SPEAKER_00: Hey, TED Talks daily listeners.I'm Elise Hu.Today's Sunday pick is an episode of another podcast from the TED Audio Collective, handpicked for you by us. Have you ever heard the phrase, your biological clock is ticking?It's often used to encourage women to have children before we reach a certain age, but there's more to the story than a simple so-called biological clock.It's Women's History Month, and this week we're presenting an episode of Am I Normal?that takes a look at the very gendered way we talk about reproduction and how we can have better conversations around fertility, no matter our body parts.I hope you'll find it as eye-opening as we did. You can check out Am I Normal wherever you get your podcasts and learn more about the TED Audio Collective at audiocollective.ted.com.We'll get to the episode right after a quick break.
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SPEAKER_03: So my mom was a stay-at-home mom, and she taught Lamaze classes.And we couldn't afford a babysitter, so I was her teacher's assistant.I can't tell you how many videos of live birth I watched, because you, as part of Lamaze classes, you watch.
SPEAKER_01: Joe Osmunson is a microbiologist and writer, and he vividly remembers those Lamaze birthing classes.
SPEAKER_03: If the partner couldn't come, I'd be like rubbing the backs.So ever since I was a little kid, I wanted to have a kid.I used to dream as like a 12-year-old that I had like a pregnant belly.
SPEAKER_01: Even as a kid, he knew he'd never have one of those tummies.But he did hope that eventually he might be a father.But into adulthood, that wasn't how life seemed to be panning out.And he started to get increasingly worried about what each passing year might be doing to his fertility.
SPEAKER_03: I first started to worry about infertility.I mean, I never didn't worry about whether or not I'd be able to have a kid.
SPEAKER_01: So at 37 years old, Joe decided to figure out if he was a candidate to freeze his sperm.He didn't want to wait any longer.
SPEAKER_03: I was terrified of telling my family that I was thinking about having a child and then finding out medically it would have been very difficult. I was freaked out about the fertility stuff, I have to admit.As a scientist, I know enough to know a little too much.So I was just freaked out, man.I was just freaked out.It was hard.It got in my head.
SPEAKER_01: While he waited for his results, Joe was agonizing over whether his swimmers were any good. His fears about having children in his 30s, especially while not having a partner, sounded like what I spent so much of my time worrying about.I told Joe about it. I love that you were freaked out.I'm delighting so much in your pain.And I know that sounds really, really cruel, but it's like even your conception, even that language that you used of knowing too much, I feel like as a woman, I was always had this conception of knowing too much.And it's so delicious to me that you were suffering. Pretty much anyone with a uterus who wants to have kids seems to have this imaginary countdown clock that feels both vague and scarily precise.Us woomers know that after a certain point, having biological children is just off the table.For spermers, things seem very different.
And I'm sorry, if the words woomer and sperma gross you out, too bad, buddy.I'm going to be using them throughout this episode. I'm in my mid-30s.That's the age when OBGYNs label pregnancies as geriatric.My friends and I talk about whether we'll have a baby alone, with someone else, what our chances of success are.It is a repetitive, familiar conversation.But it felt different talking with Jo. And really, I've never heard any spermers talk about their biological clocks the way that Jo does.It made me wonder, should spermers be more worried about their fertility?I'm Mona Chalabi and I'm a data journalist.
Numbers help me make sense of a chaotic world, but they can never tell the whole story. From the TED Audio Collective, this is Am I Normal?OK, so to start, I just want to get the lay of the land.When we're talking about challenges with infertility, what kind of numbers are we talking about? I asked my mum, not only because she's expressed a desire for grandkids on a regular basis, but because she was a practising OBGYN for two decades.
SPEAKER_02: I think it's about, I didn't check how many, 20% or 15% of couples don't conceive within the first year.And we used to think it's two years waiting, but now it's one year if they're trying to have children. Normal relationship, like twice a week, once a week.
SPEAKER_01: My mum's talking about having sex once or twice a week.
SPEAKER_02: Then they don't conceive, then it is worth considering what is the reason.
