#16: Reproductive Reshuffle: Mary Fusillo Decodes Egg Donation and Surrogacy

WEBVTT
00:00:00.000 --> 00:00:07.080
So for listeners who are new to, so can you step out the medical steps, legal contract costs, et cetera, et cetera?
00:00:07.706 --> 00:00:20.756
Okay, so surrogacy that I'm discussing is gestational carriers surrogacy, which means that the surrogate has no genetic connection to the child, so it's somebody else's sperm and eggs implanted in her.
00:00:20.995 --> 00:00:24.181
And so finding a surrogate takes several months because there's a.
00:00:25.135 --> 00:00:28.146
fewer surrogates than there are people that are needing surrogates.
00:00:28.146 --> 00:00:32.415
We have a wait of anywhere from two months to six months to match with a surrogate.
00:00:32.776 --> 00:00:35.865
Once you guys have matched, each person decides if they wanna match.
00:00:35.865 --> 00:00:39.585
So it's a much more open process than most egg donation is at this point.
00:00:40.066 --> 00:00:45.585
Then you're gonna go to your clinic, you're gonna be screened, and you're not gonna do genetic screening or anything like that, but they're gonna look at your uterus.
00:00:45.591 --> 00:00:46.470
They're gonna do all these blood tests.
00:00:47.331 --> 00:00:48.801
After that, then you do legal.
00:00:48.801 --> 00:00:50.060
Legal takes the longest.
00:00:50.430 --> 00:00:58.651
In my company, we have a worksheet that the surrogate has already filled out with her compensation, that she wants her choices about all these things.
00:00:58.651 --> 00:01:02.790
It's six pages long, when will you allow them parents to make choices for you?
00:01:02.841 --> 00:01:05.391
How much compensation do you want for a c-section?
00:01:05.671 --> 00:01:07.141
Do you wanna pump breast milk?
00:01:07.141 --> 00:01:11.501
So all these questions are in there that goes to both couples, the couple and the.
00:01:11.831 --> 00:01:15.790
Surrogate and her husband, if she has a partner, have signed this and it goes to the attorney.
00:01:15.941 --> 00:01:19.930
The attorney then writes the contract based on this, the intended parents approve the contract.
00:01:20.260 --> 00:01:23.021
Then the surrogate and her attorney approve the contract.
00:01:23.171 --> 00:01:25.031
They write a letter saying everybody is happy.
00:01:25.031 --> 00:01:31.031
Now the intended parents fund the escrow account with her compensation and the miscellaneous stuff.
00:01:31.240 --> 00:01:34.540
And then the clinic says, okay, we received the letter, you're ready to go.
00:01:34.751 --> 00:01:42.131
And they can have an embryo transfer no sooner than 14 days after the signature on the, because that gives people time to change their minds.
00:01:42.131 --> 00:01:42.400
Okay?
00:01:42.611 --> 00:01:43.781
So soup to nuts.
00:01:43.960 --> 00:01:47.740
Some of the time you have matched until you have a transfer is probably five to six months.
00:01:48.775 --> 00:01:50.036
People want it to be faster.
00:01:50.215 --> 00:01:52.706
It's the dang lawyers that take up all the time.
00:01:53.006 --> 00:01:53.426
Okay?
00:01:53.486 --> 00:01:55.525
So they take a long time to do their stuff.
00:01:55.706 --> 00:02:05.396
So all in right now, I'd say that without the cost of IVF, because remember that changes from every different clinic has their own price range.
00:02:05.635 --> 00:02:10.945
But if you're gonna do agency fees, secret compensation insurance,'cause you have to have insurance, it costs a lot of money.
00:02:11.306 --> 00:02:14.786
Legal, psych, medication, travel, all that.
00:02:15.056 --> 00:02:25.316
You're talking probably somewhere between, I'd say 105, 110,000 to 130,000, depending on if you need more than one transfer of embryo.
00:02:25.316 --> 00:02:26.336
So the first time doesn't work.
00:02:26.336 --> 00:02:27.656
You're not starting all over again.
00:02:27.866 --> 00:02:28.705
She's coming back.
00:02:28.705 --> 00:02:32.276
But you're gonna make payments, she's gonna get paid for the transfer, the clinic will get paid.
00:02:32.515 --> 00:02:37.705
So that's what we call, so when you throw in the IVF portion, you're asking another 25,000 or so.
00:02:37.705 --> 00:02:39.086
If you throw in donor egg.
00:02:39.890 --> 00:02:40.911
can see that cost.
00:02:40.911 --> 00:02:45.350
So you would say if a donor egg surrogacy pregnancy for say two same sex.
00:02:45.591 --> 00:02:49.131
Same sex couple, you're looking at 160, 175,000
00:02:54.200 --> 00:03:02.961
Welcome back to Biohacking Eve, health Optimization for Women with Judith Miller, where we shine a light on everything that will help you reach your best self.
00:03:02.991 --> 00:03:08.001
As a woman, as unique and individual as then you can be live long and prosper my friend.
00:03:14.623 --> 00:03:15.044
Hello.
00:03:15.074 --> 00:03:16.544
Welcome back everyone.
00:03:16.544 --> 00:03:18.463
Today I've got Mary Fusillo with me.
00:03:18.463 --> 00:03:19.183
Hi Mary.
00:03:20.335 --> 00:03:21.205
Thanks for having me.
00:03:22.123 --> 00:03:28.248
So Mary, you've been a practitioner in assisted reproduction for the last 25 plus years, so tell us about what you do.
00:03:29.748 --> 00:03:30.139
Okay.
00:03:30.139 --> 00:03:38.118
I own three companies under the umbrella called Family Solutions International and we work with people that need an egg donor that's the donor solution.
00:03:38.329 --> 00:03:46.368
They need a surrogate that's three sister surrogacy and then if they just don't know which way to go, we have the fertility consultants that helps them navigate it.
00:03:46.368 --> 00:03:48.739
So I've owned this business for 18 years.
00:03:48.739 --> 00:03:56.329
I started it after a career in both nursing in the hospital and then managing IVF clinics and doing consulting.
00:03:56.329 --> 00:03:58.908
So this is the end, end part of my career.
00:04:00.408 --> 00:04:02.818
You've seen quite a tectonic shift in the industry.
00:04:02.818 --> 00:04:07.679
I imagine today I actually wanna focus on egg donors and surrogacy.
00:04:07.709 --> 00:04:10.889
'cause I think they're topics that are really not looked at that much.
00:04:11.278 --> 00:04:18.759
And as you say, end of career in the sense that it's the end of the line for many couples that have, try to conceive naturally they've gone through IVF, et cetera.
00:04:19.028 --> 00:04:21.968
So let's start with egg donors.
00:04:22.028 --> 00:04:26.709
I appreciate that the landscape is quite different in the US than it is in Europe.
00:04:26.709 --> 00:04:29.528
Tell us a bit, what is the process in the us?
00:04:29.528 --> 00:04:30.939
How do people actually come to you?
00:04:30.939 --> 00:04:31.838
What are they looking for?
00:04:31.838 --> 00:04:32.949
What are they confused about?
00:04:34.149 --> 00:04:35.435
Okay, it is totally different.
00:04:35.435 --> 00:04:42.154
And being a member of esra, which is European Society for Reproductive, whatever, the whole long thing, Esra.
00:04:42.334 --> 00:04:46.504
I know I see the European side too,'cause I go to the meetings and I'm part of that group.
00:04:46.504 --> 00:04:47.180
But the biggest.
00:04:48.185 --> 00:04:54.064
I think difference is a, we compensate donors and we compensate them well.
00:04:54.454 --> 00:04:56.615
Okay, not just a token, they compensate.
00:04:56.665 --> 00:05:00.235
Two, you have a large variety of donors.
00:05:00.444 --> 00:05:03.774
You can pick somebody who could be your double basically.
00:05:03.834 --> 00:05:05.064
And that's the goal.
00:05:05.334 --> 00:05:11.694
So what we're doing is we are recruiting young women between say, 21 and 29 to be donors.
