When LaQuana Cardwell began experiencing issues with her menstrual cycle as a teenager, she never imagined that at the age of 23 doctors would tell her she may never be able to have children.
“I was diagnosed with [polycystic ovarian syndrome] and premature ovarian failure,” said Cardwell, an educator living in West Midtown. “It was very devastating to me because I had no knowledge of infertility in general. Growing up, you learn all about how people reproduce, and you have that dream of getting married, having two kids, a white picket fence, but no one actually talks to youth about what could happen if things don’t go the way you plan.”
Cardwell isn’t alone with her infertility diagnosis.
Black women in the U.S are twice as likely to experience infertility compared to white women. Despite these rates, Black women are also less likely to use fertility services like in vitro fertilization, also known as IVF.
Cardwell, now 48, was eventually able to have a son through an egg donor. She said had she known earlier about the high rates of infertility in Black women and fertility services, she may have been able to save herself time and money as she said her total costs were around $40,000 to $50,000.
One 2025 study from the Centers for Disease Control and Prevention showed that compared to white and Asian women, Black and Hispanic women both had lower rates of seeking medical services to get pregnant.
Advocates, healthcare professionals, and patients told Capital B Atlanta there are various barriers that can keep Black women from accessing fertility services. Those include financial costs, lack of insurance, and seeking care too late.
Cardwell used her experience to create the No More Empty Christmas Trees Foundation, an organization raising awareness about infertility and offering financial and emotional support to those experiencing it.
Since founding the organization in 2015, Cardwell said one of the largest barriers she’s seen to Black women accessing care to services like IVF or egg freezing is the high financial cost.
In Georgia, where Black residents are uninsured at higher rates than white residents, lack of insurance coverage can make costs for services even higher.
One cycle of IVF can cost out of pocket anywhere from $15,000 to $30,000 in Georgia. Egg freezing in the U.S. can cost as much as $15,000 per cycle, with storage costs of around $1,000 per year.
Adding to the costs are the series of testing, appointments, medication, and more, Cardwell said. She’s known people who have taken equity out of their home in order to cover their fertility treatments.
“The medication, the services … when it doesn’t work the first time, and you have to go back several times and try again, it’s sad that you have to choose. Do I save money for retirement, or do I put my money into trying another round of IVF,” Cardwell said.
When Saundria Zomalt was trying to get pregnant at age 40, she said she was “willing to risk it all” to be able to have a child. Putting the costs on credit cards or taking equity out of their home to access fertility treatment would have been options.
Zomalt, a former South Fulton resident, said she was fortunate the clinic she used in Sandy Springs, Reproductive Biology Associates, offered military discounts. Her now ex-husband was on active duty at the time. She said they were able to get 50% off of their treatment costs and still ended up paying around $35,000.
With the help of IVF, the elementary school principal gave birth at 43 to her daughter Brooke, who she calls, “mommy’s angel.”
“I would have spent double, triple to have my little girl. She has been the biggest joy of my life, especially going through divorce,” said Zomalt, now 47. “She’s given my life like a new purpose. So it is expensive, and I was blessed to have the resources to pay for it on top of the discount, which made it more palatable.”
While she said she doesn’t regret the process, she said if she could go back and do things differently, she would have sought fertility treatment much earlier.
“My advice is: First of all, freeze your eggs. Don’t even blink or think about it because freezing eggs is $10,000, and again, that would have saved me so much stress had I done that,” Zomalt said.
Dr. Karenne Fru, who runs Muna Fertility, a metro Atlanta-based clinic focused on providing fertility services for people of color and LGBTQ residents, said seeking care later in life is something she runs into often with her Black, female clients.
“For Black women, who experience infertility at higher rates than other women but also seek care later, it was important to me that they had a purpose-built home — some place where you didn’t have to start by explaining your cultural context,” Fru said.
The reproductive endocrinologist said while many of her Black patients are seeking care at a later age, it can shut them out of fertility treatment options.
“I keep telling them to talk to their younger sisters, siblings, relatives, cousins, whoever, looks like them, but is much younger, to tell them to seek out the help sooner rather than later, because outcomes, of course, are age dependent. And so, if you’re Black and brown and coming to see me, you’re typically starting out at a disadvantage,” she said.
Fru and Cardwell said there are a handful of reasons that can lead Black women to seek care late, including issues like gaps in information on the issue and preexisting medical disparities.
“First of all, [infertility] is not talked about enough in any community, but then, especially in the Black community, it’s something that’s kind of hushed,” Cardwell said.
“Maybe if I had that knowledge, I could have had a chance to use my own eggs, you know. But I didn’t, and so I think sometimes knowing something ahead of time … being proactive versus reactive definitely can help in this situation,” she said.
Fru echoed Cardwell’s sentiments.
“Infertility is more common than diabetes, and yet we treat it like this taboo thing that should be borne only by women, and it really it’s an everybody thing. It takes at least two bodies to reproduce,” Fru said. “So those conversations are starting to be had. Could we do a better job? Absolutely, but we’re not there yet — otherwise, I’d give a lot fewer talks.”
She urged any Black woman thinking of having children to seek out fertility care as soon as possible.
“You don’t need permission to come see me or someone like me to just have the conversation and get a deeper understanding about where you, as a person in your context, are currently standing and what you might need to do in order to achieve your goals,” Fru said.
Cardwell encourages those who are struggling to connect with groups like her organization.
“A lot of times we say, ‘Don’t suffer in silence. Infertility is not a scarlet letter.’ I want others to know and be more aware that there is one out of six people worldwide who are affected by infertility, and that’s a great number and so that’s nothing to be ashamed of. You’re not alone,” she said.
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