There are several lively conversations currently going on in the comments. I’m not at all sure I can sustain all of them. But having spent some time revisiting the post on social infertility I wanted to consolidate some of the thoughts I’ve had and move them here. (After a while I find it very difficult to read through the comments. It just gets to be too many indents, etc.)
This particular thread of conversation started with some musings of mine about “social infertility.” This is a term that has gained currency only fairly recently. I would guess (though I do not know) that forty years ago it was unknown. And I can see why the emergence of the term would be linked to the development of assisted reproductive technology as an industry/commercial enterprise.
There’s more to be said about that, no doubt, but there’s a different line I want to follow for the moment. I want to think about infertility in couples as opposed to in individuals.
You could say that all individuals are infertile–if what you mean is that they cannot, by themselves, have kids. Individuals always need some other component–sperm, say. For some individuals that is all they need–and these are people who might be described as “socially infertile”–because their infertility is solely a result of their social position. Other people might need medical intervention in addition to whatever component they lack and some people, of course, couldn’t have kids even with currently available interventions.
But how to think about couples? Or do we even think about couples (as such) at all? After all, couples are just two individuals and so you can always say the correct unit of analysis is the individual. And perhaps, from a medical point of view, this makes sense. I think lots of people in the comments have suggested that thinking about infertility only makes sense on an individual level.
I, however, am really starting to have my doubts. First off, there’s a really important comment by Tess noting (with citation) that 1/3 of couple infertility is attributable to subfertility in both people. I take this to mean that it is the combination of A and B that is infertile, while if we re-matched A and B with new people neither might be infertile.
This, it seems to me, focuses us on what our expectations are of couples where one person is infertile. And I think (as several of you have pointed out) that this has changed over time. Once upon a time (I’ll just be vague about when) if a couple didn’t have kids they had three options. One was adoption. One was to remain childless. One was to split up, with the fertile member of the couple going off to have kids with some other fertile person.
I’m confident these were often very difficult choices and that many couples made each of the choices. I suspect (though I don’t really know) that splitting up because of childlessness was somewhat socially acceptable, given the other available options. (I say this even though infertility was NOT a ground for divorce in the US. I suspect I am open to challenge here.)
Today there are four options. The three above plus ART–which encompasses an array of possibilities including third-party gametes, surrogates and IVF. Given this new option, many couples that could not have children now can have children–though in many instances the children may not be genetically related to both members of the couple. And I think it is fairly clear that many couples with infertility issues at least explore the ART option.
It seems clear to me that the use of ART–at least some forms of ART–has become widely accepted. (I do not mean to say it is uncontroversial and obviously different techniques are more and less controversial, as you can see from discussions here.) This might be in part because the ART industry has marketed itself successfully. There are doubtless other reasons, too. For the moment, I don’t know that the “why” matters.
Whatever the reason, I think the wider acceptance (and availability) of ART has changed how we think of infertility. I think it is less acceptable for a person to leave a couple just because there are some fertility issues. Instead, the wider expectation is that the person will stay around while the couple tries to find a path through ART that ends with a child. In other words, I think some (and probably many or most) couples where at least one person has fertility issues who once might have split up now stay together and try to use ART. And when they do that, it is, I think most of us would say that the couple that is dealing with infertility.
Using ART–really any form of ART–is stressful and demanding. And in any good/well-functioning couple even if only one person is directly involved in the physical process, the other is deeply enmeshed, too. There’s something about our cultural and romantic ideal of coupledom that determines this, I think. The fertile partner goes on the journey with the subfertile one–and that’s how we (as a society generally) want it to be.
I’m not saying this isn’t complicated and fraught with all sorts of internal issues and tensions. But I think, in a very real way, it is fair to say that couples are infertile and have to confront fertility issues. The positions of the individual within the couple may be different, but they confront he issues together. And at that point, I’m not sure it matters very much whether we call the infertility social or not.