00:05:11.845 --> 00:05:19.805
We're looking for people, they have to have a minimum of two years of university or college education or be in a trade.
00:05:19.805 --> 00:05:26.944
So they could be an esthetician or they could be a hairdresser, but they can't, they have to have something that they do that would appeal to others.
00:05:27.214 --> 00:05:29.165
They also had to have a clean family history.
00:05:29.480 --> 00:05:30.829
So we're checking medical records.
00:05:30.829 --> 00:05:33.519
We have a very large intake form.
00:05:33.519 --> 00:05:37.569
It's 26 pages long that talks about all their family members and diseases.
00:05:37.569 --> 00:05:41.589
And did grandpa have diabetes and does your sister have this?
00:05:41.870 --> 00:05:44.720
We're also looking for disease states in people.
00:05:44.720 --> 00:05:48.689
Although there is genetic testing now, we wanna kind of weed them out early.
00:05:48.810 --> 00:05:51.089
We probably receive with my company.
00:05:52.589 --> 00:05:55.350
Five or so, six applicants a day.
00:05:55.350 --> 00:05:59.310
Sometimes if we're doing a big advertising blitz, we'll get 10 or 15.
00:05:59.730 --> 00:06:06.870
Usually that kind of translates to five or six that actually make the cut and not because we're so tough.
00:06:06.930 --> 00:06:09.240
Yeah, we are tough, but it's because people drop out.
00:06:09.240 --> 00:06:10.485
They're like, oh, this sounds fun.
00:06:10.649 --> 00:06:15.509
And then they go, oh, I don't wanna fill out this paperwork, or I don't wanna have to get my college transcripts and I don't wanna get my medical records.
00:06:15.720 --> 00:06:17.459
So that's how come we end up with that.
00:06:17.459 --> 00:06:22.660
So we usually range between 250 and 300 egg donors at any one time.
00:06:22.870 --> 00:06:30.259
We have multi-ethnicity, we're based in Houston, Texas, which is a very international city because of the oil business and the medical business.
00:06:30.439 --> 00:06:33.889
So we have a lot of people from there, but we are across the country.
00:06:34.220 --> 00:06:35.410
So that's the egg donor side.
00:06:36.483 --> 00:06:45.059
And when you say you've got a certain number of any one time, does that mean donated eggs are always fresh or would they come from frozen as well?
00:06:45.670 --> 00:06:46.660
We do fresh.
00:06:46.660 --> 00:06:49.720
The pendulum has swung back and forth repeatedly.
00:06:50.139 --> 00:06:56.899
I would say that people a lot of private equity money, which is one of my favorite subjects, got into the egg freezing thing.
00:06:56.899 --> 00:06:57.290
This is good.
00:06:57.290 --> 00:06:58.550
We're gonna make it just like sperm donation.
00:06:58.850 --> 00:07:12.470
The issue was that when you retrieve the eggs, then you freeze them, then you thaw them to inseminate them down the road, then you freeze them again because remember, you're gonna have to do genetic testing.
00:07:12.709 --> 00:07:14.420
So now you've thawed and froze.
00:07:14.420 --> 00:07:17.569
Thaw, andro, I always use this analogy that, think about it.
00:07:17.569 --> 00:07:21.290
When you leave the ice cream out, out, you go, oh, I forgot to put it away.
00:07:21.290 --> 00:07:25.250
And you put it back in the freezer and then you eat it again and it's gross and it has ice crystals.
00:07:26.029 --> 00:07:28.350
my, now the scientists would go, oh, you're wrong.
00:07:28.560 --> 00:07:32.480
But the pregnancy rates are lower per transfer.
00:07:32.509 --> 00:07:36.740
It's better to do a fresh donor per transfer at the end of the day.
00:07:36.740 --> 00:07:49.699
If you use up all your embryos with frozen eggs, you will achieve a pregnancy about 60, 60% of the time, whereas you're gonna achieve that same percentage at one transfer.
00:07:49.879 --> 00:07:57.290
So the bottom line is you don't get as many eggs with frozen, whereas you get all the eggs from that cycle with a a fresh donor.
00:07:58.718 --> 00:08:07.723
And what are the costs that a couple or, someone who's looking to use an egg donor would have to look at in the US and in Europe.
00:08:09.223 --> 00:08:12.884
I would say we do get European, we get a fair amount of Europe,
00:08:13.079 --> 00:08:13.199
I.
00:08:13.274 --> 00:08:20.053
20, 25% European couples, mainly because they want to be able to choose their genetics for their child.
00:08:20.053 --> 00:08:21.584
They don't want someone else to choose them.
00:08:21.793 --> 00:08:25.423
Nothing against my Spanish colleagues, but they basically say, here's your donor.
00:08:25.723 --> 00:08:33.974
When I first got into this business in the late 1990s, there were clinics on the East coast, which we thought were so progressive, but they really weren't.
00:08:34.163 --> 00:08:37.693
That would sit down with a psychologist that I would like, I'm the patient, right?
00:08:37.854 --> 00:08:40.854
And they would say, okay, here's the egg donor we've chosen for you.
00:08:41.573 --> 00:08:46.114
that made me furious because I thought would you let the real estate agent pick your house?
00:08:46.323 --> 00:08:50.974
You're gonna let some other person that's met you for an hour pick your egg dough?
00:08:51.423 --> 00:08:52.563
I just, I hated that.
00:08:52.563 --> 00:08:57.094
So that's why, one of the reasons I went into my own business, I'm not the first one to do it.
00:08:57.094 --> 00:09:03.423
I didn't invent the wheel, but I really tried to make it so that you had massive amounts of information, you have lots of pictures.
00:09:03.474 --> 00:09:05.783
You had really, truly informed consent.
00:09:06.083 --> 00:09:22.724
So with the European model A, there's not compensation like we have in the US and B, there's a lot less information, a lot more emphasis on the altruism and where my argument from an ethics standpoint is, okay, so you're asking the egg donor to be altruistic.
00:09:22.754 --> 00:09:24.104
Everyone else is making money.
00:09:24.884 --> 00:09:25.244
Okay?
00:09:25.634 --> 00:09:26.774
The clinic's making money.
00:09:26.774 --> 00:09:28.754
The people that work at the clinics are making money.
00:09:28.754 --> 00:09:30.254
The drug people are making money.
00:09:30.254 --> 00:09:32.024
The people that freeze the embryos are making money.
00:09:32.293 --> 00:09:35.323
But you are asking the donor not to be compensated.
00:09:36.734 --> 00:09:48.739
So the cost factor in the us, if you use an in-house donor, let's say it's a clinic that has maybe 15, 18 donors I started out in that world, so I'm really, I appreciate it.
00:09:49.188 --> 00:09:53.418
You are talking, you're not gonna pay an agency fee, what you're gonna pay us.
00:09:53.719 --> 00:09:58.489
So I'd say you can probably get out, for$30,000.
00:09:58.729 --> 00:10:13.759
So that'd be the egg donor, her compensation, the whole thing from IVF to making the embryos genetic testing to transfer of the embryos, gonna probably add five to$8,000 to that on using an agency.
00:10:13.879 --> 00:10:15.589
But you're gonna have a wider choice.
00:10:15.649 --> 00:10:19.038
Agency donors pick their own compensation, and that's the difference.
00:10:19.038 --> 00:10:20.989
So we don't say you're gonna get this much.
00:10:20.989 --> 00:10:22.308
We say, what would you like?
00:10:22.369 --> 00:10:27.908
And then we have to educate them and say, you're not really gonna get picked at that compensation level.
00:10:28.119 --> 00:10:29.469
This is probably more appropriate.
00:10:29.769 --> 00:10:30.994
So that's what our job is.
00:10:31.803 --> 00:10:36.538
And the 30,000 step per round is that to have the baby.
00:10:36.767 --> 00:10:37.366
That's to get all the eggs.
00:10:37.397 --> 00:10:39.823
That would be like, let's say you did a fresh cycle.
00:10:40.033 --> 00:10:42.134
You would get the eggs from that fresh cycle.
