Real In/fertility

Curator's Note

In July, 2019 Gretchen Rossi, former Real Housewife of Orange County (Seasons 4-8 & 12) and long-time fiancé Slade Smiley welcomed baby girl Skylar Gray – after 4 years of in/fertility treatments.

Unlike most heterosexual couples that choose IVF after attempting to conceive naturally, they began with IVF due to Smiley’s vasectomy. However, after a round of IVF, which produced no viable embryos, Smiley reversed his vasectomy and the two tried to conceive naturally. After 18 months without success, they returned to IVF for 3 more rounds, the details of which are vague.

The Rossi/Smiley path to parenthood was, like many families, complicated. Their initial use of IVF was for fertility, not infertility reasons. Then, once deemed “infertile” because of their inability to conceive naturally, IVF became an infertility procedure – until it produced a baby, thereby rendering it fertility once again. Their economic resources allowed for enough infertility procedures to result in fertility. 

For couples without the means, one round of IVF may be the entire journey; and dependent on outcome, it is either a journey of fertility or infertility. Infertility is indeed pathological, but is it biological or fiscal? And what of queer families? When conceiving “naturally” is a social and physical impossibility, to label their process as one of infertility is by default to pathologize them. 

According to, Infertility is defined as “a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity either as an individual or with his/her partner.” This definition is not only heterosexist but also pejorative. While medical definitions of pathology may never change, social terminologies can. I suggest the term “infertility” is heterosexist, misogynistic, patriarchal, and pathological and a switch to “fertility” can be a move towards empowerment, inclusion, and equality.  




This is such a great question.

There are many couples for whom fertility can only be achieved at the cost of tens of thousands of pounds. In the US, I suspect the figures involved are even higher.

On the NHS the recommendation from the National Institute for Clinical Excellence (who determine what treatments are/should be available through the public health system) is that a couple should get 3 rounds of IVF covered. In reality, healthcare cuts mean that there are almost no health trusts that offer 3 rounds any more and a steadily increasing number don't offer any at all.

I attended the conference of the European Society for Human Reproduction and Embryology in June and it was fascinating to learn from people from all over the world how access to infertility treatment changed outcomes. In the Netherlands the standard number of covered cycles is 6, I think. In the US is it none. In India it is none.

Given how hard women (in particular) and their doctors and nurses have worked to create an accepted definition of infertility that allows access to treatment, I think doing away with that definition in the name of inclusivity is shortsighted. We need to look at why that definition exists and how it functions before we replace it with something poorly defined and unhelpful.

Add new comment

Log in or register to add a comment.