This is a free preview of a paid episode. To hear the full conversation, visit keelysemler.substack.com.

If you're exploring fertility options or know someone who is, this episode is a must listen.

This week, we're joined by Kallie Fell, MS, BSN, RN, Executive Director of the Center for Bioethics and Culture Network to unpack Big Fertility. Kallie brings a wealth of experience as a perinatal nurse, shedding light on the overlooked aspects of assisted reproductive technologies (ART).

In our conversation, we delve into the lack of regulation and transparency in the fertility industry, the ethical concerns surrounding egg freezing, IVF and surrogacy, and the pressing need for a restorative, preventive approach to reproductive health. Kallie emphasizes that true healthcare means addressing the root causes of infertility, not just offering “high-tech solutions” that are not accessible to everyone.

This episode challenges us to rethink our approach to reproductive health and consider the human rights implications of ART. It's a conversation that calls for greater accountability in how we support individuals and families on their fertility journeys.

This episode compliments my latest piece on how our over reliance on technology short circuits embodied knowledge and what that means for our fertility and wellbeing. Spoiler: reconnecting with our bodies is a public health necessity.

If you're navigating fertility decisions or advocating for better healthcare practices, please share this episode. Let's continue to have these nuanced conversations and work towards a more informed and ethical approach to reproductive health.

To my clients who’ve undergone IVF this message is for you:

I deeply appreciate the trust you’ve placed in me as your doula and educator, and I honor the experiences you’ve lived through. This episode is shared with full respect and compassion for your journey. At the same time, many individuals and families deserve greater transparency and equity when accessing assisted reproductive technology. From a public health and human rights perspective, everyone pursuing IVF deserves dignity, autonomy, and clear information.

Kallie Fell started her career in reproductive science at Vanderbilt’s OBGYN department, after earning her Master’s in Science from Purdue with an emphasis in Reproductive Physiology and Molecular Biology. While researching endometriosis and preterm birth, she pursued her nursing degree, driven by a desire to support women directly as a perinatal nurse. Kallie began volunteering at the Center for Bioethics and Culture in 2018 and over the next few years, she progressed from volunteer writer to Research Associate and today leads the organization as its Executive Director.

Unlock an exclusive, deep-dive conversation with Kallie Fell available only to Behind Closed Doors subscribers. We explore ectogenesis (artificial wombs) and its emotional and physical implications when a mother’s body is separated from her baby. As a subscriber, you’ll also get access to bonus content, including my personal reflections as a women’s health educator, mentor, and doula; designed to enrich your understanding and connection to your body and your choices.

By subscribing, you're directly supporting independent storytelling and sustaining meaningful public‑health dialogue. You’ll help cover production costs and ensure these essential conversations continue. If you value honest storytelling and perspectives that often go unheard, join our community at keelysemler.substack.com.

4:43 Further education and conversations needed around fertility

11:03 Egg freezing: limitations, process, attrition, and selling hope

15:51 Ethical implications of employer egg-freezing benefits

17:19 The cost of freezing eggs

19:14 Egg count, reproductive years, and hormones

22:49 Long-term impacts of IVF medications

24:55 Preimplantation genetic testing and eugenics

28:06 What transparency do we owe children born via ART?

29:37 Surrogacy: contracts, consent, commercialization & costs

36:01 Surrogacy is inherent risk & commodification

37:51 How do we come to terms with the cost on surrogate mothers and babies?

40:21 The exacerbation of the class divide through eugenics

41:51 Unused embryos and parental rights

43:58 Should surrogacy have age limits?

44:49 Transparency and risk of embryo storage and use

45:45 Ectogenesis, artificial wombs, and the risk of “harvesting” life

49:18 What does artificial birth mean for embodiment, connection, and parenthood?

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