Don’t Call It ‘Infertility’Reading Time: 4 minutes
As a Single Mom, I Wasn’t ‘Infertile.’ I Just Needed Some Sperm., New guidelines from the American Society for Reproductive Medicine will help more people access reproductive medicine, but the terminology they use feels off., Infertility: Single parents an
When I conceived my son with donor sperm, I wasn’t in a relationship. I’d seen too many friends get married and have babies mainly to calm their ticking biological clocks, and then soon divorce. One such friend recently told me she had never been in love. I had the rest of my life to find love with the right guy, I figured. Better to have a child on my own while I was still fertile. I briefly discussed having sex with a male friend to get pregnant, but decided that conceiving with donor sperm from a bank would avoid potential legal and emotional gray areas around paternity.
It took a few months to get pregnant with the help of a midwife who came to my home. I never considered myself ‘infertile.’ I simply needed some sperm.
But according to a new report from the American Society for Reproductive Medicine, a woman in that position today would be ‘infertile.’ The definition of infertility now includes ‘the need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos to achieve a successful pregnancy either as an individual or with a partner.’
In other words, basically anyone who conceives children outside heteronormative sex between a man and a woman is doing so because they are ‘infertile.’ The former definition stated that infertility was failing to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.
With this new definition, people who need to ‘borrow’ DNA and wombs from fertility helpers—egg donors, sperm donors, and gestational carriers—have more protection from being discriminated against at fertility clinics and by insurance companies. ‘This revised definition reflects that all persons, regardless of marital status, sexual orientation, or gender identity, deserve equal access to reproductive medicine,’ said Jared Robins, the CEO of ASRM, in a press release.
The ASRM is moving in the right direction. Everyone does deserve equal access to reproductive medicine. But I bristle at the idea that I was ‘infertile’ because I used donor sperm—and at the idea that others who use modern technology to have a baby on their terms are infertile, too. While some have dubbed these circumstances ‘social infertility,’ this, too, makes it feel like there’s something wrong with you if you’re in love and want to make a baby with someone of the same sex, or on your own because you’re not in the the right relationship in your fertile prime.
Instead of infertility, let’s just call it modern fertility planning, or ‘collaborative reproduction,’ a term coined by bioethicist John Robertson that refers to the expanded array of lifestyle choices and medically supported reproduction methods.
I have spent the better part of my career writing about ways to change the narrative about fertility and infertility, and helping women and men speak more openly about their modern conception challenges, including egg and embryo freezing and single parenthood by choice. These new routes to a successful pregnancy are meant to avoid infertility. They allow couples and single people to expand the options they have for living their lives while also being, well, fertile, with a little help from modern science. I know a couple who decided to freeze embryos when they were in their late 30s to have a baby in their 40s. They decided parenthood would work better for them a little later in life—and they didn’t want to risk infertility, so they used modern medicine to prepare.
Infertility is a devastating experience for those who go through it, and without negating that experience, it’s also important to note that there are a wide range of reasons behind the rising use of reproductive medicine. In addition to allowing for couples to have kids later in life (and leaving them more time in their 20s to invest in their education and careers), reproductive medicine is now openly supporting the changing shape of the family. According to the Williams Institute at UCLA, an estimated 3 million LGBTQ+ Americans have had a child, and as many as 6 million American children and adults have an LGBTQ+ parent, either through adoption or being conceived with donor gametes. The number of babies born to single parents by choice is also on the rise. Society is finally acknowledging family fluidity, the full spectrum of biological possibilities and family arrangements we have available today for creating and raising a child.
Insurance coverage for all modern families is what will make the reproductive science that supports modern fertility planning more affordable for patients. ‘I hope that we will see changes in coverage for patients with this new definition,’ says Aimee Eyvvazadeh, a fertility doctor in the San Francisco Bay Area. She likens the new definition to a change that the ASRM made in 2012: removing the qualifier ‘experimental’ from the process of egg freezing, as success rates improving meant more companies started to cover the procedure on their insurance plans.
While expanding the definition of ‘infertility’ is positive in that it will allow more people access to reproductive medicine, it doesn’t make sense to lump everyone who uses reproductive medicine into that box. ‘The notion that the presence or absence of sperm should measure a woman’s fertility is a very heteronormative perspective,’ said Brooke Warner, the publisher of She Writes Press. ‘As a lesbian mom, I needed sperm to have my son, but it’s not the donor sperm that granted me my fertility.’ I hope our definitions and language around modern families continue to evolve as advances in reproductive science help more people their build their lives and families however they want them to be.
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