On television shows infertility usually serves as the basis of a dramatic storyline. Tears are shed, hilarious hijinks sometimes occur, but then—plot twist!—they magically manage to bring a baby home. Real-life roadblocks like financial strain and relationship stress are often glossed over, with the actual journey to parenthood resized for a 30-minute time slot.
Here’s what these top five TV shows get right, and what they get wrong when it comes to telling the story of infertility:
1. This Is Us: PCOS
What happens: After Kate has a miscarriage, she and her fiance, Toby, explore IVF. According to Kate’s doctor, the fact that she is 38 years old, obese and has polycystic ovarian syndrome (PCOS) all present risks regarding her ability to conceive. And on Toby’s end, his use of antidepressants contributes to low sperm count. Still, they end up pregnant after one round of IVF.
What it gets right: Age, weight, and PCOS can definitely impact a woman’s ability to get pregnant. Here’s a simplified explanation—the older you are and the more you weigh, the fewer viable eggs you may have. With PCOS, you may not ovulate regularly, which means no egg to fertilize for the possibility of a baby in the first place. And sometimes all three risk factors coexist, like in Kate’s character.
Plus, This Is Us brings miscarriage into the infertility picture. “Infertility in the media is routinely focused on the issue of getting pregnant,” says Dr. Brian Levine, founding partner and practice director of CCRM New York. “However, miscarriage is incredibly common, with close to one-third of all pregnancies ending in miscarriage. The problem of staying pregnant is a common cause of infertility, and we need to flip the proverbial script.”
What it gets wrong: First, while some types of antidepressants can impact sexual function in men, says Dr. Daniel Kort with Neway Fertility, there are no great studies that document the impact on sperm count specifically.
Second, despite all Kate’s risk factors, she gets pregnant after the first round of IVF, which isn’t realistic. Dr. Kort says the average success rate of IVF is significantly lower than 50%, and the average number of IVF cycles to achieve a pregnancy is between 2 and 3. On the other hand, even though Kate struggles with her weight, that doesn’t mean it’s impossible for her to get pregnant.
Though television producers do get it right in some instances, they also romanticize and promote infertility myths, which is not only misleading, but also hurtful.
Finally, some view this particular plotline as light on accurate details. “Personally I think TV shows make infertility seem like a minor inconvenience,” says Steph M., a mom of one who has gone through several rounds of IVF. “Kate is told she has a 1% chance and then, surprise surprise, IVF works. I also don’t think it adequately shows the raw emotion of waiting two weeks to see if the $15,000 you spent worked. You over analyze every symptom.”
2. The Mindy Project: Egg Freezing
What happens: In an attempt to market her fertility practice to college-aged women, Dr. Mindy Lahiri introduces a New York City “spring break” trip for egg freezing. She frames it as a sight-seeing opportunity concluding in a supposedly simple procedure, and tells the participating women that their decision to freeze their eggs will give them time to find the right partner.
What it gets right: Yes, technically freezing your eggs gives you more time to find the right partner, if that’s your primary hang-up. It’s also true that most people interested in freezing their eggs aren’t necessarily ready to try to have a baby right then, due to relationships or age, and that’s why this process can be a good fit.
“Women who want to wait should seriously consider freezing their eggs,” says Dr. Tiffanny Jones of Dallas IVF. “It is not a 100% guarantee, but it can give women a much-needed chance of conceiving, especially if they are going to wait until they are 40.” Still, the show does a nice job of normalizing the topic of egg freezing versus keeping it a hush-hush option.
What it gets wrong: Even though egg retrieval itself is a simple process as an outpatient procedure, it typically takes a couple weeks from start to finish for the whole process—in other words, longer than spring break. Additionally, the episode barely mentions the cost of egg freezing (do most college students have 10K to drop on this?) and minimizes the emotional or psychological side effects of doing so.
3. Parenthood: Secondary Infertility
What happens: Julia and her husband, Joel, have one child and decide to try for another, only to learn she has uterine scarring from her first pregnancy and will not be able to conceive again. They adopt two more children, and in the series finale, Julia is unexpectedly pregnant with a fourth child.
What it gets right: A lot—the depiction of frantically timing sex for an ovulation window (like at their nephew’s birthday party in a relative’s bathroom!); the awkwardness of delivering a sperm sample; the anxiety, excitement, and disappointment around fertility testing in general; Julia’s urge to apologize to her husband for her body being “broken”; the overall emotional stress and impact infertility has on marriage; secondary infertility as a whole.
