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Creating a stronger health system through better evidence

Health & Medical

AN Obstetrics and Gynaecology expert says changing the way reproductive health research is gathered and funded will help patients and the industry get better results.

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Dutch clinician and academic Professor Ben Mol is aiming to strengthen evidence-based reproductive health research and recently started a five-year posting from the University of Amsterdam to the University of Adelaide’s Robinson Research Institute and the South Australian Health and Medical Research Institute (SAHMRI).

“In a general sense, I believe the medical system is organised in such a way that many of the individual players don’t have an incentive to know the truth,” explained Professor Mol.

“This is harmful for individual patients because people get treatments that aren’t effective. It’s also harmful for society because there is a resource issue.”

Professor Mol said his recent study showing that, despite common practice, the use of progesterone is not effective in improving health outcomes for babies in most twin pregnancies threatening preterm delivery is a case in point.  

“Twin pregnancies are very much at risk of preterm birth, with half of these pregnancies delivering before 37 weeks’ gestation,” said Professor Mol.

This research – which consisted of rigorous analysis of pooled data from 13 studies covering more than 3700 women and 7500 babies – showed that for most pregnancies, the treatment is ineffective.

It was only for a sub-group of extreme high-risk twin pregnancies that an impact could be seen.

“For women with a short cervix who are also pregnant with twins, there was a 50% reduction in risk of preterm birth for this group of pregnancies,” said Professor Mol.

Professor Mol has also conducted research showing that improved pregnancy rates can be achieved in couples seeking fertility treatment by the very simple step of encouraging women to lie down after an insemination procedure.

“We found that if women are inseminated in a clinic, and then undergo 15 minutes of bed-rest, over four cycles their pregnancy rate increased from 30% to 40%,” said Professor Mol.

It’s a message some fertility clinics don’t want to hear.

“I think they don’t like the result because it’s too simple, because it interferes with the way the clinic is run, because they need to see a new patient every 10 minutes,” explained Professor Mol.  

“From the perspective of the couple, it’s crazy. Why not try one hour lying down if you can avoid IVF that way?”

Whilst in Adelaide Professor Mol hopes to improve the creation of useful evidence for reproductive health through improving international collaborations and addressing the way that health research is funded.

“One of the best things about Adelaide is that it’s relatively small,” he said. “So if you put people like me into a ‘warzone’ like Sydney or Melbourne, it’s very hard to make change. I think Adelaide and South Australia are of the size where you can actually have an impact.”

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