Fertility as a luxury? Don't blame tech
Updated: May 12, 2020
There have been a few articles lately dealing with issues surrounding one big aspect of modern fertility: money.
On the blog Jezebel this week, Frida Garza argues that fertility treatment is elitist. ("The Rise of Fertility Tech Makes Pregnancy a Luxury Good".) While the article is certainly thought-provoking (give it a read), we also have a few big issues with it.
Her point is that as demand grows for ways to help us have babies even as our natural fertility declines, the majority of people are getting priced out. The technology isn't cheap.
She particularly highlights a company called Future Fertility, an AI biotech startup focused on reproductive innovation. The firm has unveiled an algorithm that supposedly detects which eggs will result in successful fertilization with 90% accuracy. Garza's problem with this is that although technology has made becoming a parent a possibility to a wider range of people "that flexibility comes at a price, which makes it off-limits to all but the most wealthy."
Garza gets it right that despite the need for fertility treatments increasing, it's not necessarily becoming more affordable along with demand. There's always a newer, better technology to be bought and paid for that increases the likelihood of success: embryo selection, assisted hatching etc.
While procreating used to be no more expensive than the price of a few tequila shots (joke), as the trend for delayed parenthood grows and many of us are leaving it "too late" for natural conception, fertility is now a multi-million dollar industry in and of itself. As such, Garza argues, "fertility treatments threaten to reinforce existing class divides as they climb in price."
But the answer is not to bash new technologies striving for progress. That's kind of like saying the computer should never have been invented because people who can't afford one miss out on its learning benefits, hampering social mobility. We didn't ban Microsoft. We improved, refined, made computers cheaper until over time the price point was more accessible.
And, really, when have fertility treatments actually been affordable? Nascent tech always comes at a price, whatever the field. And when it comes to fertility treatment, part of the reason we see sky high costs is the cumulative rounds of treatment needed to result in a pregnancy. Despite the average age of people receiving fertility treatment rising, this is actually falling. Embryologists have got a lot better at their jobs, meaning higher success rates. A higher success rate in one cycle of IVF equals fewer cycles needed on average, which equals, yup...MORE affordable treatment overall.
And why have success rates improved? Because companies like Future Fertility pour money into research that results in new techniques and equipment. Let's take "rapid vitrification", for instance. Scientists used to freeze eggs and embryos using an older "slow vitrification" technique. Since the invention and implementation of the new, better processes, their ability to successfully freeze and thaw eggs and embryos has come on leaps and bounds, giving hopeful people a better shot at biological parenthood.
But that wouldn't have happened without investment, R&D and, ultimately, an industry driving it. Put plainly, coming up with new healthcare technologies is expensive. Once its widely used, the pricing becomes more competitive.
Infertility sucks. There's no way around that fact. And it sucks even more that people who can't afford it don't have the option of fertility treatment.
But as one commenter on the Jezebel piece put it:
"The invention of an algorithm to determine if an egg is viable is a godsend. We paid for 5 rounds of IVF, but only one worked. If something could have better predicted which ones would succeed, it would have saved us a large amount of money and time."
No doubt, as things stand in the US, it is a privileged few who can afford to have a procedure like egg freezing or IVF, or to access insurance that will cover it.
But what we need is more innovation, not less. Start-ups that make the treatment process shorter and more reliable ultimately do make it more affordable.
Meanwhile, thanks to regressive maternity policies and a healthcare system that fails to include so many, having kids at all is becoming an expensive luxury, not purely having them via assisted reproductive technologies. Perhaps commentators should be turning their attention to that first?