The Silence of Infertility and One Doctor Who Refuses to Accept It

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There’s a kind of silence couples don’t talk about. It’s the quiet after another negative test, the space between appointments, the pause when someone asks, “So when are you having kids?” For nearly 17% of couples in America, that silence is their reality. And it carries a weight most of us can’t see, emotional, physical, and financial.

Dr. Tiao-Virirak Kattygnarath knows that silence well. He’s spent more than 20 years in exam rooms and labs helping families who want nothing more than a child. “Becoming a father changed how I saw everything,” he told me. “I realized this little baby was the most precious part of my life, and I would do anything to protect him.” For him, fertility isn’t just about science, it’s about giving families back the joy that silence steals.

Infertility isn’t simply about getting older or unlucky biology. It’s a disease, officially recognized by the World Health Organization, and yet in the U.S. it’s often treated like an elective procedure. Insurance coverage is inconsistent. Government support is practically nonexistent. And the result is that access depends far more on wealth than on medical need.

“Many people think infertility is only about age or biology, but it is also about access and fairness,” Dr. Kattygnarath explained. “It should be treated like other diseases and funded by insurance or government, the same way cancer is.” Right now, many families are shut out of treatment simply because they can’t afford the $15,000-plus average cost of a single IVF cycle. That’s not just unfair, it’s unsustainable.

Beyond individual heartbreak, declining birth rates have national consequences. Countries like Japan and South Korea are already staring down shrinking populations, weakened workforces, and unstable pension systems. America isn’t immune. Without fertility support, our demographic curve could bend the same way.

“Supporting fertility treatments should be part of a national plan to keep birth rates high,” Dr. Kattygnarath said. From his perspective, investing in reproductive health isn’t just family policy, it’s economic policy. Every successful treatment means new citizens who will one day become workers, innovators, and taxpayers. It’s about securing the country’s long-term competitiveness as much as it is about helping a couple start a family.

Of course, numbers only tell part of the story. The emotional cost of infertility runs deep. Couples blame themselves, carry guilt from past choices, and often wrestle with depression. “Infertility can cause strong emotions like low self-worth, guilt about past events, and sometimes depression,” Dr. Kattygnarath said. “It can be a serious test for a couple’s relationship.”

Some partnerships fracture under the strain. Others survive, but with emotional scars and financial stress that linger long after. And yet, he’s quick to point out, many couples display extraordinary resilience, sticking together even after multiple failed attempts. That persistence inspires him as much as it challenges him.

In a healthcare system known for rushing patients in and out of exam rooms, fertility care demands a different approach. It’s intimate, emotional, and life-altering. “Being kind and caring does not take much time,” he said. “Whether patients pay themselves or not, they all deserve our full attention.”

That philosophy comes not only from decades of professional practice but from his own journey as a father. He knows firsthand that when someone entrusts you with their hopes for a family, you can’t treat it like just another appointment on the schedule.

If he could change one policy tomorrow, Dr. Kattygnarath wouldn’t hesitate to encourage insurance or employer coverage for egg freezing. Many women choose to delay children for career, education, or financial reasons. But biology doesn’t wait. “Once fertility declines, we cannot reverse it, and it is heartbreaking to tell someone their only option is egg donation,” he said. Funding egg freezing would give women real control over their futures instead of closing doors on them later. That single shift could change millions of lives, keeping more families intact, expanding workforce participation, and strengthening the country’s demographic outlook.

Infertility is often seen as a private struggle. But it’s not. It’s a public health issue with economic, cultural, and generational consequences. Left unaddressed, it threatens the stability of families and the strength of the nation.

Dr. Kattygnarath’s work reframes the silence of infertility into a call to action. His vision is simple but powerful. He aims to make fertility care accessible, compassionate, and equitable. That way, more couples can move from quiet heartbreak to joyful noise. And for a country that depends on strong families and a stable future, that might be one of the most important investments we can make.

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This content is brought to you by Melissa Moraes.

Photo provided by the author.

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