00:10:42.134 --> 00:10:43.844
It could range from 10 to 40.
00:10:44.053 --> 00:10:44.443
Okay.
00:10:44.714 --> 00:10:48.524
And then they're gonna fertilize them and there's always a drop off.
00:10:48.884 --> 00:10:58.134
And usually the rule of thumb is that you get 25% the retrieved eggs turn into embryos.
00:10:58.134 --> 00:11:07.734
So if you have 20 eggs at day five, when they're blasts, and you're gonna freeze them, and you will probably end up with four or five.
00:11:08.063 --> 00:11:08.364
Okay?
00:11:08.724 --> 00:11:15.854
Now, in today's world with fertility, we're not trying to get these donors to make 40 eggs, it's not good for them.
00:11:15.943 --> 00:11:17.864
And the egg quality is lower.
00:11:18.043 --> 00:11:20.203
So the goal is you want to get.
00:11:20.563 --> 00:11:29.354
3, 4, 5 really high quality embryos, which you get by less medication, less pushing the donors, and it's made it much easier.
00:11:29.354 --> 00:11:31.394
They don't get hyperstimulated, they don't get sick.
00:11:31.644 --> 00:11:32.663
So it is a great deal.
00:11:32.754 --> 00:11:35.783
People still have this mindset, oh my God, I need 15 embryos.
00:11:36.083 --> 00:11:37.134
Then what are you gonna do with them?
00:11:37.224 --> 00:11:39.259
You are gonna have a soccer team, a football team.
00:11:39.798 --> 00:11:41.328
So yeah,
00:11:41.448 --> 00:11:41.903
Why not?
00:11:43.403 --> 00:11:43.553
Yeah.
00:11:43.707 --> 00:11:52.168
And you've mentioned that some people come from Europe to the S'cause obviously the, not obviously, but the anonymity rules are different in Europe than they are in the us.
00:11:52.168 --> 00:11:57.778
And how would you say advice, someone coming from Europe to navigate the whole process?
00:11:57.807 --> 00:12:02.337
'cause obviously there's the legal process, you've got the transport.
00:12:03.278 --> 00:12:04.269
I would say.
00:12:04.298 --> 00:12:07.839
Okay, so let's say you are a couple from Spain.
00:12:07.958 --> 00:12:08.109
Okay.
00:12:08.109 --> 00:12:12.068
We do a lot from Spain because they don't necessarily like the system in Spain.
00:12:13.058 --> 00:12:15.489
and so they come and they're, let's say they're a heterosexual couple.
00:12:15.639 --> 00:12:19.808
They pick their donor, they're gonna have a VF clinic, so everything is done in the United States.
00:12:19.808 --> 00:12:22.778
They just fly over and do their thing in the United States.
00:12:22.778 --> 00:12:26.438
So the husband comes and he does his thing, and then they come over for the transfer.
00:12:27.339 --> 00:12:33.038
We have three levels of disclosure in egg donation in the United States.
00:12:33.038 --> 00:12:35.918
One is completely anonymous, so nobody knows anything.
00:12:35.918 --> 00:12:37.144
You have a dossier.
00:12:37.413 --> 00:12:41.229
We give the donor information that's generic about the couple.
00:12:41.528 --> 00:12:43.208
Number two, you have identity release.
00:12:43.208 --> 00:12:57.614
Identity release is when each side signs a contract that says at when the child produced from these gametes reaches 18, they can request to correspond with the donor.
00:12:57.854 --> 00:12:58.214
Okay.
00:12:58.604 --> 00:13:05.443
And then number three is an open donation where they actually have a zoom call or they meet in person with a chaperone.
00:13:05.693 --> 00:13:07.224
They trade all their information.
00:13:07.553 --> 00:13:15.293
I would say I've gone in my career since the late 1990s from a hundred percent anonymous, which was perpetuated by the IVF clinics.
00:13:15.354 --> 00:13:15.683
Okay.
00:13:15.923 --> 00:13:20.754
The people that work in it, the donors, we weren't all into this complete anonymity.
00:13:20.754 --> 00:13:23.754
It was the clinics thinking, no, no one will know.
00:13:23.764 --> 00:13:26.163
They used to preach, don't even tell your kid.
00:13:26.163 --> 00:13:29.283
And like in 2000 I was saying, you gotta tell your kid, come on.
00:13:30.144 --> 00:13:33.354
And then we've swung to more identity release.
00:13:33.354 --> 00:13:40.073
And even now, I would say the people who do totally open tend to be single people and same sex couples.
00:13:40.433 --> 00:13:44.933
The heterosexual couples are still in that identity release world, but very few are anonymous.
00:13:45.114 --> 00:13:48.144
So there's not the anonymity there was 25 years ago.
00:13:49.644 --> 00:13:50.634
So that's interesting.
00:13:50.634 --> 00:13:54.293
We'll dig into the ethics of, telling kids, et cetera later on.
00:13:54.833 --> 00:13:59.749
But it's actually interesting to see that the donor gets a doss on the couple.
00:13:59.749 --> 00:14:04.129
So who picks whom or do they have to pick each other, if that makes sense?
00:14:04.619 --> 00:14:04.889
No.
00:14:04.889 --> 00:14:10.129
Most of the time the donors the intended parents pick them, like they say, okay, here's my top five choices.
00:14:10.339 --> 00:14:14.548
We contact each of the girls and say, what's your availability?
00:14:14.548 --> 00:14:15.538
What's your blackout dates?
00:14:15.538 --> 00:14:16.619
Are you in a wedding or, whatever.
00:14:17.489 --> 00:14:19.889
And then we say, this is the information.
00:14:19.889 --> 00:14:21.958
And then the couple goes, okay, I want number 1, 2, 3.
00:14:22.754 --> 00:14:24.193
we tell number 1, 2, 3.
00:14:24.224 --> 00:14:25.303
This is a lovely couple.
00:14:25.303 --> 00:14:34.864
They're from York and they have no children and they've gone through IVF four times and he's an engineer and she's a nurse and they really are just desperate to have a family.
00:14:34.864 --> 00:14:35.553
They have two dogs.
00:14:35.913 --> 00:14:36.063
Okay.
00:14:36.063 --> 00:14:45.793
They don't get a full blown 26 page thing, but it gives the donor information that she can take and say, okay, now I'm helping, Sam and Sue.
00:14:46.004 --> 00:14:46.423
Okay.
00:14:46.783 --> 00:14:52.124
And I feel like I have this connection with Salmon Sue as I go through this process.
00:14:52.124 --> 00:14:53.293
I'm doing it for them.
00:14:53.953 --> 00:14:56.774
That's the difference with the egg freezing model.
00:14:56.774 --> 00:15:01.063
Seriously, egg freezing is you're just giving'em up and they're gonna be in a bank.
00:15:01.453 --> 00:15:06.778
And I think a lot of donors are I don't know how I feel about that because this is a very touchy feely business.
00:15:06.778 --> 00:15:08.969
It's not, I think here I am.
00:15:09.359 --> 00:15:17.649
Private equity again I think they try to turn it into this commodity and here's your, go into the store and pick out your eggs and go to the clinic instead.
00:15:17.698 --> 00:15:21.239
It's very much a female dominated area of fertility.
00:15:21.328 --> 00:15:21.658
Okay?
00:15:21.869 --> 00:15:23.969
This is woman to woman helping woman.
00:15:25.219 --> 00:15:25.818
Interesting
00:15:25.889 --> 00:15:26.188
So
00:15:26.328 --> 00:15:26.538
there.
00:15:26.538 --> 00:15:29.538
There's a couple of points I wanna touch on later when we talk about the ethics.
00:15:29.899 --> 00:15:39.739
Something that I find interesting about the logistics, because the couple are going say to the states in this case, to have the embryos implanted.
00:15:40.038 --> 00:15:46.578
How does flying, obviously the whole back and forth, et cetera, how do you think that impacts the newly formed pregnancy, hopefully?
00:15:46.578 --> 00:15:49.474
Or do people just stay in the states for six months and see what happens or.
