Speaker 1: Welcome to Stuff Mom Never Told You from how self
Speaker 1: works dot Com. Hello, and welcome to the podcast. I'm
Speaker 1: Caroline and I'm Kristin. And last time on the podcast,
Speaker 1: we talked with Dr Jessica Zucker about miscarriage, which is,
Speaker 1: as we established, definitely a taboo topic in our society.
Speaker 1: It's really difficult for people to talk about, to acknowledge,
Speaker 1: to even reach out and seek help. And in our
Speaker 1: conversation about infertility today, it's sort of a continuation of
Speaker 1: that theme. Infertility is not uncommon, or struggles with fertility
Speaker 1: in general are not uncommon, but as we'll talk about
Speaker 1: in this episode and as we saw in our research,
Speaker 1: what's so heartbreaking about it is the fact that no
Speaker 1: matter who you are, no matter what your background is,
Speaker 1: no matter what part of the world you live in
Speaker 1: or what time him that you lived, women have experienced
Speaker 1: so much shame, both internally and from other people over
Speaker 1: the issue of infertility. Yeah, I mean, in all of
Speaker 1: these conversations that we've had, not only about a miscarriage
Speaker 1: and then today about infertility, but also other times we've
Speaker 1: talked about pregnancy and just women's bodies in general, there's
Speaker 1: always this theme of the limitations of what we can
Speaker 1: and do and feel comfortable talking about UM. So this
Speaker 1: is one where it is something that affects so many
Speaker 1: of us, but we don't hear about it nearly as
Speaker 1: much as we should. And when we do hear about it,
Speaker 1: it tends to be from the perspective of a woman's
Speaker 1: problem or it's the woman's fault. That's historically what how
Speaker 1: this issue has been framed. And as we'll talk about,
Speaker 1: this is not a woman's problem. This is this is
Speaker 1: everyone's problem. If you are a person who wants to
Speaker 1: have children, you very well might be affected by infertility. So,
Speaker 1: just to cover the basics of what um infertility is,
Speaker 1: it's medically defined as a difficulty conceiving a pregnancy after
Speaker 1: a year of unprotected sex. But because as we've talked
Speaker 1: about in the podcast before, obviously our fertility declines with age,
Speaker 1: So for women over thirty five, doctors recommend checking in
Speaker 1: if they've been unsuccessful getting pregnant after six months of trying.
Speaker 1: That's right because for perspective, most fertile couples, according to researchers,
Speaker 1: do conceive within six cycles when they're using timed intercourse.
Speaker 1: Doesn't that sound so sexy and romantic six cycles. Use
Speaker 1: your timed intercourse in your in your cycles. They're talking
Speaker 1: about menstrual cycles, not yeah, not mons cycles, although I
Speaker 1: mean there you go. Still tychnically the same. Yeah, you
Speaker 1: could time up by the moon if you wanted, you know,
Speaker 1: full moon. Don't come a knocking or no please do
Speaker 1: yes well yes, um. And of course related under this
Speaker 1: umbrella of infertility is impaired fecundity, which encompasses non surgical sterility,
Speaker 1: which is an impossibility to conceive, subfecundity, which is uh,
Speaker 1: conception is difficult but not impossible and quote long interval
Speaker 1: without conception. So there's a lot of different types of
Speaker 1: fertility struggles wrapped up in our conversation today. And basically
Speaker 1: this happens. Infertility is said to happen when there's a
Speaker 1: breakdown somewhere in the conception process. It could be one place,
Speaker 1: that could be multiple places, but you know, brief run
Speaker 1: through refresher biology course for you. The conception process starts
Speaker 1: with ovulation fertilization. Then the fertilized egg takes a little
Speaker 1: swan dive through the fallopian tube towards the uterus and
Speaker 1: then has to implant itself successfully in the uterus well,
Speaker 1: and because it wasn't until the mid twentieth century that
Speaker 1: we really started to understand all of the steps in
Speaker 1: this process, humans just made up all sorts of reasons
Speaker 1: why infertility would occur, which has only ingrained a lot
Speaker 1: of the stigma um that we're going to talk about
Speaker 1: that is still very much alive and well today. UM.
Speaker 1: But here's the thing. In addition to all of those
Speaker 1: steps where things could possibly go awry, just getting pregnant
Speaker 1: in and of itself, despite what um absence only sex
Speaker 1: education might lead you to believe, getting pregnant is it's
Speaker 1: hard to do. I mean, if you think about it,
Speaker 1: you have this window in our menstrual cycle during which
Speaker 1: conception is even possible. I eat ovulation, and the probability
Speaker 1: of inception is only each month. Now, going back to
Speaker 1: sex education, if you are listening to this and you're
Speaker 1: sexually active, Uh, this is not Christen and Caroline endorsing
Speaker 1: you to just go have unprotected sex um. But I
Speaker 1: think it's just worth understanding the challenges that can naturally
Speaker 1: occur with getting pregnant. Yeah, because it's estimated that ten
Speaker 1: of normally fertile couples don't manage to conceive within the
Speaker 1: first year, so it's it's not uncommon to struggle with
Speaker 1: these issues. And so let's dive into some sex based
Speaker 1: stats and facts, and that's biological sex, not literally getting
Speaker 1: it on. So, like we said earlier, culturally we tend
Speaker 1: to just sort of frame this as the fault of
Speaker 1: the woman or the woman's problem. But depending on what
Speaker 1: statistics you're looking at, about a third of the time
Speaker 1: it's the man's fertility issues causing problems with conception, about
Speaker 1: another third of the time it is something going on
Speaker 1: in the woman's body. But the remaining third, give or take,
Speaker 1: it's either both partners or an unknown cause. So if
Speaker 1: we look just at men's fertility um for instance, just
Speaker 1: to get a better grasp on that, the two thousand
Speaker 1: two National Survey of Family Growth found that seven point
Speaker 1: five percent of all sexually experienced men under forty five
Speaker 1: I saw a fertility doctor at some point, and within
Speaker 1: that group, eighteen percent or diagnosed with a fertility problem.
Speaker 1: But that doesn't necessarily account for all of the dudes
Speaker 1: who have had fertility issues. That's just people who have
Speaker 1: sought out treatment for it. Yeah, and male fertility specific
Speaker 1: problems include abnormal sperm production, function, and delivery, and this
Speaker 1: can be caused by problems like undescended testicles, genetic disorders
Speaker 1: like cystic fibrosis, health issues like diabetes, and also retrograde ejaculation,
Speaker 1: which is when semen doesn't go out, it goes into
Speaker 1: the bladder instead. I had never heard of that before
Speaker 1: me neither, but I create when I read it because
Speaker 1: I don't know if it's painful, but it sounds like
Speaker 1: it's uncomfortable. So things that can contribute to male fertility
Speaker 1: problem that that actually actually right, we should actually actually contribute, uh,
Speaker 1: include overexposure to heat. Now I had heard this stuff
Speaker 1: like anecdotally about laptops, like I had seen some studies
Speaker 1: in the past couple of years about like men, don't
Speaker 1: leave your mama's don't let your babies grow up to
Speaker 1: put their laptops on their laps because it can affect
Speaker 1: your fertility. No, and and this is not funny, but
Speaker 1: it's it's true. Uh, Like things like hot tubs and
Speaker 1: saunas can affect fertility. And a condition uh that also
Speaker 1: affects fertility is when you basically have vericose veins in
Speaker 1: your testies. Having those enlarged veins makes your testies warmer
Speaker 1: and heat degrades the quality and quantity of sperm. And
Speaker 1: also you've got to worry about exposure to overexposure, i
Speaker 1: should say, to chemicals like pesticides, radiation, and steroids. So
Speaker 1: if we look at what contributes to email fertility, we
Speaker 1: have to think again about all of those steps along
Speaker 1: the way from ovulation all the way to implantation. So
Speaker 1: if we go back to ovulation, you might have disorders
Speaker 1: that prevent the ovaries from releasing eggs to begin with,
Speaker 1: or something called primary ovarian insufficiency, which is when your
Speaker 1: ovaries begin to fail before the age of forty. And
Speaker 1: then of course there are hormonal disorders like polycystic ovarian syndrome,
Speaker 1: which is the most common cause of female infertility. And
Speaker 1: we've talked about PICOS before on the podcast. There's a
Speaker 1: stuff I'm Never told you video breaking down how PICOS
Speaker 1: works if you're not familiar with it, and um in
Speaker 1: a in a very small nutshell, what that leads to
Speaker 1: is your body creating a surplus of androgen hormones, which
Speaker 1: leads to irregular ovulation. Yeah, and you've also got hormone
Speaker 1: issues like your body producing too much testosterone again a
Speaker 1: male hormone or prolactin, which we've talked about on the
Speaker 1: podcast before, which is actually a hormon that helps you breastfeed.