SPEAKER_01: Most of the fertility numbers we have are based on the age of the womb.And there, the science tells us that our peak reproductive years are from our early to late 20s. After our 30s, fertility declines.At 35, we're geriatric.And by 45, it's nearly impossible to get pregnant without serious medical intervention. That being said, lots of people manage to make a baby once they're out of their 20s.My parents had me when they were both much older.They're not sure exactly how old, because like many immigrants, their birth documents are long lost.
SPEAKER_02: But my mum thinks... Late, very late 30s, and maybe I could have conceived in my early 40s as well.
SPEAKER_01: Not all couples are that lucky, and the challenge seems to be increasing.In the US, fertility rates have plummeted.They're at an all-time low.See, in the 1950s, there were more than 120 births per 1,000 wombers in the US.In 2019, there were 58 for every 1,000 wombers.Just to recap, that's from 120 down to 58.That is a big difference. Now, some of that change is because people are just trying to have babies later on in life.A 2018 report found that the median age wombers became first-time mothers was 26, up from 23 in 1994.But researchers think there is more to this story.
They are increasingly worried that environmental pollution might also be contributing to our lower fertility. This pretty doomscape-seeming reality is part of why my Wuma friends talk about fertility all the time. So the way that fertility rates are calculated is based on the number of babies that are birthed per womb.But it's not just up to people with wombs to make a squirmy, crying, adorable blob.It takes two to tango.
SPEAKER_02: It's got to have both sides to be looked at.It's not someone's fault.There is something can be done to make fertility more achievable. There is the female side of fertility and there is the male side.
SPEAKER_01: That's just straight birds and the bees basics.It obviously takes both an egg and a sperm to make a baby.But often when fertility problems arise, people's response is very one-sided. Because you practiced obstetrics and gynecology in Iraq and in the UK, did you see any differences in approaching male fertility in those two clinical contexts?
SPEAKER_02: Yes, and in Iraq, usually the man does nothing whatsoever.He keeps trying to have another wife, divorce his wife and marry another woman and another woman to see if he can conceive.
SPEAKER_01: Oh, that's an interesting approach to figure out your fertility problems.Yes.
SPEAKER_02: Yeah, but because they were allowed to marry more than once, so they marry again.
SPEAKER_01: But that's really awful for the woman, because if the guy is infertile, he's going to marry you and then dump you.She stays his wife, doesn't dump her.Goes for wife number two, huh?
SPEAKER_02: Yeah, yeah.Oof.Oof, yes it is, oof.
SPEAKER_01: Now, that Iraqi example might sound super foreign, but I actually don't think it's a million miles apart from Western culture.My mum told me that when couples would visit her in London, the fertility conversation was also always focused on the womb.Woma's fertility has been a cultural obsession over here too.
SPEAKER_02: In the old days, usually the wife or the female partner goes to the doctor to seek some help to find out why she's not conceiving.But this has changed now.They do go together.Even when they go together, it was the problem his wife is not getting him pregnant. It's not him not getting her pregnant.So this sort of attitude you get, the burden is on the woman.
SPEAKER_01: I certainly feel that burden.For God's sakes, growing up, there was a large photograph that was sat on top of our TV showing a vaginal birth taking place. My mum's masked face apparently smiling as she grabbed the head.Now, if that doesn't get one's curiosity about motherhood going, I don't know what does.Well, I mean, I guess maybe societal pressure too?Whatever the reason, us wombers are told that we're born with a set number of eggs.And when they're gone, they are gone.That's it.We've missed the biological baby boat. No wonder some of my friends have spent thousands of dollars to have their eggs frozen before they find someone that they want to have kids with.
In order to address our quickly depleting geriatric eggs, science has come up with a whole suite of invasive procedures.Doctors thread catheters into our wombs to deposit sperm.And if that doesn't work, there's IVF, where they pump us full of hormones so that we produce more eggs, scoop those out, fertilise them and stick them back in, in the hopes of engineering a pregnancy.
SPEAKER_02: Most of the tests for the male are non-invasive.Lots of women tests are invasive.Even an internal examination is invasive for a woman.
