On 11 November we were happy to host the second workshop in our series The IVF Experience (see our report of the opening event here). Sarah Norcross from the Progress Educational Trust was our special guest for the second time and she succeeded in making our workshop such a welcoming and warm one. Everyone who joined us got the chance to respond to the research data that we presented, and many shared personal reflections from their own experiences. Some people spoke about what they considered to be especially important during their fertility journeys, others shared feelings or thoughts about the experience of being given embryo videos or images during their treatment.
Participants appreciated the opportunity to see how their own experience related to research data and findings and to the accounts of other participants, and some underlined how they got the chance to bring home feelings they had but hadn’t been put into words yet. It was so rewarding for us to see how our research could contribute to making some people feel more equipped to think back on their experiences, and how this event also allowed one of our participants to learn more about infertility and fertility treatment through exchanges with others.
We look forward to meeting more people at our next online workshops. Natalie Silverman will be with us on the 20th and 24th of November!
See our Events page for more details about how to sign up for the next dates.
The project team were present at this year’s Modern Family Show and the Fertility Show Online Summit. The timing of these shows presented a perfect opportunity for us to share our new animations, which you can watch on our website here.
Our booth at the Fertility Show Online Summit contained lots of details about the research project, our publications and, of course, our videos. The research team enjoyed visiting other booths as well as the many excellent seminars that were on offer across the four days. It was great to virtually ‘meet’ other show participants in the summit’s online chat.
Later in September, Manuela and I were interviewed by BBC reporter Sophie Sulehria as part of the Fertility Show’s live seminar series, which extended into the weeks following the online summit. We thoroughly enjoyed speaking to Sophie and having a conversation about fertility patients’ and professionals’ perspectives on IVF treatment add-ons.
We also screened our videos at the Modern Family Show, which took place in central London on 18 September. Unfortunately, the research team was unable to attend the show in-person, but the videos were screened on the main stage during the event for all attendees to watch.
We were thrilled to launch our online event series ‘The IVF Experience’ this week. Our first workshop coincided with Fertility Network UK’s National Fertility Awareness Week, which is an whole week dedicated to having conversations about infertility and the realities of fertility treatment.
Our first workshop was hosted by Sarah Norcross from the The Progress Educational Trust. Workshop participants had wide-ranging experiences of and relationships to IVF, which fostered really important conversations about the complexities of treatment decision-making for patients, feelings of control and lack of control, and the role of embryo images.
We are excited to have more conversations with others at our next workshops! See our Events page for information about how to sign up.
In June 2021, Manuela Perrotta and I submitted written evidence to the UK government’s Women’s Health Strategy for England. We believe the consultation presents a key opportunity to improve the treatment experiences of IVF patients.
In our response, which you can find in full on our Publications page, we make five policy recommendations:
Women need a more coordinated provision of up-to-date information about IVF, especially information about novel IVF treatment add-ons
Improving the clarity, visibility and accessibility of already available information is a relatively low-cost measure that will bring timely positive change for IVF patients
There is an opportunity for the NHS A-Z website to direct IVF patients to the Human Fertilisation and Embryology Authority’s website for information specifically about new IVF treatment add-ons
Different understandings of evidence should be considered to improve the quality of information on new treatment add-ons
Accurate information about the nature of available evidence should be provided when treatment add-ons are experimental
We are very grateful to Inflect Partners for their advice in preparing our submission for this call.
At the beginning of May we were delighted to spend an afternoon on Zoom with visual artist Sally Butcher, who is currently working on her Arts Council England funded project re.conceive. Sally approached us a while back to explore some of the synergies between our projects, which in different ways explore how reproduction, fertility and (non-)reproductive bodies are visualised or, sometimes, become invisible. Sally very generously shared some of her work-in-progress with us and we shared details about our research process and findings.
Each member of the research team was able to spend some time with Sally individually, and I include our reflections in our own words below.
