Ep 279: Eggs: To Give is To Receive

In this episode, Dr. Carrie Bedient (Fertility Center of Las Vegas), Dr. Susan Hudson (Texas Fertility Center), and Dr. Abby Eblen (Nashville Fertility Center) welcome Lauren Makler, co-founder and CEO of Cofertility, for a powerful conversation about redefining egg donation and fertility preservation.

Lauren shares how Cofertility is changing the landscape by giving young women, typically ages 21 to 34, the opportunity to freeze their eggs at the ideal time in life, at no cost, by donating half to intended parents. This fully disclosed, mutual-match model brings transparency and connection to a process that has long existed in the shadows.

The group explores how Cofertility empowers intended parents to feel confident and proud in their family-building journey, and how donors find meaning in helping others conceive. The emotional and financial benefits are real—for both sides.

Whether fresh or frozen eggs are used, this new approach is providing families with more options, greater openness, and increased hope. Tune in to hear how Cofertility is making egg donation a shared journey worth celebrating.

Transcript

Susan Hudson (00:01)

You're listening to the Fertility Docs Uncensored podcast, featuring insight on all things fertility from some of the top rated doctors around America. Whether you're struggling to conceive or just planning for your future family, we're here to guide you every step of the way.

This podcast is sponsored by ReceptivaDx. ReceptivaDx is a powerful test used to help detect inflammatory conditions on the uterine lining, most commonly associated with endometriosis and may be the cause of failed implantation or recurrent pregnancy loss. Take advantage by learning more about this condition at receptivadx.com and how you can get tested and treated, providing a new pathway to achieving a successful pregnancy. ReceptivaDx, because the journey is worth it.

Carrie Bedient, MD (00:52)

Hello everyone and welcome to another episode of Fertility Docs Uncensored. I am one of your co-hosts, Dr. Carrie Bedient from the Fertility Center of Las Vegas, joined by my totally fantastically, phantasmagoric, phenomenal, even though that's a P-H and not an F, co-hosts, Dr. Susan Hudson from Texas Fertility Center, and Dr. Abby Eblen from Nashville Fertility Center.

Abby Eblen MD (01:13)

Hi, everybody.

Carrie Bedient, MD (01:14)

And we are joined today by Lauren Mackler, who is the co-founder and CEO of Cofertility, which is a phenomenal egg donation agency and fertility preservation entity that she will tell us all about in a minute. However, prior to her fertility world experience, both as a patient and as part of the industry in this world, you were at a very non-fertility entity and were pretty much in charge of opening up half of the country to it. And so tell us about your life before fertility.

Lauren Makler (01:40)

Yes, thank you for having me. I'm so excited to be here. And I really love that this is a concept that you guys took from a little seed of an idea to being out in the world. And it's amazing. So thank you. But yes, before starting Cofertility, I spent eight and a half years at Uber. So I joined Uber in the first couple hundred employees. I was on the East Coast helping launch the core rides business throughout New England and then went down to Miami to start the business down there. ⁓ And I felt strongly that Uber should be in the healthcare space. And so this started with our first experiment in healthcare, which was on-demand flu shots, where you could press a button in the app for one day only and a nurse would come to you and give you a flu shot. So it was an interesting sort of test of what happens when we removed two of the biggest barriers to getting a flu shot. One is awareness and two is access and convenience. So we brought them to people. So we literally were in conference rooms or just walking up to people at their desk and giving them a flu shot. So that was a really interesting experiment. But at the time, no one else at Uber cared about healthcare except for me. And so I became Uber's de facto healthcare person entirely by accident.

And I saw a paper that came out that said millions of people missed a doctor's appointment every year because they didn't have access to a reliable ride. And I felt, well, Uber has reliable rides in spades. We should really figure out a way to help these people. And it turned out that most of the people that are missing a doctor's appointment are low income and elderly. And so they're not really well versed in using a smartphone. ⁓

And so we needed to build a product that would enable a healthcare organization to request rides on behalf of their patients. And that's exactly what we did. So I pitched our executive leadership team on a business line that's now called Uber Health. That is a HIPAA secure ordering platform for rides without the need of a smartphone. And so we launched that in 2018 and I stayed through, I would say, middle of 2021. And during that time we had helped over 10 million patients get to the care that they need. And now it's an even more massive business.

