well, and are very grateful to those who shelter them. they will not forget the generosity, but it wouldn't be a good story for europe if it's worth to drive these people into a corner. now he doesn't sound like a mob boss there at all. nice places you guys have over there in your it would be a shame if something were to happen to it. i'm sure that you printing refugees fleeing complex would be absolutely thrilled to hear zalinski describe his own people as some kind of sleep for ages. who could activate against europe if he doesn't get what he wants? li chapman of the german council for constitution and southern se ralph named this is the key of isn't doing yourself any favors with those statements. i think dave simply think they are the center of the universe. i'm on you're pregnant, got them. and at the moment they are just solving themselves because they seem to have no real support anymore. also not from watching because many of the

senators, not all the republicans, i'll say, why should be finance for this war? so they are running out of time and running out of money, so they have to blame someone else and that's what was going on, let them. and we can say, i mean these fine organizations of the red cross as the united nations to text them when they don't speak the way that you wanted. that is really bad. and that's how the world is looking at 11 31 pm this tuesday, even in moscow for all the latest developments you subscribe to outside of gum channel. we've gotten more in 13 minutes time. thanks for watching the 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. now here's an on this edition of a $360.00 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 it 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 is so strong it can even break the company. however, there is no way to rejoicing that 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 of a dell was discussed, infertility around the globe is more shy and horn now she is a professor of anthropology in 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. i think i would call the 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 imprecise, 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 uh, 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 in 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 federal tardy. but more than a half of all cases of involuntary childlessness around the world are due to male factors. and so we really need to be acknowledging male infertility, and much more than we do a mentor just sort of ignored in this, in this issue altogether. and so i really appreciate your bringing it up on 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 called x the 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 affility is 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 infertility 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 delivery cases due to, you know, due to environmental factors that really need to be studied further. you have said male infertility 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 like 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 level um the united arab emirates i, i'm basically a scholar of the middle east, although recently i have a new book out on egg 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 called calm. so i'm going to use 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 males, firm 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 steven 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 a jacket called age. those premiums are so they're 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 it's a sort of started coming out with their mail and facilities struggles going to i the clinics to, you know, seek this exceeds solution. and so there was a real change, a real recognition. the that 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 unfortunately 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 is ation, 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 we hear 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, 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 and fertility 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 you need to do procedures to look at the so it is a condition of the flow of the 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. so 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 ideas 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 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 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 through 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 there's a dramatic decline of women's facility around the age of $37.00, which has been called the for till of 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. the kind of colleges 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, strict security 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 an early forty's who got their, you know, they maybe 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 want 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 age affility. 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 mothers celebrity culture really has helped 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 after the break, we're going to continue our discussion and look at the options now available to address the growing infertility christ,

the advisory lucas really do not return back. it's really about being broadly more brief. but i also see that democracy is another one. database system of both issues mixture all times. we try to allow me to do all

the welcome back. we're going to continue our discussion about global infertility with marsh and weren't now. she's a professor of anthropology 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 a superficial reasons or for science? yeah, you know, the, to some solutions that have come about for women who really are having, you know, profound difficulty in conceiving one solution is an 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 that, 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 employing the room if you will, of another woman in order to bear the child. and it, it often today is not using that person's eggs is, 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 cannot carry a pregnancy. and that's really how it started. and i guess that's what it was intended for, right? 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, 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 circuit. so surrogacy services are 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 the 1st choice, i mean, it is like you said sort of a last option for,

for people who are facing infertility problems. i have not studied surrogacy um, 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 circuits. usually because it's much less expensive to do so. so yes sir, you can 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 of 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 all for to lity. 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 male fertility. 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 interest, so the 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 to consider in futility, 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 infertility 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 injured silly 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 is extraordinarily expensive, as we discussed. and so many countries could be doing a lot more to help in fertile 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 of 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 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 a show 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, where 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 or no science 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 it be environmental or cultural, what we do is progress might just be the path to mankind to own reduction sky. now

here's an, this has been a, your 360 view of the news, affecting new se. so watch the, [000:00:00;00]

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