SPEAKER_01: All of this puts the financial, physical and emotional burden of baby making on the wombers.And all of this comes with a weird kind of social cost too. One night a year ago, I matched with a guy on a dating app.This was my first real date in a long time because, you know, the global pandemic.While we were talking, the subject got onto birth control.So he turns to me and he says, when I sleep with girls who are in their 20s, I don't really bother with condoms.But girls who were in their 30s, they just, you know, they're trying to steal your sperm.It actually happened to a few friends of mine. What?I was so surprised and disgusted and angry.
Here was this guy in his 30s who just assumed that I had to be way more concerned about my fertility and my desire for parenthood than he could possibly be.Steal his sperm?Seriously? See, there's this idea that spermers are these well-oiled baby-making machines, that they're able to produce that white gold well into their 80s, that they can always make great swimmers at the drop of a hat or the flick of a wrist.Spermers can apparently just sit back, be as relaxed as George Clooney and not even think about fatherhood until well into their 40s or 50s.Must be nice.
SPEAKER_03: Even how we talk about gametes is gendered by society.You cannot possibly think about sperm and eggs without thinking about the egg having all these nutrients, right?And so it's like the nurturing mother figure.So even some of the ways in which scientists talk about gametes themselves is influenced by how we think about gendered roles of parenting.
SPEAKER_01: But for Joe, this whole womb obsession just didn't seem quite right.And he was determined to make sure that he would always have what he'd need to make a biological child.
SPEAKER_03: the process was weird you know my my act was to go in and jerk off in a cup but in a doctor's office right it was a very odd sort of mix of something that is normally a sexual act whether it's alone or with someone else the sperm donation clinic was very like clinicalized they draw your blood there for all your blood tests the same place where you put your cup with your sperm you put your cup with your urine for your STI testing.It's just, you feel a little bit like a piece of meat.Like you're checking all of these boxes and you're producing this tissue that may or may not become a human person.I didn't feel like a whole person at all. Was there porn?Oh, the straightest straight porn.
SPEAKER_01: Oh, wow.
SPEAKER_03: So I have pictures of this whole process.I have pictures in the cup of the jizz that may or may not become a human being.I have pictures of the jugs magazine that was up on the wall.So I just thank God.I bless the Lord for Twitter porn. There is a whole world of the weirdest gay porn right here on this phone device that I'm recording on that got me through.It really just got me through.
SPEAKER_01: Sperm donation is no party, even if Juggs is what does it for you. But given that we know fertility is a 50-50 split, surely this seems way easier than scooping eggs out of a body or any of those other incredibly invasive procedures, right?So why is Joe the only sperma I know who is doing this? Part of why spermers just don't seem to be talking fertility over mimosas seems to be the science of fertility itself.See, scientists have been tracking humans' ability to conceive for the same amount of time that they've been looking at gravity, since at least the 1600s. By the late 1800s, fertility disorders in womas were well known.But it would be decades before scientists had a standardized way to even assess sperm characteristics, let alone their ability to affect reproduction. A 1916 study making the case for deeper research into sperm said, quote, the study of this subject has been seriously handicapped by the almost universal assumption on the part of the laity that in the event of a childless marriage, the wife is wholly responsible.And for much of the rest of the century, science didn't spend much time questioning sperma fertility. To this day, one study found that in roughly a quarter of the cases where couples were having trouble conceiving, the spermers weren't even evaluated.
And it wasn't until 2019 that the US Census Bureau published its first report on male fertility.And even though the word fertility appeared in the title, the report itself focused on family structure and relationships rather than biological fertility. And on top of all of that, much of our fertility data about wombers might not be telling us what we think it does.See, very few scientific studies about fertility have properly accounted for things like the age of the father.That means our data about fertility problems often obscures the role of sperm. What I'm trying to say here is that this is not just cultural.The research itself reinforces this emphasis on wombers and overlooks spermers.And that has real consequences for our bodies. A 2017 study followed couples who had fertility problems, and it found that many of them had difficulties conceiving, even when the woman had super invasive procedures.Later, these couples tried using donated sperm and a less invasive procedure.
The couples then had a 44% success rate. 44% may not seem super high, but this was a group of people who weren't able to conceive even after these extreme lengths that they had gone to.And they switched sperm and they were more successful.Listen, I get that there are loads of people who are really into the idea of having children that share their DNA.But it seems like the way that we get there is often by resorting to just poking and prodding wombers. And yes, it's true, it's those people that carry the pregnancy for nine months and give birth to the baby.But it still doesn't make sense that the burden for male fertility problems is almost entirely placed on female bodies.
