Podcast Review: Baby or Bust

As someone who is far from an expert on the current landscape of reproductive treatments available to budding parents, I was intrigued to listen to the recently launched, tell-all 'Baby or Bust' podcast. The podcast, hosted by Dr Lora Shahine, a reproductive endocrinologist, features discussions with experts and patients about their experiences of fertility clinics in the USA.

The podcast launched in January this year and has so far featured episodes with both fertility experts who provide up-to-date and medically backed advice to current and former patients who reveal their stories of travelling on the rollercoaster journey of fertility treatment.

The tone of the episodes was quite variable: funny moments interspersed with very sombre anecdotes, both personal and second-hand, and yet never coming across as ridiculous or fake, the only exception being the cheesy outro music which appears to belong in a Maroon 5 song! In the first episode, author Karen Jeffries was featured and she took a comical approach to fertility treatment. This was best characterised by her casual banter with Dr Shahine, using such phrases as 'Oompa Loompas' to describe her imagined idea of the fertility clinicians 'buffing' her husband's sperm.

A more serious conversation was held in the following episode with Dr Ruth Lahi when discussing the very sensitive issue of miscarriage. Dr Lahi emphasised especially how the patient should never be blamed no matter how indirectly for the failures of their treatment or the occurrence of their infertility. Something often done by well-meaning but otherwise clumsy friends and family whose efforts to offer reassurance end up trying to affix the blame.

What I was most impressed by with this podcast was how human the fertility experts came across when interviewed. Most, if not all, of them had undergone the fertility treatments themselves and they spoke so candidly about how it had affected them emotionally both personally and concerning the relationships with their spouses.

I really appreciated the level of the language used in these episodes with both experts and patients alike speaking in colloquial terminology. When mentioned, the medical terms were used only when necessary and followed by brief but accurate descriptions.

However, despite the high number of clinicians featured on the podcast, there was a lack of detailed discussion about fertility treatments concerning the scientific principles behind them and which ones were designated for different patients. Further, this podcast is not recommended if you want to learn more about the different fertility treatments available or how they actually work. It provides more of a holistic overview into the human side of fertility treatments, in particular describing the emotional rollercoasters experienced by those receiving the therapies.

Hearing the reports of how many women receive discrimination and inadequate medical advice based on their age, race, and sexuality when seeking fertility treatment left me truly shocked. This included the fertility concerns of younger women being ignored, advised instead to wait until they were approaching their forties before undergoing fertility treatment, as recalled by Dr Natalie Crawford from a patient of hers during episode seven.

One area where the podcast may resonate with listeners in the UK is the topic of discrimination faced by same-sex couples. For instance, podcast guests Jaime and Robin, two lesbians who host the podcast 'If These Ovaries Could Talk', broached the discrimination from insurance companies faced by same-sex couples when pursuing fertility treatment. They described health insurance plans which require a medical reason for a patient to qualify for fertility treatment. Jaime and Robin felt these requirements did not consider the needs of same-sex couples. This echoes the case of lesbian couple Megan and Whitney Bacon-Evans who are bringing a legal case against their local NHS Clinical Commissioning Group (CCG) (see BioNews 1121).

Furthermore, it was incredibly sobering to listen to podcaster and documentary maker Chiquita Lockley, featured in episode four – 'Black Women and Fertility', who outlined the experiences of many black women.

She revealed that black women are twice as likely to experience fertility issues as their white counterparts, but are half as likely to seek treatment, and even when they do, it's on average two years later. She explained that reproductive health is rarely discussed within the black community, with many black women affected by the stereotype that they are more likely to be fertile. This myth has roots in outdated and racist American stereotypes, leftover from the slave trade. It was perhaps most shocking to find out that Serena Williams was refused a test for a blood clot when in labour, despite explaining that she was prone to blood clots. Only after her white husband insisted, was a test performed, which revealed a blood clot that may well have killed her if left untreated. According to Lockley, if the pleas of one of the most famous athletes can be ignored by medical professionals, how can ordinary black women expect fair treatment?

The issue of 'non-bio parents' – parents with no genetic relation to their children – was a topic very sensitively discussed by both Robin and Dr Shannon Clark in episode five – 'Donor Egg Family Building'. Robin's partner underwent fertility treatment using a sperm donor, and Robin initially feared that she would be unable to love a child she had no genetic relation to. Dr Clark described a different approach to dealing with the use of an egg donor to conceive, saying how giving birth to her child caused her to feel a deep connection. Nevertheless, she did admit that searching for an egg donor did feel as though she was searching for her own replacement. What was beautiful to hear was how many of the guests described feeling grateful for all their failed courses of reproductive therapies as it enabled them to parent the children they have today. I do not classify myself as the overly sentimental type but even I could not deny that this struck a chord with my heart.

Overall, if I could summarise the podcast's most attractive attribute it would be the incredible bravery and honesty with which each many of the guests described their fertility journeys. This clearly is such a difficult process on a number of fronts: socially, economically, mentally, and physically and yet the strength of these people was as clear as day to me.