“The media seems to ignore those who have trouble with a second child or third child, also known as secondary infertility,” says Dr. Levine. “In fact, the struggle to have another child can be just as stressful as trying for the first child.”
If you take the show at face value, especially for when it first aired, it positively introduces themes of infertility, adoption, and surrogacy into mainstream media.
What it gets wrong: Primarily, it propagates the “miracle pregnancy” storyline, just like so many other shows, says Kelly O., a freelancer who has struggled with infertility for the past nine years. “Though television producers do get it right in some instances, they also romanticize and promote infertility myths, which is not only misleading, but also hurtful,” she says. “One that pops up over and over again is that of the miracle pregnancy after an infertility diagnosis or after the couple has decided to adopt. To be fair, for some couples this does happen; however, for the vast majority of couples struggling with infertility, this fairy tale ending is a myth.”
4. Friends: Adoption & Surrogacy
What happens: Two infertility storylines occur throughout the series: Monica and Chandler, a married couple, cannot get pregnant, so they adopt twins at birth, while Phoebe, a single character with no children of her own, serves as a gestational surrogate to her brother.
What it gets right: Not much. Yes, adoption and surrogacy are *technically* options for anyone facing infertility, and may certainly offer ways to expand one’s family, but the sitcom fast-tracks the journey to adoption, glosses over the inability to conceive, and skips over the process of surrogacy. But if you take the show at face value, especially for when it first aired, it positively introduces themes of infertility, adoption, and surrogacy into mainstream media.
What it gets wrong: Both storylines are made to look like NBD decisions with a speedy timeline, a lot of laughs, and a final “awwww” to satisfy the viewer. With adoption, there are often complications regarding birth parent(s), length of time, getting matched, and age of child(ren) adopted—none of which is depicted here, as Monica and Chandler literally just decide they want to adopt and end up with two newborns. On the surrogacy front, Phoebe’s lack of birth experience is actually a no-go in real life. “The fact that the surrogate is a young, unmarried woman with no children is completely inaccurate,” says Nichelle Sublett, founder of #StartAsking, a movement to encourage women to ask about their fertility health sooner than later. Although there’s the rare possibility that someone can work with a close relative as a surrogate, as Phoebe did with her brother, “there is no surrogacy agency in America that allows surrogates who have never been pregnant and carried a child to a normal, healthy delivery.”
5. Sex and the City: IVF and Natural Conception
What happens: Even though Charlotte seems like the type of woman who has it all, she can’t get pregnant. She tries everything—acupuncture, IVF, ovulation calendars—and eventually goes through a divorce with her first husband, gets remarried, and adopts a child. Later on, Charlotte does become pregnant.
What it gets right: Charlotte’s behavior toward friends and strangers who get pregnant is spot on, along with her experience of making peace with a life that looks different than planned. “I like how they showed the raw emotions that come with infertility,” says Sublett. “For instance, one of Charlotte’s friends, Miranda, accidentally gets pregnant, and Charlotte’s visceral reaction of jealousy and anger toward Miranda is very typical of women dealing with infertility. We find ourselves extremely envious and confused when friends of ours who weren’t planning pregnancies, and seem like unlikely candidates, fall pregnant so easily. I’ve felt that many times when unmarried friends or associates of mine pop up pregnant after knowing someone for 2 minutes. It feels so unfair.”
What it gets wrong: There’s nothing wrong with Charlotte’s character eventually getting pregnant; however, that’s an uncommon endgame for those struggling with infertility—suggesting that if you just wait and try hard enough, it’ll eventually happen. This is harmful because it promotes the “just relax!!!!” mentality instead of focusing on the fact that some women never do get pregnant, no matter what.
All in all, stories of infertility on television have come a long way over the past two decades, which is a positive shift. At the same time, there’s still a major opportunity for shows to get even more real in depicting on screen the physical and emotional toll of infertility. When authentically portrayed, these plotlines can be a powerful testament to and inspiration for anyone going through the experience, and we need to see more of it.
Julia Dellitt is a Midwest-based freelance writer and mom of two whose work has been published by BuzzFeed, SELF.com, Forbes, Lifehacker, BRIDES, Aaptiv, Work + Money and more. Her first book, Get Your Life Together(ish), will be available in April 2019. To learn more, visit julmarie.com or find her on Instagram at @julmarie.
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