Giulia: Sally’s work has inspired our conversation around reproduction in its different forms. We have especially discussed the relationship between medical knowledge, technologies and tools to visualise reproductive body parts or phenomena, and embodied experiences of them. We talked about the role of visual experiences in the construction of dominant narratives of gendered reproductive lives, and about the visibility and invisibility of specific reproductive experiences (for example infertility, miscarriages, abortion). We explored the notions of common and uncommon, known and unknown, expected and unexpected, we discussed how individual experiences relate to standardised measures and protocols and how people adjust and react to these, especially when these intersect with other medical, legal and geographical infrastructures (for example in the context of transnational reproductive travels).
Sally Butcher, Infertile Platitudes of Embodied Emptiness, Sonogram 7/9, Archival Inkjet Digitised Monoprint (2020). Used here with permission from the artist.
Manuela: Among the many things we talked about, Sally and I had an interesting conversation regarding some of her work-in-progress – in my interpretation, an inspiring visualisation of the current developments in the field of embryology. Sally’s representation of sets of data embedded within an image of an embryo captured the current turn in embryology, by highlighting visually the novel and increasing use of data-driven algorithms in this field. In our research, analysing the case of Time-lapse incubators and their incorporated algorithms, we have investigated how new knowledge about embryos is generated in the complex interactions between professionals and machines. Although the use of algorithms has the potential to release unknown biological information on embryos (and therefore reveal their hidden secrets), algorithms do not simply add medical and reproductive knowledge as they require human input and therefore still rely on professional expertise.
Sally Butcher, Human Algorithm V, pencil and pen on paper (2021). Used here with permission from the artist.
Josie: During our conversation, Sally and I found many shared interests: for instance in how themes of absence and presence, and proximity and distance, shape ideas about reproduction as well as experiences of infertility. Being a geographer (academically and at heart!), I was drawn to how the body exterior and interior are ‘mapped’ in some of Sally’s work. We talked about the role of measurements, ordering, boundaries and boundary-making in relation to how reproductive processes are visualised and described. We also talked about the intrigue and mystery of magnifying or looking inside things.
Sally’s work also drew my attention to all the other kinds of imagery that fertility patients encounter before or during their IVF treatment. The focus of our research is on images and videos of embryos, which are exterior to the body or in vitro. But fertility patients often encounter a whole range of other visualising techniques that allow them to see inside their bodies. Ultrasound scans and dye tests, for instance, are routinely used to medically investigate female reproductive organs and check that these appear to be functioning ‘normally’. Ways of visualising bodies and embryos have (personal and political) implications for how infertility is seen and known, and therefore very real consequences for patients’ treatment experiences and trajectories.
Sally Butcher, Sub-Maternal Exhaustion During a Pandemic, Archival Photograph, egg, ink and hand gel (2020). Used here with permission from the artist.
Sally: My conversations with the Remaking the Human Body team have been invaluable in my research project. As a visual artist, Re.conceive was driven by the invisibility of Infertility within the new wave of maternal visual arts, where, as in society at large, infertility still remains mostly hidden and shrouded in silence. My project aims to explore and visually theorise the transformational process of ‘becoming’ a (M)Other, challenging traditional reproduction to reconceive a form of sub-maternal.
My meetings with Giulia, Josie and Manuela helped thoroughly contextualise my thinking, aiding my understanding of how infertility connects with the broader narrative of reproduction, as well as giving me greater insight into the scientific procedures within embryology and new practices with AI, and drew my focus onto patient interpretation of these new technologies. It especially moved my thinking toward the visual and verbal languages used within infertility. As a cultural researcher, I am drawn to the rhetoric of medical terminology, weighted in ‘success’ and ‘failure’, aimed at potential ‘geriatric mothers’ with ‘inhospitable uteruses’, and how this may sit alongside hidden personal testimonies, confessional spaces of the coded #TTC online community, or conversations with family and friends where it so often generates a real sense of unease. As an artist, I try to use a feminist gaze to challenge institutionalised power within visual tropes of medical and commercial imagery of infertility. These meetings enlightened me as to how much power we place in these visuals and how these become naturalised into our knowledges of reproduction, with narratives of the embryo constructed from the encounters we have with these visuals. The immediate resonances I felt between my own practice and the fantastic work being done by this team, has encouraged me to continue using this imagery, exploring its symbolism alongside the power of the maternal imagination.