SPEAKER_03: There has long been the assumption that sperm don't matter, right?The sperm has been looked at as sort of a binary.If the man is infertile, then there's a problem with the sperm.If the man is fertile, good to go.So age doesn't matter.Underlying conditions don't matter.Health doesn't matter.You're not infertile.You have good sperm. Therefore, you're good to go to make a child.
And I think that has begun to be interrogated in the last decade with, again, studies on how sperm changes over age.
SPEAKER_01: And that's why Joe waited so anxiously for the results of his deposit.What makes a good sperm manager?
SPEAKER_03: I learned more about this than I wanted to know.So everyone's like, oh, your sperm count, your sperm count.So, yeah, it's about the sperm count, but also the sperm volume.Count is like number of cells per milliliter of fluid.If you jizz 10 milliliters of fluid, there will be more sperm than if you jizz 2 milliliters of fluid.
SPEAKER_01: Yeah.
SPEAKER_03: Mobility is like how much they swim.Morphology is like the size and shape of the cell.So for IVF, they also freeze your sperm and then thaw them out.And then it's like the percent of sperm that survive freezing is another metric.And it's really all of these things together that indicates quality.
SPEAKER_01: All of this might be things that sperm should be worried about.But we actually don't know because of that lack of research. Now, there are some scientists who have tried to highlight the implications of low-quality and low-quantity sperm, but their data was considered inconclusive and controversial. Part of the problem here is that there aren't enough volunteers who are willing to provide sperm.And the ones who do participate tend to already have fertility issues.See, the samples mostly come from people in Western countries where there have been declines in sperm quality.There has been growing evidence that may be due, in part, to the amount of chemicals that are now routinely entering our bodies. The research that is available suggests that age affects sperm makers just as it does egg makers.Over the course of a year, spermers over the age of 40 were a third less likely to conceive a child compared to those under 30.Which, you know, feels kind of like the 40-year-old eggcliff.
This isn't just about conception.It's also about the likelihood of keeping a pregnancy and having a healthy birth.See, this other study found that sperm from people over the age of 35 has more DNA damage compared to those under 35.So just like we think of wombers as having this higher risk of birth defects as they get older, the same is true for spermers. So we don't know much about how factors like age, diet or lifestyle affect sperm's quality.Should spermers who are trying to make a baby take their own kind of prenatal?Or should they stop balancing laptops on their actual laps?Should they eat loads of tuna?Or watch how they're riding a bike?
SPEAKER_03: I remember getting the phone call.I was biking and I felt the phone buzz in my pocket and I was like, I almost got in 13 car accidents.You almost ruined the sperm on that bike.The sperm was already in the goddamn clinic at that point.
SPEAKER_01: I was good.The news Joe got about his sperm was pretty good.
SPEAKER_03: My sperm froze very well.And so my sperm was like on the low average side going into the freeze, but then gangbusters coming out.
SPEAKER_01: Joe's sperm was good to freeze for posterity.Who he might have this baby with, he doesn't have to figure that all out right now.His half-cell kiddos are in the deep freeze, ready for if or when he decides that he wants to reproduce.
SPEAKER_03: I feel so much chiller about death now that my sperm is sitting in a freezer somewhere.I'm like, oh, I could die and something of me is still sitting somewhere.
SPEAKER_01: Most spermers don't carry around this infertility stress because science rarely tells them that they need to.They're going around the world clueless as to the risks of waiting too long to have children.But they do need to be aware of the implications, just as much as us wombers do.And here is the wildest part.Are you ready? Surveys that ask about fertility show us that male infertility is likely higher than female infertility.Science is approaching this whole issue ass backwards.OK, so we've covered culture, we've talked about science, but there is also psychology. Some research that I came across found that when a sperma discovered that they themselves were infertile, they experienced similar levels of distress and depression as infertile wombers did.All of that George Clooney chillness that society says men have is not so true.
