Host Brendan O'Connell interviews guest Kallie Fell about the traditional definition of infertility, the official parameters of such, how the new definition is trying to improve equal access to reproductive medicine, infertility insurance laws in 22 states and how they may increase insurance rates, the "Big Fertility" industry, the ramifications of IVF, & more.
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Life Matters
The following commentary does not necessarily reflect the views of the staff and management of WBCA or the Boston Neighborhood Network. If you would like to express another opinion, you can address your comments to Boston Neighborhood Network, 302-5 Washington Street, Boston, Massachusetts, 02119. To arrange a time for your own commentary, you can call WBCA at 617-708-3215 or email radio@bnnmedia.org. Hello, welcome to Life Matters, I'm your host Brendan O'Connell. Well, in the War of Life, the battles that have gone on for over half a century, words become important and definitions become important. And today we're going to look at the definition of infertility because there's an effort to change the definition of infertility. And we have with us Callie Fell, who is the executive director of the Center for Bioethics and Culture. Well, welcome, Callie. Thank you so much for having me, it's a pleasure to be on. Callie, what has been the historical, well, first of all, what is the historical definition of infertility? Sure, most people and most doctors, most people will recognize that infertility is kind of defined as a couple who's unable to conceive after a year or 12 months of regular unprotected intercourse. And that's dependent a little bit, nuanced on the women's age. So we say about 12 months of regular unprotected intercourse if the woman is under 35. And then for someone who's older than 35, that margin narrows, so a couple who's unable to conceive after about six months for older women. And so, and that changes because women, as we age, we lose our ability to produce. Nice. Now, why has a major medical association tried to redefine the definition of infertility? Yeah, so if you follow this at all, and if you're in this space, the ASRM, the American Society for Reproductive Medicine, has issued a new definition of infertility. And this new definition really just is so woke, if I will use the term woke. So what it's doing is it's trying to improve equal access to reproductive medicine. So improve access or give access to single men, single women, those who might be in the alphabet soup of LGBT, plus, plus, plus, plus. It's broadening this definition so that we can also, as a country, justify subsidies, tax benefits, insurance coverage, and all sorts of benefits and medical interventions for people who might not fit under the standard definition. So I think it's important to kind of understand what this new definition is so that you can understand the full scope of it. So I'll continue with that. And so, this new definition is an inability to achieve pregnancy based on a person's medical sexual reproductive history, their age, or any combination of those factors. It's a need for medical intervention, including, but not limited to the use of donor gamete. So that's donor eggs or donor sperm, the use of donor embryos, and possibly the use of womb, so like surrogate pregnancies, to have a successful pregnancy. And that's either with an, as an individual or with a partner. And so this is just kind of crazy because most people know, like a single man is not fertile, he's just single. You cannot, we are not asexual beings. We cannot reproduce on our own. But this change in definition is kind of saying, oh, well, you should have unfettered access to all of these technologies because you're just a single person who wants to have a child. Can I ask you then, the Centers for Disease Control, and in this show, Dr. Mildred Jefferson used to say pregnancy is not a disease. But does the CDC define it that way, or have they going beyond what the traditional way that fertility used to be defined? Yeah. You know, CDC is still defining it along the traditional guidelines, but only really for cases than public health data collection, which I just find that very odd because the CDC is there to help collect data, right? They collect data as far as birth rates, live birth rates, multiples, that sort of thing. But they are not interested in collecting data when it comes to the health of, like, egg donors. So when I talked about that definition just a minute ago about gamete, those requiring gamete donation, so that's egg donors, and I put donors in quotes because donors are often paid. But it's not a free thing, they're giving money for their eggs or their sperm. But egg donors, it's quite risky for women to sell their eggs. But yet the CDC is still not tracking the health of those women. They're still not tracking what happens when we put young 20 and young 30-year-olds on high doses of hormones or other drugs. And we're not seeing their development of cancer later in life, breast cancer, GI cancer, all kinds of things. But so for the sake of answering your question, the CDC will still use the traditional definition of infertility when it comes to tracking and public health data collection. Now, 21 states in DC have passed infertility insurance laws, eight of which have single parent and inclusive policies for those not in a heterosexual relationship. What is this all about? Yeah. So, and actually that data in the article is already outdated