Is The Fertility Industry Empowering Us, Or Just Making Us Broke & Anxious?

Recently, I was treating myself to a mindless Sunday night scroll when I was hit with one of life’s big (sponsored) questions: ‘Do you want kids someday? We should talk’. As a 31-year-old cisgender female, I’m well acquainted with the prevailing presumption that procreation is my priority. But do I want to be targeted with the ticking clock when I’m nursing a two-day hangover? Not particularly.

I should probably get used to it, though, because baby-making is big business. 

In what has been dubbed 'the FemTech revolution', the current market size of apps dedicated to women's health (menstrual care, pelvic health, fertility and pregnancy care) is estimated to be between US$500 million - $1 billion.

The Australia & NZ Fertility Services market (which includes IVF, surrogacy, intrauterine insemination and services to help single mothers, couples facing infertility and people from the LGBTQ community procreate) is projected to reach $1,020 million by 2026 — and research predicts that the global industry will pull in US$41 billion in sales. Recently, an Australian for-profit assisted reproductive service accepted an AU$704.8 million takeover offer from a European investment firm after a 'bidding war'. 

In other words, the fertility industry is booming — for a number of reasons. 

“One in 20 babies is now born through IVF, and it’s largely because women are having babies when they're older,” Dr Fleur Cattrall, fertility specialist and Medical Director at Melbourne IVF tells Refinery29 Australia. 

“I think the pandemic has also accelerated it because people realised family is important to them. Single women haven’t been able to date, so they’re freezing eggs to have a baby on their own with donor sperm.” 

Dr Cattrall also attributes the growth to shifts in cultural conversation.

“There’s an increasing trend for people to share their story. Women in particular are more proactive in seeking information, and there’s a hunger for knowledge that’s driving demand for more online resources and apps to help women be proactive with their fertility. The stigma around seeking help is decreasing, and knowledge around options is increasing.” 

Unequivocally, less social stigma and more choice is a positive, much-needed development, particularly in the historically male-dominated arena of women’s health, which is fraught with stereotypes and misinformation — as well as for the LGBTQ+ community. Advancements in technology and fertility specialists who make parenthood possible profoundly impact many lives.

But the decision, opportunity and ability to have children is a delicate, and personal one. As the increasingly lucrative fertility industry attracts investors and egg-freezing startups take over Silicon Valley, is there a risk of exploiting reproduction anxiety? 

“I’m fearful that mental health is being overlooked,” Therese Sheedy, a psychologist and mindfulness practitioner working with couples facing infertility, tells Refinery29 Australia. 

“Women have more anxiety around their body, and being perfect in all the roles society tells them to play. FemTech is mostly a positive advancement in women’s healthcare, but it can play on vulnerabilities — to belong, to fit into stereotypes — such as motherhood. It can also increase women’s anxieties with an overload of information that is constantly accessible. 

“It’s in their pocket now. No matter where they are, they can check and have it buzzing at them. They can compare it with others. One app has 40 signals to stay on track with your period — so women can worry about 40 different things.” 

There’s also the risk of being sold a false sense of hope and control. 

“I’ve noticed some language they use — like ‘get pregnant’ or ‘plan your life’. We know that one in six couples struggle with fertility — you can’t plan for that,” Sheedy continues.

“Then there’s the falsehood of social media, especially celebrities, where endorsements are involved, which creates the belief you can have a baby at any age. So, when women struggle to conceive, they think they’re broken — which is absolutely untrue,” she says.

On the other hand, social media connects women who’ve suffered miscarriages and other previously taboo fertility struggles — which is positive.

But while knowledge is power, I can’t help but question the impact of turning our phones into portable egg-timers — and the associated cost. One app charges AU$300 for blood tests charted in a ‘fertility dashboard’ and ‘reproductive timeline’, which costs less than a third through Medicare — and requires medical context to be accurate. 

“FemTech can be empowering as women’s health information has been so poor, but problems can come from lack of education about two things,” Lisa Ransome, a perinatal and reproductive psychologist at Seeds for Hope, tells Refinery29 Australia. 

“One is that a lot of these things can often be accessed through our GPs at a much lower rate. So, there’s a scapegoating of women who aren't informed. Then it’s tapping into that emotional knowledge of ‘I'm not in a relationship or haven’t met Mr Right’ and what that’s going to mean. 

“Often it's sold as a decisive piece of information when it’s actually one part of a bigger picture — your family history and underlying health conditions must be considered. If you don't have the education to understand the implications, that's where we could see an increase of anxiety, and people not making very good decisions,” says Ransome. 

As with much of globally accessible technology, regulators are struggling to keep up. In 2019, a study presented by the Fertility Society of Australia and New Zealand (FSA) showed that up to 70% of women initiating fertility treatment tracked their cycles using apps, but only 42% of apps "were correct in what they promoted to do for women".  

Regulation of the whole industry can be ‘wishy washy’, says Ransome. Currently, egg freezing is not covered by Medicare and IVF is only partially covered by Medicare — and each clinic sets its own price. 

“There’s less regulation when Medicare isn’t involved. Egg freezing is a real growth space being pushed currently. While it’s great to give women more options, it's often sold as an insurance policy when it’s not a guarantee,” Ransome says. 

“There also seems to be a push within the infertility space for add-ons and additional treatments that aren't heavily researched yet. It’s not necessarily a problem if limitations are explained effectively to make an informed decision, but I don't know how often that occurs.” 

While the privatisation of clinics may feel like a grey area, more money means better treatment. In the business of baby-making, live births make happy customers — and that is their goal. 

“The reality is a lot of IVF groups are now owned or co-owned by private equity groups,” Dr Manuela Toledo, FSA board member and TasIVF Medical Director, tells Refinery29 Australia. 

“The advantage is they invest in better technology and research because in the future, that's how women in their forties will be able to have babies. We’re so busy because women are having babies 10, 20 years later than their mothers. We only want to help people who need it.” 

The world of women’s health is a complex territory, and everyone’s journey looks different. So how can we navigate it? 

“We need to be looking more broadly at who we are, and what we want to achieve in life,” says Sheedy.

“We also need a full spectrum of people to support us. One avenue — even one doctor — is not enough. Make time to slow down and take in all the information — without being dragged by expectations — and work out what is right for you.”