Biomedical imaging technologies, professional and lay visions

Tag: Arts

Re.conceive + Remaking the Human Body

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.

Reproduction in Law and Art

The early summer conference season has been quite eventful for us. We had the pleasure of presenting some of our initial findings at two events: the British Sociological Association’s (BSA) Human Reproduction Study Group Annual Conference on May 24 and Visualising Reproduction on June 4. Although both took place in Leicester at De Montfort University, they each took a unique and innovative angle on issues emerging in reproduction studies. I here reflect not only on our project’s fit within larger conversations on assisted reproduction, but also on the impressive breadth of topics covered at these two conferences.

Reproduction and the Law  

With a very timely choice of topic, the BSA event highlighted critical intersections between reproduction and the law. Coupled with the anticipation of the Irish referendum, I was reminded that the law plays a crucial role in determining our reproductive choices. As someone who has only recently moved to the UK, Professor Emily Jackson’s plenary talk was particularly eye-opening with regards to the legal work that still needs to be done here in order to improve women’s choices. Of course, improvements are necessary everywhere, but the UK has its peculiarities and unique challenges. Most notably, the country has a 10 year storage limit on eggs frozen for social reasons, thus not always allowing women sufficient time to use them to conceive. (An online petition you can sign to change this is in place at https://petition.parliament.uk/petitions/218313) I was also intrigued to find about the various barriers women face as a result of the 1967 Abortion Act. Unquestionably, it is time to change regulations to improve access. Professor Jackson’s talk was an important reminder that we can and should push further.

The presentations I attended throughout the day allowed me to reflect on how we might best regulate gamete donation, surrogacy, and egg freezing, to name just a few topics that came up. The range of global contexts (including North America, Europe and Asia) that presenters explored was impressive and highlighted how ethical challenges are influenced by national policies. In particular, economic inequalities have affected assisted reproduction practices, as governments often fail to keep up with such the changing landscape of assisted reproductive technologies. The regulations required to protect those who are vulnerable, such as surrogates and gamete donors who are based in lower-income countries, are either flawed or non-existent. The BSA event provided a vital space for discussions on how we might proceed. Even though many of us are unsure of the best course of action, starting these conversations is definitely a promising start.

Presenting on Time-lapse

The use of imaging technologies in IVF has been itself caught up in larger debates on commercialisation and best course of treatment. I tried to capture the contentious place that such technologies occupy today in the world of IVF during our presentation at the BSA event. Views on time-lapse have changed tremendously even during the course of our research.

The two conferences we attended perfectly capture the debates/conversations that time-lapse is part of. On one hand, it is a contested technology that potentially calls for more regulatory action in the UK. On the other hand, it captures imaginations with its ability to give us unprecedented insights into the life of embryos. This second aspect brings me to the visual of reproduction and how this was explored during the Visualising Reproduction event.

Visualising Reproduction

With topics ranging from the history of embryo illustrations to menstruation in the visual arts to holographic visualisations of the clitoris, Visualizing Reproduction was fascinating, unique, and much-needed conference that showcased the significance of reproductive imagery. Listening to the invited speakers (including our very own Manuela Perrotta), I realised that many topics we study in the social sciences are intricately related to art and visualisation. In particular, the conference highlighted collaborations between artists and academics. This stood out me as interdisciplinarity at its best. For example, Isabel Davis from Birkbeck and artist Anna Burel talked about the Experimental Conception Hospital imagined by Robert Lyall, a 19th century physician. Anna’s illustrations of pregnant women and art pieces made Lyall’s imagined institution come to life. Another example of amazing work from artists was Liv Pennington’s exploration of pregnancy tests – a technology so mundane yet at the same time so mysterious. Thinking about such work, it strikes me that the visual has the power to break down taboos and barriers, as also exemplified in representations of menstruation in the arts – a topic that Camilla Røstvik brilliantly covered in her presentation.

Visual Representations has taught us that fruitful collaborations between artists and academics might be able to provide a better-rounded picture of the topic studied. It has also taught us that we need to further emphasize the visual in our project’s exploration of time-lapse and its uses.

Fertility Fest 2018

During the second week of May the Bush Theatre in London hosted Fertility Fest – an arts festival dedicated to fertility, infertility, modern families and the science of making babies. Organised by Jessica Hepburn and Gabby Vaultier, the event brought together artists, fertility experts, regulators, infertility patients and campaign groups over multiple days to talk about a huge range of issues relating to the modern ‘condition’ of human reproduction. I arrived at the Bush Theatre on Wednesday 9 May and attended again for a full day on Sunday 13 May. With my festival wristband and a schedule of events, I was ready to explore!

Wednesday: There’s ‘more to life’ than having children

Wednesday’s evening event, hosted in partnership with the Fertility Network, revolved around the statement ‘there’s more to life than having children’ and opened with talks by Jessica Hepburn, who introduced her new book, and Jody Day from the support network Gateway Women. These talks were followed by short PechaKucha style presentations (20 slides shown for 20 seconds each) by a range of guests who talked about their ‘plan B’ or personal pathways to accepting unwanted childlessness, from swimming the English Channel, to adopting a dog, establishing a childless-not-by-choice magazine or practicing yoga.