00:15:49.528 --> 00:15:50.099
do anything.
00:15:50.759 --> 00:16:08.634
They've done studies on it and the best study I know is the fact that, I guess it was two Olympics ago, the one I forgot what they were, but it was two Olympics ago and one of the beach volleyball players, women, okay, so you think beach volleyball, they're in those little Skippy things and they're running and they're jumping and everything and she didn't know she was.
00:16:09.224 --> 00:16:16.033
Okay, so she was like blah every morning and didn't realize that she was pregnant and they won the gold medal.
00:16:16.033 --> 00:16:18.134
And literally eight months later she had a baby.
00:16:18.163 --> 00:16:18.403
Okay?
00:16:18.614 --> 00:16:26.923
So if you can go travel to the Olympics, back and forth, flopping on your belly, running around, God only knows what you were doing and you still maintain a pregnancy.
00:16:27.073 --> 00:16:35.563
The thing is, the embryo, when it is transferred to the uterus, I don't know if you have this in the uk, but we call it jello, it's gelatin.
00:16:35.563 --> 00:16:38.504
Like your mom or your grandma used to make it and they used to put fruit in it.
00:16:38.509 --> 00:16:39.254
It was like gross.
00:16:39.254 --> 00:16:39.974
You didn't wanna eat it.
00:16:40.004 --> 00:16:40.183
Okay?
00:16:40.484 --> 00:16:41.923
So think of gelatin, okay?
00:16:41.923 --> 00:16:47.024
Now think of the fact, think of the gelatin as the lining of the uterus.
00:16:47.144 --> 00:16:58.724
So in comes this straw with the embryo in it and it boom, and then it ejects the embryo into the gelatin, and then they pull it out.
00:16:58.783 --> 00:16:59.474
What happens?
00:16:59.474 --> 00:17:00.614
Is there a hole in the gelatin?
00:17:00.614 --> 00:17:02.114
No, it just covers it back up.
00:17:02.264 --> 00:17:04.304
So the embryo is put into this.
00:17:04.939 --> 00:17:11.328
Gelatin, mass, and then it takes about three or four days for it to actually make its way over to the wall of the uterus and implant.
00:17:11.568 --> 00:17:14.659
So there's really nothing you can do to dislodge it.
00:17:14.898 --> 00:17:20.118
So they usually come over, they'll have their transfer of embryos and they'll stay a couple days and then they'll go.
00:17:20.298 --> 00:17:29.864
Studies have shown that Lang still does not help implantation back in the day, they used to say five days laying down, You're better to get up and get the blood flowing.
00:17:30.449 --> 00:17:31.769
Radiation for flying.
00:17:31.769 --> 00:17:32.519
If nothing else.
00:17:32.519 --> 00:17:35.429
So gamma radiation, if you've got a long distance day flight.
00:17:36.058 --> 00:17:37.078
Has anyone studied that?
00:17:37.868 --> 00:17:41.108
No, I don't think, flying attendants are pregnant all the time on planes.
00:17:41.108 --> 00:17:42.909
People are on planes pregnant all the time.
00:17:43.144 --> 00:17:43.433
Yeah.
00:17:43.693 --> 00:17:44.173
Fair enough.
00:17:44.294 --> 00:17:44.713
Okay.
00:17:44.834 --> 00:17:45.798
I stand corrected.
00:17:45.919 --> 00:17:47.598
Everything in life is a risk.
00:17:47.749 --> 00:17:48.169
Okay.
00:17:49.534 --> 00:18:04.864
So don't think a one time flight back to the UK or to Spain from New York City and it's nine hours is going to impact your pregnancy because you probably haven't even had an implantation by the time you get back on the plane.
00:18:05.134 --> 00:18:05.374
Fair enough.
00:18:05.463 --> 00:18:05.763
Okay.
00:18:05.763 --> 00:18:07.294
That's definitely something I want to look into.
00:18:07.294 --> 00:18:22.513
There's one episode we're gonna record with someone who's a space biologist and they've been having some issues, trying to, so the idea is that we can get to humanity into space, but reproduction apparently is very difficult for various different reasons, both radiation, anti-gravity, et cetera.
00:18:22.753 --> 00:18:24.693
So that's gonna be very interesting episode.
00:18:25.233 --> 00:18:26.374
I'll let you know when that comes.
00:18:26.844 --> 00:18:31.864
We briefly touched previously regarding progesterone support in early pregnancy.
00:18:31.864 --> 00:18:33.993
I think this might be a good point to pick up from here.
00:18:34.173 --> 00:18:36.213
So tell me, what does progesterone do?
00:18:36.213 --> 00:18:36.963
Why do you need it?
00:18:36.963 --> 00:18:38.374
Why would it help in early pregnancy?
00:18:39.174 --> 00:18:44.855
Okay, so progesterone is what The follicle, okay.
00:18:44.875 --> 00:18:46.585
The follicle is the home of the egg.
00:18:46.615 --> 00:18:51.194
So when you think of a think of a chicken egg, and okay, inside is the yolk, and that's like the egg.
00:18:51.464 --> 00:18:51.825
Okay.
00:18:51.825 --> 00:18:54.285
On the outside is the shell, okay?
00:18:54.765 --> 00:18:56.954
And on the inside is like the white part.
00:18:56.954 --> 00:18:57.105
Okay?
00:18:57.105 --> 00:19:02.865
So when you take out the yellow part and you're left with the white part, then the, it starts producing progesterone.
00:19:02.865 --> 00:19:04.365
That's a super simplified thing.
00:19:04.605 --> 00:19:14.015
But progesterone the hormone that tells your body, oh, don't shed the lining of the uterus yet we're having an implantation.
00:19:14.194 --> 00:19:20.255
So if you don't have progesterone, the feedback mechanism in your brain goes, oh, we didn't get pregnant this month.
00:19:20.285 --> 00:19:21.755
We're gonna shed the line of our uterus.
00:19:21.904 --> 00:19:23.345
So that's why you take progesterone.
00:19:23.555 --> 00:19:31.325
When you're gonna do anything nowadays, people even using their own eggs are freezing and then they're transferring later down the road after testing.
00:19:31.595 --> 00:19:39.605
So you're gonna start taking progesterone five or six days before your transfer to mimic what happens when you have ovulation?
00:19:39.694 --> 00:19:43.234
Okay, so you ovulate the egg, supposedly goes down the fallopian tube.
00:19:43.414 --> 00:19:51.365
In the meantime, the follicle spewing out progesterone and it spews out progesterone until implantation occurs, when it starts making its own.
00:19:51.424 --> 00:19:51.724
Okay?
00:19:51.724 --> 00:19:56.765
That's super simplified, but that's the whole reason of taking progesterone support in an IVF pregnancy.
00:19:56.884 --> 00:20:03.694
They feel like they need to give it to you and everything, like they give it to you as deodorant and shampoo and everything, just so you can have massive amounts of progesterone.
00:20:03.845 --> 00:20:07.275
It does make you really cranky, but it's worth it.
00:20:07.275 --> 00:20:19.904
So you're gonna have more progesterone than you ever dreamed of when you're doing an IVF pregnancy there is a thing in surrogacy now where they're doing what they call natural cycles, and they don't give them extra progesterone.
00:20:20.234 --> 00:20:28.845
They let them ovulate on their own, and then they do it with the ovulation predictor kits, and then five days later they transfer the embryo.
00:20:29.085 --> 00:20:30.765
Some clinics have had good luck with it.
00:20:30.765 --> 00:20:32.384
Other people are like, no.
00:20:32.474 --> 00:20:33.704
So just an anecdote.
00:20:34.429 --> 00:20:44.288
Interesting'cause that's, kinder on the donor, but then I guess if you are losing embryos that way, which, took a while to, to, so not kind on the donor, kinder on the birth mother, and
00:20:44.329 --> 00:20:49.109
You're peeing on the stick on those ovulation predictor sticks, constantly.
00:20:49.259 --> 00:20:55.859
And a lot of, a lot, honestly, surrogates sometimes can't handle, they always, the surrogates usually have to do the injections.
