Why Aren't We Talking About Infertility?

By Dr. Karenne Fru, MD PhD | Founder and Medical Director, Muna Fertility

You, dear reader, know someone who is struggling with infertility. This person may be the person you wind up discussing this article with. They may be your neighbor, your sibling or that young couple with only one child. They may be the CEO of your company, the janitor or even yourself. Infertility is not limited to a single race, socioeconomic class, gender or any of the other ways we, as humans, are categorized in today’s society. All around the globe, in high and low-income countries alike, infertility and declining birth rates are a cause for concern. In April 2023, the World Health Organization published an alarming report noting that 1 in 6 adults will struggle with infertility in their lifetime. This common condition is increasing in frequency among all of humanity, and we are not talking about it. Each of us should bring this up in safe spaces so that it is robbed of its power to isolate and bring shame.

What is infertility?

The long-standing definition of infertility is the inability to achieve pregnancy after 1 year of unprotected intercourse. 

The American Society for Reproductive Medicine, as recently as 2023, updated the old definition to be more inclusive and reflective of the people who regularly seek treatment with fertility doctors (reproductive endocrinologists, REI).

"Infertility’’ is a disease, condition, or status characterized by any of the following:

• The inability to achieve a successful pregnancy based on a patient’s medical, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors

• 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 patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at 6 months when the female partner is 35 years of age or older

By this new definition, even more individuals will be classified as infertile. Infertility is already more common than diabetes among American adults and yet is shrouded in shame, isolation, and misinformation.

Why is talking about infertility important?

We need to talk about infertility because identifying its presence is the first step towards finding a root cause. Finding a cause is possible in most cases so that the appropriate cure might be applied. Even in cases of unexplained infertility, effective treatments exist. The treatments are more extensive than just in vitro fertilization (IVF). The treatment also does not have to come with a hefty price tag. But how would one know all of this without first identifying that they need help conceiving? The treatment for infertility involves medication, time, and support. Wouldn’t it be delightful if every patient got as much support as they desired or needed? Unlike what most people think, infertility affects both men and women equally.

How can it be that we live in a culture where it is customary to ask individuals when, not if, they are going to have kids but not if they are struggling with infertility? When an individual feels isolated, they tend to try folk remedies instead of seeking out the advice of trained professionals. There are also professional organizations like ASRM (American Society for Reproductive Medicine) and support societies like Resolve or Fertility for Colored Girls that exist to provide resources to anyone who suspects a reproductive issue. But first, we have to talk about infertility like we talk about any other human condition. I’ll go first; “Hello, I’m Dr. Fru and I survived 5 years of infertility. How may I help you?”