Humans have been having babies since forever, but never before have there been so many complexities to producing the warm and cuddly infants that are now all over your Instagram. Fertility is a matter of cutting-edge science, economic revolutions and basic human equality. Read on to discover a new form of IVF, how Emmanuel Macron is leading a French revolution in fertility and how the pandemic could affect the future of human reproduction.
Fiona Zublin, Senior Editor
1. Nouveau IVF
A new form of in vitro fertilization known as INVOcell uses a woman’s body as an incubator for the embryo instead of sheltering it in a lab before uterine implantation. Not only is the technique cheaper than standard IVF by about 40 percent, it’s also offering lesbian couples the opportunity to share the experience of carrying a child — one partner can incubate it before the other carries it to term. Meanwhile, 2020 saw the first baby born at a Parisian hospital via a new egg-freezing technique that harvests immature eggs without first having to stimulate a woman’s hormones — which will help women with some diseases, like cancer, that can be exacerbated by IVF hormone treatments.
2. There’s an App for That
Fertility tracking apps are a popular way for women hoping to get pregnant (or not!) to set their schedule. But one recent study found that they don’t actually work very well, and doctors caution that using most of them as a birth control method is essentially Russian roulette. Just one, Natural Cycles, has been cleared by the FDA as a contraceptive. Meanwhile, Harvard grad Ridhi Tariyal was annoyed at the inaccessibility to fertility testing, so she set about developing a smart tampon, NextGen Jane. The company is now beta-testing the technology, which hopes to use women’s periods as a natural biopsy to test for endometriosis, sexually transmitted diseases and more.
The increasing push in the U.S. for bills mandating that life begins at conception, though largely aimed at stopping legal abortions, could mean that fertility research is stopped in its tracks. Doctors who routinely unfreeze multiple embryos to give women the best chance of getting pregnant say the prospect of facing criminal charges if some of those embryos prove unviable will probably have a chilling effect, and could put a damper on life-changing fertility research in the years to come. Before Supreme Court Justice Amy Coney Barrett was seated, the editors of a leading fertility journal published their objection to her nomination based on her support for groups that oppose not only abortion but also the practice of IVF.
While the vast majority of fertility talk focuses on women’s bodies, there’s a looming crisis for male infertility: Sperm counts are plummeting, having crashed more than 50 percent across Western nations. Some research suggests a correlation between screen use at bedtime, whether it’s a TV or smartphone, and a drop in sperm quality. Scottish researcher Sarah Martins da Silva is dedicating her research in this niche field toward one day creating a pill to reverse male infertility. Meanwhile, South Korean researchers recently found success in reversing infertility by implanting proteins in the testicles of mice.
As birth rates drop in wealthy countries across the world, some nations have turned to generous bonuses for parents: One Finnish municipality offers a 10,000-euro bonus to anyone giving birth, while Estonia and France offer child benefits that increase exponentially the more children you have. Some experts say the money isn’t the only thing spurring heightened birth rates in these places, which boast family-friendly policies like child care and cultural preferences for large families. Still, the only continent where population is expected to be growing at the end of the century is Africa, where the number of people is forecast to triple by 2100. Nigeria is even expected to outpace China as the world’s most populous nation.
2. Parental Needs
National governments are also adapting to the needs of those who want to be parents but need a little help. Japan recently promised to cover the costs of IVF with health insurance for the first time, after years of a falling birth rate that’s expected to hit a record low this year. Meanwhile, French President Emmanuel Macron has pushed social reforms that would make assisted reproductive technology available to lesbian couples and single women — existing laws extend IVF to straight couples only. Still, some who oppose surrogacy — currently illegal in France, along with most of Europe — worry that the unwinding of longtime norms around IVF will open the door for more ethically complicated issues.
Given that infertility treatments are time-consuming, expensive and often uncomfortable, some are pushing more workplaces to offer benefits like time off and flexibility for employees dealing with conception woes, if only to attract the most-valuable workers. But this goes way beyond individual companies: Just 14 states in the U.S. have laws in place requiring insurers to cover infertility diagnosis and treatment (two more say insurance companies must at least offer such coverage), meaning that where an American lives could well determine their reproductive future.
4. Fighting for Basics
Soccer governing body FIFA just proposed new regulations that would mandate maternity leave for all female players in a bid to create minimum standards for soccer across the globe. Currently, soccer players’ leave is governed by the national laws of their countries — from Estonia, where new moms can draw their full wages for 18 months off work, to the U.S., the only one of 41 OECD nations without a legally mandated paid leave for parents.