Abby Eblen MD (03:56)

So is it primarily to take patients back and forth to doctor's office visits or surgery or that kind of stuff?

Lauren Makler (04:06)

There's so many use cases, but could be pre-op appointments or for procedures or things like that. If you're booking an OR and someone doesn't show up, the amount of waste that happens in the healthcare system, both of people's time and the missed opportunity is really high for these healthcare organizations.

Susan Hudson (04:25)

So it gets ordered by the doctor's office, not by the actual patient.

Lauren Makler (04:30)

Exactly. So the office will set it up and it might send an SMS or call the patient and say, Hey, are you ready for your ride? And then it initiates the ride. And so it's interesting, the doctor's office or the hospital will call you and say, Hey, do you have transportation? Most people don't even realize it because you're so used to having a ride, but a lot of people really don't. And so that's when they would set it up.

Susan Hudson (04:51)

Interesting. We often have people who are wanting to get some sort of ride like this after egg retrievals. We have always been very hesitant because of essentially having somebody who's been under anesthesia in a compromised state getting in a vehicle with a stranger.

Lauren Makler (04:58)

Exactly. Yes.

Totally.

Susan Hudson (05:13)

How did Uber deal with that part of it?

Lauren Makler (05:15)

So in that case, Uber Health is not the right answer. The driver is not a companion. ⁓ I haven't been there in probably four years now, so I don't know if it's changed since then, but I think that there is opportunity for additional layering on of services and things like that, where you could have a companion, but absolutely, should be for ambulatory and coherent patients only.

Carrie Bedient, MD (05:40)

Got it.

Abby Eblen MD (05:40)

Yeah, that's really great.

Lauren Makler (05:41)

Yeah. So that's my first, I call it intrapreneurship because I was an entrepreneur within a company and now during Cofertility, it's a little bit different and then I'm an entrepreneur. So I'm doing it outside of a big company. Yeah. Yeah.

Abby Eblen MD (05:43)

Yeah. Impressive. Yeah. Impressive.

Carrie Bedient, MD (05:57)

Awesome.

All right, so let's jump to our question of the day and then we will jump into Cofertility.

Lauren Makler (06:04)

Yeah, let's do it.

Susan Hudson MD (06:05)

Starting a family is one of life's greatest adventures, but sometimes the path to parenthood isn't as straightforward as expected. Shady Grove Fertility is there to guide hopeful parents every step of the way, offering compassionate care and advanced fertility treatments to help make parenthood possible. With their exclusive 100 % refund program for IVF and flexible monthly payment options, Shady Grove Fertility makes treatment more accessible.

Visit ShadyGroveFertility.com to schedule a consultation and take the first step, because the adventure of a lifetime starts at Shady Grove Fertility.

Susan Hudson (06:38)

Okay, so our question of the day is, Hi, I'm getting ready to try to conceive. I have a Kyleena IUD. How long after it being removed should I wait before trying? I read that it is best to wait a couple of months for the uterine lining to build up because you're more likely to miscarry if you get pregnant immediately after having an IUD removed. Is this true? Thank you.

Carrie Bedient, MD (07:04)

And we don't know how old she is.

What do you think?

Abby Eblen MD (07:06)

I mean, I think it's reasonable for her to a couple of months. It depends a little bit if she's having periods now or not. Some people with IUDs don't have periods at all. And I always tell my patients, the embryo is the seed and the lining is like the soil. And you want to make sure that the lining is built up enough to be able to support an embryo, if the sperm and the egg get together. So I would say a couple of months is reasonable for most people. But I think it depends a little bit on if she's back to having regular, normal periods again.

Susan Hudson (07:30)

I'd say at least wait until you've had a menstrual period because I would be more concerned if you had your IUD removed before mid cycle but you're already ovulating and you may have been somebody who ovulates while you're on your I with your IUD and I don't think you'd want to get pregnant that cycle because I think your endometrium would definitely be thin. It would have progestin exposure at the wrong time, all those kinds of things. So I would say at least that one menstrual cycle to get things normalish. And then also remember you need to already be on your prenatal vitamins. Ideally, we'd like you to be on those for two to three months before trying to conceive.

