How the media and medical system shortchange single women pursuing motherhood 

I was 26 years old when I was first diagnosed with Stage 4 endometriosis, a condition in which endometrial tissue grows outside the uterus. This tissue sheds and bleeds every month when a woman gets her period, causing scar tissue, extreme pain, and, in some cases, infertility. My case was aggressive and unresponsive to treatment, and it quickly became clear my fertility was on the line.

“I’m going to refer you to a fertility specialist,” my doctor said after my second surgery in six months. “If you want to be a mother one day, I really think you need to consider your options now.”

A reproductive endocrinologist explained my options. I could freeze my eggs, which, at the time, carried the lowest odds of one day bringing home a baby. I could use a sperm donor and freeze embryos for later use, which offered slightly better odds of success. Or, I could use a sperm donor and proceed with a fresh in vitro fertilization (IVF) cycle — meaning I would try to get pregnant right away. This option had the best odds of achieving pregnancy and a baby, but it would mean pursuing motherhood entirely on my own.

The reproductive endocrinologist I was meeting with seemed to heavily push our conversation toward egg freezing. “You’re young and single,” he said. “You don’t want to have a baby by yourself.”

It was the first of what would feel like many not-so-subtle jabs at my single status. But the clinic wasn’t the only place I was receiving the message that fertility treatments weren’t for me. Even today, nearly a decade later, news outlets from Time to The New York Times focus on couples in their fertility coverage. They rarely mention that these options may be pursued by women or men alone, a bias that slights the growing number of Americans who have decided not to wait for a partner to have a child.

Egg freezing offers no guarantees

Egg freezing was still a relatively new concept when I was first dealing with infertility ten years ago. Today, it’s become a theme women throw parties around.

The media often characterizes it as a viable option for women hoping to expand their fertile years. But few articles discuss the potential risks egg freezing could pose. I, for instance, developed endometriosis only after donating my eggs in college — a process that is nearly identical to what’s involved in egg freezing. And I wasn’t the only one to develop long-term complications following the process.

But so far, we don’t have good research on the long-term impact of pumping young, healthy women with these hormones for the purpose of preserving their future fertility. Few articles about the benefits of egg freezing choose to mention the work of Diane Tober, a researcher at UCSF who is investigating the potential risks involved in the process.  

Worse, most articles touting the benefits of egg freezing fail to mention the overall success rates of producing a viable pregnancy from those eggs years down the line. This is likely because success rates can vary widely based on the clinic, as well as the age and health of the woman freezing her eggs. But more journalists should be pointing out the fact that freezing eggs is far from a guarantee of a future pregnancy.

In my case, egg freezing meant putting my eggs on ice without knowing whether they would be viable until I might finally be ready for them five, 10 or 15 years down the line. At which point it would likely be too late to try again if it turned out they weren’t. That wasn’t a risk I was willing to take when I was told a fresh IVF cycle had nearly double the success rate at the time.

Bias in reproductive health care

Reproductive endocrinologist Dr. Aimee Eyvazzadeh, host of “The Egg Whisperer Show” on YouTube, says that doctors trying to push single patients into egg freezing over IVF are doing so because of their own worldview.

“They are projecting their belief system onto the patient,” she said. “It may just be unconscious and not because they don’t want to help the patient, but it’s because of their own comfort level with the options available.”

While I’d like to believe these attitudes are changing, The Guardian recently had a story about the persistence of this point of view in health care — the idea that solo moms are bad for parent and child — and how it’s impacting single women pursuing treatment across the globe.   

While Eyvazzedeh does promote egg freezing as an option for preserving fertility to her patients, she says, “It’s important that fertility doctors talk to women about their goals today and their goals in five years. This way they can talk to patients about all their options before they run out.”

But while the number of single women pursuing fertility treatments is increasing, few (if any) health publications are addressing how medical practitioners should be approaching those patients.

In my case, choosing to proceed with IVF was only half the battle. I then had to deal with paperwork that was clearly created specifically for couples, forcing me to cross out entire pages asking for my partner’s information.

It was a small reminder that I was in this alone — and that the fertility industry wasn’t quite used to accommodating patients like me.

But it wasn’t just the fertility industry that didn’t know what to do with me. It was also the world at large. At the time, very few publications were writing about single women pursuing motherhood, leaving me feeling completely alone as I relentlessly Googled in search of stories like mine. And even today, the media tends to over-simplify our reasons for doing so. HuffPost recently featured an expert who posited  more women are embracing single motherhood because of “the lack of male partners prepared to commit,” and painted women willing to do so as not being “focused solely on their careers.”

While that may be true for some (perhaps even for many), it fails to recognize the nuance behind these decisions. Rarely do I see stories of women battling health issues woven into these narratives, perhaps because that would be less striking to general audiences. Not quite as astonishing as simply growing tired of waiting for the right partner.

But single women pursuing motherhood are not anomalies, and health journalism should focus more on the myriad reasons driving their choices. We should be writing more about the risks and benefits of the options available to them. And we should be counteracting the stigma of single motherhood by more thoroughly exploring the research that has found children of choice moms fare just as well as those born into two-parent homes.

Changes at the clinic level

Eyvazzadeh said that today, “Most clinics use an electronic medical record system.” That means single women aren’t being forced to cross out page after page of questions pertaining to a non-existent partner’s information, like I once was. 

But single women pursuing fertility treatments still face other issues. “While fertility clinics have risen to the occasion of offering all people fertility help, insurance companies haven’t completely caught up,” Eyvazzadeh said.

Not all insurance companies even cover infertility. Those who do require proof of the need for medical intervention. This is an obstacle for single women pursuing fertility treatments, because while they may not have a medical reason for needing treatments, they do have a personal one: The lack of a partner.

Insurance companies, unfortunately, don’t see it that way.

This is a problem especially because of the growing numbers of single women pursuing fertility treatments. “In the Bay Area, I think 10% of all fertility patients are single,” Eyvazzadeh said. “The rates are going up. And they’re going up world wide.”

A recent report from Bio News in the UK found that the number of single women pursuing IVF across the pond went up 4% between 2016 and 2017, to 2,279 cases.

More than ever before, women are choosing to pursue motherhood while they are still young enough to achieve success, even without partners by their side.

In her practice, Eyvazzadeh invites patients to bring their friends, moms, or other family members to appointments so that they have someone with them who understands the process and is on their side.

But we don’t often hear the stories of such women in mainstream health reporting. I’ve long felt that reporters could do far more to bring these women’s experiences into the conversation surrounding fertility treatments, making them part of the fabric of the story, as opposed to passing mentions or caricatures trotted out for novelty or pathos.

Becoming a mother

I went through it all mostly alone. I had the support of my friends and family, but going to those appointments and pursuing those treatments felt like my burden to bear. When I was dealing with infertility, the only thing I knew for sure was that I wanted to be a mother. In fact, I feared never getting that chance far more than I feared going it alone.

And in the end, it didn’t work. At 27 years old, I had two failed IVF cycles under my belt.

But I didn’t give up. A few years later, just months shy of my 30th birthday, I brought my daughter home from the hospital. Only, I wasn’t the one who had given birth to her. Her adoption was finalized when she was 3 months old.

And by choice, I was officially the single mom I’d felt ready to be for years.

That little girl is 6 years old today. She’s the love of my life and the best thing to ever happen to me. I’m still single, but I don’t feel like I’ve missed a thing. And I’m grateful every day I ignored the nudging of a doctor who seemed to think it might be better if I wait for a partner to pursue motherhood.

Because if I had, I probably still wouldn’t be a mother today.