00:20:56.099 --> 00:21:01.099
And the injections are either with sesame oil or peanut oil or whatever, and they leave, welts on your heine.
00:21:01.549 --> 00:21:03.230
And so it's not a good thing.
00:21:03.500 --> 00:21:09.500
They have tried vaginal progesterone and a lot of clinics like, Hey, it's nicer, but other ones go, you don't get the full effect.
00:21:09.500 --> 00:21:10.609
It's the big question.
00:21:12.109 --> 00:21:13.490
So some more studies to look at.
00:21:13.970 --> 00:21:18.500
Let's have another look at the whole concept of donor eggs.
00:21:18.500 --> 00:21:21.200
So tell me about the vineyard graft analogy.
00:21:22.500 --> 00:21:22.980
Okay.
00:21:22.980 --> 00:21:24.390
So that's one of my favorites.
00:21:24.390 --> 00:21:38.750
'cause I had just been in California and we stayed in a vineyard and then we went on a private vineyard tour and the owner of the vineyard gave this whole story about when they had this horrible something or other that happened in France and like basically killed all the vines.
00:21:38.799 --> 00:21:41.859
And they were taking the United States and they were making like eaux.
00:21:41.890 --> 00:21:42.190
Okay.
00:21:42.430 --> 00:21:46.299
And what they would do is, here's your vine, it's coming out and the roots are there.
00:21:46.299 --> 00:21:48.279
And then they would go and they would take this.
00:21:48.579 --> 00:22:00.970
Piece of a vine from France and they would cut a hole or like a little slit into the American one and they would then put this other one in there and lo and behold it would graft in and it would make that kind of grape.
00:22:01.329 --> 00:22:04.119
And I love that because I thought to myself, that's what you're doing.
00:22:04.329 --> 00:22:13.089
You are just grafting this lovely person who's giving you a piece of her DNA, your DNA tells you how to make an arm and an ear and whatever.
00:22:13.089 --> 00:22:16.650
It also tells you what color hair you have, but you don't get the girl.
00:22:16.769 --> 00:22:25.890
I always have to tell people, listen, I know you're real obsessed with her GPA and her college degree and what she majored in, but you don't get the degree.
00:22:25.890 --> 00:22:28.349
The baby does not come out and go, here's my diploma.
00:22:28.410 --> 00:22:29.880
Now you don't have to pay for college.
00:22:30.089 --> 00:22:31.470
No, it's up to you.
00:22:31.710 --> 00:22:36.240
So that's to me is really cool because this is not a one-off thing.
00:22:36.289 --> 00:22:45.869
Donor egg is your grafting new DNA into your family's DNA and I always feel really awful sometimes when people they just feel so.
00:22:47.365 --> 00:22:52.454
and so sad and it's oh my gosh, 50 years ago you couldn't do this.
00:22:52.875 --> 00:22:54.315
You get to be pregnant.
00:22:54.375 --> 00:22:56.265
This gets to be your baby.
00:22:56.464 --> 00:22:58.565
Without you, it would never be a baby.
00:22:58.565 --> 00:23:00.244
It would just be an embryo and a petri dish.
00:23:01.744 --> 00:23:02.390
Good point.
00:23:02.590 --> 00:23:03.280
about the subject?
00:23:03.349 --> 00:23:04.579
I can, I love it.
00:23:06.079 --> 00:23:06.369
Yeah.
00:23:06.845 --> 00:23:10.085
So how long does it take for typical donor X cycle?
00:23:11.134 --> 00:23:14.694
Say from matching the donor to actual embryo transfer.
00:23:15.765 --> 00:23:17.654
It depends on the clinic.
00:23:17.954 --> 00:23:20.265
So you have fast clinics and you have slow clinics.
00:23:20.714 --> 00:23:31.615
The slow clinics tend to be big, giant clinics that have, four and five satellites and they have one donor coordinator and they're doing, five, 10 cycles a month of just donor.
00:23:31.615 --> 00:23:33.025
Not to mention regular IVF.
00:23:33.944 --> 00:23:41.585
They take a long time'cause the donor has to be seen at the clinic and they get a big souped up Wellwoman exam and look at her ovaries and have all this blood test.
00:23:41.825 --> 00:23:43.654
And then they gotta wait two or three weeks for her to come back.
00:23:43.654 --> 00:23:57.884
And a lot of times if they have not had genetics yet, if it's a first time donor that takes a month to get those genetics back and then you find out that the husband of the intended parents he has some really weird esoteric genetic disorder.
00:23:58.095 --> 00:24:06.265
So now you gotta test her for a single gene test, which takes three or four weeks to come back So by that time, four months have gone by and everybody's a little tired.
00:24:07.015 --> 00:24:14.724
you have a clinic that I'd say has three or four doctors and they tend to not be part of a big network, you can pick the donor.
00:24:14.815 --> 00:24:17.694
They bring her in the next week, she has her.
00:24:18.505 --> 00:24:30.855
All the stuff she's gonna do, they do legal and seven weeks later you're having, a retrieval and then usually you as the patient have to wait a couple weeks'cause you have to get your testing back on your genetics or whatever.
00:24:31.125 --> 00:24:33.914
But I'd say speedy is three months.
00:24:33.914 --> 00:24:39.345
So from the time you pick the donor until they transfer the embryo into you 90 days, that would be super speedy.
00:24:40.755 --> 00:24:46.490
Okay, and is there a maximum age for the birth mother implementation?
00:24:46.519 --> 00:24:51.880
There's obviously legal levels and there's, age you would recommend as after that you'd say maybe don't bother.
00:24:52.634 --> 00:24:55.414
Okay, I will tell you in the United States, there are no rules.
00:24:56.914 --> 00:24:58.954
There's guidelines, but there are no rules.
00:24:59.194 --> 00:25:06.394
And so this is one of my all-time favorite subjects because I really feel that they do not look at the ethics of having a baby.
00:25:06.394 --> 00:25:08.345
I am all for reproductive justice.
00:25:08.375 --> 00:25:08.674
Okay.
00:25:08.884 --> 00:25:14.285
I believe that you should decide when, if, where, how, why you have your own baby.
00:25:14.494 --> 00:25:14.825
Okay.
00:25:15.815 --> 00:25:20.005
On the other hand, I'm also looking at, the justice for the child.
00:25:20.005 --> 00:25:25.255
So your reproductive autonomy, is that gonna usurp the for the child?
00:25:25.404 --> 00:25:29.244
Is it justice for a child to be born to two 60 year olds?
00:25:30.535 --> 00:25:34.974
Who are gonna be in their eighties when this child completes university?
00:25:35.154 --> 00:25:39.894
And I always think to myself, I remember when I was moving, I have 2 27 year olds are twins.
00:25:40.194 --> 00:25:45.384
And I was moving my son, helping him move out of his apartment when he graduated from college.
00:25:45.835 --> 00:25:48.085
And I was a spry young chicken then, right?
00:25:48.085 --> 00:25:48.174
And.
00:25:49.569 --> 00:25:52.089
I remember walking up and down the stairs.
00:25:52.089 --> 00:25:54.369
He went to college in Tucson, Arizona.
00:25:54.700 --> 00:25:57.220
It's not exactly a cool place.
00:25:57.220 --> 00:25:57.940
It's very hot.
00:25:58.359 --> 00:26:01.569
And I thought, how would you do this if you were 75?
00:26:01.759 --> 00:26:02.569
You couldn't do this.
00:26:02.569 --> 00:26:03.950
And this is a rite of passage.
00:26:04.160 --> 00:26:05.720
This is a thing that parents do.
00:26:05.720 --> 00:26:09.464
You move your kid in and then you move them out and they get their own life or whatever.
00:26:09.464 --> 00:26:15.615
And I thought, my kids actually need me more now at 27 than they did when they were seven.
00:26:15.974 --> 00:26:16.934
When they were seven.
00:26:16.934 --> 00:26:18.404
I was the carpool.