Carrie Bedient, MD (08:12)

When you look at all the data, there's really no delay in return to fertility after the IUD comes out. So do remember if you take it out and then you never get a period again, check the pregnancy test because that can for sure occur. I would agree just with get at least one cycle to return. I know that when I am looking at gestational carriers in particular, we always have them take at least two months off of their IUDs before we bring them in for screening.

It doesn't necessarily mean that they can't get pregnant. It's just in the world of fertility where we're trying to optimize everything. It's one way to help ensure that, okay, if there's going to be a delay, they've had plenty of time to restore closer to normal before embarking on this involved journey. So, very nice. Okay. All right. So, Lauren, tell us about the entity that is Cofertility and how it's different.

All of us have heard about each type of organization that Cofertility is as separate places. Combination is what makes it cool. So tell us about what it is and how it got here.

Lauren Makler (09:09)

Yeah. It's so interesting. I've never heard anyone put it that way, but I think the combination of it is what makes it work. I think you're definitely onto something. So at Cofertility, we essentially serve two different groups of people, but we are reframing egg donation. Traditional egg donation is done with cash compensation.

At Cofertility instead the donor keeps half of the eggs retrieved for her own future use. So a woman who's interested in egg freezing can come to us and if she qualifies, so she has to meet all of the standards for egg donation that are set forth by ASRM and the FDA. So if she qualifies, she has the opportunity to freeze her eggs for free and store them for free for up to 10 years when she donates half of the eggs retrieved to intended parents that can't otherwise conceive. So we are essentially making egg freezing more accessible and making egg donation less transactional at the same time. And so what we found is that the women who come to Cofertility interested in egg freezing are really moved by this idea of helping grow another family while doing something for themselves at the same time.

But we're not really competing with other egg donation companies for the same donors because our donors are out living their life. They're incredibly accomplished. Maybe they're in med school or maybe they're pursuing their careers or their travels or whatever it might be. They're not looking to do this as an income source. And so they are really not looking to do this with several families. It's something that they really feel connected to that one family on the other side.

Susan Hudson (10:57)

So what are the age restrictions for someone to participate in Cofertility?

Lauren Makler (11:01)

So we follow the ASRM standard of ages 21 to 34, but really that's up to the physician that's overseeing the cycle or receiving the eggs. We know that some doctors would like to see donors of a specific age, but typically we see comfort from the 21 to 34 standpoint.

Abby Eblen MD (11:21)

And what is the interaction with the two? Because to me that fascinates me like how you match these groups of people together and what the ongoing interaction is with them.

Lauren Makler (11:29)

Yes. So this is really special to Cofertility. Before we started this company, and I'm happily will tell you the story of what brought my co-founders and I to this, but we have listened quite a bit to the perspectives of donor conceived people who now for the first time are old enough to tell us what it was like to grow up donor conceived. And we have many of them on our team actually at Cofertility, but this idea that there is a lot of benefit to having access to knowing where your genetics come from. And so more and more, intended parents want to have direct contact or at least the contact information of the donor that they move forward with. And so at Cofertility, we offer what we call disclosed relationships between the donor and the intended parent where they have the opportunity to meet one another in our match meetings where someone from our team will join them on a call. We provide conversation starters to get to know each other. And after that, both parties have to opt into the match. So we believe in what we call mutual match, knowing that we think it's kind of weird when the donor has no say in where her eggs go. We just feel like if this is a lifelong thing that you are getting into sharing your genetics, and you may have contact down the line, which we know is absolutely the case now that things like at home DNA testing exists, right? No donation can truly be anonymous. Why not just be open about it from day one and feel good about who your eggs are going to? And so some decide and they have a legal agreement between them that they want to remain in touch once a year or they want to have an ongoing relationship cadence. There's a lot of different flavors and we help them through.

There are interactions with our member advocate team to decide upfront what relationship type feels most appropriate for them.

Susan Hudson (13:14)

If someone's going through the path of desiring an egg donor and they're attracted to this model, do they have to go to a certain clinic or do they contact Cofertility? How do the logistics of that work?

