Podcast Review: Why are there so few Black sperm donors in the USA?

Though fertility issues impact many women across the United States, Black women, in particular, face the brunt of these challenges. From increased risk of infertility to low diversity of donors, Black women have to navigate an already complex system that directly works against them.

The Guardian asked the question, 'Why are there so few Black sperm donors in the USA?' and turned to Angela Stepancic, a Black woman who recently navigated her way through the complex fertility system in the USA to help answer this question and many others.

Assisted reproduction notoriously costs an exorbitant amount of money, oftentimes not covered by insurance in the USA, and comes with heavy emotional baggage. 'The speedbump that we didn't predict was the lack of diversity in sperm donors,' Stepancic said.

Stepancic and her wife chose to pursue intrauterine insemination (IUI) over other methods, including adoption and IVF. The podcast's host, Hannah Moore, expertly and digestibly introduces the sometimes confusing concepts of IVF and IUI to listeners who might not understand the details of the procedures. Moore explained that IVF 'would involve finding someone they know or someone they don't know to donate sperm and for one of their eggs to be fertilised with it in a lab.' IUI, on the other hand, would involve the sperm being 'inserted directly into the

womb.'

This episode mastered the art of addressing heavy and important topics while not excluding audiences who may not be particularly well-versed in fertility procedures and vocabulary. Moore and Lisa Armstrong, a reporter and assistant professor of journalism, bring listeners all the way back to slavery as they chart the extensive history of racism in the fertility industry and highlight the complex nature of fertility for Black women. In the 1800s, Black women's fertility was abused: 'Black women were seen essentially as livestock to be bred,' Armstrong said. But over the course of American history, the view of Black women's fertility changed: they went from being perceived to be hyper fertile to being sterilised, causing a shift in many Black women's ability to conceive.

While Moore points out that fertility problems affect twice as many Black women as white women, Black women also experience access to advancing fertility technology differently than most white women. To truly understand these struggles, Moore asks Stepancic about the intricacies of her experience. The interview-style episode coupled with Moore's genuine tone of voice allows listeners to develop a human connection to this epidemic. Starting with an introduction to Stepancic's relationship with her wife and her quippy remarks about the fertility process (including her comparison of the process to online dating and aiming to find a sperm donor who emulated Denzel Washington), Stepancic balances the seriousness of her story with humour.

Though the format of the episode could be choppy and hard to follow at times, it allows listeners to feel they are a part of the conversation while helping them learn. Although Moore asks thoughtful and valuable questions, she relies heavily on Stepancic to guide listeners through the podcast episode.

Moore made an interesting choice in selecting only one patient to answer her guiding question, but that choice was backed by intention. A key pivot in their conversation occurs when Moore shifts the conversation to Stepancic's own fertility bank. Listeners start to understand why Moore chose Stepancic, outside of her captivating and astute responses. Stepancic is building a new kind of fertility bank. 'What we really want to do is change the experience of the fertility journey for everyone,' Stepancic explained.

She describes traditional cryo banks as 'lonely' and 'transactional' and cites these feelings as the catalyst for creating this new vision of fertility treatment. 'We want to provide holistic care for both the clients and the donors. Historically that hasn't really been the case for Black people, or brown people, or indigenous people when they interact with the healthcare industry in the USA.'

Potential Black donors often get turned away due to health conditions such as high blood pressure. Stepancic's new vision for fertility care includes caring for prospective donors who may be rejected by normal cryobanks by connecting them to resources and partners to help them become eligible. Stepancic plans to provide prospective donors, accepted donors, and patients alike with real care to help expand the number of Black donors and create a more empathetic fertility system.

What makes this episode so impactful is the host and each guest's ability to dissect the difficult questions. In addition, Stepancic provides a real solution to the fertility crisis for Black women instead of merely explaining the situation. While the episode lasted only thirty minutes, the Guardian made a succinct and powerful addition to the evolving world of fertility treatment and attempts to provide a bright light to the sometimes painful industry.

View published version here.