We were very pleased that two papers from the project were presented at the Nordic Science and Technology Studies conference on 20-21 May, which was hosted (online) by Copenhagen Business School. I presented a paper on IVF treatment ‘add-ons’ from the perspectives of IVF patients and partners, fertility professionals, and the UK regulator. This paper explored the category of add-ons as something that exists ‘outside’ or on the boundary of what is considered ‘routine’ IVF. It considered how such a category works differently across national regulation, professional practice and patient experiences of treatment. Manuela presented a paper on ‘the travel of reproductive imaging from the lab to the social world’, drawing on material from patient interviews to explore what happens when images of embryos are encountered outside of the lab or clinic setting.
Now that all of our fieldwork is completed, we are excited to be able to start thinking across all the elements of our research. We will be sharing more of these findings over the course of the next months.
Three months after our event on Visions of Reproduction at the Being Human Festival, we are glad to offer a new way to engage with our research project. If you are more comfortable with hearing than reading about vision (no jokes!), connect and listen to the wonderful podcast that Natalie Silverman has produced for The Fertility Podcast (also embedded below).
In this podcast, Natalie accompanies the audience through the topic of visualising reproduction in historical, sociological and aesthetic terms, introducing and interrogating expert scholars and artists whose work dives into visual representations of conception, pregnancy, and miscarriage. The listening experience is a gripping one, where vision becomes imagination, shaped by the words of people who describe the making and meaning of imagery in ancient books, biology labs, contemporary fertility clinics, and in personal artistic creations and performance. We hope you enjoy!
Natalie Silverman, founder and voice of the Fertility Podcast, led the audience through our first event ‘Visions of Reproduction’ where speakers shared and discussed a wide range of videos, pictures, drawings, prints and embroideries of embryos, foetuses, pregnancy tests, pregnant and not pregnant bodies.
As part of this event, we ran a poll among the audience asking them (anonymously) to enter three images about reproduction that they had come across in their life. We received so many fascinating responses! Pregnancy tests, ultrasound and embryo were definitely the most chosen words, but people had also come across paintings, celebrity pregnancy photos, a real-life foetus-museum, 3D scans and many more. People are confronted with reproductive images multiple times in their lives and in very different situations.
Josie Hamper, from our research team, opened the event by presenting some unpublished results from the study. She launched a poll where the audience was invited to select the correct description for an image shown on-screen. People selected almost all available answers, including: A human embryo; An IVF embryo; Eight cell embryo; Grade one embryo; A potential baby; and baby’s first picture. It was revealed that all answers did in fact describe the image and that the diverse responses reflect different perspectives according to people’s expertise, experience or agendas. Josie accompanied the audience through the data of her own research on IVF patient’s experiences of receiving time-lapse videos of embryo development. She illustrated how videos may be welcome by some who receive them, while creating more uncertainties for others, especially if they feel unequipped to interpret what they are seeing. She ended by inviting a more nuanced public discussion around time-lapse embryo imaging technology, and the use of the videos and images that derive from this technology, beyond the clinic.
This question was taken up by Tabitha Moses who talked about her artwork around IVF experiences, involving photography and intricately embroidered hospital gowns. She accompanied the audience through the experience of various visualising technologies throughout infertility journeys, IVF treatments and pregnancy loss, and she discussed the possibility of trusting or privileging the feeling of a pregnancy through quickening or other embodied sensations, including those of pregnancy loss, over the images produced through medical technologies.
Tabitha Moses, Investment, Tabitha, 2014. Photo portrait by Jon Barraclough. Used here with permission from the artist.
