IVF: The Numbers They Do Not Tell You

An Essay on What the Pioneer of British IVF Has Finally Said Out Loud

In September 2026, Robert Winston sat down on a podcast couch and told his hosts what his profession has spent forty years concealing. He is eighty-five years old. He is Lord Winston, one of the pioneers who built British in vitro fertilization from an academic curiosity in the late 1970s into what he now calls a twenty-three billion dollar global industry. This essay walks through what he actually said, in his own words, and then names what he did not say. The paradigm this project works within holds that failure to conceive is a symptom, not a disease. Most modern reproductive breakdown traces back to the categories of insult that produce all disease: toxic exposure, nutritional depletion, and unrelenting stress. Where the essay quotes fertility medicine’s own vocabulary, that vocabulary sits inside attribution. In the author’s voice, it does not.

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The confession

“We as a profession are not telling the truth.”¹

Winston said that to Konstantin Kisin and Francis Foster on their program Triggernometry, in September 2026. He said it in the context of a question about IVF success rates. He is not a critic of fertility medicine. He built the field. He performed some of the earliest work on preimplantation genetic diagnosis in Britain. He ran one of the first laboratories to secure reliable pregnancies at Hammersmith Hospital in the 1980s. He served as one of the public faces of assisted reproduction for four decades. The Prince of Wales visited his lab in the early years, when Winston was still trying to persuade the country that any of this was worth doing.¹

An admission of this kind, from this source, does not require interpretation. It requires only that the listener notice what he said, keep noticing, and then read what he said next.

He said the industry now sits at roughly twenty-three billion dollars globally.¹ He said the fees have become huge in every country. He said young researchers no longer go into real academic work because private clinics pay five or six times more. He said research on the culture medium in which embryos spend their first five days of life is “negligible,” because commercial clinics have no incentive to fund it and there is no other funder.¹

Then he began to describe the numbers.

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The rate the industry does not quote

Winston said, more than once during the interview, that his profession does not tell patients the cumulative success rate. The industry advertises a per-cycle number. The number a patient actually needs to plan her life around is the cumulative number: her real chance of having a live baby after completing her whole course of treatment, however many cycles that turns out to be.

The largest population study of that number in the UK is McLernon and colleagues, 2016, published in Human Reproduction. It followed 178,898 women through the national IVF registry between 1992 and 2011.⁸ The study reports three cumulative live-birth rates depending on statistical assumption. The conservative estimate, which assumes women who dropped out of treatment would never have succeeded, is around forty-four percent after six full cycles. The prognosis-adjusted estimate, which is the figure the mainstream press typically reports, is 65.3 percent after six cycles. The optimistic estimate is higher again.⁸

Whichever number you take, the pattern is the same. Even on the most flattering possible reading of the data, one in three women who enters IVF and completes six full cycles will leave without a baby. At the more conservative end, more than half will. Six cycles is not a small commitment. At five to ten thousand pounds per cycle in the private British clinics, and fifteen to twenty-five thousand dollars per cycle in the American ones once medications and monitoring are counted, six cycles is a mortgage payment.¹ The physical toll is separate and cumulative. Ovarian suppression, ovarian hyperstimulation, egg retrieval under sedation, embryo transfer, hormonal support, the two-week wait, then failure, then start again.

For women aged forty to forty-two, the McLernon paper reports a cumulative live-birth rate after six cycles of 31.5 percent.⁸ That is the age group that most closely tracks what corporate egg freezing programs are actually selling: the woman who freezes at twenty-eight and returns to attempt pregnancy at forty. The industry does not quote the McLernon age-adjusted number to her. It quotes the per-cycle rate at intake.

Winston said in the interview that he does not believe the twenty percent per-attempt rate the industry advertises is what the industry actually delivers.¹ He was more direct in the House of Lords on June 4, 2026, three months before the interview: “clinics are telling patients, I hear this again and again, that if you come to the clinic you have a sixty percent chance of having your eggs frozen, with a successful baby afterwards.”⁹ That is the pitch. It bears essentially no relation to what the data show for any age group in any published study.

