Fertility, the capacity to reproduce, is becoming more and more abstracted from reproduction itself. Since around 2010, public health campaigns exhort middle class women in the global north to protect and cultivate their fertility, to plan its preservation and deployment. Without careful strategy, we are told, women in their mid to late thirties may plunge off the fertility cliff, and find that grasping at the straws of IVF on the way down does not save them. This advice, while well-intentioned, does not address the political economy of women’s’ life course which pressures women who want children towards later conception attempts. The soaring cost of household formation, the vagaries of relationships and tinder dating, the need for ever more credentialing and heroics to establish one’s career, the absence of affordable childcare; all these push women towards attempts for children in their later thirties, when the normal physiology of reproductive biology involves lessening fertility.
The growing public awareness of the fertility cliff has nevertheless offered unparalleled business opportunities to various commercial providers of fertility management services. Private investment in reproduction is nothing new. IVF clinics are typically private sector and some are global publically listed companies. However, over the last few years a new fertility management sector has coalesced around the desires and anxieties of women who fear falling off the cliff. Ovarian reserve tests sold online and egg banking services are available through a disruptor sector that is intent on contesting the dominance of IVF clinics, and carving off the fertility testing dimension of IVF consultations into a stand-alone business model. Big data companies and smaller startups offer ever more complex kinds of fertility tracking apps and devices, that encourage day by day and even hour by hour attention to the fluctuations of the menstrual cycle and the identification of optimum conception time. Some apps send coy text messages to the male partner, inviting him to come home soon for some baby making.
Each of these developments can freeride on current fertility public health campaigns and build on the higher levels of awareness and anxiety they generate to constitute consumer markets for their services and pursue multiple opportunities for revenue. While egg banking is very expensive, (and in the United States often forms part of the sign on benefits for women beginning their careers in law, banking and tech), online ovarian reserve testing is far cheaper (and less reliable) than the same process conducted in a clinic, while tracker apps are available to anyone with a smartphone and the diligence to self-monitor. Hence the fertility management sector can form markets at a wide swath of income levels and ages.
In effect, testing, banking and tracking practices are transforming some women’s fertility into an abstractable quality, a potential asset, managed by the woman herself with the expectation of future value. Fertile assets depreciate rapidly, losing value over the first half of women’s life course: this accelerating loss is exactly the quality that tracking and banking technologies are designed to pinpoint and arrest. While these services promise to reconcile the demands of the economy with the limits of women’s reproductive biology, they in effect offer a limited privatised solution to biopolitical issues that demand an appropriate social response.
Professor Catherine Waldby