Speaker 1: And of course problems with your thyroid gland, which is
Speaker 1: part of your handy dandy endocrine system, and we've talked
Speaker 1: about that before on the podcast too. Other major factors
Speaker 1: include uterine or cervical abnormalities. You might have issues with
Speaker 1: the shape, the opening, or the mucus happening there in
Speaker 1: UH fibroids, that's a major issue because it can block
Speaker 1: fallopian tubes and distort the uterine cavity, and we've done
Speaker 1: a stuff Whenever Told You podcast all about fibroids. If
Speaker 1: you're not up on those, that's true. And UH women
Speaker 1: also might struggle with pelvic adhesions, which is scar tissue
Speaker 1: that binds organs together after surgery. UM Indometriosis is also
Speaker 1: a huge factor, as is inflammation of the fallopian tubes.
Speaker 1: And to once more promote past stuff on Ever Told
Speaker 1: You podcast, you should definitely listen to the one on
Speaker 1: endometriosis or watch our video about it because it affects
Speaker 1: so many women, and it takes an average of at
Speaker 1: least going to five different doctors to get at the
Speaker 1: correct diagnosis, and it's a major contributor to infertility as well. Um.
Speaker 1: But then they're also other medical issues that can lead
Speaker 1: to infertility like celiac, Cushing's disease, sickle cell anemia, diabetes,
Speaker 1: and also STDs like gonorrhea or chlamydia, which if left
Speaker 1: untreated can cause big trouble in your reproductive tract and
Speaker 1: possibly lead to pelvic inflammatory disease. Yeah, oh boy, definitely
Speaker 1: definitely practice safe sex. It's just and then that just
Speaker 1: means it's one less thing to worry about for so
Speaker 1: many reasons. Please please practice safe sex. Um. But a
Speaker 1: couple of risk factors regardless of sex include cancer and
Speaker 1: its subsequent treatment, radiation and chemotherapy. Age. We mentioned age earlier.
Speaker 1: Women's fertility, for instance, starts declining in their thirties, men
Speaker 1: in their forties, and this is sort of a growing
Speaker 1: issue for people looking to have children because about twenty
Speaker 1: percent of women in the United States specifically are having
Speaker 1: their first children after age thirty five. So that just
Speaker 1: means that age is a growing contributing factor to in
Speaker 1: fertility and Among those couples where the woman is over
Speaker 1: thirty five, a third report having fertility problems, and then
Speaker 1: of course tobacco and alcohol use don't help matters. UM.
Speaker 1: Being overweight can lead to fertility issues and can also
Speaker 1: affect men's sperm count by the same token. Being underweight
Speaker 1: also isn't great for fertility as well, UM, and can
Speaker 1: lead to a co occurring issue of a minorrhea, which
Speaker 1: can also be sparked by over exercise or excess stress. Yeah.
Speaker 1: Stress is always such a culpritive so many things. Yeah,
Speaker 1: and we'll touch on the issue of stress here again
Speaker 1: in a little bit, because there is also that I
Speaker 1: don't know if it's a stereotype or the assumption that
Speaker 1: stress makes you unfertile. And it's not quite that black
Speaker 1: and white. So how common is this well, um, very common,
Speaker 1: to put it in layman's terms. UM. It's important to
Speaker 1: remember though that rates are going to differ depending on
Speaker 1: factors like the age group of the people included, the
Speaker 1: number of people in the surveys and studies. UM. But worldwide,
Speaker 1: around two to ten of couples just don't have any
Speaker 1: children UM, and ten to cent struggle with what's called
Speaker 1: secondary infertility, and that's when you have your first kid,
Speaker 1: everything's fine, but then you have a really hard time
Speaker 1: getting pregnant the second time around. Yeah, So there was
Speaker 1: this huge global meta study in that found that there's
Speaker 1: nearly fifty million couples worldwide who were unable to have
Speaker 1: a child after five years of trying. They found that
Speaker 1: nearly two percent of women forty four years old who
Speaker 1: wanted to have kids were unable to have their child.
Speaker 1: That's primary infertility, and about ten and a half percent
Speaker 1: of women experienced secondary infertility, which is what Kristen just mentioned.
Speaker 1: But the thing is they also pointed out that those
Speaker 1: rates were similar to what they had been twenty years earlier,
Speaker 1: so we're not seeing a ton of advancement in terms
Speaker 1: of in terms of sort of stemming that infertility tide basically.
Speaker 1: And it is kind of counterintuitive when you look at
Speaker 1: those age breakdowns, because for women between twenty and twenty
Speaker 1: four years old, primary infertility rates are higher compared to
Speaker 1: older women, but that pattern is reversed for secondary infertility,
Speaker 1: where if you are younger and you have had that
Speaker 1: first successful childbirth, then it's not as hard to get
Speaker 1: pregnant a second time. As it is if you are
Speaker 1: older and you have a successful first childbirth and then
Speaker 1: try to get pregnant a second time. Yeah, And if
Speaker 1: we look globally, primary infertility is actually higher in North
Speaker 1: Africa and the Middle East when compared to a region
Speaker 1: like Latin America or the Caribbean. And secondary infertility in
Speaker 1: Sub Saharan Africa specifically affects more than thirty percent of
Speaker 1: women between the ages of five and forty nine. And
Speaker 1: if we zero in just on the US, six percent
Speaker 1: of married women between ages of fifteen and forty four
Speaker 1: are infertile. But if you look at all women trying
Speaker 1: to get pregnant, regardless of relationship status, twelve percent of
Speaker 1: that age group struggles within fertility issues. And I appreciated
Speaker 1: that source for making that distinction between or even examining
Speaker 1: the distinction between married women and women in any relationship
Speaker 1: status trying to get pregnant, because so much of this
Speaker 1: data is obviously very heteronormative. UM and you could also
Speaker 1: say like sis sexist as well. I don't think that
Speaker 1: we saw any studies on like AND's fertility issues at all.