Lauren Makler (13:19)

Yeah, great question. So if they're interested in this, they would start at our website. So cofertility.com, they can create an account for free and they can view donor profiles for free. We think it's important not to gatekeep that information. And if they're interested in moving forward, they can place a hold on a match on our website and then our team will reach out.

Or before they even match, they can set up a call with one of our matchmakers on our team to help them figure out who the right donor is for them. And we will directly connect with their clinic to help facilitate this experience. We offer fresh donation and we offer frozen donation. So depending on which path the intended parent chooses, in some cases, if for fresh, the donor might travel to the intended parent's clinic.

In other cases, we can ship frozen eggs depending on whether or not they choose fresh or frozen. But the idea is that we have no interest in taking anyone away from their clinic. If you love your doctor and you love your clinic and you want to stay local, we really want to support that and we want to keep you there. If you're in a situation where maybe we get a lot of intended parents, especially if they're a same sex male couple, maybe you don't have a clinic yet.

Then we can help introduce you to clinics in your area that we have experience working with, or that we think could be a good fit for you. So it's a little bit of an, it depends, but the goal is not to take anyone away from their clinic for sure.

Abby Eblen MD (14:54)

So is part of the value in this cost per se or is it more just the value in getting to know the donor ahead of time and both having a mutual relationship as opposed to using an egg bank for example?

Lauren Makler (15:04)

So I would say all of the above. I think, especially if you think about fresh egg donation. With fresh egg donation, an intended parent is paying cash compensation to the donor that starts around $10,000, but we hear it goes up and up and up the more specific you get with what you're looking for in a donor.

It can be even into the $80- 90,000 range, depending on how specific you are or how hard it is to find a specific donor. Intended parents want a donor that reflects their background, and that can be hard to find. And so at Cofertility, no donor, no matter what her background, she could have gone to an Ivy League school or be the most hard to find donor in terms of her heritage. There will never be a different cost to an intended parent from one donor to the next ever.

I just, that's not something we will ever do. There's $0 in cash compensation for Fresh. So definitely cost is a certainly, I guess something that intended parents find value in as is meeting the donor. I think the other piece of it is that there was actually a study that came out from Harvard Med School in 2021 where donor conceived people, majority of them said that they were disturbed that their parents had exchanged cash for their genetics. And so I think even just this feeling of I'm doing something that feels more in alignment with my values and feels more ethical and feels like something I'd feel more proud to tell my child someday is something that really resonates with a lot of intended parents. And so we know that, we know no one's first choice is starting with an egg donor. We know that third party reproduction is never like, Ooh, yay, I'm so excited. I meet intended parents and I say, look, I know you don't want to meet me. That's okay. I can get down with that. But what my hope is by the time that you are through this experience, you can feel like you didn't settle. You can feel proud of how you chose to grow your family.

Susan Hudson (16:59)

Exciting news from Fertility Docs Uncensored! Our long-awaited book, The IVF Blueprint, is now available on Amazon. Go now to pre-order your copy to learn everything you need to know about IVF, egg freezing, and embryo transfer. Did you know that you can cram decades of experience, science, and heartfelt advice into a book, and then the whole thing hinges on what happens in week one? Yep, week one is basically the prom queen election of publishing. So if you've ever thought, "Huh, I should check out The IVF Blueprint by the Fertility Docs Uncensored crew." Now is your moment to shine. Buying it early tells bookstores, "Hey, stock this." It tells publishers people care about this. And most importantly, it helps get real information into the hands of people staring down fertility treatments with more questions than answers. The book's called The IVF Blueprint. It's for folks considering IVF, already in the thick of it, or just trying to figure out what the heck their doctor is talking about. Help us help more people and maybe confuse a few algorithms while you're at it.

Susan Hudson (18:06)

So one thing that people who are searching for donor eggs always want to know is how many eggs am I going to get? Are the prices based on how many eggs they end up getting or is it a flat cost whether you end up getting three or 30? How does that work?

