Infertility and The Handmaid’s Tale: could it come true?

There are lots of movies and television shows that deal with the future of the human race and potential apocalypses. While many focus on the rise of machines or technology, often the scariest ones (at least for me) are concerned with infertility. Most recently The Handmaid’s Tale deals with what would happen to society if there were widespread infertility. Watching it got me thinking: could mass infertility be possible and are there solutions to this?


Current Situation:

It certainly does not seem likely that the world suffers from a fertility problem with 7.5 billion people alive today and if current trends continue, it is likely that the world be home to an astonishing 9.7 billion by 2050! But this growth is driven mainly by Africa and Asia. Western nations are starting to feel the effects of an ageing population; people are having fewer children so there are more elderly compared to young people. This change has been put down to societal and cultural shifts, but could there be another underlying cause?

Image from Flickr, by sparrowz2006

Is there a problem?

Everyone knows of Henry VIII and his issues of fertility. He was by no means the only ruler to experience these issues. So if infertility has existed for a very long time, are current issues anything new? Is there a real increase in infertility rates? Unfortunately this information is not accurate, however a recent report released this year suggests infertility might be on the rise, especially amongst males.

The systematic review looked at sperm counts and how they have changed over the past few decades. It found that western men, both those that have had children and those that haven’t, there was a significant decline in sperm counts. This decline was around 50-60% from 1970s levels to present day levels. This is a huge and shocking change.

The authors did not address why this could be happening but others have theorized that environmental and lifestyle factors could be to blame. These could be exposure to chemicals, consumption of alcohol, smoking or low levels of exercise.

Finally dropping birth rates and fertility could be linked to people putting it off longer and longer to have children, thereby decreasing their chances.


So what could be done to change it?

Well if this apparent low sperm count leads to mass infertility, could there be a solution? Luckily science has already come up with many ways to help people become parents. The rise of IVF and decrease in its cost has enabled hundreds of thousands, maybe millions, of children to be born.

But this method still relies upon people having viable sperm and eggs. If they didn’t have this, what could they do if they wanted their own biological children? Amazingly, scientists have been able to create both sperm and eggs using skin cells. Finally, with the success of uterine transplants it seems likely that humans could avoid major population infertility. But due to the costs of treatment, it may lead to only allow those that are wealthy to conceive.

8 Responses to “Infertility and The Handmaid’s Tale: could it come true?”

  1. Alasdair Browning says:

    Thank you Jack. It certainly becomes more difficult to understand if there is a real decrease in biological fertility or whether cultural changes are the main motivating force. Certainly it’s an area that needs more prospective studies.

  2. Alasdair Browning says:

    Those are very interesting insights Debbie. It certainly seems like there is a lot going and many factors contributing to infertility. I did come across a suggestion that BPA and birth control could effect fertility, with both increasing or mimicking estrogen. Both of these chemicals seem to be persisting in the environment and water supplies, but the science linking it to human fertility is not clear.

  3. Jack Simkin says:

    It’s a really interesting topic and article. Especially when you consider it against the reduced population growths of ‘developed’ nations. As with Michelle’s comment – it’s not too hard to see how there could be a cascade effect from these growing societal differences. One of the many ethical questions raised by The Handmaid’s Tale was that of fertility being seen as a public good. Nice work Alasdair!

  4. Debbie says:

    Endocrine disruptors – the answer to any unanswered fertility problem!

    What’s interesting is that over the past few decades there has actually been a morphological shift in sperm – we (or should I say scientists/doctors) are seeing an increase in the frequency of sperm with shorter tails and fewer mitochondria (which basically means they can’t swim as well or as fast, so are less likely to fertilise an egg). Although, whether this is because there actually has been a morphological change or whether we are simply testing/researching more is unclear.

    There is also some suggestion that a change in our diets is altering the hyaluronidase enzyme in sperm (with sperm containing less) or hyaluronic acid in the ovum (becoming more acidic) so once the sperm has reached the egg, it is becoming increasingly difficult to penetrate and fertilise. Interestingly, hyaluronic acid is becoming a fairly common ‘beauty trend’ because it may have some ‘anti-aging’ benefits for skin – if only people new it could mess with their fertility.

  5. Alasdair Browning says:

    Oh yes I remember Children of Men, also very disturbing. It does seem like some areas of science can more obviously advantage some areas of society, but like you said it seems incredibly difficult to predict how scientific outcomes will be used.

  6. Alasdair Browning says:

    I definitely agree, especially if manipulation of genetics leads to unknown biological consequences or creates further societal imbalance. I hope that this science is used more to help those disadvantaged by their infertility rather than for non-ethical reasons.

  7. Teresa Hassett says:

    That’s so crazy that they can make sperm and eggs from skin cells! Science is so cool, but all of the new technology surrounding reproduction, especially in the genetics field does worry me sometimes. You mentioned movies… I don’t really like the thought of a Gattaca-type situation where every genetic condition is known from birth, affecting the rest of a person’s life. Definitely an interesting topic you’ve chosen!

  8. Michelle Quach says:

    Another film that comes to mind that plays out this scenario is ‘Children of Men’. Very interesting point you ended with regarding the issue of only the wealthy having access to treatments – I think often the social implications that could cascade from these new biological concerns can be more difficult to predict and to address than the science itself.