Podcast Review: Global infertility - Could The Handmaid's Tale become reality?

The BBC's World Service weekly podcast series, CrowdScience, invites listeners to pose questions about life, Earth and the universe. To find answers, they interview experts at the frontiers of knowledge.

In this episode, a listener, Mark, has been watching the TV series, The Handmaid's Tale which is an adaptation of a dystopian book by Margaret Atwood. In this fictional world, mass infertility is pandemic but the reason is unclear. This gets the listener, Mark, thinking – could this become a reality and, if so, what would be the political consequences? As an avid Margaret Atwood fan, I'm keen to find out what this 40-minute programme will uncover as presenter, Marnie Chesterton, investigates possible causes intimated in the series. 

A string of compelling interviews follows. The first is with Joy Lawn, Professor of Maternal Reproductive and Child Health at the London School of Hygiene and Tropical Medicine. Together they explore the possibility of real-world diseases spiralling beyond control that could result in mass infertility (and, possibly, human extinction). A common theme that will likely be recognised by Atwood fans from her other works. 

Syphilis, gonorrhoea, mumps and malaria are discussed as each can affect fertility or pregnancy outcomes. I'm surprised chlamydia is not on the list, since it is more prevalent globally than gonorrhoea. However, as sterility appears to happen quickly in the TV series, the spread of disease is dismissed early by Chesterton. Despite this, I find growing epidemics a plausible argument for mass infertility given a longer time period. 

Next, toxins in water supplies and endocrine-disrupting chemicals are considered and some great real-world examples are given. Heather Pattersaul, professor of biological sciences at North Carolina State University, cites pesticides causing infertility in alligators. She also illustrates the catastrophic effect of mass-prescribed synthetic oestrogen to pregnant women up until the 1970s. Chesterton is also chilled to learn that people are exposed to 1500-2000 untested endocrine-disrupting chemicals in everyday household products like toiletries and furniture. Professor Pattersaul adds that the insidious effects of toxic chemicals on fertility will be hard (or impossible) to track. Consequently, a cause of this nature could remain abstract, as is the case in the TV series.

In The Handmaid's Tale, the notion of a sterile man is forbidden, there are only women who are fruitful or barren. Inevitably then, the focus of the podcast shifts to male infertility. Reference is made by Chesterton to data published about sperm counts in the West halving over the past 40 years, yet the cause is unknown, conjecture is rife.

In the next interview with Allan Pacey, Professor of andrology at the University of Sheffield (and a trustee of PET, the charity which publishes BioNews), the two discuss his suspicions. Men's testes are an indicator of how many sperm they will produce; bigger really is better, yet he offers no evidence on the shrinking of men's testicles. He also suggests the issue could be lifestyle, the environment, or that compromised sperm DNA could be hereditary which is a current debate. From the start, it is clear that not much is known about male factor infertility, which may be in part due to a lack of research funding.

Does this indicate infertility is still considered a largely female problem? If so, it worryingly reflects the denial of men's culpability that is heavily featured in the Handmaid's Tale. 

Chesterton then tackles the second part of Mark's question. What would be the political fall-out of mass infertility? A terrifying totalitarian example of female subjugation that took place in Romania in 1966, is offered as a real-world example. At this point, Mihail Hoerger of the East European Institute for Reproductive Health explains that communist politician and dictator, Nicolae CeauÅŸescu, outlawed abortion. Consequently, illegal abortions took place, resulting in thousands of deaths and rendering many infertile. Hospital staff members were forced to become whistleblowers much like Atwood's Handmaids who keep each other in check. Those who could not afford to keep the babies abandoned them in hospitals. Shocking footage of unwanted children tied to filthy cots in grossly dilapidated Romanian orphanages hit the news in the late 1980s. You may remember it. I do.

It is equally horrifying that in 2019, 13 percent of countries globally continue to ban abortion. Likely, there are powerless women and children alive today who are suffering similar fates. Chesterton mentions that people have started wearing the red smock of the Handmaids at protests to symbolise the injustice women continue to face. Fiction meets fact in the real-world as the fight for women's rights rages on.

In the programme's wrap-up, Chesterton is depressed when she concludes there are many real-world examples to draw on. This is hardly surprising, as Atwood acknowledges all her fiction draws on current trends or events that could happen. This is a fact openly shared at the start of the podcast. Despite this, I would recommend Atwood fans, and anyone interested in exploring dystopian futures to have a listen. Equally so, anyone interested in the importance of keeping women's rights front and centre are encouraged to tune in. Overall, it is an engaging, unsettling and thought-provoking podcast, that accentuates many blurred lines, not dissimilar to the infamous, brilliant, salient works of Atwood.

Global infertility: Could The Handmaid's Tale become reality? is available on BBC Sounds.