How Iran became a leader in fertility treatment, courtesy of the Ayatollahs

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Marco Werman: Most of us don't think of Iran as a country with progressive social policies. Homosexuality, for example, is a punishable crime in Iran. Yet there is one area in which the Islamic Republic has shown a progressive bent: fertility treatment. Iran is actually a leader in the field, attracting couples from all over the Middle East looking for in vitro fertilization, or IVF. It's all due to support from the Ayatollahs. Azadeh Moaveni is an Iranian-American writer and journalist, and she's looked into the popularity of fertility clinics in Iran Azadeh Moaveni: To begin with, demand for IVF in Iran is very high and that's because women in large numbers go to universities, they get jobs, so Iran is sort of in line with the West in age of marriage being pushed up. It's very common now for women to have children in their 30's, even into their early 40's. But when we turn to IVF and whether there's religious sanction for having embryo donation or egg donation - that's something that, in Iran, came very specifically handed down from Ayatollah Ali Khamenei in 1999, who made these things permissible. Werman: What was the Ayatollahs motivation? Was it just, "We need more Iranians," or what? Moaveni: Well, part of it was that there was a very strong medical lobby. Iran has a fairly advanced medical system and we've had a long tradition of very progressive, very ambitious doctors who want to keep the country in step with the West in terms of availing themselves of all the different kinds of technologies and treatment available. I think it also worked in tandem with the government's own population control policy. After the Islamic revolution Ayatollah Ali Khamenei encouraged Iranians to have large families, so the population growth rate was very high. Of course, that was also the decade of the war with Iraq, so when the war ended in the 1980's, Iran found itself with a devastated economy that it needed to rebuild and a baby boom that it couldn't really support. It wasn't simply, "Stop having babies, Iranians." It was, "Let's all figure out what we need to do. Some people need to get their families smaller, some people need to help to have families." It was actually a very savvy way to get the population down at the same time. Werman: I think we get a pretty good idea of who's getting the treatment. This is not just an Iranian clientele, is it? Moaveni: No, it's drawing couples from throughout the Middle East and even farther, with Muslim countries like Indonesia, because Iran is the only Muslim country in the world that is practicing this kind of fertility treatment. Couples come from Turkey, although Turkey's even made a move to ban that kind of reproductive trouble. Sunni couples from Egypt, throughout the gulf. A lot of these clinics have pamphlets and information in Arabic and in translation to accommodate these reproductive tourists. Werman: Are these fertility clinics Iran being criticized in the region by religious leaders? Moaveni: I think that it makes Sunnis in many parts of the Middle East absolutely aghast that Iran is going away with this. I know at medical conferences there have been almost scuffles. Sunnis from Bahrain and other countries are saying, "This is haram. This is against Islam. How can you do this?" But the fact remains, we're seeing the couples travel. Werman: Azadeh, you're of Iranian descent. Does it surprise you that of all the countries in the Middle East, that Iran is the one that's turned into the hub for fertility treatments? Moaveni: Well, interestingly, Iran has in its own way, even under the Islamic republic, been quite progressive in areas of biomedical ethics and research. Iran has pushed ahead with stem cell research. It's religiously accepted, and has in many cases paid for, transgender operations, so having spent a lot of time living Iran and having seen its frankly impressive medical system, despite the country's poor management in lots of other areas. It's something that did take me by surprise, to see how extensively this has become part of babymaking and people's access to widening their families. Werman: So big fertility clinic business in Iran - how does that factor into general attitudes about sexuality in Iran? Moaveni: That's been a really important offshoot of all of this fertility treatment, is that couples are forced to talk about things that have, for centuries really, been taboo. Seuxal dysfunction, sexual health, the role that sex plays in a marriage. I think it's forcing people, at the medical level, to talk about how babies are made, how reproduction works, and it's making possible all of the conversations that are culturally so sensitive and difficult to have, something that, especially for a younger generation, is not the tainted, difficult subject it has been for so long. Werman: Iranian and American journalist Azadeh Moaveni has a new article on foreign policy. It's called, "The Islamic Republic of Babymaking." Thanks very much for speaking with us Azadeh. Moaveni: Thanks Marco.