âITâS A GIRLâ, shouted the headline of the Daily Express the morning after Louise Brownâs birth. On 27 July 1978, newspaper readers across Britain met the blinking, slightly quizzical gaze of a baby no more than a few hours old, and to all outward appearances exactly the same as thousands of other babies born across the land that day. Of course, appearances can be deceptive. As the first child born as a result of the technique of in vitro fertilization (IVF), at that moment Louise Brown was utterly unique in the history of humankind. The successful deployment of IVF has had manifold consequences, including an irrevocable shift in public debates on reproductive technology, the creation of a discourse of the ârightsâ of couples to biological parenthood, and new possibilities for the configuration of âthe familyâ itself. Above all, IVF has made infertility socially visible, but in such a way that involuntary childlessness is now often perceived as inseparable from issues surrounding the development and use of assisted reproductive technologies (ARTs).1
This post-IVF conflation of infertility and ARTs is so ingrained in contemporary Western discourse that Margarete Sandelowski and Sheryl de Lacey have even claimed that infertility was âinventedâ in 1978.2 This claim rests on some very fine distinctions. They argue that infertility is âa medically and socially liminal state in which affected persons hover between reproductive incapacity and capacityâ because they believe that modern medicine can eventually bypass âvirtually any kind of biological or physical impediment to reproductionâ. As such, Sandelowski and de Lacey view âinfertilityâ as different to âbarrennessâ, which connotes âa divine curse of biblical proportionsâ, and to âsterilityâ, which implies âan absolutely irreversible physical conditionâ.3
The etymological differences between these terms provide some, albeit limited, support for this claim. Although the English word âinfertileâ dates from the sixteenth century, it seems that until the mid-twentieth century, it was more often applied to animal and plant than to human life. The Middle English word âbarrenâ, on the other hand, was used to describe women incapable of bearing children before it was applied to trees or plants, and the late Middle English term âsterileâ and its derivatives seem to have been indiscriminately applied to women, animals, and plant life more or less from their first entry into the language.4 The definite preference for âinfertilityâ over other available terms is a late twentieth-century phenomenon, and it is difficult to disentangle this etymological history from that of IVF.
Yet the claim that infertility was âinventedâ in 1978 is not only about language. It implies first that the experience of late twentieth or early twenty-first-century âinfertilityâ is qualitatively different to earlier experiences of âbarrennessâ or âsterilityâ, and second that this difference resides in the indeterminate status of infertility as a condition that sufferers believe can be bypassed (if not cured) by medical intervention. This approach emphasizes âinfertilityâ as a medicalized state, in which the possibilities of reproductive technology keep sufferers suspended in a state of hope. Some scholars implicitly or explicitly accept this definition, but argue that the âmedicalization of infertilityâ began much earlier, whether in early nineteenth-century North America or in ancient Greece.5 However, there are many other potential objections to Sandelowski and de Laceyâs argument: that it privileges a medicalized definition of infertility; that it is Western-centric; and that while it posits a definitive shift in the experience of involuntary childlessness as the result of IVF, it is clear that there are important continuities in the experience of infertility in different historical periods and contemporary cultures (see Introduction for further discussion of these issues).
Nevertheless, this radical statement about the âinventionâ of infertility should not be dismissed out of hand, even if we ultimately find it unconvincing. Sandelowski and de Laceyâs argument highlights the existence of multiple definitions and concepts of infertility and related terms, and how and why they might change over time. Crucially, it also opens our eyes to the manifold ways in which current concepts of involuntary childlessness are inevitably shaped by our own location in a post-IVF world. It forces us to engage with the implicit and explicit definitions that scholars of infertility adopt, how these definitions shape their approaches to the subject, and the challenges they face in attempting to unpick past and present understandings and experiences of involuntary childlessness.
There are no simple solutions to these thorny issues of definition and method. The chapters in this section explore the variety of ways in which infertility has been defined in different periods and contexts, and illustrate a range of possible scholarly approaches to the condition. Taken together, they invite readers to consider the extent to which the âbiologicalâ category of infertility has always been mediated by social and cultural concerns; how initial definitions of infertility help to determine the findings of any study; how changing definitions have shaped the experiences of sufferers; and some of the practical difficulties in researching the history of infertility. These chapters therefore reflect on issues of perennial importance to the history of infertility, controversies which have not been resolved, and methodological problems which remain constant. Like the volume itself, this section is a sustained attempt to resist easy assumptions about âinfertilityâ, and in this way to generate more complex and historicized understandings of involuntary childlessness.
The section opens with Sally Bishop Shigleyâs moving meditation on different âstoriesâ about infertility, including her own. Shigley interweaves autobiography with medical, legal, and literary interpretations of infertility. She reflects on the consequences of defining infertility as disease and as disability, and how these definitions resonate (or do not) with the lived experience of infertility. Through examining a range of literary texts, including memoirs, chick-lit and comics, Shigley shows how prevalent modes of narrating stories about infertility can variously unsettle, reassure, or attempt to normalize certain aspects of the experience of infertility. Above all, she demonstrates how these âstoriesâ inflect the experience of infertile women, sometimes to reinforce stigma and self-blame, sometimes to delude with unrealistically neat happy endings, and sometimes to offer comfort through the identification of shared absurdities, indignities, and pain. Her chapter is not only a contribution to scholarly debates on infertility, but a story offering solace and strength to those who suffer now, and need to see how they might survive.
Laurence Totelinâs chapter moves us from the contemporary USA to ancient Greece and Rome, and from personal experience to plant infertility. Totelin shows that ancient medical texts often employed agricultural metaphors to describe human fertility, and then examines how Greek and Roman authors explained plant fertility. She argues that references to plants in medical texts were not only metaphorical. In fact, the ancients extended their conclusions about the causes of sterility in plants to humans, and there are important similarities in their approaches to infertility in different forms of organic life. They perceived intervention by a human male and the active contribution of the female human/earth as essential to the âtreatmentâ of both human and plant infertility. This analysis of infertility provides new insight into how approaches to infertility were gendered in the ancient world, but even more importantly for our purposes, Totelin provokes radical new ways of thinking about how we might study human infertility by looking at the topic from the unexpected angle of ancient botany. As in Shigleyâs chapter, Totelinâs approach and her findings underscore that modes of narration are not incidental to the formation of knowledge about infertility: metaphors and analogies reveal shared origins of understanding across different domains, and both reflect and shape mentalities.
Bridget Gurtlerâs chapter picks up on many of the same themes, as she examines understandings and practices of artificial insemination in Britain, France, and the USA in the nineteenth and twentieth centuries. Before the cryopreservation of sperm became possible in the 1950s, eventually leading to the creation of commercial âsperm banksâ, and especially in the pre-HIV era, artificial insemination was one of the simplest âtreatmentsâ for infertility.6 It therefore has a much longer history than most of the treatments still in use in the Western world today. However, as Gurtler shows, shifts in the nomenclature of artificial insemination reflected important changes in the medical and social contexts of the practice. As the diverse vocabulary of âartificial fructificationâ, âartificial fertilizationâ, âartificial fecundationâ, and âartificial impregnationâ (all terms common in the nineteenth century) gradually narrowed to the familiar language of âartificial inseminationâ used today, medical science gradually established control of the procedure, and its practice became acceptable to shore up ...