With education across much of the country being done remotely, Carlos talks to the leading expert on remote learning, Khan Academy founder Sal Khan. Khan dives into his push for accessibility to world-class education, how he plans on working with the Biden administration and how we can use innovation in virtual education to improve political representation.
At least one recent study from the University of Miami found that men with COVID-19 could experience reduced fertility as a result of the virus. Further study found that the virus can invade the reproductive system even in men who are asymptomatic. Still, some fake stories are peddling the opposite information: Over the summer, a viral social media hoax shared thousands of times claimed that a COVID-19 vaccine causing infertility has been approved, which could scare healthy would-be parents from getting the vaccine despite the dangers of the virus to themselves and their potential offspring. Some mothers infected with the virus have been found to pass antibodies — but not the disease — to their babies through gestation or breastfeeding, but it’s unclear how long those antibodies last or how robust they might be.
2. Family Planning
COVID-19 lockdowns inspired the same tittering commentary that arises during every snowstorm or blackout, with speculation that it’ll cause a baby boom. But those baby booms aren’t supported by data, and economists say it’s even less likely that COVID-19 will spur people to become parents, since the pandemic-related shutdowns are being accompanied by a global recession, which is known to depress fertility rates. Early data indicates that births in the U.S. will drop by half a million in 2021, and one telehealth service said requests for birth control were up 50 percent. The pandemic could also exacerbate the demographic crisis in countries with already-low birth rates like Japan, where reported pregnancies in May through July 2020 were down more than 11 percent from last year. Meanwhile, Singapore is so distressed by the looming baby bust that it’s planning to offer extra one-off payments to those who procreate, on top of the $7,300 payment already extended to new parents.
Many people, particularly women in their 40s who are racing against their biological clock, saw their plans for a family postponed, perhaps forever, as IVF clinics shut their doors this spring. Things were even more difficult for those who opted to travel to obtain less expensive IVF treatment abroad, but found the rules governing whether such travel qualifies as “essential” to be unclear. And with such treatments dependent on women’s monthly cycles, they have to be carefully scheduled — meaning two-week quarantines or further closures can delay treatment by months rather than days. Still, countries like Northern Ireland are responding to the pandemic by allowing an extra year for women who are about to age out of eligibility for fertility treatments to remain on a waitlist. Meanwhile, one at-home fertility testing company said sales increased 234 percent year over year as couples continue to self-monitor while cut off from professional help.
4. But Could They Have Waited?
Last year, a 74-year-old in India gave birth, becoming the oldest mom on record. Her twins were the product of IVF. She and her husband, who is in his 80s, say they were long stigmatized in their village for not having children.
While fertility treatments have been largely normalized over the past few decades, British women of color say they’re often stigmatized by their communities for pursuing avenues like single motherhood via fertility technology, which is supported by the vanishingly small numbers of South Asian- and African-descended Brits using such treatments. That’s further complicated by the fact that sperm and egg donors in Europe are overwhelmingly white, meaning that anyone of non-white heritage may wait as long as five years to receive genetic material that reflects their ancestral background. Meanwhile, U.S. data indicates that Asian women are actually the most likely to seek out IVF.
2. The Greatest Loss
Prominent women like Chrissy Teigen and Meghan Markle have recently spoken out about their miscarriages and the accompanying grief and loneliness. In a New York Times op-ed, the Duchess of Sussex wrote, “When one person speaks truth, it gives license for all of us to do the same.” Both women were faced with a mix of gratitude from others who felt empowered to speak out about their own miscarriages, and online abuse: Teigen in particular was targeted by QAnon conspiracy theorists while grieving the loss of her son, Jack.
When Canadian billionaire Charles Vance Millar died in 1926, he willed the majority of his estate to the Toronto woman who gave birth to the most children over the subsequent decade. Thus began the Stork Derby, which ended with four massive families, with nine children each, sharing the prize. Along the way, Millar inadvertently sparked a moral panic among Toronto’s well-to-do about poor families reproducing; myriad legal battles by his distant relatives, who wanted the money for themselves; and objections from women who claimed to have had even more than nine kids but were disqualified for miscarriages or out-of-wedlock births.
Thousands of women have reportedly been able to conceive after rubbing fertility statues from the Ivory Coast now displayed at Ripley’s museums across America (this is according to, you guessed it, Ripley’s). Japanese women hoping to get pregnant travel to a festival each March featuring giant phalluses. And in France’s Bordeaux wine country, tourists to the tiny town of Saint-Émilion can avail themselves of an ancient fertility rite by sitting on the chair that belonged to the town’s namesake — which legend has it is a surefire way to get pregnant.