00:26:18.404 --> 00:26:20.025
I came to cheer'em on at the games.
00:26:20.025 --> 00:26:22.424
I made sure they did their homework at 27.
00:26:22.424 --> 00:26:26.204
They're like, mom, I don't know about the career I've picked.
00:26:26.204 --> 00:26:27.075
What am I gonna do?
00:26:27.075 --> 00:26:27.914
Oh my.
00:26:27.964 --> 00:26:30.125
And so it's bigger kids, bigger problems.
00:26:30.484 --> 00:26:36.724
Hence I can't imagine being 22 or 23 and your parents in their eighties and they're declining.
00:26:36.724 --> 00:26:37.625
They could be fabulous.
00:26:37.835 --> 00:26:40.414
But very few parents are Mick Jagger.
00:26:40.444 --> 00:26:41.075
Okay.
00:26:41.825 --> 00:26:43.714
you might not want make Jagger as a parent.
00:26:44.955 --> 00:26:46.096
No, but Paul McCartney, he's
00:26:46.145 --> 00:26:46.836
fair enough?
00:26:47.086 --> 00:26:47.476
Yeah.
00:26:48.146 --> 00:26:48.626
right?
00:26:48.836 --> 00:26:55.287
And so I think that people, they think this, and so for me personally, I believe in reproductive autonomy.
00:26:55.497 --> 00:26:58.287
But I go by the a hundred rule.
00:26:58.287 --> 00:27:04.467
And the a hundred rule is the two partners to get when you add their ages together should not exceed a hundred.
00:27:04.707 --> 00:27:06.626
Now, that's when I started in the 1990s.
00:27:06.626 --> 00:27:08.547
Now it's morphed up to 110.
00:27:08.846 --> 00:27:15.477
So basically most clinics will not let a woman carry the pregnancy if she is older than 55.
00:27:15.866 --> 00:27:16.136
Okay?
00:27:16.136 --> 00:27:18.146
So at 55 the door shuts.
00:27:18.146 --> 00:27:21.027
You can't, but that doesn't mean they can't help go have a surrogate.
00:27:22.047 --> 00:27:22.346
Okay?
00:27:22.346 --> 00:27:23.457
So that's the issue.
00:27:23.721 --> 00:27:25.155
Which will come in a minute.
00:27:26.156 --> 00:27:26.396
yeah.
00:27:26.881 --> 00:27:27.451
Interesting.
00:27:27.451 --> 00:27:31.490
So let's stick with that for before we move on to surrogacy, we'll stick with that for a minute.
00:27:31.490 --> 00:27:35.901
So what are the main reasons that people pivot to donor eggs?
00:27:35.901 --> 00:27:37.760
Is it age and quality?
00:27:37.790 --> 00:27:40.221
Previous failures, or just emotional exhaustion?
00:27:41.311 --> 00:27:44.372
The number one reason is age.
00:27:44.551 --> 00:27:45.061
Okay.
00:27:45.342 --> 00:27:52.561
They could, generally speaking, they could be in their early forties, which is not outta the real of possibility to conceive naturally.
00:27:52.832 --> 00:28:01.781
But if they haven't conceived and they haven't conceived, they show up in IVF and they're a MH, which is antimularian hormone, which is the marker to see how well your ovaries are performing is.
00:28:02.721 --> 00:28:06.711
Oh one, it's all over, but the shouting you don't have any follicles sitting on your ovaries.
00:28:06.761 --> 00:28:08.771
That then multiple miscarriages.
00:28:09.172 --> 00:28:16.912
And then I'd say back in the day when I first started, it would be because they carried genetic conditions and we didn't have the genetic testing.
00:28:17.092 --> 00:28:22.731
So they might be a carrier for Huntington's disease, they could be cystic fibrosis.
00:28:22.731 --> 00:28:27.382
So let's say two people married each other and they each had family members with cystic fibrosis.
00:28:27.862 --> 00:28:31.821
They didn't know were they gonna have a baby with cystic fibrosis, so they would go to that.
00:28:32.102 --> 00:28:38.521
I've had people that had been, I will say this, I actually had a couple years ago that I thought was a really brave thing.
00:28:38.701 --> 00:28:47.761
The husband had azoospermia, so he didn't have any sperm and so he was gonna use a donor sperm and she said, you know what, I will use a donor egg.
00:28:48.166 --> 00:28:52.007
That way, neither of us has priority.
00:28:52.336 --> 00:28:54.136
And I thought that was cool, right?
00:28:54.186 --> 00:28:58.717
That she said, I'm okay without I get to carry the baby this way.
00:28:58.717 --> 00:29:00.547
We have, reproductive autonomy.
00:29:00.547 --> 00:29:01.777
So that's it.
00:29:02.017 --> 00:29:03.696
One, people get older.
00:29:03.997 --> 00:29:09.396
I think I've noticed this trend, women that are like, say mid thirties, that have premature ovarian failure.
00:29:09.646 --> 00:29:12.987
They've had cancer and it's wiped out their, eggs or whatever.
00:29:13.346 --> 00:29:18.537
They're so excited about this, they're so excited to be able to have this opportunity, blah, blah, blah.
00:29:18.777 --> 00:29:26.876
Whereas for some reason, women like 45 plus lot more anger issues about it.
00:29:26.926 --> 00:29:29.176
They're looking for the perfect donor.
00:29:29.176 --> 00:29:30.257
It has to be perfect.
00:29:30.467 --> 00:29:38.606
And I always think to myself, which is probably not very nice, but I think to myself the reason you're in this boat is that you were too picky to find the right guy.
00:29:38.636 --> 00:29:38.757
Okay,
00:29:38.807 --> 00:29:39.211
I hear you.
00:29:39.842 --> 00:29:47.852
Speaking of how attached do you find people are to their own DNA as it has to be my baby.
00:29:47.942 --> 00:29:48.122
What?
00:29:48.152 --> 00:29:49.352
What makes it my baby?
00:29:50.382 --> 00:29:56.511
The people in their own DNA, they will, I guess I'm so jaded'cause I've been doing this for so long, it's this is my thing.
00:29:57.741 --> 00:30:01.442
You have to go in within yourself and maybe meditate on it.
00:30:02.271 --> 00:30:06.051
Do you want a baby or do you want a family?
00:30:06.291 --> 00:30:08.211
And a baby means you want a baby.
00:30:08.211 --> 00:30:10.102
You want that baby to be your baby.
00:30:10.102 --> 00:30:12.112
You want that baby to have all your DNA.
00:30:12.321 --> 00:30:16.791
It's like the actress Jennifer Aniston came out a little while ago and people jumped her for it.
00:30:16.791 --> 00:30:20.352
'cause she said the reason that she never did donor egg is she wanted a baby with her DNA.
00:30:20.531 --> 00:30:22.632
Okay, I respect that a hundred percent.
00:30:22.781 --> 00:30:23.112
Okay.
00:30:24.162 --> 00:30:28.442
and she also went through, a zillion IVF cycles and nothing ever happened.
00:30:28.471 --> 00:30:28.711
Okay.
00:30:28.711 --> 00:30:31.682
So she would've been a perfect candidate to donor egg.
00:30:31.711 --> 00:30:32.011
Okay.
00:30:32.011 --> 00:30:33.281
But she opted not to.
00:30:33.281 --> 00:30:34.182
I respect that.
00:30:34.902 --> 00:30:40.241
the other hand, I think that people get, if they want a family, they want the whole nine yards.
00:30:40.241 --> 00:30:43.362
They wanna drive carpool, they wanna go to, music practice.
00:30:43.541 --> 00:30:45.432
They wanna go watch the soccer game.
00:30:45.701 --> 00:30:48.432
They want the picture, they wanna have dinner at night.
00:30:48.612 --> 00:30:51.761
They're not just focused on my DNA and this baby.
00:30:52.061 --> 00:30:52.362
Okay?
00:30:52.541 --> 00:30:53.291
And I yell that.
00:30:53.291 --> 00:30:56.741
My last analogy I'll use, I've used this for 25 years, is an old analogy.