Speaker 1: UM and also a lot operating under the assumption that
Speaker 1: all women want to get pregnant, and especially if women
Speaker 1: are married. UM. So I think it's those kinds of
Speaker 1: contexts are are good to keep in mind as well
Speaker 1: to go through this. Sure, and it's not just women
Speaker 1: in relationships who want to have children. I mean there
Speaker 1: are women who are not in relationships who, for instance,
Speaker 1: might be seeking a sperm donor and want to get
Speaker 1: pregnant that way and then have struggles with it. So
Speaker 1: it I think it is important to kind of break
Speaker 1: out of the mindset of like, Okay, we're only going
Speaker 1: to research people who are in relationships because well, what
Speaker 1: is I mean, that's not the full picture? Then I
Speaker 1: would think, yeah, and also only research people who are
Speaker 1: in straight relationships too, there's not you don't see a
Speaker 1: lot of variation within like the sexual orientation of UM
Speaker 1: people in these studies as well. So just a little
Speaker 1: background demograph, background on the available data that we're working with, right,
Speaker 1: and as we move into talking about treatment, I mean,
Speaker 1: I think it's worth mentioning how health in general, but
Speaker 1: also access to healthcare and socioeconomics are such a huge factor. UM.
Speaker 1: There was a study way back when I was five
Speaker 1: years old in h that found that the only group
Speaker 1: to suffer a rise in infertility rates since the nineteen
Speaker 1: sixties was women under twenty four and that was thanks
Speaker 1: to a spike in STDs. That goes back to what
Speaker 1: we mentioned about chlamydian gnarrhea, that those conditions are nothing
Speaker 1: to laugh at or sniff at. You need to practice
Speaker 1: safe sex and then successfully treat these conditions in order
Speaker 1: to keep your fertility from suffering. Yeah. I remember when
Speaker 1: that study came out and reading about it um in
Speaker 1: the New York Times, as I did every day as
Speaker 1: a four year old. Baby Kristen Yes, yes, a little
Speaker 1: baby glasses well Fisher Price glasses, Yes, yes, baby cup
Speaker 1: of coffee, and you were just like, this is this
Speaker 1: is such a shame. This is such a shame. Kids
Speaker 1: these days need to practice say sex exactly. You took
Speaker 1: the words right out of my mouth, right out of
Speaker 1: your toddler mouth, just like candy stealing candy from baby Kristen. Um.
Speaker 1: And of course, doctors know that overall poor health can
Speaker 1: contribute to infertility problems. And this is a huge deal
Speaker 1: when you think about and I mean again, I'm speaking
Speaker 1: as an American, but this is a huge deal when
Speaker 1: you talk about people who don't have access to doctors
Speaker 1: or healthcare or insurance. And yes, we have the Affordable
Speaker 1: Care Act, but I personally know plenty of people who
Speaker 1: still don't have health insurance and therefore still do not
Speaker 1: have access to a regular doctor. And then it comes
Speaker 1: back to to the cost of fertility treatments, which are
Speaker 1: insanely prohibitive. They're definitely not accessible to everyone because they
Speaker 1: can run you more than ten grand. Yeah, I mean,
Speaker 1: that reminds me of one of the stories that we
Speaker 1: were reading about infertility treatments and this couple that had
Speaker 1: saved up ever since they got married for their future
Speaker 1: children's college fund and had put all this money away,
Speaker 1: and they ended up spending all of that money just
Speaker 1: trying to get pregnant because those fertility treatments are so expensive,
Speaker 1: not to mention all of the travel involved if you
Speaker 1: live somewhere that might not have um this kind of
Speaker 1: treatments available. So, speaking of which, in two thousand nine,
Speaker 1: the World Health Organization classified infertility as a disease, and
Speaker 1: part of the motivation for that was paving the way
Speaker 1: for more insurers to cover treatments. Because, as of are
Speaker 1: the most recent data we found at least only fifteen
Speaker 1: states require insurance coverage for fertility treatments, so a lot
Speaker 1: of this is like out of pocket costs, right, Yeah,
Speaker 1: that which is I mean, that's huge. It's a huge
Speaker 1: cost um And treatments can involve assisted reproductive technology gene
Speaker 1: this is any treatment in which the egg and sperm
Speaker 1: are handled, and of course IVF in vitro fertilization falls
Speaker 1: under that. It's the most common type of assisted reproductive technology,
Speaker 1: and it involves retrieving multiple eggs, fertilizing them in the lab,
Speaker 1: and implanting the embryos in the uterus. And there was
Speaker 1: just an article that I just shot over to Kristen
Speaker 1: last night that there's apparently a trial starting in the
Speaker 1: UK for a controversial IVF technique to allow women thirty
Speaker 1: and older And I'm like, oh god, I'm I'm a
Speaker 1: thirty and older um to get their eggs quote unquote rejuvenated.
Speaker 1: And basically this involves taking mitochondria from immature cells and
Speaker 1: sticking them into mature cells to be used egg cells,
Speaker 1: that is, to be used for IVF. And this matters
Speaker 1: because aging mitochondria, which is like the cell's little powerhouses,
Speaker 1: contribute to IVF failure. So if the succeeds, it could potentially,
Speaker 1: you know, maybe stave off the repeated costs of going
Speaker 1: back over and over again to try IVF. And it
Speaker 1: seems like the primary controversy with this is that it's
Speaker 1: very unclear at this point that it could even be successful. Yeah,
Speaker 1: they're not sure that it could could work. UM. Now,
Speaker 1: if we look at treatment for women specifically, there of
Speaker 1: course our fertility drugs to stimulate ovulation UM. There's intra
Speaker 1: uterine insemination where healthy sperm is placed directly into the uterus,
Speaker 1: and there's also surgery to correct uterine problems. And for men,
Speaker 1: their treatments for various infections that might affect the reproductive
Speaker 1: system as well as sexual dysfunction. You can also undergo
Speaker 1: hormone treatments and surgery to correct and obstructed vast deference.
Speaker 1: I used to be on a trivia team called Uptown
Speaker 1: John and the vast deference UM or that condition that
Speaker 1: we talked about earlier, where the enlarged veins and the
Speaker 1: testes make them too hot, and of course also the
Speaker 1: procedure in the process of hating sperm for that assisted
Speaker 1: reproductive technology. But according to research from the CDC, A
Speaker 1: majority of infertility treatments fail. Fifty seven percent of IVF
Speaker 1: cycles using women's own eggs failed, whereas procedures using donor
Speaker 1: eggs do better. They had only a thirty seven percent
Speaker 1: fail rate. And not surprisingly, this has psychological side effects
Speaker 1: as well. There was a Harvard study that we were
Speaker 1: looking at, um finding how women who have difficulty getting
Speaker 1: pregnant can be as depressed as those who have major
Speaker 1: heart problems or cancer. Yeah, I mean it makes sense, Like,
Speaker 1: think of your friends, who all they or maybe it's you.
Speaker 1: You know, all you've wanted your whole life is to
Speaker 1: have kids. You know. I'm I'm not on that wave length,
Speaker 1: but I know many people who um. You know. For instance,
Speaker 1: I had a coworker years ago who had pekos and
Speaker 1: before she was in gauge, before she was married, she
Speaker 1: was with the man she knew she wanted to be
Speaker 1: with forever. She's like, let's just start trying because I
Speaker 1: might never get pregnant. And I know that, you know,
Speaker 1: watching friends struggle with that idea of like, I want
Speaker 1: nothing more to than to be a parent, uh, and
Speaker 1: to have that be a difficult process. Of course, I
Speaker 1: can totally see how it would lead to massive depression
Speaker 1: and stress, and it's that stress that can affect weather
Speaker 1: and how long people stick it out for for treatment.
