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a person of African descent standing against a pole

Most people understand in-vitro fertilization to be privilege for the wealthy, the well-insured, or those living in a country with a generous social safety net. In 2014, IVF clinics across Europe reported 508,433 cycles. In 2015, the United States reported 231,936 cycles. In 2013, across Africa—the entire continent—there were only 25,550 cycles.

Yet the effects of infertility are outsized precisely where there is little support. In 2001, at a World Health Organization meeting, two researchers proposed a continuum of social suffering to measure the effects of infertility. The language is banal, but the extraordinary pathos remains. In the developed world, couples tend to experience social suffering in level 1 (fear, guilt, self-blame) through level 2 (marital stress, depression, helplessness) and level 3 (mild marital or social violence and abuse, social alienation). Spend any time on the thousands of internet chatboards devoted to infertility, and you’ll see comments that align rather well with these levels. But the consequences of infertility extend to level 4 (severe economic deprivation, moderate to severe violence, total loss of social status), level 5 (violence-induced suicide... see more