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Fertile Ground: The Silent Struggle Of Infertility

Cartoon image of fertilization.
Flickr Creative Commons
Though infertility affects millions of people of all genders in the United States, it is rarely discussed openly.

Infertility is a disease that affects millions of people in the United States but is rarely discussed openly. Twelve percent of married women between the ages of 15 and 44 experienced infertility, along with just over nine percent of men in that age group, according to a 2013 report from the Centers for Disease Control and Prevention. Those numbers translate to about one in eight couples who have trouble getting or staying pregnant. There are a variety of treatments for infertility, but they can be costly and are not accessible to everyone.

On this episode of Embodied, a series about sex, relationships and your heath, guest host Anita Rao talked to doctors, experts and those with firsthand knowledge about the issues surrounding infertility in American culture. Dr. Steven L. Young joined Rao to talk about who is affected by infertility, what causes it and what treatments are available. He is a professor of obstetrics and gynecology at the University of North Carolina School of Medicine and a physician at UNC Fertility.

Dr. Young also talked about the technology available today that is advancing fertility treatments.

“Preimplantation genetic testing allows looking at all the chromosomes with a pretty good accuracy now — say 98 to 99 percent accuracy,” he explained. “And so one can choose among many embryos the best one by finding which ones have normal chromosomal complement.”

CDC statistics show African American women are more likely to be infertile than white women, but they are almost half as likely to seek treatment as white women. Dr. Desireé McCarthy-Keith explored the reasons why black women are more likely to experience problems with fertility and why they are less likely to seek treatment. McCarthy-Keith is a reproductive endocrinologist and infertility specialist at Shady Grove Fertility Atlanta.

She said knowledge is power and recommends that women who would like to have children investigate their ovarian reserve.

Women need to understand that we are on a timeline with our fertility from birth. - Dr. Desiree' McCarthy-Keith

“You can have an ultrasound at the beginning of a menstrual cycle to look at the ovaries and see how many follicles  — or little egg sacs — are developing in the ovaries. There's a hormone test that can be done called AMH, which stands for anti-müllerian hormone. It's a simple blood draw that will measure this hormone level in your blood. And that level is a reflection of how much activity and follicle development there is in the ovary,” she said.

Nichelle Sublett and Belle Boggs share their personal journeys with infertility. Sublett had five miscarriages over five years. She is a fertility advocate and Mrs. North Carolina 2018. She discussed the emotional and psychological impacts of pregnancy loss.

“It really is a death. I know some people may not understand that, but this is a child that you hoped and dreamed for, and you had plans for. And you've probably mapped out half their lives by the time you see your positive pregnancy test,” Sublett said.

It's absolutely the hardest thing my husband and I have ever been through, was going through those five miscarriages. - Nichelle Sublett

Boggs is an associate professor in the department of English and director of the Master of Fine Arts program in creative writing at North Carolina State University. She struggled with fertility for five years, and during that time wrote the memoir and cultural history “The Art of Waiting: On Fertility, Medicine and Motherhood” (Graywolf Press/2016).

Cost was a big factor for Boggs and her husband when it came to fertility treatments.

“Only 16 states in the whole country have laws requiring health insurance companies to write fertility care into their policies. And North Carolina is not one of those states,” she explained.

Medical sociologist and ethnographer Liberty Barnes digs into how cultural stereotypes play into who receives fertility treatment. She also discusses the financial barriers to fertility treatment, LGBTQ couples and her book, “Conceiving Masculinity: Male Infertility, Medicine, and Identity” (Temple University Press/2014).

There was a lot of care in the medical system around protecting these men's masculine identities, I would argue, and that it was about making sure that men felt comfortable in the clinic. - Liberty Barnes

Barnes also described the historically inaccurate statistics used in the United States when it comes to fertility.

“We were looking at the statistics that we use in the United States to track infertility and the statistics we've used since 1955 … The study is reproduced every five to 10 years in waves. Women of color were not included in the study until the fourth wave, which wasn't until 1970. Men were not included until this century — until 2002. And there were no questions asking about the sexual orientations of the respondents until 2002.”

Note: This program originally aired July 18, 2019.

Amanda Magnus is the executive producer of Embodied, a weekly radio show and podcast about sex, relationships and health. She has also worked on other WUNC shows including Tested and CREEP.
Anita Rao is an award-winning journalist, host, creator, and executive editor of "Embodied," a weekly radio show and podcast about sex, relationships & health.
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