Cycle by cycle, this is what her body actually goes through. First, drugs to shut down her natural cycle so the clinic can control the timing. Then, daily injections of hormones designed to force her ovaries to mature many eggs at once rather than the usual one. Then, days of transvaginal ultrasound monitoring to watch how the follicles develop.² A “trigger shot” tells her body to release the eggs. Then, under sedation, a needle is threaded through her vaginal wall into each ovary to extract the eggs. She returns days later for the embryo transfer, more hormonal support, and the two-week wait.² Ovarian hyperstimulation syndrome, the condition in which pharmacologically stimulated ovaries leak fluid into the abdominal cavity and can produce anything from bloating to renal failure to death,⁶ appeared nowhere in the Triggernometry interview. It rarely does.

The egg-freezing numbers the HFEA does not publish

Winston moved from cycles to eggs. Specifically to frozen eggs, the product currently being marketed to women in their late twenties and early thirties as insurance against career-driven delay.

He has been submitting written parliamentary questions on egg-freezing outcomes to the Minister for Health for over a decade, roughly every three years, because the Human Fertilisation and Embryology Authority does not publish the data any other way.⁹ ¹⁰ The most recent question was answered in December 2025.¹⁰ In the June 2026 Lords debate on fertility treatment regulation, he laid out the current numbers in the clearest form he had ever given them publicly.

Approximately 250,000 frozen eggs are currently held in storage in the United Kingdom.⁹ Over the five years leading up to the pandemic, 75,958 of those eggs were subjected to thawing for attempts at pregnancy. Roughly 13,000 of them survived the thaw process. Of those 13,000, 11,400 were fertilized. Of those fertilized eggs, 7,257 produced an embryo. Of those embryos, 1,695 were considered suitable for transfer. Of those transfers, 288 women became pregnant. Of those pregnancies, 205 resulted in a live birth. Eighty ended in miscarriage.⁹

The two numbers that follow from those figures are the ones the industry does not put in front of a patient at intake. Less than 0.2 percent of eggs subjected to thawing produce a live birth. Only 1.7 percent of eggs that are successfully fertilized produce a baby.⁹

Winston said in the Lords, and repeated in the interview, that the HFEA’s public messaging tells a different story. The HFEA states on its website that egg freezing success rates are improving. A senior HFEA figure recently gave the number on BBC radio as 18 percent per egg.⁹ The HFEA’s own data, provided in response to Winston’s written questions, contradicts both claims. The public number and the filed number are not the same number, and there is no institutional accountability for the gap.

Vitrification, the flash-freezing method now standard in the industry, subjects the cell to a massive temperature drop in a fraction of a second. The antifreeze medium is a toxic solvent that “you would not drink, for obvious reasons.”¹ Because clinics tend to stimulate hard in order to bank many eggs at once, and because batches must be thawed together, women who freeze eggs at twenty-eight are not banking a linear insurance policy. They are banking a probabilistic long shot in which the odds against any individual egg are overwhelming, and the odds against the whole batch producing a live baby are worse than the industry’s marketing implies.

Corporate wellness programs at technology firms now offer egg freezing as an employee benefit. The pitch is straightforward. Delay children, focus on career, freeze in your twenties, unfreeze in your late thirties or early forties. A curious skeptic sent this pitch by their employer may reasonably assume the underlying success rate is at least broadly reasonable. It is not. Winston noted, as an aside, that after age thirty-five, egg freezing is “probably not worth doing” because the technology’s slim margin collapses further with age.¹

The general failure to distinguish between a frozen egg, a thawed egg, a fertilized egg, a viable embryo, and a live-born child is not a public misunderstanding. It is a marketing achievement. Winston mentioned, in a moment of surprise even to him, a stranger at a party telling his wife, “Yeah, we have kids. We have two frozen ones.”¹

The message being sold to a twenty-eight-year-old woman is that she can safely prioritize her career because when she comes back at forty her frozen eggs will be waiting to become her children. That message is a lie. Not a marketing exaggeration. A lie. The eggs she is freezing at twenty-eight have less than a one-in-five-hundred chance per thawed egg of becoming a live baby.⁹ By the age at which she is likely to use them, her cumulative chance of a live birth even across six full IVF cycles is 31.5 percent.⁸ The technology is being sold to her as insurance. It functions as a lottery ticket. The odds are concealed at the point of sale, and the sale is being made by an employer that has packaged the lie as a benefit.

The black box

The five days that follow fertilization are, in Winston’s own words, “critical to the development of a human being when genes are being switched on and being programmed by the environment.”¹

Those five days, in IVF, are spent in a dish of commercial fluid in a dark container.