because I think I wrote this article in early September. And by the end of the month, California passed SB729, which just included us on that list. So what it is, it's a policy for those people who are again single, wanting access to fertility care. And insurance policy. Yes, insurance can cover that policy, correct, or state. I think there's a law in New York that's looking to pass so that you get a tax benefit. So it may be insurance doesn't cover it, but they'll get a tax benefit if they want to use these services. And every state is a little bit different, and that's something that's really interesting about the United States is we are a patchwork of all kinds of laws when it comes to what I call big fertility. So big fertility, it's like big pharma. It's big pharma is another side step of that. It's big fertility. It's the fertility industry that's really capitalizing off of the pain and heartbreak of not being able to have a child and making money off of that, but what I'm saying is in the United States, there's all kinds of laws different in the world of surrogacy, for example, that's something our organization covers a lot. And every state is different, whether it allows surrogacy, it bans surrogacy, it doesn't really have a law on surrogacy. The same is true of what we're talking about, these fertility insurance laws, and they're all going to be a little bit different, because it really should be, you know, because we want voters to be, you know, laws to pass that are corresponding to the voters' needs. But I think, so it becomes tricky to kind of follow these laws. And so I recommend listeners and viewers to follow the laws in their state and to really understand these types of things, because it's going to depend if you live in New York or if you live in California or in Vienna, it's going to change. I see, and is this a nationwide movement so that all men and women can have unfettered access to buy eggs and rent wombs, and will insurance rates go up because of this? I'm afraid so, however, I'm a little encouraged, perhaps, well, I'm a little torn with the new administration that's coming in. I think that, yes, I think at the end of the day, big fertility and the fertility industry is trying to make its way into every home, every family. And I do think it's sweeping across the United States, but I do think that we might have people in office, there are people who are working, good people who are working on laws that actually will help men and women who have infertility or issues with their ability to have children. And I think that we need, there's one called the Restore Act that's just been written, and it really looks at how do we actually restore fertility rather than just kind of offer a band-aid to it, and I'm hopeful that in the next year or so we see, we start to see some headway there, and that we kind of stop infertility, and we start to really think about how can we actually help men and women who are struggling with infertility. Because I've interviewed, and I've talked to a lot of people who practice in this space, if all IVF does, no matter how you define infertility, it kind of puts a band-aid on, it doesn't even really put a band-aid. It comes up with a solution to a problem without fixing the problem, right? So people who go to IVF, they want a child, whether it's a couple or a single person, they want a child, and instead of looking at why might this couple be infertile, why might there be problems, they kind of bypass it, they don't look deep into the issue. And so I'm hopeful that over the next four years we start to see laws in place that actually work to restore reproductive function rather than just let anything go. Right. I've done a lot of shows on reproductive medicine where you don't have to violate your religion and that sort of thing, and with men it's really three issues. It's the sperm count, how well it swims, and then if the sperm is overheated. So with women though, it takes about six or eight months to figure out all the issues that could be more involved. Right. Now, I wanted to ask you, is your organization against IVF? Because I know for instance, Trump being in an election campaign said, "Oh, he's for building families and IVF being one of those ways." How do you understand or should the public understand the IVF issue? Yeah. It's really unfortunate that President Trump made those promises, and we're yet to see how that does play out, because there's a lot to consider with that promise. He made that the United States are... So I think he has a lot of research to do on the impact that that might make. And as an organization, yeah, IVF, I'll say flat out, we are against the practice many reasons. The biggest is that it's really not safe for women or for children. We don't track, we're actually starting to see some studies coming out that show children born of IVF have different health risks or different health factors that we have to consider. We know that IVF pregnancies are often high risk, and so putting undue risk on the mom. And any time there's undue risk on the woman carrying the child, there's going to be a risk to the child as well. So one, health risks, right? Two, it's a really, really low success rate. The CDC passes all kinds of sorts of data on this, but you kind of have to dig through the data and get through the smoke and the mirrors and the fog to really kind of understand what you're looking at. And I would say that for younger women, IVF really only has a success rate of maybe 