said he wants your up to be sovereign. would know about such things perhaps through living and learning from his errors because he's the one who brought france back into us, lead natal to man speaking of nato. ukraine says it's basically ready to join that now to since what's left of its army. after an estimated hundreds of thousands of losses is apparently ready to protect all of europe. i think we can join nato as soon as we anticipate victory. the end of the war and one of the strongest most powerful and decorated armies in the world will suddenly be the biggest security guarantee for europe. sounds like you have a nato secretary general. yeah. and stilton berg, who said that your brain has never been so close to nato membership are suffering from the same kind of delirium. it's all sounds good in fantasy until you end up standing face to face at the altar, probably in a looping in vegas and realize that it could all very well and into years or in

world war 3. so, so now he's on the team, take a closer look at infertility and the latest episode of the 360 view coming your way to the by the the latest study on infertility released by the world health organization says one and 6 individuals globally are affected by infertility in their lifetime. sky know who is in on this edition of a 360 view, we're going to look at the reasons why infertility in some regions of the world is growing. well, other regions are on the decline. let's get started. the, the human body is extremely complex and the ability to reproduce involves multiple systems to work together and to individuals all in order to produce

a single human life. for some, it might be easy, while others, a challenge, if not impossible. infertility is a motional struggle, which is deeply personal and it is a global phenomenon which does not affect an individual or region uniformly. if you've ever looked into the eyes of a couple who are trying to have a child, but cannot, you see a deep emotional and physical pain, which is sometimes arms is so strong, it can even break the couple. however, there is nowhere to rejoicing then from a couple who has faced the challenge and overcome either naturally or with the help of science. both of these examples are what united, regardless of our nationality is human. a dell was discussed, infertility around the globe is more shut in horn. now she is a professor of anthropology and international affairs at yellow university and author of the book, motherhood on ice. thank you so much for joining us. thank you. do we have

a global growing and fertility crisis and why? yeah, infertility is a global reproductive health problem. i think i would call it a crisis because approximately 10 percent of all reproductive age couples around the world are going to face the problem of infertility at some point in their reproductive lives. and, you know, there are a causes of infertility that are growing around the world, for example, something called poly sophistic ovary syndrome, a hormonal metabolic problem. so yeah, we are facing a significant infertility problem. it's estimated that anywhere between $50000000.00 and a $186000000.00 people around the world are internal right now. the estimates are emphasized, but it's millions of people around the world suffering from the inability to conceive a child. and so it's a, it's a problem i, i consider it to be a reproductive justice issue as well. because the definition of reproductive

justice is the right to have a child, the right not to have a child and the right to parent, a child in a safe and healthy environment. and infertility is about the right to have a child and the difficulties and having a child. so it's really something that we should be addressing as part of the reproductive health agenda around the world. marsh, i love the fact that you're bringing up man. so why do you think male sperm counts, and total testosterone drops so precipitously in the past several decades? mainly on the west? is this a global trend? yeah, you know, male infertility is the, should be reproductive health problem. when we think of india to infertility, women are always the ones that seem to be the fertile tardy. but more than a half of all cases of involuntary char loose this around the world are due to male factors. and so we really need to be acknowledging male infertility much more than we do a manner just sort of ignored in this,

in this issue altogether. and so i really appreciate your bringing it up. a lot of male infertility is really not preventable and not curable because there's a genetic etiology to it. there are genetic factors that cause male infertility, and, you know, men are born with this problem. it's a chronic reproductive health condition for them. and there's not a whole lot that they could do to treat it. there are assisted reproductive technologies, particularly a variant of ivy. i've called exceed interest cytoplasmic sperm injection. that is, you know, a solution for many internal man. but, you know, you're right. why, you know, there are other things going on that are causing, you know, these cases of male of utility if more than half of the world's cases a childless, this are due to male factors. and so we need to be looking at things like smoking, more than 50 percent of the world's been smoke, and smoking is not good for male, reproductive health. it's from out of toxic. and there probably are environmental

factors that are coming to play. you know, for example, that certain pesticides cause in facility and in agricultural workers, certainly all of the chemicals and toxins that have been used in worser around the world are not good for facility. and so, yeah, we're, we're probably seeing an increase in mainland for utility cases due to, you know, due to environmental factors that really need to be studied further. you have said male and fertility is the hidden story of the middle east. why do you believe this is an issue for men? why is it not being addressed? yeah, i mean, for me, the reason i focus on the middle east is that's where the majority of my scholarship has been located for the past 30 years. they've done a lot of work and in each up loving the united arab emirates site, i'm basically a scholar of the middle east. although recently i have a new book out on x freezing in the united states, which we can talk about. but yeah, so i worked in the middle east for a very long time and early on i was focusing on female and fertility,

