'I don't have the money.' Welcome to the era of 'social infertility'.

When we think about infertility, it's almost exclusively in medical terms. Images of gruelling IVF injections, heartbreaking 'single line' pregnancy tests and countless medical procedures and failed attempts at conception flood the mind.

But according to researchers, there's a new kind of infertility sweeping the country, one that has nothing at all to do with your body's ability to conceive a child.

'Social infertility' relates to those who are unable to have a baby not because of biology, but because of their financial status, their life-stage readiness, or not being able to find a partner to conceive with.

36-year-old Katelyn* is a single woman from Brisbane who recently went for an 'egg timer' test to check the state of play on her fertility.

"It came back higher than the average woman my age," she explains, "almost double the amount of eggs in reserve I'd be expected to have."

Katelyn said the doctor's gentle advice was that she was "very fertile" and "still had time".

"It's as though she thought she was giving me the great news that I could still have a baby if I wanted to," she continues, "even though my body's ability to make a baby is actually the least important factor in whether or not I can become a mum. I still don't have a partner. I don't have the money to have one by myself either through IVF, so while I may be fertile in a medical sense, I'm decidedly infertile in every other way. And unless something changes, I probably always will be."

Women — and men — like Katelyn are increasingly common in Australia, suggesting the falling birth rates (Australia's fertility rate dropped to a record low of 1.5 babies per woman this year, far below the 'replacement rate' of 2.1 required to keep our population stable) are due to more than age-related medical infertility alone.

So why does the language we use to describe infertility even matter? If the end result is not being able to have a baby, does the reason behind it count? 

If you're talking about Medicare, then yes.

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This is the view of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), an organisation that has allied with ANZSREI (Australian and New Zealand Society for Reproductive Endocrinology and Infertility) and FSANZ (Fertility Society of Australia and New Zealand) this year to redefine clinical infertility beyond the scope of purely medical terms. 

The alliance came to the historic consensus in August at the 2024 ANZSREI National Conference, where ANZSREI president Prof Louise Hull said "The right to have children and raise them in a loving home is surely one of the most fundamental human rights."

The consensus definition expanded "infertility" to include "the inability to achieve a successful pregnancy based on a patient's medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of these factors". 

"Thanks to remarkable advances in science and modern medicine in recent decades, we are now able to overcome many of the challenges that previously prevented many people from becoming parents," Professor Hull continued.

"Nothing in the Medicare definition should be used to deny or delay fertility treatment to any individual, regardless of relationship status or sexual orientation."

The group wrote to Health and Aged Care Minister Mark Butler advising him of the expanded definition, and calling for the federal government to apply it to Medicare funding for Assisted Reproductive Services in Australia.

For women like Katelyn, it brings hope that her lack of a partner might not be the ongoing barrier to motherhood it once was, should the Federal Government decide to expand the definition of infertility under Medicare. 

"If I could access help getting pregnant via IVF with donor sperm and it was covered under Medicare that would shift a lot for me," she admits.

"I'm not sure if the ongoing costs of raising a kid on my own would be doable, but it would certainly get rid of that massive hurdle when it comes to the cost of actually getting pregnant without a partner. I've been paying for the top prenatal cover in my private health insurance for the past decade, hedging my bets in case I can manage to do it on my own and hope to get some of it covered. Having Medicare take some of that financial burden would be a game-changer." 

At the time of publication, a RANZCOG spokesperson said the organisation has yet to receive any response to its letter from the government.

*Names have been changed.

Feature Image: Getty.