Lauren Makler (18:14)

Yeah, it varies with fresh and frozen. So with fresh, you pay Cofertility, a coordination fee, and it is variable. We don't know how many eggs you'll get because the cycle hasn't happened yet. But with fresh, we want to make sure that the donor is likely to have a good outcome. And so we have multiple different checkpoints throughout the process before moving forward to make sure that she is a good candidate for this. So we wanna make sure her AMH is above a certain number. We wanna make sure her antral follicle count is above a certain number. And then yes, the eggs will be split at the end of the retrieval. And if there's an odd number of eggs, the odd egg goes to the intended parents. A lot of people do decide to do two cycles with their same donor for fresh because maybe they wanna have a sibling journey or it just depends on what their goals might be. And so we talk about all those things upfront, but on average with a Cofertility fresh donor, an intended parent is receiving 12 mature eggs. That's the average. On the frozen side, we do know how many eggs a donor has because they're frozen already. And so we offer different cohorts and the prices vary based on the number of eggs in the cohort. And so it is a per egg pricing, but within certain, if it's six to eight eggs versus nine to 11 and so…

Susan Hudson (19:40)

How do those prices compare to industry comparisons?

Lauren Makler (19:44)

Yeah, so on frozen, is definitely in line with what you see at other egg banks, especially the egg banks that also offer some ability to have a disclosed relationship where you meet the donor. I wish more would do that. But yes, definitely in line with what you see out there.

Susan Hudson (20:01)

What about for fresh?

Lauren Makler (20:02)

For fresh, our coordination fee is $10,000 and it's less than what you'd see elsewhere. Plus there's $0 of cash compensation. So you're certainly paying less. But you do have to pay the clinic for the cycle, which I also wish I could discount, but I can't.

So how many donors do you have coming to you who are thinking about, right, do I freeze my own eggs? Do I donate to someone else? How many of them hear about this, you would be known component to it and say, no, that's not for me. I want to go the anonymous donation only route.

Lauren Makler (20:35)

Yeah. Yeah. Yeah.

So, it's interesting. We do a lot of education about it. And what we say is look, ancestry.com or these at-home DNA tests are available and pretty widespread today. 20 years from now, we think you'll have even more access. When these kids grow up.

And so any donation that you make anywhere truly cannot be anonymous. So if someone is promising you anonymity, they're lying. It's just not real. And so we're really explicit about that with the people that are donating and with intended parents. They can opt with us, and I will say a vast majority. So like, really overwhelming majority choose disclosed where they share contact information. That doesn't mean that they're gonna become best friends or that they're gonna be like involved in one another's lives. In a lot of cases, it's just let's exchange contact information so we have it. We'll send you a baby photo when the baby's born or we'll send photos once a year, that kind of thing. But then we also offer what we call the undisclosed donation where you can choose not to share contact information as long as both parties are really clear that it is possible that they could be found by one another someday. And I find that most people who go that route, I would say it's either for cultural reasons or because maybe the intended parent has just had a really, really long road to getting this far and it just feels too hard to get to know the donor at this point. But I think there's a lot of times where people feel like, okay, at least like when my child is 18, I do want them to have.

And so we talk a lot about that. I'll say this though, Carrie, the number one stigma behind egg donation that we hear is actually related to this. think a lot of people fear that they're gonna be walking down the street one day and they're gonna see someone who looks like them and they're gonna think, was that the child born of my egg donation 20 years ago? And to that, I say, it doesn't need to be like that. If you enter into a disclosed relationship and you have an openness around knowing where your eggs are going and knowing the family that raises that child, you can know about them. And you can know who they are or even talk to them once a year so that that would never be the case or that your own future children would know that there was a child born from a donation.

Yeah, I mean, I recently was talking to a woman who I was at a female founder dinner and I went around, everyone around and I said what I do, Cofertility and she raised her hand and she said, I just have to tell you that I donated eggs 13 years ago and I just went to my eggs bar mitzvah, she called him. I just went to my eggs bar mitzvah and she brought her three sons with her and her husband and her egg, as she affectionately refers to him, he wanted, he asked his parents if she could come because he wanted in front of everyone to thank her for the gift that she gave his parents. And so she showed me a photo of her three sons and her egg and it was just a very healthy way, I think, to think about disclosure and how there's in no way does she think about him as her son. But it meant a lot for her, for her kids to get to know this person and for him to thank her in front of his whole community.