but really realize that a lot of the, you know, infertility really wasn't a problem facing the women and a couple it was really due to the husbands, infertility problems. and so i, you know, began to study it and i actually have a book about male infertility in the middle east. i think that there are some genetic issues in the region. there are high rates of what we call come 2nd gluteus marriage, where people tend to marry within the larger family. you know, 2nd cousins, 1st cousins. and so there probably are some genetic issues that play. but also there's a lot of heavy male smoking in, in the middle east. and in the big cities there's probably a lot of environmental pollution. and then we know that things like heavy metals are toxic to males firm. and so this issue of declining sperm counts. i mean, it's been reported in the media sort of globally, and it's inconclusive. are,

you know, man is male sperm around the world. is it getting worse over time? there's some debate about that. but certainly, you know, male infertility is a really important reproductive health issue that just doesn't get much attention. and frankly, most men have no idea if they're fertile or infertile until they get married and started having problems conceiving with their partners. and then they go for seem and analysis, and this is where they discover whether they have a 1st firm coat or low motility. this firmed up move. well, some men have no sperm in their jack, you'll it called a those for me or so there are a variety of different male infertility problems. and again, you know, it's just isn't something people talked about in the middle east though. i think one of the most interesting stories is that when this new reflective technology called ecc, arrived in the region in the mid 19 ninety's ma'am started hearing about it and they sort of started coming out with their male infertility struggles going to i,

the clinics, to you know, seek this x, the solution. and so there was a real change, a real recognition. the know infertility isn't just a women's reproductive health problem. men can be infertile to they need to take the burden off their shoulders of their female partners and sort of acknowledge and accept that their insured will. and that really happened. and in fact, sort of, you know, in facility and personally is often associated with manhood or womanhood. you know, it's something wrong with a man, he's not a man. but with, you know, the recognition that infertility is a medical condition that can be overcome in many cases. this medical as a sort of helped to less of the stigma of infertility, including male infertility. and that's what a really good development in the middle eastern region, the middle east also, you know, although in the west 3 here, nothing good about the middle east. the middle east has a remarkable assisted reproductive technology sector. there are many ivy clinics

throughout the region as actually one of the regions of the world that has done a lot uh you know, to sort of make treatment for infertility accessible. so it's a very interesting region, you know, globally, and i would say that gender relations around infertility have improved dramatically over the years that i've been working there. now in the past, do you think and for tardy was probably diagnosed, considering we didn't have the medical technology we have today. yeah. you know, it's, it's, um, we have now, you know, that does it seem and analysis, for example, has been around for a very long time. you know, the to diagnose female infertility. you need to have sophisticated hormonal testing . sometimes we need to do procedures to look at the so it is a condition of the flow of be in tubes. so these technologies for diagnosis have been around for awhile. the problem here is just access it and can people access a place where they can get effective infertility, diagnosis, and treatment?

and that is a global issue. it's estimated that only about half the infertile couples in the world, and this includes infertile couples in western nations. only about half of them ever get to a place where they could be diagnosed for their infertility problems. and then beyond that, the ones who get to the actual treatment, it's even a smaller percentage of infertile couples. and so how does the problem, the problem is the cost of doing infertility diagnosis and treatment is costly. it's not covered in most parts of the world. i mean infertility and it's treatment is really something that we find in the private medical sector. and so there are huge issues of accessing affective diagnosis and treatment, especially i vs and all of the variance survive. yes. including except for male infertility, it's very costly just to give you an example. the us is the most costly place in

the world to do one cycle of in vitro fertilization. it costs at least $12000.00 to get one cycle of ivy up in the us and often people to be successful have to do several cycles of idea in order to to have a baby. and so the us is just sort of too expensive for many american couples. it's, you know, 3 times it's about the average around the world is, is much less. so it costs about $3.00 to $4000.00 to do an ip sec a cycle sort of globally. but still for many infertile couples, that's a huge amount of money. they can't afford it. and so the is to globally, is just inability to access a safe, effective, legal, and affordable infertility diagnosis and treatment services. and i care a lot about that. there's been a movement with which was called the low cost i've yes, movement,

effort to try to bake idea. just more affordable for people. that movement has been going on for a while, but i can't say that it's really solve the issue of accessibility and there's a long, long way to go. so what about this effect of age on childbearing? could one of the main solutions simply be emphasizing having families and a younger age as humanity has done throughout history. i'm so glad that you brought up this issue because it's one that in my recent research, i need about a great deal. yeah. first of all, around the world of global marriage rates are declining dramatically. so people are getting married less than they used to. and the age of child bearing has increased dramatically. so women are having children at later and later ages, you know, in, in western countries as close to the age of 30 for 1st, for, for women. but what i discovered to a large study i did in the united states of women who had frozen their eggs is that,

