New study 'reimagines infertility'

December 7, 2017, Lancaster University

New research from Lancaster University has identified the 'invisible infertile', a group of marginalized people missing from survey data sources because they do not fit neatly into popular notions of who is at risk of infertility.

Around the world, the 'invisible infertile' includes racial and ethnic minorities, those with limited economic resources, those who do not have access to affordable healthcare, the LGBTQ community, persons with disabilities, and more often men than women.

While it is estimated 15% of couples worldwide are infertile, researchers say this figure, hinges critically on the quality, inclusiveness and availability of data sources used to track infertility.

The article, 'Reimagining Infertility: A critical examination of fertility norms, geopolitics and bias' was published in the journal, 'Health Policy and Planning'.

The article states current infertility data and statistics fail to account for the infertility experiences of some . Because these data and statistics are used for policymaking and decisions about services, omission of these groups contributes to uneven access to state resources and health services.

Authors Dr Jasmine Fledderjohann at Lancaster's Department of Sociology and Dr Liberty Walther Barnes at the University of Oregon in the US, refer to the omission of these groups, whether intentional or unintentional, as the process of 'invisibilisation'.It has previously been identified that many cultural factors complicate efforts to track infertility across populations including infertility regarded as a taboo subject in some cultures.

Dr Fledderjohann and Dr Barnes outline how reproductive health (RH) survey datasets include or exclude different social groups within and across populations.

The study identifies two processes through which invisibility is produced in survey data:

  • Sampling, with focus on how it is decided who will be selected to participate in the survey
  • Questionnaire design, with focus on who is asked particular questions and how those questions are worded

Examples of these processes are drawn from the Integrated Fertility Survey Series and the Demographic and Health Surveys.Dr Fledderjohann and Dr Barnes argue that research is not designed in an objective vacuum. Surveys and sampling techniques are shaped and influenced by the sociocultural norms and geopolitical context of the time and place in which they are created and conducted, reflecting broader social beliefs about family building and reproduction.

Relatedly, population policy aimed at curbing overpopulation in some places contributes to the problem of 'invisibilisation' by effectively rendering the infertility of some groups as unfathomable. In this light many marginalised groups are missing from the reproductive health statistics.

"The omission of entire groups from the scientific discourse casts doubt on the quality of the research questions, validity of the analytical tools and the accuracy of scientific findings," says the article.

This can lead to misguided evidence-based reproductive health and family planning policies and deter equitable access to reproductive healthcare for some social groups.

"The common perception that infertility is disproportionately a white, Western, middle-class woman's issue is really inaccurate and problematic," says Dr Fledderjohann.

"The highest rates of infertility in the world are in the Global South, but the population level data on infertility in many countries in the Global South are severely limited. This just compounds the problem - we collect much richer infertility data on Western women, which increases their visibility and further contributes to the misperceptions around who is—and is not—at risk of ."

The research suggests positive routes forward including calls for:

  • An examination of existing data to consider who is missing and what the implications are
  • Revision of survey wording and design to reduce bias
  • Engagement of policymakers, medics, and researchers in an open dialogue about the invisible infertile

Explore further: Infertility linked to higher risk of death among women

More information: Jasmine Fledderjohann et al, Reimagining infertility: a critical examination of fertility norms, geopolitics and survey bias, Health Policy and Planning (2017). DOI: 10.1093/heapol/czx148

Related Stories

Infertility linked to higher risk of death among women

November 1, 2017
Women with a history of infertility have a 10 percent increased risk of death compared to those without reported infertility struggles, according to results of a new study from researchers at the Perelman School of Medicine ...

Research shows infertility tied to relationship disruption in Ghana

March 7, 2017
Infertility is taking its toll on relationships in Ghana.

Infertility risk posed by endometriosis may be half of previous estimation

May 17, 2016
About 5 to 10 percent of the general female population is affected with endometriosis, and a higher prevalence is found among women with infertility. Although endometriosis is commonly observed in women who are infertile, ...

Infertility a common problem for Otago-Southland women

November 20, 2015
Infertility is common amongst women aged 25–50 years in the south of New Zealand and significant health resources go towards helping them become mothers, new University of Otago research suggests.

The hidden trauma of male infertility

November 1, 2017
There has been a lot of alarm in recent years about the declining fertility rates of Western men and the potential problems this may pose.

Mandated coverage for fertility preservation featured in NEJM

November 1, 2017
This summer, it was announced that Rhode Island became the first state to pass a law explicitly requiring coverage for fertility preservation prior to gonadotoxic medical therapy, treatment that could directly or indirectly ...

Recommended for you

India launches 'Modicare', world's biggest health scheme

September 23, 2018
India on Sunday launched the world's biggest health insurance scheme which Prime Minister Narendra Modi said would cover some 500 million poor people.

It's not just for kids—even adults appear to benefit from a regular bedtime

September 21, 2018
Sufficient sleep has been proven to help keep the body healthy and the mind sharp. But it's not just an issue of logging at least seven hours of Z's.

Patient-centered visual aid helps physicians discuss risks, treatments with parents

September 21, 2018
A series of illustrations and charts designed as decision aids for parents of children with minor head injuries helped them communicate with emergency medicine physicians and make informed decisions about their child's care, ...

Alcohol responsible for one in 20 deaths worldwide: WHO

September 21, 2018
Alcohol kills three million people worldwide each year—more than AIDS, violence and road accidents combined, the World Health Organization said Friday, adding that men are particularly at risk.

Smart pills dumb down medical care, experts warn

September 21, 2018
Enthusiasm for an emerging digital health tool, the smart pill, is on the rise but researchers at the University of Illinois at Chicago have published a paper in the American Journal of Bioethics that cautions health care ...

China's doctor shortage prompts rush for AI health care

September 20, 2018
Qu Jianguo, 64, had a futuristic medical visit in Shanghai as he put his wrist through an automated pulse-taking machine and received the result within two minutes on a mobile phone—without a doctor present.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.