Breaking the taboo of discussing fertility issues

Our fertility remains a hushed conversation, discussed in private with those we trust not to pass judgment. The path to parenthood, however, is not always a straightforward road. Riddled with misconceptions and myths, infertility is still perceived to weigh heavier on the side of the woman rather than the man, despite issues in conceiving affecting both.

Women face higher stigma on a number of levels when conceiving is not a straightforward occurrence. Firstly, on a societal level, there is the associated belief that having children is a natural and presumed atypical tradition for women. The repeated conversations endured by women as to when they are going to get pregnant, or start a family amplifies this attitude that the primary role of a woman is carry a child. As such women are shrouded in stigma on an individual level as that belief is embedded in their psyche. Clinical words and phrases such as geriatric pregnancy, inhospitable womb and spontaneous miscarriage play into a narrative of blame and isolation.

Dr Hans Arce, medical director at ReproMed, says, "Despite the fact that infertility is relatively common (one in six in Ireland), wanting to have and having kids is seen as a societal norm which means people who don't conform to this norm are potentially at risk of experiencing stigma. Much of this is related to a woman's age and the associated biological clock that's commonly referred to as a timeline for women having children.

“The topic of infertility is still utterly taboo and that’s why so many women with infertility suffer in silence. The challenge with infertility is that we’re talking about body parts that make people feel uncomfortable. Humans are biologically wired to procreate. That’s why it’s so frustrating when something that is supposed to be so natural doesn’t work. Infertility can make you feel ‘less than’ or ‘other than’ because your body has failed you. That’s why infertility often comes wrapped in a package of shame.”

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Hidden burden

Stigma is the hidden burden of infertility for women which is ultimately an entirely complex issue. Often seen as a final blow in the hope of becoming a parent, it is rather a diverging path in seeking treatment and advice from professionals in navigating a route to potential parenthood. Rectifying the misinformation surrounding the stigma and myths of infertility is essential in normalising something which is essentially commonplace.

While open and honest conversations are not always easy to have considering the emotional, physical and financial toll of traversing infertility, it is vital to break the taboo of seeking help. Dr Arce encourages women to be proactive in looking after their fertility with a keen balance of information and education to raise awareness. He also suggests women encourage and support one another to engage in conversations that can challenge perceptions and help forge positive change across our society.

“No taboo,” he says, “just talk about sex and fertility without judgment and guilt. Sex and reproduction is as much a biological function as eating and breathing but there are no taboos surrounding that so why is there one around sex and fertility? We’ve seen many times that a sense of community can empower people to address their infertility and tell their own story. People struggling with infertility might not suffer in silence if the topic was better understood and if more people were willing to discuss it.”

Debunking the ingrained myths are a significant block in challenging the stigma women face in relation to their fertility. The more frequent and well known being that women are more likely to be infertile than men, that stress causes infertility, and that IVF works for most patients. Dr Arce also recognises that due to the woman carrying the baby, not the man, people often think that the infertility issue must be related to the female anatomy.

“In fact, men and women are equally responsible,” he says. “One-third of cases are down to the male, one-third attributable to the female, and the rest are either both sides or unexplained. But the fact of the matter is that infertility is nobody’s fault. It is just a medical condition like asthma and should be treated with the same scientific approach.

“Guilt and the secrecy shrouding infertility makes what is already an emotionally, financially, and physically demanding process even harder. The secrecy and aura of shame surrounding it also helps perpetuate the misconception that infertility is somehow more of a lifestyle choice than a medical condition.”

Empower women

In an effort to educate and empower women, ReproMed launched an awareness campaign aimed at women in their 20s and early 30s simply referred to as #letstalkfertility. Seeking to provide women opportunities to take their fertility and reproductive health into their own hands and manage the possibilities of parenthood, whether or not it is a current consideration. In many ways, encouraging women to actively focus on their reproductive health aligns them with understanding and appreciating their bodies in its entirety in order to focus on their health as we challenge the gender health gap afforded to women. As generations become more comfortable in talking about fertility issues, women will break the taboo and stigma surrounding the ability to conceive.

Over the past two years, ReproMed has witnessed a 30 per cent increase in fertility consultations with a 42 per cent increase in patients requesting egg freezing services. This increased awareness of fertility options among women shows a desire to take more control of their reproductive health. The invisible weight of the baby deadline no longer holds as much control with the many options available to women. However, the stigmatised narrative can create a significant block in women accessing treatment and most notably this can impact on having the necessary familial supports in place when undergoing treatment.

Dr Arce says, “It can be a challenging subject to discuss which is why we need to have open and honest conversations with friends and family around fertility to normalise the conversation and make sure anyone interested in accessing fertility services, whether that is AMH testing or IVF, can do so feeling fully supported at every stage.”

Women's Health Gap
Part 1: Unheard and dismissed
Part 2: Discussing fertility issues
Part 3: The female body