Abby Eblen MD (23:55)

Aw, that's a great story.

Lauren Makler (24:00)

Yeah.

Susan Hudson (24:00)

That's beautiful.

Carrie Bedient, MD (24:00)

That's amazing.

Carrie Bedient, MD (24:01)

I think all of us are speechless because none of us ever hear adult-type stories.

Susan Hudson (24:02)

Thank you.

Abby Eblen MD (24:02)

I was thinking the same thing.

Aww.

Lauren Makler (24:06)

Yeah, you don't get to hear what happens when they grow up. And I think that, now in this role, I've had the privilege of talking to so many people at different points in their lives as it relates to donor conception. A story like that versus, I was at the dentist and my dental hygienist told me that her youngest child is donor conceived, but her family still doesn't know. And what gets me is that this unfortunately is fertility's last taboo. We see celebrities all the time talking about miscarriage. We see them talking now about using a gestational carrier. If you don't see them for the nine months before they have a baby, maybe they can hide that they used one, but they can't hide it.

Susan Hudson (24:48)

But at 47, they don't mention that they used an egg donor.

Lauren Makler (24:53)

Exactly.

And it's because we don't have to. Like a surrogate, if they use one, they have to admit it because we saw them. We knew they weren't pregnant last month. With an egg donor, there is no compelling reason other than you feel like you should to tell people that you used an egg donor. And so I think it does a disservice to all the people out there who are contemplating using an egg donor, but maybe just don't feel comfortable because people aren't having this conversation. And so

Lauren Makler (25:21)

I guess I see that as my cross to bear. So many people use an egg donor and it is only growing and there is no shame in any way you grow your family.

Carrie Bedient, MD (25:31)

Except for perhaps stealing a child. We're not advocating pure on kidnapping or thievery. But all of the other ways, we're totally down for…

Abby Eblen MD (25:38)

Ha ha

Lauren Makler (25:39)

Yeah.

Abby Eblen MD (25:40)

Well, and I think a lot of people do feel shame around it. You hit the nail on the head. They feel like they're less than if they can't make an egg and have a child. And that's a great point that people really need to feel that, there's more than one way to have a baby, and this may not be the way you wanted to have the baby, but it's still, this baby wouldn't be here if you hadn't done all this work and gotten this egg donor. And so that's really important. You're right. That's the last sort of final thing that people need to put out there and other people need to accept.

Susan Hudson (26:05)

Curious, do you know of any statistics of how many egg donor cycles there are in the United States? Like how many donor conceived children from egg sperm? I don't know. I'm just like throwing something out there. One thing I always tell patients is I never ever make a comment to somebody about, your baby looks like you unless I was intimately involved in the making of that baby. Because it happens so many times and it happens with your best friend who you have no idea it's actually happening. And I'm just curious if we have any numbers out there. Do any of y'all know any?

Lauren Makler (26:41)

Yeah, there are numbers. The latest I heard is that it's at least 12 % of IVF cycles. And I think it's one in three IVF cycles for women over 40. That is the latest I've heard. I don't know, Carrie, if you have other data, but is that consistent?

Abby Eblen MD (26:55)

Mm-hmm. I believe that.

Carrie Bedient, MD (27:00)

I am pulling up because with the national data...

Lauren Makler (27:07)

So hard to find this data, isn't it?

Carrie Bedient, MD (27:10)

Yeah, more importantly, it's hard to interpret it. The finding the numbers is not, not crazy hard, but knowing what they mean is, I'm actually pulling them up right now to see if I can just figure them out while we're sitting here talking. So this might, this might take me a minute to A get it loaded and B get through enough the information. So hold that thought, keep going.

Lauren Makler (27:14)

Yes.

Susan Hudson (27:32)

I'll ask you another question while Carrie's doing some research for us. So you mentioned that you do have some basic AMH and antral follicle count guidelines. What are general estimates of what you're wanting in somebody who is desiring to be a Cofertility donor?