Speaker 1: Harvard Medical School researchers found that thirty cent of patients
Speaker 1: under forty with insurance for at least three IVF cycles
Speaker 1: dropped out after only one or two. They also found
Speaker 1: that sixty eight percent of patients over forty gave up
Speaker 1: before exhausting their insurance coverage for the procedure. And they
Speaker 1: write about how this whole thing, it just swallows your
Speaker 1: life up. I mean, you become a slave to your
Speaker 1: monthly side if you're tracking your ovulation and your periods,
Speaker 1: and it's they talk about that that extreme disappointment, like
Speaker 1: disappointments to week of a word, when you get your
Speaker 1: period the next month, because you've put so much time, energy,
Speaker 1: and potentially money into this process. But of course a
Speaker 1: doctor is saying, just relax isn't going to help matters.
Speaker 1: Those same Harvard researchers did find that lowering anxiety was
Speaker 1: linked with improved pregnancy rates, and that patients with psychological
Speaker 1: support do feel less distress about treatment and are quicker
Speaker 1: to try other options like donor eggs, sperm, or adoption
Speaker 1: and this is a big reason why it's important for
Speaker 1: us to talk about this even more because, uh, a
Speaker 1: lot of times, if you are experiencing infertility, you don't
Speaker 1: want to tell anyone about it, and the downside of
Speaker 1: that is that you don't have a support system in
Speaker 1: that case, which research you know finds can can be really,
Speaker 1: really really helpful. Yeah, and we should say again and
Speaker 1: emphasize that depression and stress do not cause infertility, but
Speaker 1: researchers have found that they are associated that people who
Speaker 1: managed to alleviate their anxiety, stress, and depression they put
Speaker 1: all of that under the term of distress um have
Speaker 1: had in studies more success finally getting pregnant. But the
Speaker 1: thing is, as much as we know about the biological
Speaker 1: factors that do and don't contribute to male and female infertility,
Speaker 1: there are still so many myths surrounding it and so
Speaker 1: much moralizing and stigma that go back millennia and and
Speaker 1: essentially have been you know, shaming infertility ever since. Yeah,
Speaker 1: and we'll talk about that after a quick break. These days,
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Speaker 1: You should. And now back to the show, So I
Speaker 1: feel like a stuff mom ever told you episode would
Speaker 1: almost be remissed if it didn't at some point go
Speaker 1: to ancient Egypt. Yeah, we're not laughing, but it's true.
Speaker 1: It's true. Um So, Egyptians had a goddess of infertility who,
Speaker 1: horrifyingly enough, was also the goddess of funerals and afterlife rituals.
Speaker 1: So right off the bat, nothing but the worst connotations
Speaker 1: around women who struggle with fertility issues. And they even
Speaker 1: had this weird test They would force feed a beer
Speaker 1: covered woman dates and if she vomited, she was fertile,
Speaker 1: which this of course makes me think of the Last
Speaker 1: Crusade where Sala catches the date in his hand and
Speaker 1: says bad dates. Sweet I got in today's Indiana Jones
Speaker 1: reference Indiana Jones and Monty Python. You're on a roll, girl,
Speaker 1: I really am. And we should say too that this
Speaker 1: timeline is coming from two sources Bustle, a great in
Speaker 1: depth article over at Bustle, and also a timeline from
Speaker 1: American radio works. And they also looked at ancient India,
Speaker 1: for instance, who thought that perhaps women were possessed by
Speaker 1: the goddess of poverty and corruption if she couldn't have
Speaker 1: children man um Things didn't get much sunnier over in
Speaker 1: China because if a woman was infertile, and I'm assuming
Speaker 1: the husband had means, you could just use a concubine instead.
Speaker 1: That's fine, Yeah, I just bringing a pinch hitter. Yeah.
Speaker 1: And in Rome, just divorce your wife over it. Here,
Speaker 1: we'll let you out of this contract pretty easily. But
Speaker 1: it's in ancient Greece where we start to see the origins,
Speaker 1: maybe not overwhelmingly, but the origins of infertility being thought
Speaker 1: of as like a medical condition and not necessarily a
Speaker 1: moral failing all the time. Overall, though, the responsibility for
Speaker 1: fertility did still lie with the woman and all Hippocrates
Speaker 1: had lots of ideas about what led to infertility. Um.
Speaker 1: He attributed to things like wait, a tightly closed cervix
Speaker 1: or menstrual retention, which Hippocrates come on. So this whole
Speaker 1: idea and this idea of measure retention would stick around
Speaker 1: for quite some time. Um. They thought that your period
Speaker 1: blood would just hang out inside of you. It wouldn't
Speaker 1: come out, it would just hang out and prevent you
Speaker 1: from being able to have babies slashing around, Yeah, slashing around.
Speaker 1: But I mean you could try praying to Asclepius, who's
Speaker 1: the god of medicine. There were also all of these
Speaker 1: different types of probes, like literally getting things just stuck
Speaker 1: up inside of you, trying to like open up that
Speaker 1: that reluctant cervix. Uh. And there were also sorts of
Speaker 1: weird like herbal cocktails that you could try. I bet
Speaker 1: there are still so many herbal cocktails out there for
Speaker 1: infertility as well. Um. And in the medieval times, not surprisingly,
Speaker 1: things took an even darker turn with the publication of
Speaker 1: the Malleus Malfaicarum, which we've talked about before is translated
Speaker 1: to the Hammer of the Witches, and this text, as
Speaker 1: you might assume from the book's title, blamed infertility on
Speaker 1: witches and or the devil, but they also thought that
Speaker 1: it could be an indication that you yourself are a witch.
Speaker 1: To the witch, there's no winning, there's no winning, Like,
Speaker 1: why should a woman who struggles with having children be
Speaker 1: considered evil? I it blows my mind, because that's your function, Caroline,
Speaker 1: that's true. Well. Other culprits during this time included a
Speaker 1: wandering womb, which christ and I. We have that video,
Speaker 1: Christian where you and I were looking for crazy, wandering
Speaker 1: hysterical uteruses by the train tracks. That's right, and I
Speaker 1: ended up finding yours. She gave it to me for christmasing. Yeah,
Speaker 1: and if you don't know what we're talking about, listeners,
Speaker 1: why are you following us on Instagram? Um? You also
Speaker 1: could have a soft womb, which means that it's too
Speaker 1: soft and wet to be able to snag that sperm.
Speaker 1: It's not vel crowe enough and giveaway. If a woman
Speaker 1: had a soft womb, was that she cried all the time.
Speaker 1: I hear soft womb, I think of a soft boiled egg.
Speaker 1: Come on, I eat boiled eggs for breakfast. Um, sorry
Speaker 1: not sorry? Yeah, okay, you you also might They thought
Speaker 1: suffered from a suffocated uterus, which was an idea similar
Speaker 1: to hippocrates idea of menstrual retention. And in terms though
Speaker 1: of this moralizing aspect um, this is going farther back.
Speaker 1: But if we look at Christianity and the whole doctrine
Speaker 1: of female piety and the Bible and the Old Testament,
Speaker 1: there's a story of Hannah who was barren, and she
Speaker 1: begged God for a child, and finally, because she was
Speaker 1: such a pious woman, God rewarded her with six more children.