Winston was direct. The composition of the culture media is proprietary. Almost no serious research is being done on how these media affect the earliest embryonic development. Different clinics use different media. The Human Fertilisation and Embryology Authority does not record which are used, in what quantities, with what outcomes. Which media a given clinic buys and whether it changes suppliers is a commercial decision made largely without oversight.¹

The reason this matters, in Winston’s own framing, is a body of research he calls epigenetics: the observation that environmental information changes how the body develops, and that this changed development can carry forward into offspring. He described the Överkalix cohort study from Sweden, which found that boys who experienced abundance around age nine had grandsons who died younger.¹ The environment during a specific critical window in one generation showed up in the health of a generation the boy would never meet.

Winston then acknowledged that the entire earliest window of development in IVF children takes place in commercial fluid that has not been properly studied, and that these children are not being followed long-term in any systematic way.¹ He said, with characteristic understatement, “I don’t want to say IVF is dangerous because there is no evidence that it is.” He then added that when the Överkalix pattern was first described, nobody could see why it mattered either.¹

The reporting in Everything Below the Waist adds context Winston did not supply. Babies conceived through assisted reproductive technology have roughly double the rate of birth defects, even among singletons who are not premature.³ Dish embryos twin at four times the natural rate.³ ICSI, the procedure in which an embryologist selects a single sperm and injects it directly through the egg’s outer membrane with a glass needle, is now used in about three-quarters of American cycles regardless of whether a male-factor diagnosis exists.³ It has been in widespread use for fifteen years. The children conceived by it are only now becoming old enough to have children of their own.

Judith Stern, professor at Dartmouth Geisel School of Medicine, told Block: “We really do not know anything about the long-term effects, not only on the kids but on the women who undergo treatment.”³ Cancer, diabetes, and cardiovascular disease all sit on the list of open questions.

Diagnosis avoidance

Winston described a pattern he had observed for decades. A couple presents with a period of failure to conceive. The clinic offers IVF. Basic diagnostic work is skipped. Sometimes a simple structural problem is present, such as a uterine polyp or a tubal adhesion. Sometimes the underlying issue is hormonal or nutritional or the residue of years on hormonal contraception. Sometimes the male partner has a treatable condition and has never been examined. Sometimes the couple would have conceived on their own within a few more months.

“Once you make a diagnosis, you often don’t need in vitro fertilization,” Winston said. “And the truth is that a vast amount of in vitro fertilization is unnecessary. It fails. But then a few months later, somebody gets pregnant spontaneously.”¹

He explained that couples typically become panicked, seek a private clinic, and enter a treatment cycle before any investigation has taken place. The clinic has no financial incentive to spend clinician time discovering that the couple has a straightforward, cheap, correctable problem. It has every incentive to move them into a stimulation cycle.

Winston was blunt about what this means for the women who never conceive by IVF and who eventually conceive spontaneously after treatment fails. The industry books their eventual pregnancies as vindication of some prior intervention. The statistics look better than they are. The couples themselves rarely understand what happened.¹

He also described what he called “professional patients.” Women who go through eighteen cycles because they can afford to. Women who know every acronym in the field but cannot get an answer to the underlying question of why their bodies are not doing what bodies are largely built to do. Women whose relationships fracture under the strain of scheduled sex, injection sites, hormonal swings, and repeated grief. Marriages that end at cycle fifteen.¹

The Block reporting names this pattern from a different angle. Paul Turek, a urologist in California, gave her the field’s shorthand for it. “The gynecologists happen to have the perfect technology for things you can’t fix, which is IVF.”³ Turek’s own data show that fewer than one in five infertile men in the United States receive a urologic evaluation. The other four in five are handed a semen analysis and the woman is booked for a cycle.³

Winston’s version of the same complaint, delivered as an insider: fertility clinics doing regular in vitro fertilization do not subject themselves often enough to advice from male experts. He believes there should be more andrology in these clinics. There is not.¹

The label that hides the terrain

“Unexplained infertility” is the diagnostic category into which somewhere between one third and one half of couples entering IVF are placed. Winston did not attack the category directly. He worked around it. He spent much of the interview describing what he thought was actually going on.