you know, women in, in this country and in many other countries around the world are facing difficulty in sort of creating a family because they can't find a partner, they're, they're sort of doing their education. they're starting their careers. they get to the age of 30 or beyond. they haven't found a partner which is an issue i'd like to talk about. but they also are not aware that fertility begins to decline slightly around the age of $32.00. but that there's a dramatic decline of women's facility around the age of $37.00, which has been called the for to the class. and i learned in my own country that most women really, i had no idea about when age starts to affect their facility. there really hasn't been any education about it in school. often they haven't talked to their gynecologists. uh, they've kind of called you have never raised the issue about, you know, age and fertility,

and so age is important to women's facility. and by the time a woman reaches the age of 40, the chances of conception are very, very low. but if women don't understand that they don't really understand what we would call age related facility decline, they might be waiting and waiting, often waiting for a partner to emerge. and in the fact sort of losing their facility, their chances for, for having a child because of age. and i think in the west, if you look at ivy clinic populations in western countries, a lot of the reason people are there is because of age related infertility. women who are in their late thirties in early forty's, who got their, you know, they may be found their partner in their late thirties, but really didn't realize that the impact of age on their, on their fertility. and sadly, you know, in the united states and in many schools, there's sort of early sex education, but it's all about how to prevent facility,

prevent childbearing. the discussion of, if you wanted to have a child, you know, what is the fertile period? you know, how long are you fertile? that's really not part of education in america, at least. and so we need to do some education around asian facility. and i think another deleterious thing that's happened is that the media, there's so much media coverage of celebrities, celebrity women who seem to be having children that age, 48850 and beyond. but without really revealing that they've probably used donor eggs in or not their own eggs because it's very difficult to conceive at those late ages using one's own eggs. and so you know, the sort of so lubbers the older mother's liberty culture really hasn't helps you know, in terms of making women realize that there's an end point to facility for women. so yeah, it's a really important issue. i'm glad you brought it up. thank you, professor marcia in horn. now to the break,

we're going to continue our discussion and look at the options now available to address the growing infertility christ the the known in vietnam, the american war,

the vietnam war lost its almost 2 decades and dragged in numerous countries yard any time between now and then you don't see it now, why it's all on the empty, hundreds of thousands of american troops was sent to the country to bank the south vietnamese on me. i got all that not, but the american soldiers murdered resistors mercilessly burned down entire villages and spread dangerous chemicals and lee by all right, did the americans ever fully acknowledge what they did and on the vietnamese veterans ready to forgive? yes, yes. yes. that's the way it's too late to

the welcome back. we're going to continue our discussion about global infertility with marsh and we're now she's a professor of anthropology and international affairs at yale university and author of the book, motherhood on ice. thank you for joining us again. marcia, i want to continue with something you said in a previous segment. what about surrogacy? what impact do you feel like that is having on infertility? and is it being more used for superficial reasons or for science? yeah, you know, the 2, some solutions that have come about for women who really are having, you know,

profound difficulty in conceiving one solution is egg donation, dinner eggs. you, if you're, if your own eggs are too old, or there's a problem with, you know, conceiving using your own eggs. there is now a huge industry globally, really of, of donor egg. okay? and so that's sort of one issue that has definitely, you know, come to the, for the, you know, many women are, are using donor eggs. and sometimes as we say, celebrities are not talking about that. but then there's surrogacy or, you know, basically implying the room, if you will, of another woman in order to bear the child. it is often today is not using that person's eggs. it's, you know, conceiving an embryo with one's own eggs and sperm of one's partner. but having the pregnancy, you know, just dated in the womb of a surrogate. and, you know, surrogacy is important for some women who have absolute medical conditions whereby

they can not carry a pregnancy. and that's really how it started. and i guess that's what it was intended for rage for, for women who, for one reason or another they would not be able to carry a pregnancy the term. and so it has an important role. busy so i think in those kinds of cases, but is there a good c, a certainly expanded in terms of who's using it. and i would say, a huge use now is among gay male couples who want to have a bio genetically related child using their own firm, and then using donor egg and having the child just stated in the web, the surrogate. so surrogacy services have definitely grown in the eligibility to commit community for game man. um and you know, you're talking about the sort of celebrity use of, of surrogates. yeah. i mean people who have a lot of money. it's extremely expensive to carry out the surrogacy. i mean, in, i think the state of connecticut, you're going to pay more than

a $100000.00 to him, you know, employ a surrogate and have everything carried out. it's expensive and it's not available in a, in a lot of places. so, it isn't fisher's choice. i mean, it is, like you said, a sort of a, a last option for, for people who are facing infertility problems. i have not studied surrogacy in the middle east where i've done most of my research. surrogacy is not allowed and it's not available. but it's certainly in western countries, there's a growing market and, and actually in other parts of the globe, there's a sort of global trans national movement of people to other countries to employs surrogates, usually because it's much less expensive to do so. so yes sir is see, is an interesting reproductive choice, a solution for some who cannot carry just state and carry a pregnancy to term in your research? have you found it? climate change has had any effect on infertility?

