A month ago, I published a 13,000-word essay on IVF and egg freezing. The core argument is that the American fertility funnel pushes women toward far higher drug doses than the rest of the world, defaulting to the most aggressive protocol for nearly every woman — usually without telling her that gentler options exist and get comparable results.

This thread is the short version and should take 5 minutes, compared to the essay's 1 hour. It also clears up the mischaracterisations I keep hearing — some of them honest, given how long the piece is, and some from people with a vested interest in my being wrong.

The straw man goes like this: Riva said egg freezing and IVF are bad, exaggerated how many days American women take stims, and then told them to copy Japan, where IVF outcomes are notoriously worse. Don't bother reading it!

Egg freezing and IVF are incredible technologies. What I'm critical of is the methods and the advice young women are given.

Three approaches exist, but the US system defaults to the most aggressive one for nearly every woman: There is a common mischaracterisation of what mild means. Several women have come up to me at events saying, "Your essay didn't apply to me - I only did injections for a week, so mine was mild."

But mild vs high is entirely dose-dependent. It's the total dosage per cycle that matters, not the number of days, or even the number of injections. You can do a single week of high-dose shots and still carry a massive cumulative load — a typical US protocol delivers several times the hormone dose a Japanese clinic would give for the same goal.

And that comparison is exactly what gets used to dismiss my whole essay: Japan's IVF outcomes are worse, so why point to their mild-stim approach?

Yes, Japan's national numbers look lower than America's. But that gap is almost entirely about who they treat and how they count, not the protocol. Adjust for those, and it largely disappears.

The metric everyone quotes is live birth per cycle. It rewards exactly what aggressive stimulation is built to do, and punishes gentle protocols by design. American clinic reporting (SART) does the same. A high-dose blast crams everything into one big round. Gentle stims get fewer eggs each time, so women do a few smaller rounds to bank the same amount. Same babies at the end, but now split across more cycles, so every individual cycle 'scores' lower.

Japan also restricts donor eggs, so older women keep cycling with their own. These are low-odds attempts that drag down the national average. In the US, those same women are quietly moved onto young donor eggs, which post high numbers and pull the average up. You're not even comparing the same patients.

I expanded on the horrors of California's government for @TheSpectator. It's much worse than you think.

Thread: 1/ Lack of resources in the face of a natural disaster cannot be blamed on global warming:

Chemical imbalance was only a theory for depression causation yet presented as facts to simplify a narrative in order to prescribe SSRIs. Most of psychology and psychiatry is based on myths.
telegraph.co.uk/news/2022/07/2… If you want to take the psychiatry blackpill, flick through copies of DSMs (Diagnostic and Statistical Manual of Mental Disorders). The first edition came out in 1952 and you can find old copies on Abebooks. I got one from every decade. Psychiatry is politics

Epstein-Barr Virus (aka HHV-4 -mono/glandular fever) is even more terrible than just potentially causing all of multiple sclerosis. Research shows links between early exposure to HHV-4 and cancer (esp gastro) and numerous autoimmune disorders (eg Arthritis and Lupus!)

https://twitter.com/kearnsneuro/status/1481772805024800769

The biologist Paul W. Ewald puts forward that many of our diseases are caused by earlier pathogen exposure - "If I were going to put my money on it, I would bet that by 2050—hopefully earlier—we'll have found that more than 80 percent of all human cancer is caused by infection."