00:30:57.221 --> 00:31:00.342
So here you are, you're struggling with fertility and you're like, what am I gonna do?
00:31:00.342 --> 00:31:01.271
I dunno what I'm gonna do.
00:31:01.271 --> 00:31:02.682
I can't decide I'm gonna do donor egg or not.
00:31:02.682 --> 00:31:12.251
And I ask people this question, okay, so the doorbell rings and you open it and there's one of those adorable little Moses baskets with this beautiful white lace on it.
00:31:12.251 --> 00:31:17.201
And you look in there and there's this adorable baby and a big note that says, this is your baby.
00:31:17.682 --> 00:31:20.291
Would you go, oh my gosh, I can't, I'm so excited.
00:31:20.291 --> 00:31:21.041
I'm running out the door.
00:31:21.041 --> 00:31:22.541
I'm, this is my baby, I'm taking it.
00:31:22.842 --> 00:31:26.471
Or would you go, I really am gonna hold out for one with my DNA.
00:31:27.461 --> 00:31:32.682
the choice that you need to think about if you were faced with this dilemma of doing donor egg or not doing donor egg.
00:31:33.596 --> 00:31:34.832
You seen both, I guess
00:31:35.997 --> 00:31:39.116
I think that, when you sit and go, the baby is sitting right here.
00:31:39.116 --> 00:31:41.787
It really looks pretty cute, and it's all mine, and I don't
00:31:41.852 --> 00:31:42.386
it's done.
00:31:43.886 --> 00:31:44.426
I'm good.
00:31:45.000 --> 00:31:45.631
Fair enough.
00:31:45.780 --> 00:31:55.530
Okay, so let's move on to surrogacy So for listeners who are new to, so can you step out the medical steps, legal contract costs, et cetera, et cetera?
00:31:56.156 --> 00:32:09.207
Okay, so surrogacy that I'm discussing is gestational carriers surrogacy, which means that the surrogate has no genetic connection to the child, so it's somebody else's sperm and eggs implanted in her.
00:32:09.446 --> 00:32:12.632
And so finding a surrogate takes several months because there's a.
00:32:13.586 --> 00:32:16.596
fewer surrogates than there are people that are needing surrogates.
00:32:16.596 --> 00:32:20.866
We have a wait of anywhere from two months to six months to match with a surrogate.
00:32:21.227 --> 00:32:24.317
Once you guys have matched, each person decides if they wanna match.
00:32:24.317 --> 00:32:28.037
So it's a much more open process than most egg donation is at this point.
00:32:28.517 --> 00:32:34.037
Then you're gonna go to your clinic, you're gonna be screened, and you're not gonna do genetic screening or anything like that, but they're gonna look at your uterus.
00:32:34.041 --> 00:32:34.922
They're gonna do all these blood tests.
00:32:35.781 --> 00:32:37.251
After that, then you do legal.
00:32:37.251 --> 00:32:38.511
Legal takes the longest.
00:32:38.882 --> 00:32:47.102
In my company, we have a worksheet that the surrogate has already filled out with her compensation, that she wants her choices about all these things.
00:32:47.102 --> 00:32:51.241
It's six pages long, when will you allow them parents to make choices for you?
00:32:51.291 --> 00:32:53.842
How much compensation do you want for a c-section?
00:32:54.122 --> 00:32:55.592
Do you wanna pump breast milk?
00:32:55.592 --> 00:32:59.951
So all these questions are in there that goes to both couples, the couple and the.
00:33:00.281 --> 00:33:04.241
Surrogate and her husband, if she has a partner, have signed this and it goes to the attorney.
00:33:04.392 --> 00:33:08.382
The attorney then writes the contract based on this, the intended parents approve the contract.
00:33:08.711 --> 00:33:11.471
Then the surrogate and her attorney approve the contract.
00:33:11.622 --> 00:33:13.481
They write a letter saying everybody is happy.
00:33:13.481 --> 00:33:19.481
Now the intended parents fund the escrow account with her compensation and the miscellaneous stuff.
00:33:19.692 --> 00:33:22.991
And then the clinic says, okay, we received the letter, you're ready to go.
00:33:23.201 --> 00:33:30.582
And they can have an embryo transfer no sooner than 14 days after the signature on the, because that gives people time to change their minds.
00:33:30.582 --> 00:33:30.852
Okay?
00:33:31.061 --> 00:33:32.231
So soup to nuts.
00:33:32.412 --> 00:33:36.192
Some of the time you have matched until you have a transfer is probably five to six months.
00:33:37.227 --> 00:33:38.487
People want it to be faster.
00:33:38.666 --> 00:33:41.156
It's the dang lawyers that take up all the time.
00:33:41.457 --> 00:33:41.876
Okay?
00:33:41.936 --> 00:33:43.977
So they take a long time to do their stuff.
00:33:44.156 --> 00:33:53.846
So all in right now, I'd say that without the cost of IVF, because remember that changes from every different clinic has their own price range.
00:33:54.086 --> 00:33:59.396
But if you're gonna do agency fees, secret compensation insurance,'cause you have to have insurance, it costs a lot of money.
00:33:59.757 --> 00:34:03.237
Legal, psych, medication, travel, all that.
00:34:03.507 --> 00:34:13.766
You're talking probably somewhere between, I'd say 105, 110,000 to 130,000, depending on if you need more than one transfer of embryo.
00:34:13.766 --> 00:34:14.786
So the first time doesn't work.
00:34:14.786 --> 00:34:16.106
You're not starting all over again.
00:34:16.317 --> 00:34:17.157
She's coming back.
00:34:17.157 --> 00:34:20.726
But you're gonna make payments, she's gonna get paid for the transfer, the clinic will get paid.
00:34:20.967 --> 00:34:26.157
So that's what we call, so when you throw in the IVF portion, you're asking another 25,000 or so.
00:34:26.157 --> 00:34:27.536
If you throw in donor egg.
00:34:28.342 --> 00:34:29.362
can see that cost.
00:34:29.362 --> 00:34:33.802
So you would say if a donor egg surrogacy pregnancy for say two same sex.
00:34:34.041 --> 00:34:37.581
Same sex couple, you're looking at 160, 175,000.
00:34:39.081 --> 00:34:43.487
And would you often see that a donor egg could also be the surrogacy?
00:34:44.467 --> 00:34:44.797
Nope.
00:34:45.677 --> 00:34:46.786
That would always be different.
00:34:47.797 --> 00:34:47.976
Yeah.
00:34:48.036 --> 00:34:53.067
We don't do what they, we don't do that girl, we don't do you're the egg donor.
00:34:54.496 --> 00:35:01.516
Caveat is we have worked with people who used a cousin, a sister or whatever and that's different, okay.
00:35:01.521 --> 00:35:03.592
'cause they do have a genetic connection.
00:35:03.802 --> 00:35:04.072
Okay?
00:35:04.072 --> 00:35:06.081
So that has a lot of legal paperwork.
00:35:06.081 --> 00:35:12.891
So you're, instead of having the eggs come out, fertilizing going to another person, you are just gonna do with the clinic.
00:35:12.891 --> 00:35:16.672
We only will work with a legal IVF clinic with all the in place.
00:35:16.942 --> 00:35:17.391
Okay?
00:35:17.632 --> 00:35:20.541
So that is, where you're the carrier and the egg donor.
00:35:20.722 --> 00:35:25.072
Most of the time I've seen it, and I get it maybe every two years or three years, is with a sister.
00:35:25.431 --> 00:35:28.132
So I actually did, the last one I did was twins.
00:35:28.342 --> 00:35:34.981
So the sisters, they were not identical twins, they were fraternal twins, but one sister was the surrogate and she get donated her egg.
00:35:35.092 --> 00:35:37.911
So who is A actually brings me on to my next question.
00:35:37.911 --> 00:35:39.536
Who is a typical surrogate?
00:35:41.036 --> 00:35:42.027
They're all over the board.
00:35:42.027 --> 00:35:47.086
I think there's this myth that they are, down on their luck, women doing this.
