Feminism and assisted reproductive technologies

[Onemorning]

My DH and I are currently going through fertility issues. He has a low sperm count, and the consultant has gaily (it seems) put me through invasive and unpleasant tests (lap and dye, HSG) to confirm that I don't have an issue too.

We're at the end of all of our testing, and I feel that there is pressure (some subtle, some not) from friends who've gone through treatment, family and some medical personnel to go ahead with IVF despite the financial costs, the potential risks to my health, the health of the potential foetus and the potential risks to my/our mental health. It seems to be the 'done' thing, so we can say 'at least we tried'.

I am upset at the thought of not being a parent (and adoption is out for us for reasons I am not willing to divulge at the mo). This whole period of TTC (2+ years) has made me really consider why I want to be a parent, and to realise that if we don't have kids then it will be a different life to the one we'd expected, but not some kind of disaster, and we won't turn into hedonistic, pleasure seeking lotus eaters (as if!).

Is there something wrong with me if I just say ENOUGH, and grieve and move on with my life?

BTW this paper is one of a few I've found surrounding reproductive technology and how women are treated in the process.

I'm sorry to hear about the fertility issues.

The societal patriarchal norm is for women to settle down, have kids, and for us to assume that, should they not have DC, there's something wrong, somewhere down the line. It shouldn't be.

I tiink it'd be perfectly acceptable for you to decide that you don't want DC if things are going to be this invasive.I'm at the other end of the spectrum; currently considering donating eggs to help couples TTC, and reading into all of the processes involved, it seems so much more invasive than what the men go through. I find it interesting that the doctor assumes you'd be so happy and willing to go through these invasive tests. Interesting, yet sad.

You need to do what you feel is right. If you'd feel happier moving on from TTC, then you need to do that. No one should be dictating how much effort you put into TTC. No one.

Onemorning Really sorry to hear your DH has fertility problems.

I had IVF a few years ago. I am really, really happy it's available. I think it's a boon to many of us (in the rich west at least) to have available to extend our family planning options. But I think you are right that there is no real mention or consideration about the negatives (other than cost if you can't get NHS treatment) of going through it. Ans it is really invasive.

We were in the US and had decided we would try 3 rounds of IUI (which I think is more common there) but not go as far as IVF. This was down to both of us thinking we wanted to try something more thanleaving it up to nature, but felt we had to draw a line somewhere as it could clearly go on for years and become very consuming. Even from a non-feminist POV it seemed that sort of obsession with having a child was unhealthy.

In the end we had one round of IUI and one round of IVF, because after looking at it more closely I thought the risks associated with IUI were too great. But I found the whole thing horrible, I refused to have any eggs frozen from the IVF round because I was not prepared to go through any more treatment. I wouldn't do it again.

From a feminist perspective I am shocked and angry at how assisted reproductive technologies focus on doing pretty much anything at all to the woman at huge cost and unkown risk, but almost no attention is spent on the man. They don't pump men full of drugs to make their sperm better. The cost is pretty much entirely borne by women.

Since the issue is with your DH's fertility, could you ask your consultant to recommend lifestyle changes for your DH or other treatments for him and see if that works before s/he starts suggesting shooting you up with hormones and messing with your body?

I'm guessing that there won't be much useful medical response, but I think it might be good for you (and those around you who are pressuring you) to be reminded (often) that you are not the broken baby factory they seem to be seeing you as.

I think it's very personal deciding what you are going to do, I hope you can resist the pressure and find in yourself how far you are happy to go to try and have children, and stop there.

Onemorning there is nothing wrong with you if you just say ENOUGH, and grieve and move on with your life?

The feminist perspective is great for identifying "judgey pants". The pressure from society/family/friends to have 2 babies - boy then girl - not too big a gap - not too small - don't have 3+ DC - don't have an only etc etc - this is something worth discussing from a feminist perspective.

The other things is that the medical profession are good at ignoring the "alternative"/non-medical things which can help.

Here are some things you/others may find of interest:

Life Coach - specialising in whether people want a baby

Hypnofertility

Taking Charge of Your Fertility - amazing book.

Zita West - good on nutrition etc

If you are an Auntie - or have a role in a child's life

Plus lots of googleable things about being "childfree by choice/circumstance".

You might want to look at boundaries regarding what you say to nosey enquiries: Broken record technique/"did you mean to say that - only that's a pretty rude thing to say/ask".

There is a chapter in this book called "Feminsts Theorize Infertilty".

one I really think you are mixing a lot of issues here.

