With the editorial for the Gold Journal of Urology on the topic of male infertility, we want to encapsulate the substantial unrecognized burden of male infertility from multiple stakeholders in one piece. We want to amplify the personal stories of patients and couples who have undergone infertility treatment. Furthermore, we want to discuss the complexity of care surrounding infertility care beyond the science -- whether it’s the negative impact it has on the mental health of the patient as well as the couple, limited access to care, or socioeconomic disparities that impact access to infertility to care or navigating infertility care for gender diverse patients.
The authors can talk endlessly about the impetus of the project and how we aimed to achieve those listed above, but we believe that the patients who read this piece will be the best to contextualize the meaning of this piece. Therefore, we’ve invited Dr. Callan Brownfield, assistant professor of the Department of Urology at Emory University School of Medicine to discuss her experience reading this editorial as an aspiring parent.
Navigating Fertility Preservation: A Urologist's Personal Journey
Being a urologist and facing fertility challenges has given me a unique perspective on the reality beyond statistics. The one in six couples affected by infertility is more than just a number—it's an emotional rollercoaster.
I'm 31, just starting my career after years of medical and surgical training. But beneath the surface, as I have progressed through my training, nagging thoughts surrounding my fertility have plagued me. Anti-mullerian hormone testing and ovarian ultrasounds were somewhat discouraging when I tested in residency, and even worse as a new attending 18 months later – but how much stock can I put in this? Despite my best efforts back in residency, the cost of fertility preservation was a mountain too high to climb. Even with institutional support and lifetime fertility benefits for residents, it was financially out of reach.
Now, as an attending, I can finally afford it. Dr. Samplaski’s perspective in the article completely resonated with me as I, too, chose one of my first financial investments to be to freeze embryos. As I write this, I'm in the midst of my first ovarian stimulation. Finally being able to take this step makes me feel empowered, like I’m taking control of something that has long felt beyond my grasp.
Balancing a career that is ramping up with family planning isn’t easy. I've dedicated so much time and effort to medicine, always aware that my proverbial ‘biological clock’ was ticking. Now, I'm grateful to have the option of preserving embryos at this stage of my life.
But there’s a bitter truth in this journey. Despite supportive policies, fertility preservation remains elusive for many residents due to financial constraints. It’s a stark reminder of the unequal access to reproductive choices.
This story isn't just about medical procedures; it's also about the struggles people face in the shadow of statistics. As I settle into my role as an attending, fertility preservation lends me a sense of mental calm amid many uncertainties.
I hope sharing my experience sparks conversation. It’s time to make fertility preservation accessible to everyone who needs it, irrespective of their career paths. Infertility isn’t just a number; it’s a deeply personal journey, and everyone deserves the chance to shape their future.
Written by:
- Callan Brownfield, MD, Department of Urology, Emory School of Medicine, Atlanta, GA
- Catherine S. Nam, MD, Department of Urology, University of Michigan, Ann Arbor, MI
- Kevin J. Campbell MD, MS, Assistant Professor, Department of Urology, University of Florida, Gainesville FL
- Scott D. Lundy MD PhD, Cleveland Clinic, Cleveland, OH