20% or so. And it gets less, the older a woman gets. The older her eggs are, which then drives up a need for donor eggs. And of course, in cases of males by themselves or in a homosexual partnership, they are always going to need donor eggs or a womb, a donor womb, a surrogate mother. And so, and those also require the process of IVF. And so there's a whole slew of ethical issues, bioethical issues, when we consider IVF. And we need to think deliberately about that. And for your listeners, for anyone who might think that conception or believes that conception starts at fertilization, they cannot be pro-life if they are pro-life and they think that life begins at fertilization, and they can also not support IVF. They can't support both. You can't be pro-life and say that life begins at conception and then say IVF is okay because there will be the destruction of embryos. There will be cases of finding out that perhaps your embryo has a genetic disorder, then what? There's all kinds of extra IVF add-ons that you can purchase to make sure that you've got the best embryo. You can select boy or girl and all these things. And you might go into it saying, "I'm not going to do any of that. I'm just going to create one embryo, I'm going to implant that." And even at that basic level, you still have that inherent risk to both mother and child. And these are just things that I can't and the Center for Bioethics and Culture cannot get on board with. Now, I noticed that Zach Nunn has a helping to optimize patients' experience with fertility services act. That's I believe in the United States Congress right at the moment. What would you do private health insurance plans to cover the infertility treatments? And then there's also another person that is going forward with another act legislatively. I guess that's on the federal level, is that correct? Yeah, at federal and state level, yes, like I said, it's kind of happening both at the same time. There are lots of stuff going on at the state level, but then there are some moves federally as well. There will be a lot of ramifications for those. And I do just want to point listeners to the Restore Act that I spoke about just a moment ago. That was by U.S. Senator Cindy Hyde-Smith, and it's called the Reproductive Empowerment and Support Through Optimal Restoration or Restore Act. And so that works within existing federal programs to expand access on a federal level to restorative reproductive medicine for those who are truly affected by the true and traditional word of infertility. And if you look at, for listeners who might be knowledgeable in this space, they might know of these types of things like napro technology that help restore. Yeah, so there's tons of studies out, and I think that our politicians would do well to read some of these studies about how successful these other technologies that are invasive that don't come with all of these bio-ethical issues and don't cost our country a fortune or insurance companies a fortune. They might do good to read these case reports and read these studies that have been published saying how much success women and men can have outside of the idea of buying eggs, renting alums. Right. Now, one organization that I've come to not like is ACOG, the American College of Obstetricians and Gynecologists. In fact, I've attended app log conventions. ACOG, right now, my understanding is, well, where do they stand on all of this? Yeah, so ACOG actually is still holding firm to the traditional definition of infertility as well. So, that's encouraging a little to see. Good. Regardless of gender or sexual -- Well, actually, yeah, you're right, you're right there. So, if I stand corrected, so they will -- they do have some recommendations on their fertility treatment. So, they haven't changed the definition per se, but as far as like their treatment recommendations, that they have -- they have expanded to include anyone regardless of their sexual orientation or gender. Mm-hmm. And are there any discussions about helping women and men restore fertility? Yeah, definitely. Like I said, there is new legislation coming out, new -- there are people I'm talking with in D.C. that are working really hard to keep this conversation going and to find real solutions for men and women who are struggling with infertility. The -- I've found that big fertility, the industry, is really the wild west with almost no regulation whatsoever. I believe that, you know, if the freezing of embryos is not good and unfreezing, because some of the embryos die in the process. Yeah. And again, we have no idea. We have no data on what we're doing, what happens to a person's health for being frozen for so long. Because now we're starting to see some embryos are being adopted by other parents, and these embryos have been -- I -- I serve been frozen for decades, if not longer. And so, what are those -- what are the ramifications there? We don't keep -- we don't keep and eat meat that's been frozen for too long. So what are we doing to embryos that have been frozen and then thought and implanted and then become a person? Those are some big questions that we really need to think and pause and consider. Now, what about assisted reproductive technologies? It's a huge money maker for the doctors. How much of these doctors making that do this kind of work? A lot. I don't have, you know, numbers, but I mean, they make a lot of money. A surrogate mother who rents her womb makes anywhere from 20,000 to 40,000 plus. And she's