yeah. climate change. i mean, as i mentioned, there's been a huge debate about whether globally sperm counts are decreasing. um and so, you know, there is some evidence that really environmental issues do have an impact on male fertility, especially when there are toxins in an environment. this is, we know that this isn't good for me. opportunity. i mean he, we know that he eats, especially when men are in, you know, there's a lot of discussion about the kind of underwear man where, or you know, hot tubs. you know, he probably isn't good for males, utility. and so given that there's been a lot of discussion and actually, you know, increasing global temperatures. ultimately, it might have some impact on male fertility over time. um, you know, in the united united states right now we're in the middle of this heat bomb, i mean, record high temperatures. and so in the future there may be some impact. i mean, i'm not a climate or an environmental expert,

but it is something to think about and something to be concerned about. our country's governments taking infertility seriously. or should they be doing more about the crisis, you know, are the countries you consider to be handling the issue of infertility correctly? yeah, i mean, governments can really help their citizens who are in for it all. and how can they do that? there need to be assisted reproductive technology services available because frankly, a lot of infertility can only be overcome through the use of what we call our cheese, including i, the ecc for male infertility, inter either and insemination. you know, these are called assisted reproductive technologies and they're expensive and that's why a lot of people cannot access them. but there are governments, especially in western europe that consider infertility to be a very legitimate medical problem. something that the government should help people with. and so as part of their health care systems,

especially societies that have what we call universal health care systems there, including, you know, infertility diagnosis and treatment as part of the sort of health care package available to couples. and so that would be, for example, in the united kingdom or in australia or in denmark, many western europe, european countries have included some kind of input till the coverage as part of their sort of national health care systems. but sadly, that is not true in most other places around the world. in most other places, entered city diagnosis and treatment is not covered by the nation. um, it does not subsidize to health care insurance, and so people are have to pay for it on their own. and it's 6 turn nearly expensive as we've discussed. and so many countries can be doing a lot more to help in federal citizens in their meds. i will say there are some remarkable examples of countries, for example,

in the middle east that have decided to make infertility services available. i think the next exceptional story is turkey. um, key decided that it should subsidize 2 cycles of ideas for every turkish citizen who needed it. and what it did is it just brought infertile couples especially from rural areas, you know, through into the ivy f world in turkey. the number of clinics increased uh, sort of exponentially, and there was a huge uptake of ideas in that country. a huge improvement in access to treatment services. so even countries that are known as sort of wealthy western countries could be doing a lot more to, to help their citizens overcome their infertility problems. so yeah, i do believe that, you know, the world could be doing a lot more, including the sort of international reproductive health world. infertility hasn't

been taken up as something that's important and reproductive health. the w h o has always sort of been interested in and cared about infertility. but a lot of the major, you know, reproductive health and global health organizations haven't really put any effort into the global infertility problem. and again, just to reiterate about 10 percent of couples in any population are going to be infertile. and there are some parts of the world where that percentage is much higher. we're 30 percent of couples in a society are going to be facing infertility problems. it's not an insignificant problem, and so there should be a lot more attention given to it, and unfortunately, there is not. so yes we, we could be doing a lot more for infertile couples around the world to help them overcome their, their problem. thank you so much for joining us, professor marsha and horn of no science. it might never be able to cure every reason which causes infertility. but as we make progress to develop various

solutions, it seems like society continues to develop factors which hurt changes for reproduction . whether be environmental or cultural, what we deem is progress might just be the path to mankind own reduction of sky. now here's an, this has been your 360 view of the news affecting new things. so watch the in 1941 with the nazis health relation. ultram national is the us dashes, the claim, the independent state of croatia. shortly off, the seizing power. they build the scene of us concentration camp a place associated with the worst atrocities committed in yugoslavia during world

war 2. the stash is used to come system to isolate and exterminate subs, roma, jews, and other non catholic minorities, and political opponents of the fascist regime conditions in the santa of us. campbell, who renders the gods tortured to arise and the prisoners they send in the concentration camps. so most of them died. it was incredible genocide. the

the and you moved. zillow for relationship is being or in m o. delta is not based on the western templates assistant, that voice can reach the leads they chosen really and talk to manage all of the functioning and developing multiple worldly foods and praises. the trends of low countries choosing best flow for an interest, so the west and mold and his speech of the a, the eastern economics for the russian investigators arrive at the scene, offer a passenger plane, makes an emergency number thinking. another said yes, region with very glass. that's what, oh here. no, i have very grateful to the group for that professionalism, thanks to the professionalism of the pilots, it was possible to avoid serious consequences and the plane crash storms.