He described a woman he had treated for years. Every test came back normal. Her husband’s tests came back normal. She never conceived. Eventually she left her husband, took up with a new partner, and continued to fail to conceive in England for a further two years. She then moved to Australia and became pregnant within weeks.¹

He described a lecture by a senior endocrinologist who insisted that in some cases, stress was a driver of ovulation rather than a suppressor of it, and that the effect of stress on fertility is not linear or well understood.¹

He described work he supervised in his own laboratory, never published, that suggested women who experienced orgasm during intercourse were somewhat more likely to conceive when the couple’s infertility was otherwise unexplained.¹

None of this is offered as a paradigm. Winston reaches for these fragments because he does not have a model for what is actually happening in most of his “unexplained” patients. The category is a placeholder for missing information. It is used to move a patient from diagnostic work into a treatment cycle without having to answer the question that patient is actually asking.

The woman with the shovel

Consider Holly. Not her full name; she asked Jennifer Block to use only her first name in Everything Below the Waist. Holly lives in Reston, Virginia. She was diagnosed with “unexplained infertility” at thirty-two, after her OB-GYN prescribed Clomid without further investigation. Holly endured “every side effect they listed, and then some.” Hot flashes. Nausea. Nightmares. Paranoia. She lost her ability to distinguish left from right. She cried every day for a week and could not explain why.³

Snowzilla arrived in January 2016. Twenty-nine inches of snow fell on Holly’s cul-de-sac. Her clinic, twenty-four miles away, had stationed doctors in nearby hotels to keep the schedule going. Holly’s husband suggested rescheduling. Holly refused. She had booked the injection, taken the trigger shot, done the ultrasounds. She spent six hours shoveling her driveway the day before her appointment. She woke before dawn the next morning and shoveled two more hours.³

Her husband had produced one semen sample, at the start. His count was low. He did not want to provide another. Nobody suggested that his low count might be the treatable problem. Holly took the drugs. Holly did the shoveling. Holly received the diagnosis. Holly went to the appointment.

Multiply Holly by several million women. This is what Winston means when he refers to “professional patients” whose marriages end at cycle fifteen. It is not abstract.

What Winston does not say

Failure to conceive is a symptom, not a disease. The couple in the clinic is not a broken machine. It is a body responding to accumulated conditions, and there is nothing mysterious about which conditions.

Winston has never quite said this. He has come close. He has described the interior of the industry with unusual candor: the numbers, the missing data, the market incentives, the ways clinics avoid diagnosis. He stops there. He has never denied that IVF produces real babies for real couples, particularly where a clear structural obstacle has been diagnosed. His argument is with an industry that has scaled a narrow application into a mass-market treatment of first resort for problems it was not designed to fix. The question sitting under his testimony is what those problems actually are.

Consider what the modern woman brings to the clinic at thirty-four.

She has spent between ten and fifteen years on a pharmaceutical that suppresses ovulation, thins the uterine lining, and elevates a binding protein that ties up her available testosterone long after the drug is discontinued. Eighty percent of American women born after 1945 have used the pill.⁴ Many began in adolescence for acne or menstrual irregularity rather than pregnancy prevention. One study of women entering IVF found that those with ten years of pill use had significantly thinner uterine linings than those with six.⁵ A separate study of some 900 women aged 19 to 40 found that current pill users had ovaries half the size of non-users and significantly lower markers of what fertility medicine calls ovarian reserve.⁵ The long-term study that would answer this question conclusively has never been funded.⁵

Layered onto that are the medications no one calls contraception. A decade of antidepressants. Repeated courses of antibiotics for acne, sinus infections, or the flu-that-was-not-the-flu. Non-steroidal anti-inflammatories for the periods that hurt more each year. Thyroid replacement, metformin, statins by thirty-five. And the exposures nobody has measured on her: mercury amalgams still in her teeth, glyphosate in her urine, phthalates from personal care products, BPA from a childhood spent drinking from plastic, ambient electromagnetic exposure orders of magnitude beyond what her mother lived with, carried in her pocket and held against her abdomen when she uses her phone.

Layered onto that are the meals. She has eaten what a modern professional woman eats: low-fat processed food, coffee, sugar, seed oils. She has never eaten the fat-soluble activators dense in organ meats, pastured egg yolks, and traditional fermented dairy that Weston Price documented in fourteen traditional populations that had no fertility problems and no chronic disease. Her thyroid function is likely marginal. Her adrenals are likely fatigued. Her mineral status has never been assessed by anyone.

