Meghan O'Brian had been trying to get pregnant for more than a year and a half when a test flashed her a positive result last July. Just 29 years old at the time, she had seen fertility specialists, undergone ultrasounds and blood analysis, and even had a procedure to see if her fallopian tubes were blocked. She had been given constant and often contradictory advice: to give it time and relax, or to go straight to in-vitro fertilization and hormone treatment. But when she finally found out she was pregnant, there was one word that flashed through her mind: "Robitussin."
Ms. O'Brian and her husband, Jon, a doctor of emergency medicine, welcomed their daughter, Mila, on Wednesday in Vancouver. They credit the baby's conception to an unlikely factor, an everyday cough syrup that is celebrated as a fertility aid by a community of women who describe themselves as TTC - "trying to conceive."
There was some serious disbelief for a good long while. Meghan O'Brian
"The one month I skeptically took it, it worked. We were pretty damned surprised," Ms. O'Brian said. "There was some serious disbelief for a good long while."
How an off-label application of over-the-counter cold medicine found a shelf life as a conception tool widely promoted online is a story marked with skepticism and disbelief. Robitussin's effectiveness has been debated on chat forums, and references to its impact can be found in bestselling pregnancy books. In a time when fertility treatments cost thousands of dollars, it's not surprising that a $5 solution has intrigued women for more than 20 years. But it is unusual that despite almost three decades of word-of-mouth debate, there's little scientific evidence to prove that it works - or that it doesn't - leaving it in a strange realm somewhere between old wives' tale and unsung miracle drug.
According to the Canadian Fertility and Andrology Society, infertility affected 10 to 20 per cent of the population in 2009, or one in six Canadian couples. The same year, assisted reproductive technology was involved in 3,500 births. But technological intervention is not cheap, with the average cycle of in-vitro fertilization costing $5,700, with no guarantee of its success.
Diane Allen, who runs the Canada-based Infertility Network, an online support community with 10,000 subscribers, said she has many members who arrive looking for information on Robitussin or other possible fertility aids, unwilling or unable to immediately pursue medically advanced treatments.
"We see people who come to the support group who seem to be rushed into IVF without a real assessment," she said. "They feel so desperate that if somebody told them to stand in the corner or cut off their arm or something - if they thought they'd have a child out of it - maybe they'd do it."
The magic ingredient
The "maybes" surrounding Robitussin start with an ingredient called guaifenesin, a tree-bark extract first discovered by the native population of the Bahamas to work as a natural expectorant, thinning the mucus in the lungs and making it easier to breathe. Adopted and exported by European explorers, the drug has been used in Canadian cough and cold medication since 1940.
In the 1980s, some women reported to their doctors that the product seemed to also effect cervical mucus, leading to speculation that it could facilitate the passage of sperm. The idea is not that far-fetched. Progesterone-based birth control pills work, in part, by producing the opposite effect, thickening cervical mucus to prevent sperm from getting through.
Thirty years ago, a diagnosis of "hostile mucus" was commonplace for women having trouble conceiving, and patients were subjected to postcoital testing to see how much of their partner's sperm had made it up the genital track.
A Pennsylvania doctor, Jerome Check, published an article called "Improvement of cervical factor with guaifenesin" in the Journal of Fertility and Sterility in 1982. It documented a study of 40 couples who had been attempting unsuccessfully to conceive for at least 10 months.