Speaker 1: And this foster's this whole idea that women without kids
Speaker 1: need to work extra hard to prove their piety, and
Speaker 1: that infertility is punishment for your sins and is reflected
Speaker 1: on women's morality. It probably could be traced back to
Speaker 1: two Eave's curse and on and on. Yeah, And much
Speaker 1: like the Greeks were like just pray to Asclepius, the
Speaker 1: Christians urged women to try praying it away or fasting
Speaker 1: it away. And yet it then evolved into a view
Speaker 1: of infertile women as promiscuous, masculine and bossy. Yeah, because
Speaker 1: I mean, what how more unpious can you be than
Speaker 1: if you are both masculine and sleeping around and boss
Speaker 1: saying doing it um. And so during a renaissance, we've
Speaker 1: got this growing medical and popular acceptance of the idea
Speaker 1: that it could also be men's fault. There was this
Speaker 1: concern you guys about cold, thin, watery or feeble sperm.
Speaker 1: There was a concern over whether you had a short penus,
Speaker 1: and also what you were eating. This didn't prevent, though,
Speaker 1: Catherine de Medici from being blamed when she and her husband,
Speaker 1: King Henry the Second could not have kids, despite the
Speaker 1: fact that he apparently had a malformed penis. Catherine was
Speaker 1: still blamed. So good for popular culture during this time
Speaker 1: where we're finally being like, I wonder if men could
Speaker 1: be to blame ever for this, But it did yet
Speaker 1: didn't help her. Yeah, I mean, there was still the
Speaker 1: belief that it would it would have to be blamed
Speaker 1: on the woman's body shape, her cervical shape, womb temperatures,
Speaker 1: and that infertility could then lead to mental disturbances. So
Speaker 1: we're still living in the whole mentality of the hysterical
Speaker 1: uterus and all of the lady brain problems that that
Speaker 1: can cause. But finally in the seventeenth century, we start
Speaker 1: to learn a little bit about how this works. We
Speaker 1: see sperm under a microscope for the first time, and
Speaker 1: so this leads to more examination of male fertility, and
Speaker 1: by the mid seventeen hundreds, we understood fertilization better and
Speaker 1: infertility was slightly less moralized. But now there is just
Speaker 1: an idea that your menstruation was unbalanced in some way.
Speaker 1: So treatments include stimulating sexual pleasure, which was thought to
Speaker 1: be helpful to conception. Yeah, I thought for sure. I
Speaker 1: was like, I must have read that wrong, because so
Speaker 1: much of what we read and talk about for the
Speaker 1: podcast goes back to like, sexual pleasure is super wrong.
Speaker 1: Women should never experience sexual pleasure. But it's interesting that
Speaker 1: it comes in in terms of fertility, like, well, maybe
Speaker 1: it can't work unless somebody's having a good time. You
Speaker 1: gotta balance that menstruation somehow. Yeah, I know, I hate
Speaker 1: when my menstruation is unbalanced. But by the eighteen hundreds
Speaker 1: we see more surgical advancements and the further development of
Speaker 1: the idea that infertility is a mechanical problem caused by
Speaker 1: cervical disorders or a male position of the uter is.
Speaker 1: But you still have ideas about quote unquote luxurious living
Speaker 1: and women's misbehavior persisting, and that includes heavy mental activity
Speaker 1: that could potentially damage your other organs. Yeah, Basically there
Speaker 1: is a longstanding idea that if a woman thinks too much,
Speaker 1: then she renders herself infertile because I mean, I guess
Speaker 1: her brain heats up our wounds and then that just
Speaker 1: ruins everything. Basically, it puts our uterus is in a microwave.
Speaker 1: And now I'm picturing like an Industrial Revolution era factory
Speaker 1: where like wheels and gears and cogs are just like
Speaker 1: working over time, and there's all this steam and like
Speaker 1: suddenly the machine just craps out, and that machine is
Speaker 1: you womb, if you womb. But in six we do
Speaker 1: get a New York doctor who's the first to argue
Speaker 1: that husbands GNA rhea infections could be probably potentially maybe
Speaker 1: likely causing their wives to be sterile. Yeah, because I
Speaker 1: mean with the Industrial Revolution, speaking of which, an urbanization,
Speaker 1: you have more men visiting prostitutes and the rise of
Speaker 1: STDs with that. But of course probably the blame for
Speaker 1: that ultimately would go back to the women and not
Speaker 1: inevitably not the men who were paying for their services. Um.
Speaker 1: But in the early twentieth century, there are lots of
Speaker 1: discoveries around hormones. There's a test developed for blocked fallopian tubes,
Speaker 1: and guidelines published for analyzing sperm count for male fertility.
Speaker 1: So we're starting to figure some things out in a
Speaker 1: real way. And in famed Dr John Rock reports the
Speaker 1: first US fertilization of human eggs in a lab dish.
Speaker 1: This is in vitro fertilization. And at the same time
Speaker 1: the public is demanding fertility treatments. They're like, listen, we
Speaker 1: want babies, and we want babies now, and you're gonna
Speaker 1: fix this. Isn't it ironic? Then that Dr John Rock
Speaker 1: would then go on to be so instrumental in developing
Speaker 1: the very first oral contraceptive for women. Oh my god,
Speaker 1: the more you know, go back and to stuff Mo'm
Speaker 1: never told you dot Com and listen to the episode
Speaker 1: The Father of birth Control, Love it Um. And in
Speaker 1: the late twentieth century, we see the first in vitro
Speaker 1: babies being born in the UK. In the US, we
Speaker 1: see sperm injected into the egg for the first time,
Speaker 1: the first successful pregnancy from a frozen egg. I believe
Speaker 1: that was at a fertility place here in Atlanta and
Speaker 1: rising at the same time, though, you've got parallel dialogues
Speaker 1: around the desire to wait to have kids because you know,
Speaker 1: maybe you're pursuing an education or a career, the desire
Speaker 1: to be child free. So you know, more than ever
Speaker 1: during this time, women are starting to be like, hey,
Speaker 1: maybe I don't want to have kids. But you start
Speaker 1: to see almost in response to that, but certainly developing
Speaker 1: at the same time, more and more media driven anxieties
Speaker 1: about that decision to put off kids and the fact
Speaker 1: that you might wind up unable to have them. And Okay,
Speaker 1: so I meant to go back and read some of
Speaker 1: the media coverage that came out when the first in
Speaker 1: betro baby I believe her name was Louise brown Um
Speaker 1: was born in the UK to offer some more background
Speaker 1: to the media anxiety about not having kids, because if
Speaker 1: I remember correctly what I've read about that, there was
Speaker 1: a lot of controversy about the so called in betro
Speaker 1: babies and people saying back at the time that oh,
Speaker 1: we're just now playing god and this is you know,
Speaker 1: technology gone awry, and so it seems like regardless of
Speaker 1: what's what angle we're looking at reproduction, it's like, no,
Speaker 1: this is helping someone have a child that they want
Speaker 1: to have. But then if we want to delay having
Speaker 1: a child that we may or may not want to
Speaker 1: have them, that's not okay either. And this just leads
Speaker 1: us into this conversation around the infort to these stigma
Speaker 1: and how a lot of times it does seem like
Speaker 1: a total catch twenty two where they're, like you said, Caroline,
Speaker 1: there's there's kind of no winning. Also because there's this
Speaker 1: longstanding misconception that it's it tends to be an issue
Speaker 1: with the woman's body, whereas is we noted at the
Speaker 1: top of the podcast, it's like a third of the
Speaker 1: time it's happening with the penis that there, at the
Speaker 1: time it's with the vagina, and the other third of
Speaker 1: the time who knows what it is. Yeah, and we
Speaker 1: wanted to definitely look globally. We definitely wanted to look
Speaker 1: outside of the United States for this conversation because, like
Speaker 1: I said at the top of the podcast, no matter
Speaker 1: where we are, no matter who you are, shame around
Speaker 1: infertility exists. Despite the fact that Christen said that the
Speaker 1: fertility issues between men and women are pretty much equal,
Speaker 1: and so we were reading these articles. One was from
Speaker 1: the World Health Organization, and one was from Newsweek that
Speaker 1: focused specifically on stigma in developing countries. However, that being said,
Speaker 1: I think despite the fact that these articles focused on
Speaker 1: developing countries, these issues can be extrapolated to apply to
Speaker 1: women all over the world because women might face everything
Speaker 1: from ostracism being considered inauspicious at weddings. Um in some
Speaker 1: Muslim regions, women can only go out if they have
Speaker 1: children with them, or a or a chaperone of some kind.
