June 26, 2022

When fertility management becomes big business

It’s a commonplace of science journalism that ethics cannot keep pace with technology. As far as assisted reproduction goes, ethics cannot keep pace with business. The public is still stuck back in 1978 with the birth of the first IVF “miracle baby”, Louise Brown — IVF clinics are places where women (mostly women) seek treatment for infertility.

In a dense but perceptive article in Reproductive Biomedicine & Society Online * Dutch researcher Lucy van der Wiel argues that this has been superseded by the corporatization of fertility. Listed companies are supplying an ever-increasing range of fertility services. As an article in the New Yorker put it, “If the old goal was to make a baby, accounting for lost time, the new goal is to make fertility, starting at any age.”

Van der Wiel’s focus is how employer-provided fertility benefits, especially egg freezing, change the dynamics of fertility.

  • Company-sponsored egg freezing is a gimmick to rationalise the employment of fertile women. “It functions as an individualist techno-fix to problems that require structural reform. When fertility is understood as an individual problem…, there is less perceived need and support for structural changes, including ‘paid parental and sick leave, affordable child care, comprehensive health insurance, immigrant health care, and adequate wages’.”
  • Bearing children is integrated into employers’ need to make workers more productive. Reproduction can be timetabled and made as efficient as possible to get women back to work with minimum disruption.
  • IVF is being transformed from a “reactive” model to a “proactive” model. In other words, instead of waiting to discover that they have fertility problems and then slowly progressing through a personally traumatic IVF process, companies encourage women to use genetic testing and high-cost IVF procedures to make sure that they spend as little time as possible off work.
  • “The big shift that emerges with fertility benefits,” writes van der Wiel is “the influence of a new type of company in the IVF sector that is beholden to its investors or shareholders, functions as a for-profit entity driven by financialized metrics of continuous growth, and propelled by an online platform that becomes a means for extracting data, shifting clinical practice, reframing fertility and changing power relations within a fertility sector in ways that require critical reflection.”

In short, company fertility benefits are a way of managing women’s biological clocks to help make companies more profitable “in keeping with the capitalist tailwinds of projected revenue growth, reimbursement rationales and return on investment.”

* RBSO ceased published in March for financial reasons.