just making a very small fraction of what the industry and the physicians are making. She's doing all of the work. She's taking all of the risk, and the industry itself is making tenfold over that easily. It's a billion-dollar industry. Wow. That's really something. Is there -- what about -- why are home births or at home midwifery not covered by the insurance that the industry is moving towards trying to have insurance cover everything? What -- how about natural birth? Yeah, you're going to get me fired up because I am -- yeah, I -- as someone who had a home birth and I have -- I have excellent, excellent health care coverage. My husband's health care coverage for our family is absolutely wonderful. And yet, it would not cover my home birth, one cent. It would cover a hundred percent of a hospital birth. And you know, I am not a conspiracy theorist, but it really drives me nuts that we as a country are allowing for all of these high-invasive issues, like it's expensive to be at a hospital. It's high intervention to be at a hospital. You're more likely to have an upper door on a C-section if you go to a hospital just by being there. And same for big fertility. This is high intervention, high risk, low reward, but yet that's where we think the answers are. We're putting so much stock and so much money into these industries. And you know, I don't -- I don't know why. I don't know why insurance won't cover home births, and they're not covering things like restorative medicine, maybe because it would actually provide holistic solutions for people and there's no money there. I think at the end of the day, like I said, don't want to be a conspiracy theorist, but it's about money. Where is money? Where can money be made? We, you know, talked a little bit about ACOG and their recommendations based on gender and sex. And that's another area where terms are starting to be really defined differently, right? We're getting rid of the word woman. We're calling her a person, a birthing person, a partner. We're getting rid of these terms. We're redefining them. We're redefining what a man and a woman is. Heck, half the country can't even define what a woman is without being afraid, but we're just -- my point -- sorry, I lost myself and all that, like I said, you got me -- got me going and talking about this. But gender medicine, quote unquote, gender medicine, following the money. Why are we doing this? There's a ton of cash to be made on hormonal therapy. There's a ton of cash to be made on the backs of children and those who are struggling with thinking that they might be born in the wrong body, which, by the way, they're not, they're children. There's money to be had in these surgeries of giving girls double mastectomies and hysterectomies and all of these things. It's money. Now, what about -- we've only got a couple of minutes left. They're looking at inclusivity. That's one of the DEI words as a ploy. Are they suggesting -- I'm talking about the big fertility industry. Are they suggesting things that are costly and morally corrupt, the treatment to people who are not diseased, they're not sick and they're not infertile? Right. Yeah. They're not. And like you said, pregnancy is not a disease. Infertility isn't really a disease either. It's a symptom of something else. It's a symptom of a disease, of something else, a disease process going on. So when we say that a man is infertile, just because he doesn't have a partner, we're doing a huge disservice to women who actually are infertile. We're doing a huge disservice to those who are actually struggling that actually need medical care. And people who need that should be upset that we're saying a single man has and deserves the same right, so to speak, to a child than those who are struggling. And do you feel, just getting back to frozen embryos, Italy and Germany, I believe, have decided not to freeze embryos anymore? And that has reduced significantly the surplus of frozen embryos, which is, I think, somewhere between a half a million and a million in this country. Oh, way more than that. We're up to like a million and a half, at least, I would say. Oh, is that right? Would you think that getting rid of the frozen embryos would be good? Yeah, I think, well, first of all, I think we need to stop it. I think we need to say no more. We need to not be adding to those embryos anymore. Secondly, I think we need to say to parents, you need to claim your, you need to come claim your embryos. It's time to clean up the mess. We need to claim them. And to then, I think, you know, whether that's letting them be adopted or if that's, you know, giving them the death that they deserve by letting them go, but giving them the dignity that they deserve. Kelly, time has come to a very quick end here. And I thank you very much for calling in all the way from the West Coast to be on this show, Life Matters, and we hope that folks today learned a lot and hope you found the show to be unique, informative, content-rich, truthful and thought-provoking. Thanks for watching. I'm Brendan O'Connell, your friend for life. The preceding commentary does not necessarily reflect the views of the staff and management of WBCA or the Boston Neighborhood Network. If you would like to express another opinion, you can address your comments to Boston Neighborhood Network, 302-5 Washington Street, Boston, Massachusetts, O2119. To arrange a time for your own commentary, you can call WBCA at 617-708-3215 or email radio at bnnmedia.org. [BLANK_AUDIO]