Lauren Makler (27:33)

Yeah. So again, depends on the intended parents goal. So we might say have a different AMH threshold for a same sex male couple that's both looking to contribute sperm to the cycle. But typically we're looking for someone who has an AMH of over 2.0. Most of our donors are over 2.5. And if someone is in that 2 to 2.5 range, we do talk to intended parents upfront about doing two cycles.

And a lot are very comfortable with that. And actually our donors, I would say 95 % of our donors are interested in doing two cycles with intended parents. And on Frozen actually, they donate all of the eggs from cycle one and they keep all the eggs from cycle two. So we're dividing it that way. But our donors are just as interested in having two cycles because they know that they get to put away more eggs for their own future as well. And so...we want to make sure that both sides are really set up for success depending on what their goals are. And so we have a lot of those conversations as well.

Susan Hudson (28:46)

I'm kind of surprised those are pretty modest numbers. I was expecting you to be more at the 3.5 and above type of number which that's a hard bar to to hold.

Abby Eblen MD (28:49)

Not huge.

Lauren Makler (28:53)

I think that age plays a big role in this too. Most of our donors are in their mid to late 20s or very early 30s. And so with the 12 mature eggs, we're seeing intended parents with five blasts. So I think that, of course, everyone's goals are different, but we're pretty excited to see those outcomes.

Abby Eblen MD (29:18)

Yeah, and I think the other group that this may be valuable for is a lot of women, even if they have great coverage, like with somebody like Progyny or Maven, and I don't know about Maven or Carrot, but now with Progyny, a good number of women want to freeze eggs, they don't pay to freeze eggs, whereas if you're a couple and you're going through fertility treatment, you have coverage for it. So for a woman who wants to freeze eggs, in fact, I have a couple of patients like that right now that have Progyny, they don't have anybody pay for their egg freezing cycle, even though they have good coverage for infertility.

Lauren Makler (29:46)

Yeah, it's interesting. Every employer's plan or coverage looks different. So you may have fertility benefits at Google and a friend who works at Meta might have the same provider of a benefit, but the actual coverage looks different employer to employer. And so some may cover it for an infertility diagnosis where others may not. Some may do preservation and others may not. And so absolutely agree. Something that I find so frustrating is that the best time to freeze your eggs is when you can least afford it. The younger you are, the better your egg quality, the better your egg quantity. And so it's just too out of reach for most women. And that's part of why we're so passionate about making this option available.

Abby Eblen MD (30:21)

That's exactly right.

Susan Hudson (30:34)

So if somebody does have some fertility coverage for IVF or donor, how does that interact with Cofertility?

Lauren Makler (30:42)

Yeah, certainly depends on which one and what flavor of coverage they have. But Carrot, for instance, if you have Carrot coverage through your employer and you need donor eggs, you absolutely can do that through Cofertility and you can submit it through their program for reimbursement and can find us in their portal. It depends, of course, the way that that shakes out on fresh and frozen. that's we have a team that will help you work through what that coverage looks like.

I know that with Cigna, there was one plan that had frozen coverage, not fresh. There's different flavors of it, but our team will absolutely help you navigate what that looks like.

Abby Eblen MD (31:13)

So do you actually have some women that want to come that actually have coverage and they want to do it just because they're altruistic and want people to be able to have children or do you see it more as a financial thing for young women who can't afford to do it?

Lauren Makler (31:30)

So it's really interesting that you asked that. So we didn't know what to expect when we started this company. We were like, what will they be motivated by? Will they do it at all? And before we started Cofertility, we actually created a survey and had a few influencers like post the survey and just to get a sense of will they even want this. And I remember within 24 hours, we had almost a thousand women reply to it.

Abby Eblen MD (31:54)

Wow.

Lauren Makler (31:54)

Get this, 66 % said yes or definitely yes to the idea of our split program. I thought it was broken and I just kept refreshing. My co-worker was like, there's no way. She was like, no, no, no. This is real. And so from that day forward, I never looked back and we have been off to the races and we've been able to bring on some amazing investors to help build this company.

