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Time will tell: Ariana Eunjung Cha and Emily Wax-Thibodeaux, “Overturn of Roe Could Make IVF More Complicated, Costly,” Washington Post, May 11, 2022, washingtonpost.com/​health/​2022/​05/​11/​roe-overturn-ivf/.

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about 12 percent: National Center for Health Statistics, Centers for Disease Control and Prevention, “Key Statistics from the National Survey of Family Growth,” last modified June 20, 2017, cdc.gov/​nchs/​nsfg/​key_statistics/​i.htm.

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twice as likely: Jamila Perritt and Natalia Eugene, “Inequity and Injustice: Recognizing Infertility as a Reproductive Justice Issue,” F&S Reports 3, no. 2 (2022): 2–4, fertstertreports.org/​article/​S2666-3341(21)00103-3/.

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twice as long: Helen B. Chin, Penelope P. Howards, Michael R. Kramer, Ann C. Mertens, and Jessica B. Spencer, “Racial Disparities in Seeking Care for Help Getting Pregnant,” Paediatric and Perinatal Epidemiology 29, no. 5 (2015): 416–425, doi.org/​10.1111/​ppe.12210.

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lack of ethnic diversity: Angela Hatem, “Sperm Donors Are Almost Always White, and It’s Pushing Black Parents Using IVF to Start Families That Don’t Look Like Them,” Insider, September 17, 2020, insider.com/​egg-sperm-donor-diversity-lacking-race-2020-9.

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have reported that: American Society for Reproductive Medicine, “Disparities in Access to Effective Treatment for Infertility in the United States: An Ethics Committee Opinion,” Fertility and Sterility 116, no. 1 (2021): 54–63, doi.org/​10.1016/​j.fertnstert.2021.02.019.

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wouldn’t feel comfortable: Jihan Thompson, “Why Are So Many Black Women Suffering Through Infertility in Silence?,” Women’s Health, October 29, 2018, womenshealthmag.com/​health/​a23320626/​infertility-race-survey/.

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raises deeper questions: Avery Stone, “More and More Companies Are Covering the Cost of Egg Freezing. But Who Is It Really For?,” Vice, May 26, 2020, vice.com/​en/​article/​ep448j/​more-companies-are-covering-the-cost-of-egg-freezing-who-is-it-really-for-v27n2.

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7 percent are Black: Genevieve Glass, “America Expected a Pandemic Baby Boom. It Got an Egg-Freezing One Instead,” The Lily, June 7, 2021, thelily.com/​america-expected-a-pandemic-baby-boom-it-got-an-egg-freezing-one-instead/.

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understudied and underreported: Leena Nahata, Amy C. Tishelman, Nicole M. Caltabellotta, and Gwendolyn P. Quinn, “Low Fertility Preservation Utilization Among Transgender Youth,” Journal of Adolescent Health 61, no. 1 (2017): 40–44, sciencedirect.com/​science/​article/​abs/​pii/​S1054139X16309582.

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“There’s no question that”: Shira Stein, “Fertility Practices, Coverage Lacking for Transgender People,” Bloomberg Law, May 17, 2019, news.bloomberglaw.com/​health-law-and-business/​fertility-practices-coverage-lacking-for-transgender-people.

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Chapter 10

most ethnically diverse place: Brittny Mejia, “How Houston Has Become the Most Diverse Place in America,” Los Angeles Times, May 9, 2017, latimes.com/​nation/​la-na-houston-diversity-2017-htmlstory.html.

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most widely prescribed: Brown University, “50 Years Ago, Clomid Gave Birth to the Era of Assisted Reproduction,” September 13, 2017, brown.edu/​news/​2017-09-13/​clomiphene.

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“involving the Pope’s blessing”: Oliver Staley, “The Strange Story of a Fertility Drug Made with the Pope’s Blessing and Gallons of Nun Urine,” Quartz, June 26, 2016, qz.com/​710516/​the-strange-story-of-a-fertility-drug-made-with-the-popes-blessing-and-gallons-of-nun-urine.

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“Donini called”: Staley, “The Strange Story of a Fertility Drug.”

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“Within two years”: Staley, “The Strange Story of a Fertility Drug.”

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from Chinese hamsters: Nadezhda A. Orlova, Sergey V. Kovnir, Yulia A. Khodak, Mikhail A. Polzikov, Victoria A. Nikitina, Konstantin G. Skryabin, and Ivan I. Vorobiev, “High-Level Expression of Biologically Active Human Follicle Stimulating Hormone in the Chinese Hamster Ovary Cell Line by a Pair of Tricistronic and Monocistronic Vectors,” PLOS One 14, no. 7 (2019): e0219434, doi.org/​10.1371/​journal.pone.0219434.

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quite low: Paolo Emanuele Levi-Setti, Federico Cirillo, Valeria Scolaro, Emanuela Morenghi, Francesca Heilbron, Donatella Girardello, Elena Zannoni, and Pasquale Patrizio, “Appraisal of Clinical Complications After 23,827 Oocyte Retrievals in a Large Assisted Reproductive Technology Program,” Fertility and Sterility 109, no. 6 (2018): 1038–1043e1, doi.org/​10.1016/​j.fertnstert.2018.02.002.

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experience mild OHSS: “Ovarian Hyperstimulation Syndrome (OHSS) Caused by Fertility Treatment,” Embryo Project Encyclopedia, last modified October 20, 2020, hdl.handle.net/​10776/​13175.

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severe case: It’s rare to die from OHSS, but the condition can lead to other immediate and serious health issues. In one case I read, a twenty-four-year-old Florida woman who had forty-five eggs retrieved had a stroke the next day, likely due to the blood clots caused by severe OHSS.

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Lupron label warns of: “Lupron Injection,” Food and Drug Administration, accessed June 19, 2023, accessdata.fda.gov/​drugsatfda_docs/​label/​2014/​019010s037lbl.pdf [inactive].

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off-label: Rebecca S. Usadi and Kathryn S. Merriam, “On-Label and Off-Label Drug Use in the Treatment of Female Infertility,” Fertility and Sterility 103, no. 3 (2015): 583–594, doi.org/​10.1016/​j.fertnstert.2015.01.011.

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has been linked with: “Women Fear Drug They Used to Halt Puberty Led to Health Problems,” Christina Jewett, Kaiser Health News and Reveal, February 2, 2017, kffhealthnews.org/​news/​women-fear-drug-they-used-to-halt-puberty-led-to-health-problems/; Jenny Sadler Gallagher, Stacey A. Missmer, Mark D. Hornstein, Marc R. Laufer, Catherine M. Gordon, and Amy D. DiVasta, “Long-Term Effects of Gonadotropin-Releasing Hormone Agonists and Add-Back in Adolescent Endometriosis,” Journal of Pediatric and Adolescent Gynecology 31, no. 4 (2018): 376–381, doi.org/​10.1016/​j.jpag.2018.03.004.

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“evaluating the need”: “Potential Signals of Serious Risks/New Safety Information Identified by the FDA Adverse Event Reporting System (FAERS),” Food and Drug Administration, last modified January 6, 2023, fda.gov/​drugs/​questions-and-answers-fdas-adverse-event-reporting-system-faers/​january-march-2017-potential-signals-serious-risksnew-safety-information-identified-fda-adverse.

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