When spermers are told to be worried about infertility, they are, just like Joe was.So on the one hand, I'm like, you know... I want men to feel these same pressures that women feel, but that's kind of just a desire to drag men down into the dirt.And it's not really about like full emancipation for all of us, you know.And full emancipation is, yes, of course, it's being responsible and like trying to be the best parent you can from the moment that you start to think about conception.Yeah.
SPEAKER_03: Yeah, I think the notion of emancipation versus pain, my favorite writer, Alex Chee, wrote a line that goes something like pain is information and it teaches you.I was so freaked out, man.I am making a human fucking being.That is like the deepest shit that I could possibly do on the face of this planet.Ramifications for decades for my life.I'm making a life.It's scary as shit.Like there is... It's painful.You're worried about it, you know?
SPEAKER_01: I don't want to make anyone feel bad for not doing what Joe did.Because this is expensive, right?The ability to freeze one sperm, or eggs for that matter, is just a luxury for most people. But our cultural obsession with female fertility affects how we approach all of this.The science and the data collection and the systems that we build around problem solving.And that in turn just shapes the culture even more.It's this vicious cycle of lazy data.See, even this conversation with Jo about fertility has some problematic stuff baked into it.
SPEAKER_03: and even like what you're talking about it's like so hard because like I don't really believe the deterministic nonsense about like egg quality or sperm quality I think it's mad ableist to talk about like older sperm leading to certain conditions in the child like I don't think autism is a bad thing for a child to have but when you're in it you feel it I felt it and I knew that it was wrong to feel it but I felt it anyway
SPEAKER_01: I love that you've added that to the conversation because, so I am also the product of like really old sperm.So on the one hand, I'm like, you know.And this is the challenge in talking about fertility because we've baked all kinds of cultural norms into our understanding of it, including what makes for a quote, normal kid. The privilege of not being told that you have to think about fertility is not just a sperma privilege, it's also a cisgender privilege.When it comes to fertility research about trans or non-binary people, there's even less of it. Culture is an extremely strong force in shaping how we frame scientific questions and how we go about solving what we see as problems.So it's really important to check the basic assumptions that are built into the questions science and research asks.Otherwise, we get bad data and a distorted understanding about our world. Personally, all of this data is still a bit of a bummer.See, the numbers show me that with every passing month, my probabilities of becoming a parent dwindle.
So much of my fertility is outside of my control.I don't even know if I'm able to get pregnant, let alone how many eggs I have left in the old ovarian baskets.But I can control when I try to become a parent and who I do it with. And so I have come up with a great solution.I am keeping my eyes open for some nice young sperm.I'm kind of kidding, but also I'm really not.If I can, I'd like to find some fast swimmers to offset my ratty old eggs.I grew up with so many images of old men with fresh-faced women on their arm.I am ready to see something new.Ideally, something with abs.
Listen, I don't take this lightly.It's going to be hard to sleep on a mattress on the floor and listen to someone talk about some genre of music that I've never even heard of.But that is how much I care about data.I am willing to suck it up and make that sacrifice if it means that we get better statistics.But don't worry, I won't just steal the sperm.I'll ask first. Am I Normal is part of the TED Audio Collective.It's hosted and produced by me, Mona Chalabi, and brought to you by TED and Transmitter Media.This episode was produced by Joanne DeLuna and Wilson Sayre.Wilson is also our managing producer, along with Lacey Roberts.
Sarah Nix is Transmitter's executive editor and Greta Cohn is our executive producer.The TED team is Michelle Quinn, Banban Cheng and Roxanne Heilash. Jennifer Nam is our fantastic researcher and fact checker.Additional production by Domino Sound.Original theme song by Sasami.Michelle Macklem is our sound designer and mix engineer.A special shout out to my OG woo mutt and a former OBGYN, my mum.To get the transcripts and research that I talked about in this show, you can check out the link in the show's description. And you can find out more from Joe Osmondson on his fantastic podcast, Food for Thought.We're back next week with more Am I Normal?
Make sure that you follow the show in your favourite podcast app.That way you can get every episode delivered straight to your device.If you enjoyed the show and want to support us, you can hit the share button and send it to someone.Maybe someone who's trying to have a kid.Or you could just send it to every spermer you know.
SPEAKER_00: PRX.
