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Are Fertility Treatments Discriminatory?

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The other day I was swimming at my local Harlem community center, and a black woman and I started talking about exercise and health. She mentioned she was about to start trying to have a baby, maybe within the next two months. She looked to be in her mid-30s, so I bit my tongue and didn't say what I always want to say—"Don't wait too long"—because I'd always hated when people said that to me. Even though they were right (and I did wait too long).

"How old are you?" I asked instead.

"46," she said. I sputtered a big gulp of chlorinated water. She was 46? Didn't she know that fertility takes a steep decline in a woman's late 30s and natural conception is nearly impossible for a first-time mom after 44?

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But I didn't say anything except to wish her luck and continued with my laps. I knew that women in general can be ignorant about their own reproductive capabilities, but I wondered: Do different communities have different education and experience when it comes to infertility?

The short answer: yes.

There are numerous studies showing how minorities—especially low-income minorities—have less knowledge about fertility treatments, less access to it and more stigma. For example, minorities do not experience less infertility than whites, according to study of 2,162 black, white, Hispanic and Asian women, who all reported suffering from infertility. The study, "Race-Ethnicity and Medical Services for Infertility Stratified Reproduction in a Population-Based Sample of U.S. Women," found that white and Asian women sought medical service much earlier than their black and Hispanic counterparts whether due to socially accepted behavior related to their ethnic group, or lack of healthcare services education.

Moreover, many low-income women are often not even aware of treatment options. But what can be done about it?

Another study found that since motherhood was so important in the black community, women experiencing fertility challenges had a "deep sense of silence and isolation." It suggests getting more information out to that community, featuring more black women's reproductive experiences and "normalizing African-American women's experiences with infertility, thereby lessening women's sense of shame and isolation."

Indeed, yet another report found that fertility websites were marketed more to affluent whites than other races. In the 2012 study "Selling ART: An Empirical Assessment of Advertising on Fertility Clinics' Websites," University of Texas professor Jim Hawkins looked at 372 assisted reproductive technology websites and found that 97.28 percent had photos of white babies and 62.93 percent had pictures of only white babies. After all, marketing dollars go where the money is. And the fertility industry is a $4 billion business.

IVF is expensive. With the 2013 average income in the U.S. at $51,939 dollars, it's safe to say that only the upper class can afford treatment. Moreover, many low-income women are often not even aware of treatment options. But what can be done about it? Here the answer is not so simple.

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Of course, many would like insurance to cover at least some fertility costs. Places like Quebec, the U.K. and Israel all have government-subsidized programs. But given how much basic healthcare is lacking, that seems far off into the future. Education, too, can be made more widespread. Professor Hawkins further suggests that government regulation should be implemented for fertility advertising and incorporate babies of other races in their campaigns.

But clearly, both the government and the fertility industry have significant roles to play in order for us to see any sort of meaningful change in the future.

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