When will we stop Blaming Women for their Infertility?

In 1997, when I first started working in the field of reproductive endocrinology and infertility (REI), there was a stigma attached to infertility, as if the women being treated for it were defective because pregnancy didn’t come easily or unassisted. Fortunately, over the last twenty-plus years, this perception has changed, and women are less embarrassed or ashamed to admit to being diagnosed with infertility. This shift is somewhat due to these women sharing their stories both publicly and privately, and increasing the awareness of the prevalence of infertility, its causes, and treatments.

Consequently, I was excited to see the publication of a recent article in the NY Times about female physicians relating their experiences with infertility. The authors represent a growing demographic within REI: women who delay family-building to pursue a career.  Unequivocally, the road to being a physician is rigorous (some would say arduous) and long: four years of college, four years of med school, and another few years of residency (and longer if you pursue fellowship). Half of all medical students are now women, and training to be a physician can occupy their peak reproductive years. (Most agree that fertility potential starts to decline when a woman is in her mid-30’s). This article underscored the importance that women who plan to become physicians (or lawyers or women who delay childbearing for any other reason) become aware of their fertility potential, options, and the procedures that are available to them.

The article was impactful, as evidenced by responses on social media.  Many were grateful that the authors gave a voice to the emotional impact of infertility. Some responded that they didn’t realize how quickly the clock ticks, in terms of fertility, and are now considering making an appointment with a specialist to review their options. Then, there was another subset of responders (largely men) whose derogatory and unenlightened comments illustrate a false, yet pervasive, narrative that women are to blame for their infertility.

“I suspect the stresses of being in that profession are much to be blamed.”-Marty G.

“Get married young and have support through graduate school.”-Nathan M.

“Older women are less fertile than younger. I’m really hoping they know this though?”-Stanley S.

“Can’t have everything, I guess.”-Tom H.

“Squanders most fertile years to pursue a career, then is surprised that their fertility went down.”-Jake W.

As if this wasn’t bad enough, faulting women who have infertility is not limited to strangers. Many of my patients have also been criticized by well-meaning relatives, friends, and co-workers who offer unhelpful advice such as:

“Just relax, you’re too stressed. Go on a vacation and it will happen. My friend’s daughter’s roommate did this and it worked” or “You are too fat to get pregnant. Lose some weight and see what happens” or “Maybe it’s a sign from God that you are too old to get pregnant.”

I don’t feel that it is worth anyone’s time debunking each of these comments, but I would like to stress the following:

Stress is never to blame for infertility. Full stop.

A woman is never to blame for her infertility. Full stop.

People make difficult decisions with the information that they have at the time. To criticize them for their choice is simply mean and short-sighted.

Finally, to the men whose responses I listed above, I would like to refer you to a quote by Brene Brown: “If you are not in the arena getting your ass kicked, I’m not interested in your feedback.”

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