1. Infertility is an issue for a couple. Yes, a male may have low sperm count, but it does not mean that the female is therefore completely healthy. These tests are not "unnecessary". Would you like to go through the treatment only to discover that you did not get pregnant because you have uterine polyps? Most HA allow only a limited number of cycles to be funded and it is only fair on the couple (self-funding or not) and the HA or insurance company (if they provide the funding) that this attempt has the highest chance to succeed.

1. Some consultants do have appalling bedside manners. I do think that women patients disproportionately suffer from patronizing attitude, particularly in the field of RM. I do not have stats, it is based purely on personal experience. I am also glad to report that there are fab consultants out there (of both sexes).

1. Society as a whole has moved a bit from the "classical" view of the family as Man+Woman+2Children. Now it does not surprise one reading/hearing that there are married hetero couples without children, single parents and gay couples with or without children. Our close friends and family are all different and we all have to be strong not to be unduly influenced by what they think, especially on the matters where they have very little clue (like ignorance about IVF potential risks).

1. There is nothing wrong with you. Yours is your body and you should be able to decide yourself what you would like to do with it and what is an acceptable risk to you to achieve it.

1. My IVF experience was grilling but fine in the end. Unsuccessful on two attempts (well, one of them is MC). In my case IVF was necessary because my dh had a vasectomy years ago upon the insistence of his then dw. He was not keen, but it was easier for him to have it done than for her to get sterilized, so the result is my perfectly good chances are damaged because of other people's choices.

Sorry for post being so long.

Completely agree with fork about "alternative" methods. The two times I got pregnant was because I realized that neither GPs nor obgyn consultants nor those in RM have a clue how to achieve highest chances of pg through non-medical means.

I have read "Taking Charge of your fertility" and followed their advice on following my cycle properly and timing the intercourse in such a way that my dh low sperms can make it in time... I got pregnant twice and this is after 10 years of trying.

Thanks for all of your responses and taking the time to respond. I appreciate eveything you've said, the hugs and the links.

I know I'm conflating a lot of issues and sometimes it's hard to unpick them.

bemybebe, I have always thought of these problems as our fertility issues, rather than my husband's. The whole thing seems to have brought us closer together, perhaps because we have a common 'enemy' i.e. infertility.

I am glad that IVF worked for you and Such, that's really good news. I'm sorry about your losses.

During the 2+ years we've been 'in the system' we have had zero advice or information about how my DH can improve his sperm count, except what we have gleaned from the internet and from reading.

The lap and dye was very much a decision by my consultant 'just in case'; I've had pretty much clockwork periods, good bloods and no gynae problems at all. I only had the HSG because the lap and dye went wrong, and I spent months thinking my womb was closed (dye wouldn't go in) until the HSG showed that it all looked ok.

We wait for appointments in the reception area for the gynae ward which is totally pink - from the seats, desk and files to the bloody BMI chart. Next to pregnant women and mums with little babies.

The emphasis on my body has made me feel as if infertilty is 'my' problem, not 'our' problem. I found a really good paper a while ago (and lost it again... will find it) around the language of infertility. Men have 'low sperm counts' while women 'fail to conceive'. The system treats us differently - the paper I linked to above talks about how women are essentially made 'invisible' by the process. I feel like a piece of meat being passed from one process to another. The one time I complained to a nurse about how fed up I was with the procedures I was told bluntly 'Well, we all have our crosses to bear.'

So several issues really: my pain around our problems, my anger and despair at 'the system' and my anger as a woman that my pain is minimised or invisible (broken baby factory is a great way of putting it, Such). (And don't get me started on the way that IVF is sold as a guaranteed source of salvation for the childless...)

Thanks again.

One - I just noticed you mention this on another thread so came over here.

I'm really ignorant about the medicine of it, but I just wanted to say you are talking so much sense, and you so clearly see all the implications of your own situation perfectly - I'm struck by the way that, despite that, you're feeling pressure on you to do something you're not comfortable with. I mean, not that it would be ok to pressure you if you were more confused or had thought about it less deeply, ... but this seems so patronizing!

Btw, I don't know the paper you mention but something I always think is how crass the phrase 'she/I miscarried' is. I won't use it if I can help it; it's a horrible view of women's bodies and blame IMO. We say a woman is pregnant (state of being), but 'she miscarried' (action), and that is all wrong to me.

So I agree with you very strongly re. the language.

Hi Anon

I hadn't thought about the use of miscarry - you're absolutely right. I've heard some horror stories about how women have been treated after losing a baby, and they make my whinges look petty in comparison.