Speaker 1: But forget running erin solo, ranging all the way to
Speaker 1: abandonment and even abuse. And then there's the whole idea
Speaker 1: that you are a failure in society because of course
Speaker 1: this is the role of women. You know, you have
Speaker 1: to have kids. And this was something that Rhea Sambuya,
Speaker 1: who's the founder of the Joyce Fertility Support Center in Uganda,
Speaker 1: was talking about and she said, quote, our culture demands
Speaker 1: that for a woman to be socially acceptable, she should
Speaker 1: have at least one biological child. Almost all cultures across
Speaker 1: Africa put emphasis on women having children. Marriage without children
Speaker 1: is considered a failure of the two individuals. Yeah, and
Speaker 1: talking about this, William Ambolet, who works with Gank Institute
Speaker 1: for Fertility Technology in Belgium, said that if you're infertile
Speaker 1: in some cultures, you're less than a dog. In the
Speaker 1: Hindu religion, as one example, when a woman without a child,
Speaker 1: particularly a son, can't go to heaven, she needs a
Speaker 1: son to perform burial ritual rituals, and similar attitudes persist
Speaker 1: in China and Vietnam, where some believe childless folks souls
Speaker 1: can't rest for eternity. And in China, again, children are
Speaker 1: seen as gifts from God, so people who are childless
Speaker 1: can be viewed as unworthy or as sinners, which makes
Speaker 1: it even harder to seek treatment, even if you can
Speaker 1: afford it, even if you have the money to go
Speaker 1: seek treatment, just that stigma of needing help prevents people
Speaker 1: from doing so. And then there's a whole angle of well,
Speaker 1: if you're infertile, you are a socio economic burden. And
Speaker 1: this was something uh that World Health Organization Productive Health
Speaker 1: and Research Department head Dr Cheryl Vanderpoolt was talking about, saying,
Speaker 1: how uh, you know, if you don't have kids who
Speaker 1: can then grow up to take care of you and
Speaker 1: also have kids who can do household chores and also
Speaker 1: contribute to local economies. Then you're just gonna be a
Speaker 1: drain not only on your community, but also to your
Speaker 1: wider family, who becomes deeply disappointed for the loss of
Speaker 1: what she calls continuity of the family, as well as
Speaker 1: again the contribution to the community. So this only intensifies
Speaker 1: feelings of guilt and shame. Yeah, and the the idea
Speaker 1: that your failure in your marriage. I mean, the World
Speaker 1: Health Organization article quoted a Ugandan woman who said, women
Speaker 1: like me often have to bear the extra marital relationships
Speaker 1: that our husbands tend to have. I have overheard other
Speaker 1: women talking about us as being cursed. There's an idea,
Speaker 1: especially in polygamous cultures, that it's completely acceptable for a
Speaker 1: man to either divorce his wife or take another your
Speaker 1: wife if that culture permits polygamy, simply in the effort
Speaker 1: to have biological children. There was one example talking about
Speaker 1: a particular ethnic group in Mozambique, where it's common for
Speaker 1: women to commit adultery in an attempt to get pregnant
Speaker 1: rather than face exclusion from traditional ceremonies and social activities.
Speaker 1: But if you are living in a society where it
Speaker 1: is acceptable for the husband to leave you and father
Speaker 1: children with other women. In the case of infertility, then
Speaker 1: he's going to be likely unlikely excuse me, to support
Speaker 1: your efforts to seek fertility treatments, or probably support you
Speaker 1: at all. And with all of this potential extramarital sex
Speaker 1: having going on, this can also lead to STDs. I mean,
Speaker 1: if you look at the developing nation in general, there
Speaker 1: are of course issues regardless of fertility with untreated STDs,
Speaker 1: if you have condom taboos, um, and just the cost
Speaker 1: of condoms and contraceptives being too high, and also infections
Speaker 1: from female genital mutilation. Yeah, and similarly, uh, there are
Speaker 1: many women across the developing world who face infections and
Speaker 1: complications from either births or abortions in unsanitary hospitals. And
Speaker 1: you know, we mentioned earlier that sperm count and quality
Speaker 1: can be affected by overexposure to certain chemicals. You've got
Speaker 1: to worry about toxins like lead, which is high in
Speaker 1: places like Mexico City and Cairo, or the chemical dioxin
Speaker 1: which is sprayed on crops. But if you get to
Speaker 1: the point to where you know that you could benefit
Speaker 1: from treatment, there are still cultural hurdles that you would
Speaker 1: have to cross because of course, some cultures consider masturbation evil,
Speaker 1: but of course if you need sperm for an IVF treatment,
Speaker 1: masturbation is required. Um. In some Muslim cultures, as the
Speaker 1: w h O pointed out, um there against egg and
Speaker 1: sperm donation because children must have what they call known parents.