Louise Ann Wilson talked about her project Warnscale, which is a walk through the fells of Buttermere in Cumbria designed specifically for women who are biologically childless-by-circumstance. She emotively described the therapeutic value of immersing oneself in the natural environment and how the embodied practices of walking and mapping the landscape can encourage new opportunities to reflect on life as well as life events that remain elusive, such as the birth of a wished-for child. Wilson commented on the lack of social rituals for women who feel grief for the absence of the life event of becoming a mother and she is currently developing Warnscale to include a walk that explores men’s experiences of infertility. Drawing also on observational research in fertility clinics, Wilson was able to trace parallels between and juxtapose the highly managed process of IVF in the laboratory and cycles of change in nature. Similarly to how reproductive processes and bodies are ‘mapped’ in minute detail through the process of fertility treatment, there is potential for re-imagining this process in/onto/through the natural landscape as a way to make sense of complex personal experiences.

Sunday: Men’s rooms, egg freezing and the awkwardness of language

I started Sunday with a session that focused on men’s experiences of infertility. The title of the session, ‘You, me and the pornstar’, turned into a key point of discussion for the panel with several comments made on how its emphasis on ‘the pornstar’ offered a limited portrayal of men’s experiences of IVF as being defined solely by the task of semen production. This discussion tied in well with Aaron Deemer’s presentation of his art photography project ‘Please make yourself uncomfortable’ through which he documented ‘sample rooms’ or ‘men’s rooms’ in fertility clinics across the UK.

I have never seen a sample room, or ever really thought about them in any detail, but seeing Deemer’s photos and hearing him talk about them emphasised the complexity of these rooms as both designed-for-a-purpose and simultaneously highly emotionally charged, full of hope for success and fear of disappointment, and embroiled with awkwardness. The rooms were all very different – one of them had a chair that looked rather like one you would find at the dentist’s, another was almost bare apart from a black and white poster of the Eiffel Tower, and a third had imposing metal bars across the window. Deemer’s discussion of his photographs drew humorously on the strangeness of these settings but it was also clear that he had found a unique entry point for opening up conversations about much broader questions of masculinity, negotiating a biomedical phenomenon in a culture that assigns value to ‘natural’ procreation and how to articulate the ‘male role’ in fertility treatment.

The session also included a reading of the play ‘The Quiet House’ with an introduction to the play’s background story by its playwright Gareth Farr. The play offers an intimate insight into a couple’s experience of fertility treatment and the effect this has on their relationship and life, with a particular voice given to the male experience of infertility. We only got to hear a snippet of the play, but it touched pertinently on the difficulty for men who feel side-lined in a treatment process that is almost entirely focused on the female body and the hurt of deciding when is the ‘right’ time to stop treatment. Throughout this session a central conversation point was the struggle to re-imagine a life-event that so many assume will happen in the most private and intimate sphere of life, and the associated difficulties of negotiating an unfamiliar, medicalised and highly controlled method of reproduction that takes place in a clinic, a sample room and a laboratory.

Another highlight of the day was the ‘Fertility Fight Club’, where four speakers had ten minutes to talk – honestly and provocatively – about ‘what makes you angry’.

Josh Appiganesi talked about how fathers often seem to be defined by their absence – men tend not to write books or start festivals about making babies and he made a point about how male philosophers have also been tellingly quiet about the experience of becoming a father. He commented on the need for men to talk more about ‘what becoming a father is really like’. Perhaps unusually, a couple of years ago Appiganesi chose to do his talking on camera, which resulted in a documentary film – The New Man – about the ‘ordeal of becoming parents in our era of IVF, late reproduction, and the crisis of masculinity’.

Emily Jackson talked about social egg freezing and the legal time limits around egg storage in the UK. Currently, she explained, eggs can be stored for up to 10 years (with up to 55 years for women who have become infertile due to a medical condition). This means that women who freeze their eggs for ‘social reasons’ (such as not yet being with a suitable partner) have a relatively short period of time to use their eggs. For instance, women who freeze their eggs during their 20s (at recommended peak fertility) are likely to have to use or dispose of their eggs before they are needed. Jackson emphasised how the legal framework, which was designed before social egg freezing was widely practiced, decidedly works against best clinical practice.

Diane Chandler, author of the novel Moondance, was deliberatively provocative in her round of the fight club where she spoke to the question ‘Secondary Infertility: What’s the Problem?’. Chandler argued that primary infertility (wanting but struggling to conceive a first child) and secondary infertility (wanting but struggling to conceive a second/third/fourth child) are not comparable and that trying to start a family is different to ‘trying to complete one’. It is not always appropriate, she argued, that people experiencing primary and secondary infertility share the same supportive spaces (such as online forums) and she presented examples of hurtful comments and competitive language used to make claims about whose grief is worst. In an honest provocation, Chandler made the case for not comparing experiences and emphasised secondary infertility as a different kind of infertility struggle.

Stella Duffy argued ‘Yes I Wanted Children. No I Don’t Want Your Children’ and talked frankly about her own infertility experience of trying to have a child followed by a cancer diagnosis. Duffy stressed the lack of words to describe parents of children who died and extended this inadequacy of words to the language of infertility. ‘There is not a word for us’, she exclaimed, people who wanted to be but did not become a parent are defined by words that emphasise their lack – childless, infertile, non-parent – and the more positive alternative child-free centres on the child as opposed to the person. The English language reflects, Duffy argued, the cultural persistence of pronatal privilege that tells us that it is better and right to have children. There is an urgent need for better words that encompass people who are not the parent they wanted to be but does not define them in terms of this. Echoing many of the other talks, the message was that dialogue follows from having the right, inclusive words – perhaps a task to be revisited at next year’s Fertility Fest…

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