I’m both grateful to assisted reproductive technology for giving me my daughter and outraged at the too-good-to-be-true promises the industry touts.
By the time I met my husband at 39, I’d been bombarded for years by messages from friends, doctors and the media that in vitro fertilization would guarantee me the baby I’d wanted. But after seven years of trying to conceive and countless pregnancy complications, I now know that the promises of the fertility industrial complex don’t hold true. Assisted reproductive technology is more an art than a science—and until the success rates for certain groups drastically improve, doctors are foisting fairy tales onto vulnerable women.
IVF was a hot button issue in this year’s election. But today’s discussion about whether IVF should remain legal leaves out a fundamental point: It assumes that IVF works. This is, however, far from the truth for many—especially Black and Brown women and older women—for whom assisted reproductive technology is far from a miracle cure.
Women of color, including Indians like me, have lower rates of pregnancy through IVF. When we are lucky enough to get pregnant, we have higher incidences of maternal health complications, including fibroids and placental problems— both of which I had. Contrary to racist imaginings, women of color have lower fertility rates than white women. Not only that, but women with my skin color tend to start treatments at 41 or older, whereas white women begin before 35, a crucial difference when it comes to bringing home a baby.
My fight to procreate lasted from age 37 to 44, and involved three rounds of intrauterine insemination, four egg retrievals, two egg fertilization cycles, two embryo transfers, thousands of injections of hormones, hundreds of physician appointments, years of nightly prayers and eventually flying to Denver for treatments when no one in New York could get me pregnant. A pre-pregnancy fibroid removal caused severe complications, necessitating three life-saving surgeries and complicating my IVF journey. Once I got pregnant, I was diagnosed with hyperemesis gravidarum (severe sickness in pregnancy), a dislocated pubic bone and a placental insufficiency.
Eventually, through persistence, privilege and pain, I willed my now 2-year-old child into existence. I’m both grateful to assisted reproductive technology for giving me my daughter and outraged at the too-good-to-be-true promises the industry touts, which keeps women in the dark about how hard it is to give birth to a healthy child—not to mention how much money it takes.
I spent almost two decades looking for a partner to have and to hold—and to have babies with—and came up empty-handed.
The reality is that birth rates for women who undergo IVF between ages 41 to 42 are hardly a slam dunk, at 8.5 percent. For women above 42 (the age of the egg creating my baby), it’s a dismal 2.9 percent. IVF isn’t a cure for age. It was created to help younger women suffering from specific fertility disorders, such as endometriosis. And even if you freeze younger eggs to use later, pregnancy risks for those 40 and above are grim—stillbirths, preterm labor and maternal illnesses are more common.
Data for women of color is even more troubling—not only because access to fertility treatments is harder to come by, but because getting and staying pregnant is more difficult.
I faced the double whammy of being a Brown woman over the age of 40 trying to have a baby. Despite the stereotype of the career-driven woman who “forgot” to have kids until it was too late, I didn’t start a family late on purpose. I spent almost two decades looking for a partner to have and to hold—and to have babies with—and came up empty-handed.
When I found myself 37 and single, I underwent two egg freezing cycles, which resulted in 21 eggs, but only one viable embryo. IVF’s dirty little secret is that most eggs die in the process. Older women have fewer eggs to begin with, and we often end up holding a whopping bill and not much else.
Instead of the fertility industry making promises they can’t back up, it can invest a portion of its astronomical profits back into science to improve outcomes. The government should do the same.
Thankfully, after all that, I now have my miracle baby. At the end of the day, though, my finances were left in tatters. My body and mind were too. My journey left me in chronic pain and caused severe stress on my marriage, with my white husband in disbelief as to why it was so much harder for us than his white peers.
My experience is not unique—but I’m one of the rare ones to snag the golden baby. I sold my apartment to foot the $250,000 bill. I had access to specialists, a remote job that let me fly halfway across the country for treatments, and formal training to research and advocate for myself. Thousands of other older women and women of color share similar stories but give up because they don’t have these advantages—there are 15,000 in my online support group alone. Many women in the group with low-wage jobs took out second mortgages or sold cars to afford treatments. Others couldn’t get out of work shifts for appointments so threw in the towel. One woman’s baby died because her fibroids pushed him out early. Another transferred several embryos that didn’t stick, and the last one ended in a stillbirth.
So, why are we selling women on the idea that they can easily get pregnant after 40 when we know that’s exceedingly rare?
The answer is money.
The U.S. fertility market is projected to grow from $5.34 billion in 2023 to $8.69 billion by 2033. Most fertility clinics get paid whether or not a patient brings home a baby. And private equity firms funnel money into the industry because of its soaring growth rates. Incentives are skewed. Clinics are motivated to convince younger and younger women to freeze their eggs in the hopes that they’ll be one of the lucky few who will bring home a baby when the time comes. In the meantime, women’s vulnerabilities and dreams are preyed on.
So, what can we do?
First steps are obvious: Keep IVF legal and mandate that health insurance plans cover infertility like any other disease.
But other solutions are needed too. Instead of the fertility industry making promises they can’t back up, it can invest a portion of its astronomical profits back into science to improve outcomes. The government should do the same.
Women should be allowed more liberal leave from work for IVF. Many employers balk at absences for fertility appointments, seeing them as elective nuisances instead of medically necessary, forcing women to choose between employment security and having a child. Although federal law requires employers to provide leave for IVF appointments, we need stronger enforcement, especially for hourly and shift employees who are overwhelmingly Black and Brown and struggle to access time off for the countless fertility appointments required.
Part of the problem is that the U.S. has no regulatory body like the United Kingdom’s Human Fertilisation and Embryology Authority, which mandates that the policies and medical research impacting care are transparent and available to all. Fertility clinics vary wildly in their protocols, and many don’t know how to create babies in cases like mine. But patients only discover this after they’ve spent thousands on failed cycles.
Infertility impacts all of us. It’s not a woman’s problem or a man’s; not a white problem or a Black and Brown one. Every one of us should be able to have—or not have, for that matter—the children we desire. It should be our inalienable right as human beings, as essential as the pursuit of liberty and happiness. But instead of funneling money into getting more women to undergo egg freezing and IVF procedures, we should be focused on the science so success rates for older and Black and Brown women increase. There will never be any guarantees when it comes to bringing home a baby, but improving outcomes is the first step in fertility equality for all.