Layered onto that are the conditions in which she has lived. Chronic overwork. Chronic sleep debt. Chronic low-grade anxiety that never resolves because the phone never stops. Sustained cortisol elevation disrupts the signaling between brain and ovary directly. As Kalish, cited in Block, puts it: “The ovaries are the victim in this. The ovaries are responding with abnormal hormonal output because of emotional, dietary, or inflammatory stress. It’s not the other way around.”³

This is the couple that walks through the clinic door. She is not a woman in equilibrium whose reproductive system has spontaneously and unaccountably failed. She is a woman in whom toxic exposure, nutritional depletion, and unrelenting stress have accumulated for a decade or two before the attempt to conceive begins. Her body has been telling her something for years. She has been medicated for each of the symptoms in turn.

The clinic does not investigate any of this. It cannot. The investigation is not billable, the diagnosis is not clean, and the treatment is not a treatment the clinic sells. The clinic sells stimulation, extraction, laboratory manipulation, and transfer. It adds those to a system already burdened, and books a per-cycle success rate as a triumph of technology, even though the cumulative outcome across a full course of treatment leaves most patients without a baby.

Modern life produces the exhausted, chemically saturated, depleted body. The fertility industry then processes that body without ever asking why it arrived. This is what Winston is circling when he mentions that clinics do not encourage patients to lose weight because “patients want to have IVF rather than losing weight.”¹ Weight is one variable. It stands in for many.

The missing statistics

Sex selection is now openly sold to British patients through clinics in Cyprus and Spain, Winston noted, and he was clear that he believes selection for other inherited traits is already happening in the United States. “That’s already happening. We’re not saying it’s happening, but I’m sure it is happening.”¹ The technology is here. The regulatory perimeter is porous. The financial incentive is enormous.

Return to the statutory obligation.

The Human Fertilisation and Embryology Authority was set up with a specific requirement to provide better information to patients.¹ Winston identified this as one of his largest complaints about the current situation. He put it this way in the Lords in June 2026, quoting his most recent exchange with the Authority directly: “when I recently asked the HFEA to write to the Minister, I was told that we do not know how many eggs are being frozen, how many end up fertilised, how many become embryos or what happens to those embryos, we only know the number of embryos transferred to uteruses and the number of pregnancies.”⁹

The Authority does not record how many eggs are stimulated per cycle across the industry. It does not record how many are frozen. It does not record how many are thawed. It does not record how many of those thawed eggs fertilize. It does not record how many of those fertilizations produce a viable embryo. It does not follow up the children born from these procedures over the long term. It does not require clinics to publish their outcomes by choice of culture media. It does not track ovarian hyperstimulation syndrome as a systematic outcome.

These are not accidental omissions. They are choices. They are the choices of a regulatory body that has decided, cycle after cycle, year after year, act after act, that the information the couple in the clinic actually needs is information that will not be collected. And in the meantime, the same regulator publishes on its website that egg-freezing success rates are improving, and a senior member of the Authority tells the BBC that the per-egg success rate is 18 percent. The number filed in response to a parliamentary question is 1.8 percent.⁹ The regulator has one number for the public and another for Parliament.

Informed consent, in the sense the medical profession claims it, is not possible in this data environment. A woman offered egg freezing at twenty-eight is not being told the 0.2 percent per-thawed-egg live birth figure because the authority that would have to compel that disclosure has declined to compel it. A couple offered a cycle at cycle four is not being told the cumulative outcome data because the industry does not want them to see the actual number. A woman handed a diagnosis of “unexplained infertility” is not being investigated because the investigation would cut into the clinic’s revenue and would not, in the current data environment, produce a legally defensible protocol.

The pioneer knows. He has been saying so, in the House of Lords, on the BBC, in the Daily Mail, and now on a podcast with an audience of hundreds of thousands. He said the industry lies. He said the regulator will not measure what needs to be measured. He said the market has swallowed the research. He said the technology is being sold to women on terms that do not match what the data actually show.

Whether the industry he built continues to lie about its results depends on whether the couples who walk into its clinics start asking questions that Winston himself has now, at last, put on the public record. The numbers he cited, and the numbers the regulator has chosen not to collect, are enough to begin.

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How to Explain It to a Six-Year-Old

Imagine a factory that promises to make you a puppy. You pay them a lot of money. First, they give the mother dog a lot of shots to make her body do something it does not normally do. Then they take some tiny pieces out of her that could one day become puppies. Then they put those tiny pieces in a dark box for five days, with a special drink that nobody has really tested. Then they hand you the box.