I think it's partly because medical professionals take a functional view of bodies - they are either 'functioning' or 'not functioning'. Consequently, infertility is 'women's problems' because the woman would be pregnant, and similar diagnostic equipment is used for gynae issues, pregnancy and infertility. None of this takes into account our mental well being - how distressing it is for an infertile couple to wait next to the antenatal clinic, how a woman suffering the loss of a wanted pregnancy is put in the labour ward...

'I think it's partly because medical professionals take a functional view of bodies - they are either 'functioning' or 'not functioning'.'

Completely agree. It's actually very spooky when you put it like that. My mate is training to be a doctor, I must talk to him more about this stuff.

I'm sorry if it was the wrong thing to say about that word, btw - I certainly diidn't mean to imply there's any kind of hierarchy of grief (hate that idea). I am very much on the outside of this as I have no children, but I do think about the words and the whole attitude a lot, especially on here where some of the threads people start are heartbreaking in terms of the reactions women have had from medics/society in general.

Anon, please don't worry, I didn't take it that way at all. I think these attitudes towards women and reproduction in general are interrelated, and it's really hard to unpick them. I don't think there are any easy answers.

I'm glad it didn't come across wrong.

I hope you find an answer that works for you, whatever it is.

I think you're very wise to decide to stop when you have had enough.

Whilst biology drives us to have kids, they are noisy, messy, expensive & time consuming.

I had 1 dd through ivf, and we decided that we were never going through the entire process again. It took a while to come to terms with having an only child, but the whole process was too traumatic to contemplate - let alone the impact on our time, finances & dd as well.

I know a lot of people who hit their 40s (without children) then say that the feeling of wanting a child fades, and they are often quite glad not to have a child. It is no-one else's business what you decide for your lives, but you will prob need to start rehearsing phrases like 'that was a very personal question - did you mean to be so rude?'

Thanks kickass and holy for sharing your experiences and advice. I'm glad IVF worked for both of you.

I'm going to look into some specific counselling to separate what I want from what I think is expected of me, if you see what I mean, and make a decision then. I love kids - I'm an auntie which has brought me a lot of joy - but at the same time I can see a future without them.

I went through a fair amount of medical intervention as a small child, and I think that some of my feelings around IVF and all the procedures may be coloured by my experiences then.

Being an auntie still brings me joy, BTW :) I realise I used the past tense by mistake.

I think that's very sensible. It is hard to know exactly why you want kids (or not).

I also agree with comments about how you're just 'the patient' to a doctor. I frequently cite the time I was having an internal exam, and the consultant told the trainee 'push as hard as like, you won't hurt the patient'.

What he should have said was, 'I'm sorry Ms X, this will feel uncomfortable, maybe even some pain, but it's necessary to get an accurate picture. It does no damage and only lasts a few moments.' Then give the student doc the nod.

Talking about me as 'the patient' when I'm lying there (with a hand inside me, ffs!) was treating me like an object, not a person.

Fertility treatment, for women, is by its very nature, invasive and intimate. There is no way to avoid that - but it could be done in a way that shows more awareness of the patient as a person, not just a medical exercise. It is one of the 'elephants in the room'. I heard a lot about how not having a child can be like grief, bereavement etc. Not so much about the intrusive side of things, and how that can make a woman feel. I found that after having dd, I have avoided any but the most necessary of internal exam. (smear test etc) as I've just had enough of people being down there.

I am generally very sympathetic to your position. But I would add my experience on one specific issue. DH had apparently disastrous sperm count, to the extent than ICSI was recommended so I was a bit to be sent for HyCoSyg which was painful and required antibiotics which brought me out in a rash. But I then became pg immediately after, and we then had three natural pgs (one of which miscarried) in the next 8 cycles. Officially HYCoSyg is just diagnostic, but unofficially it's always worth doing because you never know.

Thanks kickas and Dilys.

Is that the same as the HSG examination? I had one about 3 weeks ago, and had heard that it can improve chances of natural conception. (Stupidly we didn't use contraception when we dtd when I ov'd after, and ironically I'm now praying I'm not pregnant this cycle because I've been on huge doses of painkillers for a bad back.)

Yes I think we're talking about the same thing. Anecdotally you can be very fertile the month after the test, so I'll cross my fingers for you. (don't worry too much about pills taken immediately after ovulation, it's only once a foetus has implanted that it's fully exposed to any toxins in your bloodstream).