Isabel Davis developed the theme of vision versus feeling in her talk on the history of potential pregnancy. She dealt with the experience of un-pregnancy, meaning the condition of not really being pregnant yet but possibly being, through the work of natural scientist William Harvey on non-generation. Isabel’s talk prompted us to reflect upon ambiguous moments after a non-protected heterosexual intercourse takes place or after an embryo transfer where someone may wonder whether or not a pregnancy has started. These are all important dimensions of reproductive imagination and experience.
The topic of the uncertain time where pregnancy is not (yet) but could be is something Liv Pennington also reflected on when she talked about her artwork on pregnancy tests and the challenges of photographing them on different occasions. Liv’s talk accompanied the audience through her performative artwork Private View, which took place in 2002 and in 2019, and how the performance differed in so many ways between these dates as people’s relationships to pregnancy tests, images and sharing have changed, for instance through the increased familiarity with sharing and commenting on images via social media. Liv reflected on how visualising a pregnancy test result opens up possibilities that may change over time and how this makes her work controversial because of the vulnerability involved in exposing someone’s private reproductive moment while acknowledging the dynamic and uncertain process of pregnancy.
Liv Pennington, Private View, 2006. Used here with permission from the artist.
Funnily enough, technical issues prevented Liv from sharing her slides with the audience, which meant that we relied on Liv’s descriptions of her images, her facial expressions and ability to represent pictures through words. An experience that turned out to be powerful for an event on visualisation!
Nick Hopwood was the last speaker on the panel. His contribution proposed a long-term historical perspective on images of embryos and foetuses to unpack how the ordering of these along a narrative of development has, since the late eighteen century, come to stand for the course of a pregnancy. Nick underlined how images of reproduction produced over the last centuries have overwhelmingly represented a linear process, leaving out experiences of miscarriage or unsuccessful stories of fertility treatment, both of which are frequent ‘events’ in people’s reproductive lives, but underrepresented and thus erroneously considered the exception.
A conversation among all the speakers, with questions asked by the audience, allowed everyone to engage with the common threads or connections among such different approaches to common and less common reproductive images. The conversations highlighted how these images evoke questions of temporality in reproductive processes; how selection and standardisation have been embedded in the use and fruition of images concerning reproduction in the last centuries; and how images have been used for defining normality, normal variations and abnormality. The talks and discussion especially emphasised how a certain production and use of images facilitates the diffusion of dominant narratives of reproduction, leaving out meaningful and relevant experiences, which do not find space in the public representation.
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We are exceptionally grateful to all the speakers and the audience who made this panel so engaging and rich in content. We also want to extend our thanks to the Centre for Public Engagement at Queen Mary and the Being Human Festival for making this event possible.
Keep an eye out for further details about our next events!
We are very excited to introduce our first public engagement event after a series of cancellations earlier this year. This online event is entitled Visions of Reproduction: The Making and Meaning of Reproductive Imaging and it brings together sociologists, historians and artists who will speak about their work on this theme. We are also delighted to have partnered with the Fertility Podcast founder Natalie Silverman, who will moderate the event and take questions from the audience.
Join us on 12 November 2020 at 6pm.
For more information and a link to the booking site, please visit the Being Human Festival event page.
The first RHB article is now out in Social Science & Medicine! The publication, entitled “The trouble with IVF and randomised control trials: Professional legitimation narratives on time-lapse imaging and evidence-informed care,” highlights how IVF professionals navigate the complex landscape of add-ons and evidence when it comes to using time-lapse imaging in embryology labs across the UK. Drawing from our interview data, we show that clinic staff see several benefits in the use of imaging technologies. These benefits are diverse and not always captured in current public conversations on add-ons. The main contribution of the article is to highlight how professionals think about the benefits of time-lapse more widely. In light of our findings, we suggest that it is worth thinking about a more nuanced understanding of evidence-based-medicine as it relates to the IVF sector specifically. Read the full (open access) article here: https://doi.org/10.1016/j.socscimed.2020.113115
