- People seeking fertility treatment face challenges beyond their medical conditions.
- Things like financial cost, shame, and accessing culturally-competent care can come into play.
Maeve McCaffrey knew that she wanted a child in the future. But when her doctor told her at age 35 to freeze her eggs, she wasn't able to spend the money.
She later went on to conceive naturally at 44, after trying one round of fertility medications. But she still thinks about what her family might have looked like if she had access to affordable egg freezing more than 10 years ago.
"If I had, I'd be the mother of two," McCaffrey said.
For the nearly 20% of Americans who suffer from infertility, growing their family can be fraught. Research shows that cost is one of the biggest barriers to care for people who are interested in assisted reproduction or seeking treatment for infertility. Emotional ups and downs, including grappling with shame and stigma, can also make it hard to access care. So can messaging about infertility that's aimed at heterosexual, cis-gendered married couples.
For people like McCaffrey, all those complications happen in a setting that already has a lot of pressure over it.
"When you are trying to conceive, it feels that with every month that passes, that window closes just a little bit more," she said.
LGBTQ+ informed fertility care can be hard to find
For members of the LGBTQ+ community, seeking help from fertility clinics can be especially vexing. Research has shown that there's a constant lack of information targeted toward LGBTQ+ people, and many clinics approach treatment from a heteronormative basis.
That can have medical and legal consequences, says Traci Keen, CEO of Mate fertility.
"Many doctors are not highly trained in LGBTQ+ reproductive health, much less LGBTQ+ fertility," she said. "Most consents, conversations, and general materials are oriented towards heterosexual, married couples."
Keen's own experience as a lesbian woman seeking healthcare has informed her approach to helping others access assisted reproduction.
"As a young adult and even more recently, I've struggled to find OB-GYNs who understand that 'organ' care is the goal, and there should be no difference in the gynecological care that I receive versus a heterosexual woman," she said. "A cervix is a cervix."
Poor bedside manners from doctors can add to shame
For Cherry, who asked only to be identified by her first name, a doctor's poor bedside manner threatened to derail the fertility treatment that she hopes will one day help her start a family. She decided to freeze her eggs at 39, something she maintains was the right decision for her.
"I was excited about freezing my eggs and felt like I was making the right decision, and my doctor just made me feel like I was an old hag and should have frozen my eggs at 25," Cherry said.
Even if she had thought to freeze her eggs that young, there's no way she would have been able to afford it, she says.
During her whole treatment, she was never fully comfortable with her doctor.
"I remember thinking it was such a relief my eggs came back normal and I was able to store all of them, but it wasn't the best experience going through the process," Cherry said.
McCaffrey also experienced poor bedside manners.
"I had a doctor tell me at 40 I should be trying to get pregnant at that moment, but I was in a new relationship," she said. "He wasn't wrong, but his delivery was condescending and dismissive."
Those feelings can compound the financial risk for people like Cherry, who has yet to become a mom.
"It's like a high-stakes gamble with money that most struggle to obtain in the first place," she said. "You're just stuck praying that everything works out the first time around, so that your dream of having a family can happen without trying to scramble to afford anything additional. It's just not realistic."