Most of the time, when you open the box, there is no puppy.

But the factory does not tell you that. They tell you the puppy is almost definitely inside. And when you come back for a second box, and a third, and a fourth, and there is still no puppy, they tell you it is not their fault and you should try again. Some people try six times. Some people try eighteen times. Even after six tries, at least a third of people never get a puppy at all. And each box costs about the same as a used car.

The people who own the factory make twenty-three billion dollars a year selling boxes.

The man who invented the factory is very old now. He sat on a couch on television and said, “We are not telling the truth about the puppies.” Then he explained the numbers. Then he pointed out that the rules say the factory has to keep track of how many puppies actually come out of the boxes, and the factory has decided not to keep track. So nobody knows the real number.

The puppies that do come out sometimes have things wrong with them, and nobody knows how many, because the factory does not follow up.

The old man said all of this out loud. Now we have to decide what to do with what he said.

In Print

The Unbekoming library is available in paperback, printed to order through Lulu and shipped worldwide. The shelf begins with the paradigm question underneath everything else — No Virus, the isolation problem, the collapse of virology’s foundational claims, and a disease-by-disease reappraisal — and moves through the suppressed compounds mainstream medicine set aside: The DMSO Book, Chlorine Dioxide: The Forbidden Remedy, The Iodine Book, and The Hydrogen Peroxide Book. Two more recover what’s still on the kitchen shelf: Baking Soda and The Castor Oil Book. Two more recover the minerals modern soil, water, and processing quietly stripped from the diet: The Magnesium Handbook and The Boron Book. Sitting alongside these is No Contagion, co-authored with Jamie Andrews — the case against germ theory itself, catalogued through 258 failed contagion experiments.

The critique books cover what medicine, dentistry, psychiatry, and veterinary practice have become. The Unvaccinated treats the completely unvaccinated as a comparison group across twenty chapters and five appendices. Medicalized Motherhood follows a woman through 123 documented interventions from teenage pill to postpartum discharge. Drilling for Profit treats cavities, gum disease, and crooked teeth as the dietary problem they are. What Your Vet Can’t Tell You applies the same critique to pets. Escape from Psychiatry documents the fabrication of the DSM and the specific damage of every major psychiatric drug class. The Vitamin K Injection covers what happens in the first hours of a newborn’s life.

The full shelf is at lulu.com/spotlight/unbekoming. A physical book reaches the person a Substack post never will — the skeptical relative, the friend who won’t click a link but might open a book, the visitor whose eye lands on a coffee table. Buy one to keep, and one to give away.

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References

1. Winston, Robert, interviewed by Konstantin Kisin and Francis Foster, “The IVF Pioneer Who Says His Own Industry Is Lying: Professor Robert Winston,” Triggernometry, September 27, 2026.

1. Direct quotations and material from the transcript, including: the “we as a profession are not telling the truth” admission; the twenty-three billion dollar industry estimate; Winston’s biographical details and history at Hammersmith Hospital; his description of culture media research as “negligible”; his account of clinics avoiding basic diagnostic investigation before offering IVF; his description of “professional patients” who complete eighteen cycles; his account of the woman who conceived in Australia after failing in England; his remark that stress may in some cases drive rather than suppress ovulation; his laboratory observation about female orgasm and unexplained infertility; his description of the vitrification antifreeze; his remark that egg freezing after age 35 is “probably not worth doing”; his account of the party guest referring to “two frozen ones”; his description of the mechanics of the standard IVF cycle; his admission that clinics stimulate ovaries hard for freezing at the expense of proper egg maturation; his estimate of clinic fees between five and ten thousand pounds in Britain; his account of sex selection now sold through overseas clinics; and his belief that trait selection is already happening in the United States.

2. Chen, Serena, reproductive endocrinologist at Institute for Reproductive Medicine and Science, St. Barnabas Medical Center, quoted in Jennifer Block, Everything Below the Waist: Why Health Care Needs a Feminist Revolution (St. Martin’s Press, 2019), on the standard IVF protocol sequence: pituitary suppression with a GnRH analogue, ovarian stimulation with follicle-stimulating hormone and luteinizing hormone, monitored follicle development, hCG trigger shot, transvaginal ultrasound monitoring, and egg retrieval.

