Have you seen the sperm prices? The time has come to democratize fertility therapy

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A big benefit in homosexuality? Built-in control for birth. A big downside to homosexuality? Built-in control for birth. As a same-sex couple, you can’t just start wanting a kid, you have to plan parenthood meticulously.

You start to take it instead of going off the pill. You are starting to buy semen, too. (If you want a shock, look at the price of sperm: it’s more crazy than Bitcoin.) And you’re starting to book doctor appointments.

And checks for blood.

Ultrasounds. And

And shots with triggers.

And you go to the hospital, and there’s magical, medicalized baby-making going on.

And you’re waiting two weeks, then.

And then you get your time and you need to do it all over again. My wife and I spent a large part of the year struggling with the above differences in 2020. Finally, she got pregnant after four IUI (intrauterine insemination) procedures and around $20,000 in bills. (Hooray!) I’m not going to go into the IUI technical details, but it’s less invasive and costly than in vitro fertilization (IVF); the drawback is that it’s not as efficient. We invested a small fortune, but we were fortunate in the end: it could have taken a lot longer to become pregnant and cost a lot more. IVF was not protected by our health insurance: if we had to go that path, I’m not sure how much longer we should try.

Some of our heterosexual mates who underwent IVF, meanwhile, had insurance covering everything. It seemed sort of arbitrary and unjust, but that was awesome for them. To be honest, I don’t think it’s a human right to have kids.

I don’t think any lesbian couple should get the state’s free boy.

But I also don’t think fertility therapies should be something only available to the fortunate or the wealthy. In England and the US, at least, that’s how the mechanism operates at present.

In England, access to fertility therapies via the NHS is a zip code lottery. (The “gold standard” of three NHS-funded IVF cycles is provided by Scotland; Wales provides two cycles.

It ranges from three to none in England.) Fertility coverage in the U.S. depends on the health insurance. This, in turn, depends on your employer’s size and the laws on infertility coverage in your state. Not to mention your sexuality: you have to go through even more hoops as a same-sex couple to be covered: I was excited when I saw the opening of England’s first non-profit IVF clinic this year in London.

By providing low-cost medication, it will resolve inequities in IVF care; it will also not provide all the costly (and sometimes ineffective) add-on services that private clinics do.

I say, did you know it was EmbryoGlue? Or would you pay extra for “assisted hatching” for that? The industry is so insane that you can not order satellite TV to calm your embryo while waiting for implantation. The amount of judgment that can still be attached to fertility is also ridiculous. “Why did you wait so long to try?” “Maybe you should have focused on finding a partner instead of pursuing your career.” “Why don’t you ‘just’ adopt?” (There’s nothing simple about adopting.) “Are you sure you should have children if you’re not married to a man?” Seriously, if I had a penny for every unsolicited opinion I’ve heard about my ovaries, I could buy an IVF round from the planet. We need to broaden access to fertility therapies, but we also urgently need to broaden the fertility discussion. Arwa Mahdawi is a Guardian columnist.

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