Whenever people ask us how many people are experiencing infertility, we all routinely recite the statistic -- 7.3 million. For those of us working in the fertility field, it is practically burned into our brains, like our social security number or our home address. But, where did this number come from and what does it actually mean?
7.3 million. This number refers to an estimate based on various surveys conducted over recent years investigating different aspects of fertility and family building. This number includes all women within the childbearing age bracket (roughly 15 to 45 years old) who are expected to experience infertility at some point during their lifetime. This includes women (mostly in the younger age range) who have not even begun to think about their fertility and haven’t yet started trying to become pregnant. Likewise, it includes women (like me) who did at one time experience infertility, but have long since resolved their situation by having a baby through successful treatment, adoption, or deciding to live child-free. This is important to know because none of these women are searching out any new information about infertility at this particular time.
So how many are left when it comes to those who are actively trying to become pregnant and will benefit from all the fertility field has to offer? Since there are no concrete statistics explaining this, let’s go with the good ‘ole process of “guess-timation” (a logical estimate based on a series of good guesses).
Let me walk you through this….there are about 4 million babies born each year in the United States. With these births, a certain number will also be unsuccessful in their attempts become pregnant during the same time period. How many? The percentages explaining those families that have difficulty getting pregnant range from about 10% to 1 in 6. For the sake of this guess-timation, let’s go with the more liberal number of 1 in 6 or approximately 17% -- 17% of 4 million is 680,000. This means that out of everyone who is trying to become pregnant at this moment, 4 million will go on to have babies and 680,000 will not. Now, in the spirit of a solid guess-timate, I like to double this number to account for all those families who continue trying year after year to become pregnant without results. This brings us up to roughly 1,360,000 women (and if appropriate, their partners) are actively trying to become pregnant at any given time.
This is our actual target audience – 1, 360,000, not 7.3 million. This is the group of women who are experiencing infertility right now and might be interested in what we have to say and what we have to offer. And of this group, previous research tells us that less than half are seeking fertility services due to a variety of moral, financial or cultural reasons. And of this number, another less than half of these are actually turning to assisted reproductive technologies. Let’s see…half of the 1,360,000 people currently having difficulty in getting pregnant is 680,000 -- these are the women who actually want to be active in seeking treatment. And half of this is 340,000 -- these are the women who end up pursuing some type of ART.
How does this compare with our other statistics? With only 150,000 IVF cycles reported to SART and the CDC last year and a few tens of thousands more worth of egg donation, surrogacy, and frozen embryo cycles, this may bring us up to about 200,000 or so. Adding to the complexity, many families attempt IVF several times over the course of the year meaning 200,000 cycles does not equate 200,000 different families. Okay…so I’m a little over, but you have to admit, this is a lot closer than our original 7.3 million, and I told you at the beginning I was being generous.
So where are all of these women and how do we get to them? This is the million dollar question. Most important, we need to assume that not all people embrace reproductive technologies like we do. Not everyone is on the IVF bandwagon, and when it comes to third party reproduction, you can forget about it! Remember we are only 30 years out from people thinking IVF was “messing” with God or reeked of science fiction. Not surprisingly, there are still a lot of lingering misunderstandings and misconceptions when it comes to infertility and infertility treatments.
As you can see, people are scared and reluctant to explore this route. It’s up to us to change this. In the wake of sensationalized stories focusing on the Octomom, designer babies, and shady fertility businesses that are scamming patients out of money, we must be purposeful and persuasive when informing people about infertility. We should never rest on our laurels and never assume that we can do no wrong and the public loves us.
We need to broaden the understanding of “infertility” and “infertility treatments.” Most people struggling to become pregnant don’t want to go down this road. After all, women, even those struggling, do spontaneously become pregnant. Women just aren’t ready to open the “IVF” door yet. And so much of what we do highlights IVF and other forms of assisted reproductive technologies. Despite our good intentions, this is exactly why our websites aren’t being flooded, our books aren’t flying off the shelves, and our doors aren’t being knocked down.
Our information is just not resonating with the overwhelming majority of people out there. In all actuality, the highly motivated, take-charge kind of woman whom we just assume are filling fertility clinic waiting rooms is not the norm. We need to allay the “common” person’s fears and effectively educate them that infertility does not equal IVF in all cases. Instead, there are many options available when it comes to building families. It’s our job to let them know we can help them find a method that best fits with their overall goals and comfort level.
As we say in Public Health, when you try to reach everyone, you end up reaching no one. This goes for trying to appeal to everyone struggling to have a baby in the exact same way. If we are going to make any improvements in our field, we need to better understand our target populations and their specific needs. This involves thinking outside the box and working hard to fill gaps. We need to reach more people with our important messages. We will all be in a better place if more people knew the realities of infertility, understood their family building options, and sought appropriate fertility care in a timelier manner.
Even if you don’t agree with our assessment of this situation, everyone can acknowledge that there are opportunities for improvement. We can certainly increase our numbers when it comes to people joining our organizations, visiting our websites, seeking our services, supporting what we do, and buying our products. Even in the best cases, we are only reaching tens of thousands of women and their families, not hundreds of thousands or anywhere close to the 1,360,000 that could benefit from hearing from us. And we are not even making a dent when it comes to all those women who don’t even know they have a fertility problem yet. This is a completely untapped market. When they finally have their fertility “A-Ha!” moment somewhere down the road, we want them to think of us and how we can make their journey to have a baby much better no matter what their circumstance.