Speaker 1: That biological relationship is important, it's necessary, and there's even
Speaker 1: hurdles to getting help. This is what's talked about in
Speaker 1: a couple of the articles we read where Westerners, for instance,
Speaker 1: have little sympathy for countries or cultures that they view
Speaker 1: very in a very self centered way as being overpopulated. Anyway,
Speaker 1: this is something that Dr Mammud Fatala talked about in
Speaker 1: the WHO article. He said, if couples are urged to
Speaker 1: postpone or widely spaced pregnancies, it's imperative that they should
Speaker 1: be helped to achieve pregnancy when they do decide in
Speaker 1: the more limited time that they have available. And basically
Speaker 1: this goes back to what um one O B g
Speaker 1: I N in South Africa described as a fertility paradox
Speaker 1: where you have both high fertility rates and high infertility rates,
Speaker 1: and those fertility rates really depend on again the use
Speaker 1: and desire to use family planning services, what your preferences
Speaker 1: are for family size. For instance, East Africa has a
Speaker 1: much higher rate of family planning and contraception use, whereas
Speaker 1: West Africans still tend to prefer the larger families. But
Speaker 1: then those high infertility rates come from everything we've been
Speaker 1: talking about, the health issues, the untreated STDs, and when
Speaker 1: you talk to infertility treatment proponents who are over into
Speaker 1: these developing countries, they note that, hey, guys, IVF does
Speaker 1: not contribute to overpopulation anymore than saving lives with vaccination does,
Speaker 1: and both alleviate suffering. So why would we not try
Speaker 1: to help establish whether clinics in general or fertility treatment
Speaker 1: specialists specifically. But the thing is, you know, we've just
Speaker 1: been talking for the past few minutes about these situations
Speaker 1: happening in areas where you might not be able to
Speaker 1: access clean drinking water, much less an IVF treatment. But
Speaker 1: that suffering and this psychological um, guilt, shame, and also
Speaker 1: social stigma and taboo around this is almost universal because
Speaker 1: if we look back in the US, where IVF and
Speaker 1: infertility treatments at large might be far more accessible, it's
Speaker 1: still often such a silent battle um There was an
Speaker 1: end up article that we read actually in Self magazine
Speaker 1: was reported on a survey finding that six of the
Speaker 1: infertility patients they talked to hid their struggle to get
Speaker 1: pregnant from both friends and family, and more than half
Speaker 1: of those people reported that it was easier to tell
Speaker 1: folks that they didn't intend to build a family rather
Speaker 1: than share their troubles. And that's I hate that. Oh God,
Speaker 1: I couldn't believe that when I read that that it
Speaker 1: was it's easier just to say, but I mean, I
Speaker 1: can I can believe it, but I can't. Uh. They
Speaker 1: talked to psychologists Linda Applegarth, who says that having difficulty
Speaker 1: getting pregnant can causes much grief as losing a loved one,
Speaker 1: but it's different. She writes, it's chronic and elusive. There's
Speaker 1: a fear that life will be eternally empty. Some feel
Speaker 1: a sense of damage and brokenness, and it goes to
Speaker 1: the heart of who they are. And she writes about
Speaker 1: the sense of dread and shame that she sees even
Speaker 1: in her own waiting room from women who won't even
Speaker 1: make eye contact with each other, and how it's different
Speaker 1: when you look in the waiting room for people, uh,
Speaker 1: male or female seeking treatment for cancer, for instance, where
Speaker 1: patients will maybe trade stories, will maybe ask each other
Speaker 1: how they're doing. She's like, there's a distinct difference in
Speaker 1: a fertility waiting room because it's almost like these these
Speaker 1: men and women don't want to acknowledge that they're having
Speaker 1: these struggles. And even when psychological resources are available and
Speaker 1: fertility patients often don't use them. Um. Apple Garth noted
Speaker 1: that only about five percent of patients in her clinic
Speaker 1: take advantage of the psychological support service. Says, uh that
Speaker 1: it offers despite data showing how helpful that it might be.
Speaker 1: I mean, we talked a while back now, um about
Speaker 1: the kind of that mind body interaction between anxiety, depression
Speaker 1: and difficulty getting pregnant as well, and a University of
Speaker 1: Michigan studies zeroed in on black women specifically in this
Speaker 1: country because they're less likely to seek medical helps, so
Speaker 1: their struggles end up overlooked. I mean, this is already
Speaker 1: an issue where people aren't talking about it, feel they
Speaker 1: can't talk about it, but when when it comes to
Speaker 1: African American women, even fewer are vocalizing their struggle. Of
Speaker 1: the women that this study talked to reported feeling isolated
Speaker 1: and lonely during their efforts to get pregnant, and many
Speaker 1: felt that they needed to take on the burden all
Speaker 1: by themselves. And it's because of this web of reasons.
Speaker 1: It's personal shame that we've talked about, but it's also
Speaker 1: cultural barriers like stigma against talking about your personal business
Speaker 1: or the expectation that Black women should be strong and
Speaker 1: resilient enough to handle their problems on their own. There's
Speaker 1: also this feeling that from the women that they talked
Speaker 1: to of abnormality for not being able to get pregnant,
Speaker 1: and this goes back to what the authors discussed as
Speaker 1: the internalization of stereotypes about African American women's hyper fertility
Speaker 1: or belief in a black fertility mandate. So a lot
Speaker 1: of women of whatever race, age background report feeling pressure
Speaker 1: of the motherhood mandate that you're a woman, you should
Speaker 1: have babies, have lots of babies, go forth and be
Speaker 1: multiply and be fruitful. And this was also the case
Speaker 1: for these UH University of Michigan research participants that they
Speaker 1: felt like, well, um, you know, I'm a an African
Speaker 1: American woman, I'm a black woman. I'm supposed to have
Speaker 1: lots of children or that's common in this culture, or
Speaker 1: it's expected of me. It should be easy for me
Speaker 1: to get pregnant, exactly, And so a lot of them
Speaker 1: hold the researchers that infertility is not something that's supposed
Speaker 1: to happen to me. It's something that happens to rich
Speaker 1: white people who can, you know, pay all this money
Speaker 1: to have treatments done well. And speaking of you know,
Speaker 1: the the wealth factor, I mean that absolutely is one
Speaker 1: of the reasons why women of color are less likely
Speaker 1: to seek treatment. But there's also the issue of having
Speaker 1: tense relationships with doctors. I mean, this is something that
Speaker 1: if you start looking in medical studies about like patient
Speaker 1: doctor interactions, Um, things do shift when uh, it is
Speaker 1: a white person sitting on the exam table versus people
Speaker 1: of color. But regardless of race, women dealing with that
Speaker 1: motherhood mandate that you described, Caroline, that every woman should
Speaker 1: have kids, or that if you don't have kids then
Speaker 1: you're somehow less valuable or a less than woman. Um,
Speaker 1: that is a really powerful myth that I think is
Speaker 1: really easy for us to believe because it's seen as
Speaker 1: just this basic feminine act. It's just something that's inevitable.
Speaker 1: You know, we take birth control in order to not
Speaker 1: get pregnant. All we're taught a lot of times in
Speaker 1: at least American sex education classes is that you know,
Speaker 1: if we have sex, then automatically we're going to get pregnant.
Speaker 1: So it's no surprise then that we have so many
Speaker 1: misconceptions about a how challenging it can be to get pregnant,
Speaker 1: and how common infertility is. And I think that this
Speaker 1: is part of what should be considered comprehensive sex education,
Speaker 1: ongoing sex education. Yeah, and what all this spoils down to,
Speaker 1: basically is that this constant shame and overwhelming stigma contributes
Speaker 1: to women not talking about their experiences, women and men
Speaker 1: not sharing their experiences, which then translates into a lack
Speaker 1: of advocacy on a governmental level. I mean, if people
Speaker 1: aren't talking about it the same way that they talk
Speaker 1: about breast cancer, for instance, there's not as much of
Speaker 1: a push for research dollars or for answers and solutions.
Speaker 1: Um Barbara Clura, who's the executive director of Resolve, the
Speaker 1: National Infertility Association based in Virginia, so as we can
Speaker 1: only get a handful of our own volunteers to speak
Speaker 1: out because of the shame and because we have some
Speaker 1: little patient advocacy, we have so little progress. And I
Speaker 1: highly recommend that if you are someone you know struggles
Speaker 1: with this issue, you go over to Resolve the website.
Speaker 1: It's a very comprehensive resource. It talks about everything from
Speaker 1: the actual infertility struggle, to mental health issues to talking
Speaker 1: about issues of insurance coverage. Um so it's definitely a
Speaker 1: great resource. But this is yet another women's health issue
Speaker 1: where we see so much, so much shame and internalization
Speaker 1: of of something that your body is doing and or
Speaker 1: your partner's body is doing. And we can all benefit
Speaker 1: from having a wider, more, a wider and louder conversation
Speaker 1: about it. Yeah. Mean, and it's a women's health issue,
Speaker 1: but it's also a men's health issue as well. And
Speaker 1: I'm glad you mentioned you know, men's silence around it too,
Speaker 1: because one of the studies we looked at evaluated the
Speaker 1: psychological impacts of infertility for both men and women, and
Speaker 1: while women in the study were likelier to experience negative
Speaker 1: psychological repercussions, many of the men did as well. So
Speaker 1: as with our conversation about say, miscarriage. It's definitely something Um,
Speaker 1: I mean, and again we were now talking more in
Speaker 1: straight couple of context, but it's still something that men
Speaker 1: need to feel more welcome and comfortable talking about as well,
Speaker 1: because you know, a third of the time it could
Speaker 1: be their bodies which might be causing the issue. But Caroline,
Speaker 1: before we wrap up, I did want to ask your
Speaker 1: opinion on something that came up in our research about
Speaker 1: infertility being considered or a disability, which some think would
Speaker 1: be helpful for getting more insurance coverage for infertility treatments.
