiculous and are impossible to substantiate.

The book has a first-person, girl-to-girl feel to it. The book’s introduction opens with “Do not pass go. Do not collect baby!” which was kind of a big “uh-oh” for me right there. In addition to her high opinion of her own popularity, Cindy also has high hopes for her involvement in the infertility cause. She says that the “issue of infertility is stored on the highest shelf of a very deep closet,” but assures us that “I’m here to change that.”

The book contains a foreword by her RE, Dr. Snunit Ben-Ozer, and Cindy’s introduction. The book then tells Cindy’s story, which consists of the usual phases. Not getting pregnant, tests and diagnostic procedures, a few IUIs, three IVFs and then what I believe was ZIFT which resulted in a pregnancy which came to term. The rest of the book examines donor gametes, surrogacy, adoption, costs of infertility procedures and then the book concludes with her husband Guy’s perspective and other miscellaneous encouragement.

I have some strong complaints about this book.

Cindy’s stated purpose is to shed light on infertility in two ways. The first is for a celebrity to “come out” as an infertile and share her experiences, which is meant to lessen the stigma around infertility. The second is to teach and inform about infertility procedures. Cindy accomplishes the “coming out” well. While I am not impressed by her celebrity, some may be, and she does share personal and emotional details like wanting to skip a photo shoot because she’s bloated from cycling, checking to see if her period has arrived in humorous ways, and her emotional reactions to the gradual realization that unassisted fertility isn’t available to her.

However, Cindy butchers her science. While her doctor is listed as “medical adviser,” mistakes abound. First is her insistence on referring to “embryo implantation.” Does this bug anybody else as much as it bugs me?

If shooting the embryos into one’s uterus in a catheter means we could implant them, we’d all be pregnant or dropping our kids off at school right now and there would be no blogs to read or write. Transfer, transfer, transfer. Doctors transfer; God implants. I expect use of “implant” from regular people but I expect an infertility advocate to get these terms right.

Cindy is also a little bit vague on her definitions. She says they tried ART “three times,” and I think she is referring to her IVFs, but not her IUIs. My definition says any manipulation of sperm or egg is technically “assisted reproductive therapy” so that’s confusing. She then goes on to tell us, in a section marked “Gamete Intrafallopian Transfer: The Winning Ticket,” that they did “a combination of GIFT and IVF.”

Huh? GIFT = gamete intra fallopian transfer. Gamete = egg and /or sperm, unfertilized. ZIFT = zygote intra fallopian transfer. Zygote means “fertilized.” I think ZIFT is what Cindy did – she says:

It was just IVF plus laparoscopy. The magic was in the mix, once the doctors gathered the ingredients.

I’m sorry – could you be more specific? What “magic” was that? At times the book’s girl-to-girl tone gets too blonde for me, and doesn’t give me a drop of useful information. This is a shame – GIFT and ZIFT are rarely performed and it would have been a great opportunity for Cindy to inform us. She botches it.

In a similarly breathless yet underinformed paragraph, Cindy tells us that “As of this writing, I know researchers are working on natural cycle IVF, preimplantation genetic diagnosis…” Natural cycle IVF was first performed in 1978, PGD in 1989. She also predicts “reduction of miscarriages” as a coming technical breakthrough – sounds great, can you be more specific?

There are a few things that will sound odd to the IVF veteran – apparently Cindy’s first IVF ended not with a beta blood test but a urine test administered at the clinic. Cindy apparently had bloodwork done to find out the result of her fourth “GIFT” procedure, but could have waited for results at the clinic. She tells of not choosing to wait, but as they were walking out, being called back by the loud happy screaming of the nurses and doctor, yelling “you’re pregnant!” “loud enough for the whole world to hear.” Ouch – I’m glad I wasn’t a patient at that clinic, that day.

Cindy does include several first person stories that touch on miscarriages, egg donation, adoption, premature ovarian failure, ovarian transplant, surrogacy, male factor, and divorce. These stories add a great deal by introducing situations Cindy herself didn’t experience or talk about, and by offering a few breaks from Cindy’s writing style.

My general reaction to this book is lukewarm. It’s not exactly well written and it breaks zero new ground for me in terms of knowledge. I caught the technical errors with quick Google searches. I’d appreciate Cindy’s personal touch a lot more if she were not telling me how famous she is quite so frequently. I think women in their twenties and early thirties might appreciate this book, if they could encounter it before they learn much about infertility. I can’t think of many bloggers I know who wouldn’t hoot and throw it across the room. I didn’t have high expectations that a former supermodel would write an intelligent book, but I hoped I could be surprised. I wasn’t.

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