3. Block, Jennifer, Everything Below the Waist: Why Health Care Needs a Feminist Revolution (St. Martin’s Press, 2019). Chapter 2, “Fertility Insurance.” Sources include: doubled rate of birth defects in ART singletons; dish-effect twinning at four times the natural rate; ICSI used in approximately 75 percent of American cycles regardless of male-factor diagnosis; Judith Stern of Dartmouth Geisel on the absence of long-term outcome data for women and children; Paul Turek on IVF as the “perfect technology for things you can’t fix”; Turek’s finding that fewer than 20 percent of infertile American men receive urologic evaluation; Daniel Kalish on the ovary as victim of upstream metabolic, emotional, and inflammatory stress.

4. Grigg-Spall, Holly, Sweetening the Pill: or How We Got Hooked on Hormonal Birth Control (Zero Books, 2013). On the prevalence of pill use in successive cohorts, the sustained elevation of sex hormone binding globulin following discontinuation, and the pattern of women being labeled infertile while in recovery from years of hormonal suppression.

5. Block, Jennifer, Everything Below the Waist, on the relationship between duration of hormonal contraceptive use and endometrial lining thickness at IVF embryo transfer; on the study of approximately 900 women aged 19-40 showing hormonal contraceptive users had ovaries half the size and significantly lower ovarian reserve markers than non-users; on the observation by the endometrial-lining study authors that long-term contraceptive use may represent a “previously unidentified side effect” of importance in counseling.

6. Weschler, Toni, Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health, revised edition (William Morrow, 2015). On IVF protocol steps including GnRH suppression, gonadotropin stimulation, and the risk of ovarian hyperstimulation syndrome; on the acknowledgment that egg freezing success rates remain “quite low” with no extensive long-term studies of children conceived from thawed eggs.

7. Hill, Sarah E., This Is Your Brain on Birth Control: The Surprising Science of Women, Hormones, and the Law of Unintended Consequences (Avery, 2019). On the connection between pill-driven delay of childbearing and the growth of the infertility treatment industry (”as it goes with the pill, so it goes with IVF”).

8. McLernon, David J., Abha Maheshwari, Amanda J. Lee, and Siladitya Bhattacharya, “Cumulative live birth rates after one or more complete cycles of IVF: a population-based study of linked cycle data from 178 898 women,” Human Reproduction, Volume 31, Issue 3, March 2016, pages 572 to 581. Funded by the Wellcome Trust and the Medical Research Council. Reports cumulative live-birth rates in the UK IVF registry between 1992 and 2011: conservative estimate approximately 44 percent after six full cycles, prognosis-adjusted estimate 65.3 percent after six cycles, and optimistic estimate higher. For women aged 40 to 42, the prognosis-adjusted cumulative live-birth rate after six cycles was 31.5 percent.

9. Winston, Robert (Lord Winston), speech during the “Fertility Treatment Regulation” debate, Lords Chamber, Hansard, June 4, 2026. https://hansard.parliament.uk/lords/2026-06-04/debates/EDD1C1D5-A58E-4017-A20B-B3E2D1A1E943/FertilityTreatmentRegulation. Direct quotations and specific numbers used in this essay, including: approximately 250,000 frozen eggs held in UK storage; the five-year pre-pandemic data of 75,958 eggs subjected to thawing, with approximately 13,000 surviving the thaw, 11,400 fertilized, 7,257 producing an embryo, 1,695 suitable for transfer, 288 pregnancies, 205 live births, 80 miscarriages; the 0.2 percent per-thawed-egg and 1.7 percent per-fertilized-egg live birth figures; the discrepancy between the HFEA’s public messaging of 18 percent and its filed data of 1.8 percent; the HFEA’s admission to the Minister that it does not know how many eggs are frozen, fertilized, or become embryos, only how many are transferred; the clinic pitch of 60 percent success; the £915 embryo freezing fee and £325 annual storage cost.

10. Winston, Robert (Lord Winston), written parliamentary questions on egg freezing outcomes, House of Lords, submitted approximately every three years since 2013. Most recent set answered by Baroness Merron, Parliamentary Under-Secretary of State (Department of Health and Social Care), December 2025, using HFEA register data as of December 17, 2025. Public record via UK Parliament Hansard and compiled at parallelparliament.co.uk/lord/lord-winston.