Speaker 1: But when I read that, I my my instinct was
Speaker 1: to not entirely agree because it seems like classifying infertility
Speaker 1: as a disability only reinforces the idea that it's women's
Speaker 1: role and purpose to reproduce. Yeah, I mean, I think
Speaker 1: that that's a conversation that literally happens anytime anything is
Speaker 1: classified as a disability, because it almost makes it sound
Speaker 1: like this defines you, and you know, what your body
Speaker 1: does does not define you. Your your more than your body. UM.
Speaker 1: That being said, you know someone who doesn't struggle with
Speaker 1: these issues. It's it's hard for me to weigh in
Speaker 1: other than to say if something is classified a certain
Speaker 1: way according to the government. It helps you get insurance coverage.
Speaker 1: I see that as a positive. Um it's I think
Speaker 1: it's less so in our conversations that we had around
Speaker 1: pregnancy and the way that like maternity leave and paid
Speaker 1: family leave happens. But as far as language goes, I
Speaker 1: think it's a shame that it has to be called
Speaker 1: a disability for that very important coverage to happen. Yeah,
Speaker 1: I mean, because I just wonder, um and and listeners,
Speaker 1: I really hope that some of you can fill us
Speaker 1: in on this. I wonder about people who find out
Speaker 1: that they are infertile and they're okay with it, and
Speaker 1: whether that leads to conflicted feelings as well, because there
Speaker 1: is an assumption that if you are inferrald that it
Speaker 1: is a shameful and sad tragedy. But I have a
Speaker 1: feeling that there there are people who are are totally
Speaker 1: fine and live perfectly happy live. So I mean, again,
Speaker 1: this is just I mean, I'm just I'm I'm genuinely
Speaker 1: curious to hear from people what these experien rances are
Speaker 1: because I don't know at all. Um So, listeners, we
Speaker 1: definitely want to hear from you on this issue, because again,
Speaker 1: this is something that we don't talk about nearly enough.
Speaker 1: Mom Stuff at how stuff works dot Com is where
Speaker 1: you can email us. You can also tweet us at
Speaker 1: Mom's Stuff podcast or messages on Facebook, and we've got
Speaker 1: a couple of messages to share with you right now.
Speaker 1: I have a letter here from April in response to
Speaker 1: our knitting episode. She says. Let me start by saying,
Speaker 1: how much to enjoy your podcast. Thank you, April. We
Speaker 1: enjoy having you listen. She says, as I was listening
Speaker 1: to the podcast on knitting this evening, you mentioned knitting
Speaker 1: during the World Wars was propaganda. This could not be
Speaker 1: further from the truth. From the Civil War to World
Speaker 1: War One and World War Two, the knitting of socks
Speaker 1: was very important. Foot rot was a constant battle. Soldiers
Speaker 1: could not march and walk long distances without good socks
Speaker 1: that helped keep the moisture away. Can you imagine trying
Speaker 1: to walk in mill military boots with wet holy socks,
Speaker 1: or even without socks altogether. Soldiers had blisters and would
Speaker 1: develop infections. Their feet would literally wrought. The knitting of
Speaker 1: socks was as important as the recycling of metal or
Speaker 1: the rationing of sugar. It was not just a way
Speaker 1: to keep the women and children busy or make them
Speaker 1: feel like they were part of the war effort. It
Speaker 1: was an important part of the war effort. I am
Speaker 1: a knitter and a feminist in the age of forty one.
Speaker 1: I am currently working on my dissertation for my PhD
Speaker 1: in history. My focus is women's history, and my dissertation
Speaker 1: is actually focused around women and the crafts that bring
Speaker 1: them together, things such as knitting and sewing. I also
Speaker 1: am an adjoinct history teacher at a local junior college
Speaker 1: and I teach a women's history class I put together.
Speaker 1: In this class, we have a section on women and
Speaker 1: the war effort, and we talked about knitting as a
Speaker 1: big part of the lives of those at home. Thank
Speaker 1: you for all the hard work you do. I just
Speaker 1: don't think you overlooked this one important thing, So thank
Speaker 1: you for filling us in April. Well, I have a
Speaker 1: delightful letter here also about our knitting episode, and it's
Speaker 1: from Elias, who writes, I'm eighteen years old and I
Speaker 1: actually just started listening to your podcast in December. I'm
Speaker 1: a big fan of stuff you should know, so I
Speaker 1: thought i'd give another house Stuff Works podcast to try.
Speaker 1: By the title, I thought I'd learned about all kinds
Speaker 1: of interesting secret things my mom never told me. So
Speaker 1: I was a bit surprised when it turned out to
Speaker 1: be a podcast about feminism, but I'm so glad I
Speaker 1: decided to keep listening. While before I only had a
Speaker 1: vague understanding of what feminism really means, after just a
Speaker 1: handful of episodes, I already feel so much more educated
Speaker 1: on the social topic and have a much better grasp
Speaker 1: on its scope and importance. Thanks for being such informative,
Speaker 1: friendly and charming podcasters. Well, thank you, Elias. And I
Speaker 1: think I might be mispronouncing your name, so I apologize
Speaker 1: um if I am. But anyway, getting on to knitting,
Speaker 1: Elliots wrote, anyway, the real reason I wanted to email
Speaker 1: you is because I'm a guy who knows how to knit.
Speaker 1: You see, a few summers ago, when I was fourteen,
Speaker 1: I went to a family camp with my extended family,
Speaker 1: and one day we were surprised to find that the
Speaker 1: arts and craft staff would be teaching knitting to anyone
Speaker 1: who'd like to learn. Two of my aunts and I
Speaker 1: thought it sounded like a fun idea, so We gave
Speaker 1: it try, but as you were both saying, it's very
Speaker 1: difficult to learn. The steps were so precise and hard
Speaker 1: to remember, and I made so many mistakes that my
Speaker 1: script first scarf turned out to be more like a
Speaker 1: scratchy rainbow shaped cloth. Still, it was fun and a
Speaker 1: little addicting, So when I got home, I looked at
Speaker 1: the steps on YouTube to really get them down, bought
Speaker 1: some fresh yard, and tried again. After a few days,
Speaker 1: I finally got it. Now I have an awesome black
Speaker 1: and blue scarf as proof of my dedicated work. So
Speaker 1: word to everyone, no matter how old or what gender
Speaker 1: you are, anyone can love to knit. Well. Thank you
Speaker 1: so much for that story and for listening, and thanks
Speaker 1: to all of you for your letters. Keep them coming
Speaker 1: to mom stuff at how stuffworks dot com and brilling
Speaker 1: all of our social media as well as all of
Speaker 1: our blogs, videos and podcasts with our sources so you
Speaker 1: can learn more about infertility and other topics. Head on
Speaker 1: over to stuff Mom Never Told You dot com For
Speaker 1: more on this and thousands of other topics. Visit how
Speaker 1: staff works dot com.