But what's been most exciting to see is that women in this age range between 21 and 34, so it's a bit of Gen Z and the youngest of millennials, they are incredibly understanding that the way we grow families today is more dynamic than it's ever been. They understand that people need the help of a third party to have a baby and that whether they are members of the LGBTQ community themselves, or maybe they have friends who've struggled with fertility challenges, or maybe they are donor conceived. They're incredibly just like, yeah, everyone who wants to be a parent deserves to be a parent. And I hope someone would do this for me someday. And so they're incredibly moved by this idea that they can help someone else grow their family and do something really thoughtful and empowering for their own future at the same time.

And so maybe they heard about us like, huh, free egg freezing. What's that? Let me learn more. Or maybe they heard about this with you've always been interested in donating eggs, but never felt right about getting paid to do it. There are a lot of paths that someone finds us, but either way we see it as our job to educate them on what it really means to donate eggs and making sure that they have truly informed consent and understanding of what that looks like for a lifetime.

And then of course they go through the same psych eval and they go through the same process, any egg donor go through to decide and make sure that this is a decision that's right for them in the long run. And so different reasons that people find us, but all in alignment over time.

Carrie Bedient, MD (33:43)

That's awesome. So reporting back on data, ⁓ it is an absolute mess and so full of confounders that it would take a full day's worth of work to sort through this. And I still don't think you would get reliable information out of the end of it. It's not just the number of cycles, it's how those eggs are distributed because so many eggs get split between multiple families because they're so challenging to get and you...don't want to create extra embryos and you want to make sure that everything is, as helpful as possible for everyone. Yeah, the long and the short of it is there's not amazing data as to exactly how many kids.

Susan Hudson (34:18)

Mmm. Wow.

Lauren Makler (34:19)

Yeah.

More than you'd think. I'll say that. I've had now even a very close friend of mine who, when I told her I wanted to start this company, said, Lauren, I've never told you this before, but my two kids are donor conceived. It is so much more pervasive. And you're absolutely right, Susan. I really hesitate unless I know for sure. I do not say, that kid looks like so-and-so because actually, I don't know if you know the, there's a company called Bobbie that makes baby formula and they have really flipped the script on formula, but they said the same thing. We shouldn't ask how's breastfeeding going. We should ask how's feeding going. It's the same thing. You have a beautiful baby. We don't need to say that baby looks like so-and-so. Who cares? Say the baby is beautiful.

Carrie Bedient, MD (35:04)

Absolutely. Well, I'm so glad that you came to play with us and talk with us today, Lauren. It's always a pleasure to see you because you are just sunshine and light every time I see you. so, and you have such a lovely team. But thank you, thank you, thank you for coming and talking to us. We appreciate it.

Lauren Makler (35:13)

Thanks for having me this was really fun.

Abby Eblen MD (35:22)

Absolutely.

Carrie Bedient, MD (35:23)

So again, this is Lauren Mackler. She is the CEO and one of the co-founders for Cofertility. And if you're thinking about any of this stuff, whether it is donating your eggs or freezing your eggs for your own purposes for later in life, definitely look them up and investigate further. And to our audience, thank you so much for listening. Subscribe to Apple Podcast to have next Tuesday's episode pop up automatically for you.

Be sure to subscribe to YouTube. That really helps us spread reliable information and help as many people as possible.

Abby Eblen MD (35:55)

And visit us on fertilitydocsuncensored.com to submit specific questions and to sign up for our email list.

Susan Hudson (36:00)

As always, this podcast is intended for entertainment and is not a substitute for medical advice from your own physician. Subscribe, sign up for emails, and we'll talk to you soon. Bye.

Carrie Bedient, MD (36:09)

Also look for our new book coming out September 23rd. can pre-order it on Amazon. Shameless plug and tell everybody you know.

Abby Eblen MD (36:17)

IVF Blueprint.

Carrie Bedient, MD (36:18)

Alright everyone, have a great week. Bye!

Carrie Bedient  MD (36:22)

This podcast is sponsored by ReceptivaDx. ReceptivaDx is a powerful test that can help detect inflammatory conditions on the uterine lining that might be preventing you from becoming pregnant or staying pregnant. If you have experienced implantation failure or recurrent pregnancy loss, ask your doctor about ReceptivaDx testing. If found, uterine inflammation can be treated, providing a new pathway to achieving a successful pregnancy.

ReceptivaDx because the journey is worth it.