Podcast Review: This Podcast Will Kill You – IVF (Part 2, Invention)

IVF probably won't kill you, but it is the subject of a three-part series on the 'This Podcast Will Kill You (TPWKY)' podcast whose instalments are aptly titled Infertility, Invention and Industry. This review will focus on part two of the series, 'Invention'. Hosts Dr Erin Welsh and Dr Erin Allmann Updyke share a cocktail recipe to accompany each episode, so pour yourself a drink, and let's get into the podcast.

I started listening to TPWKY during walks to my epidemiology classes in 2019. Their deep dives into infectious disease were the perfect primer before lectures on cohort studies and relative risk. As TPWKY has evolved since its debut in 2017, so too have the topics covered, expanding into any condition of medical importance. Even before its conception, IVF has been a topic of discussion in politics and biology classes. Thus, IVF fit naturally with TPWKY, and I appreciated learning more about IVF from my favourite epidemiologists.

The episode begins with a call from a listener named Dominique. She used IVF to get pregnant after her husband had testicular cancer. 'Everybody's IVF journey is really, really different, but they're all roller coasters I think, they all have ups and downs whether those are big or small.'

There are five other first-hand accounts to tell of the complicated mix of feelings one might have as they go through fertility treatments throughout the episode. Centring on the lived experiences of patients is a rarity in science. Scientific journals are devoid of the very real emotions that are behind every health issue, and the excitement scientists have for their research subject is typically counterfactual to how patients feel. Hearing listener stories made this episode a more emotional experience than listening to a strictly fact-based podcast.

A listener named Adrienne sets the stage for the history of IVF with her first-hand account saying, 'I'm a wildly successful example of IVF and it was still one of the most difficult times in my life, not to mention the special hell it is trying to get pregnant by committee.' This quote particularly struck me, as it so succinctly captured how different IVF is from spontaneous conception simply through the amount of people it takes to conceive a baby.

The host of characters within the history section form the basis of Adrienne's 'committee'. Dr Welsh's storytelling brings the listener along through the history of the invention of IVF, leading up to the first successful IVF birth in 1978.

The current political landscape surrounding IVF is not included in this episode, but the basis for it is. Much of it centres around the book Brave New World, published in 1932, which details a dystopian future. With this book in the cultural zeitgeist, IVF had very controversial developmental years.

Although IVF's history is relatively short, the modern information surrounding the technology is vast. Even during a cumulative five hours of podcast, the biology of IVF cannot be covered in its entirety. However, I think Dr Allmann Updyke does a good job to inform the listener of the most important aspects of the basic biology behind it. This includes how eggs are retrieved, IVF, embryo transfer, and development.

The final first-hand account in the episode was more harrowing than the others. A listener named Lillian had a particularly heart-breaking experience with IVF, ending her account with 'There aren't many stories from long haulers who've suffered multiple miscarriages like myself for whom IVF doesn't end with a live baby because our stories are sad. But we do exist.' This quote came before the end of the podcast, where there was a distinct tonal shift from the hosts.

Calling back to the name of the podcast the last segment was about the risk IVF poses to health. Pregnancy in general is a risky state of being. Although modern advancements have decreased maternal mortality globally, conditions such as pre-eclampsia and gestational diabetes pose risks. IVF accrues additional risks compared to spontaneous conception. Typically, there are more anaesthetics and prescriptions involved, each with their own side effects. Also, IVF pregnancies tend to have more risk of blood clots and strokes after delivery.

With these additional risks, one would expect the outcomes of IVF to be well known, but our pedantic hosts point out that we don't really know the true success rate of IVF. You can find numbers online claiming to be the success rate of IVF, from both the government and fertility clinics. These numbers rarely line up. The hosts said there needs to be better break downs of IVF success calculations, as a gross number of live births does not capture the nuance of each factor of IVF.

The episode wraps up from there, on a very realistic, but not very optimistic note. If you are looking for positive accounts of IVF for reassurance, TPWKY might not be your best option. However, the storytelling aspect of history and biology make it a fascinating listen. If you're interested in hearing more, I encourage you to start at part one of IVF and listen to the short series in order. Each episode ends with a list of references that you can find on the TPWKY website if you'd personally like to explore the topic further.