00:35:47.086 --> 00:35:48.016
No, they can't be.
00:35:48.016 --> 00:35:51.047
So in the United States, you can't be on any kind of government assistance.
00:35:51.047 --> 00:35:57.947
So you can't have government subsidized healthcare or you can't be on aid families of dependent children, and you can't have, food stamps.
00:35:57.947 --> 00:35:58.666
You can't do that.
00:35:58.817 --> 00:36:04.237
You have to be able to pass a background check, which you have to be employed or your partner has to be employed.
00:36:04.487 --> 00:36:05.237
I don't do well.
00:36:05.237 --> 00:36:07.306
People go I don't work and I'm not married.
00:36:08.056 --> 00:36:08.806
are you doing that?
00:36:09.137 --> 00:36:11.597
I'd say the most part, they're middle class women.
00:36:11.657 --> 00:36:14.032
I do get some teachers, which are really good.
00:36:14.032 --> 00:36:17.452
They wanted like another kid, but they didn't wanna have another kid.
00:36:17.702 --> 00:36:19.501
And they do it so that they have the baby.
00:36:19.501 --> 00:36:23.012
In the summer, I get NICU nurses.
00:36:23.012 --> 00:36:28.322
So neonatal intensive care nurses they have been good because they've seen what happens when there's tragedies.
00:36:28.681 --> 00:36:38.152
I get a lot of people, I'd say preschool teachers sometimes they're stay at home moms and their husband works and this is a way to give them a step up.
00:36:38.391 --> 00:36:41.751
Lot of these are women in their twenties, maybe early thirties.
00:36:41.992 --> 00:36:43.012
This gives them a step up.
00:36:43.012 --> 00:36:46.822
Most of them want to use the money for a down payment on a house.
00:36:46.822 --> 00:36:50.222
'cause as we all know, globally, the whole housing thing is awful.
00:36:50.461 --> 00:36:58.382
And so having 50,$60,000 in cash that you can then use on a house really can change their family's.
00:36:59.586 --> 00:37:00.097
Interesting.
00:37:00.306 --> 00:37:02.586
And you mentioned, they might want the kits for the summer.
00:37:02.586 --> 00:37:06.817
Does that mean they would normally have some sort of connection to the kit later on?
00:37:08.317 --> 00:37:12.226
Most of them have what I'd call an acquaintance type relationship.
00:37:12.226 --> 00:37:17.286
Now that's, maybe 10, 15% actually have a, and it's usually with the same sex guys.
00:37:17.447 --> 00:37:22.211
They tend to have a closer relationship with their surrogate, but there's not a woman that's having a loss.
00:37:22.211 --> 00:37:34.422
And I think that if I try to educate the surrogates about when you are stepping into her role of gestating her baby, whether it's with her own eggs or with a donor egg, she's lost.
00:37:34.601 --> 00:37:35.771
She doesn't feel part of it.
00:37:36.012 --> 00:37:36.521
Okay?
00:37:36.581 --> 00:37:43.402
So it's understandable that she wants that part of her life to go away, and now she is a mom and dah.
00:37:43.402 --> 00:37:47.021
So don't be upset if she doesn't want to talk to you once a week.
00:37:48.192 --> 00:37:53.262
So that's why most of the surrogates I see really gravitate towards same sex couples.
00:37:53.291 --> 00:37:55.286
'cause they're like, I'm gonna be, and they do.
00:37:55.306 --> 00:37:56.621
And it's not bad.
00:37:56.621 --> 00:38:05.652
I just tell, think it's very important to educate not only the intended parents that are of opposite sex, but also the surrogate sex, but is the dynamics.
00:38:05.652 --> 00:38:11.532
So we offer, so like our surrogates have a a social work visit before they get approved and they talk about all these things.
00:38:11.831 --> 00:38:17.081
And then during the course of the pregnancy, they have three opportunities to meet with a psychologist.
00:38:17.601 --> 00:38:18.561
Just to talk about this.
00:38:18.561 --> 00:38:23.601
'cause I think sometimes the intended parents get real anxiety ridden, is she doing drugs?
00:38:23.661 --> 00:38:26.181
No, she's eating, organic food.
00:38:26.521 --> 00:38:30.521
And so I think it's hard for them to say what would make somebody want to do this?
00:38:30.521 --> 00:38:31.992
Be glad someone wants to do it.
00:38:31.992 --> 00:38:33.492
And they've been thoroughly vetted,
00:38:33.612 --> 00:38:34.152
I think it's.
00:38:34.206 --> 00:38:34.686
a surrogate.
00:38:35.217 --> 00:38:50.447
When you look at the incentives in a way, obviously there's the money, but I think otherwise there, there's probably quite an emotional, I think trauma's not the word because, you went into this knowingly in a way, but I don't know if most people, most surrogates actually know the emotional impact that's gonna have on them.
00:38:50.956 --> 00:38:52.577
'cause you do have the hormones and everything right.
00:38:54.077 --> 00:39:01.746
I will say, because we get really close to our surrogates and I'd say probably 60, 70% come back to do a second journey, which is astonishing.
00:39:01.797 --> 00:39:06.516
But the difference is maybe they had two or three kids and they had them over six or seven years.
00:39:06.516 --> 00:39:07.836
So they had'em pretty close together.
00:39:08.257 --> 00:39:08.376
Okay.
00:39:08.376 --> 00:39:13.577
So they go and they remember the exhaustion that happens when you bring home the baby.
00:39:13.606 --> 00:39:13.876
Okay?
00:39:13.876 --> 00:39:14.987
And I just think about it now.
00:39:14.987 --> 00:39:16.757
And I had twins and they were 27 years ago.
00:39:16.786 --> 00:39:17.086
Oh my God.
00:39:17.086 --> 00:39:17.806
I was tired all the time.
00:39:18.467 --> 00:39:19.637
So they don't do that.
00:39:19.637 --> 00:39:26.516
They go home and if they're not going to pump, they, quit leaking breast milk in a week or so.
00:39:26.516 --> 00:39:27.327
It's painful.
00:39:27.356 --> 00:39:28.947
'cause having it dry up is painful.
00:39:29.217 --> 00:39:37.567
But then they get back, literally two, three weeks later, they're back at the gym or they're back to walking or whatever, and they bounce back and they're not taking care of a baby.
00:39:37.806 --> 00:39:42.967
So when you don't have a baby to take care of, all of a sudden it's I'm not living on no sleep or whatever.
00:39:43.237 --> 00:39:45.786
Most of them wanna go home within 24 hours.
00:39:45.907 --> 00:39:51.786
Now, the US healthcare system is a whole nother discussion, but they wanna go the moment that they can get outta the hospital.
00:39:51.786 --> 00:39:52.012
They wanna leave.
00:39:52.731 --> 00:39:55.692
Okay they don't wanna sit around and lay around and postpartum.
00:39:55.722 --> 00:39:57.041
They want to go home to their family,
00:39:58.001 --> 00:40:03.706
It's potentially, when you look at it that way, it's potentially really neat way of co-parenting
00:40:05.206 --> 00:40:05.715
maybe.
00:40:06.440 --> 00:40:07.280
in the sense.
00:40:07.931 --> 00:40:12.771
I think that most, and then the surrogates, because most of the time they don't live in the same city.
00:40:12.771 --> 00:40:15.356
No matter how much we try to match people in the same location.
00:40:16.085 --> 00:40:16.356
don't.
00:40:16.505 --> 00:40:21.965
Okay, so then you could live in Houston and you're serving your B in Austin and that is a three hour drive.
00:40:22.146 --> 00:40:22.536
Okay.
00:40:22.715 --> 00:40:26.346
So you're not gonna have opportunities to go run into them.
00:40:26.626 --> 00:40:33.596
Most of the time the relationship lasts for about a year as far as, they send pictures or whatever after that.
00:40:33.596 --> 00:40:37.106
It seems to be Christmas or holidays and the birthday.
00:40:37.436 --> 00:40:42.835
And but with the same sex couples, it tends to be a little bit more vibrant and last longer.
00:40:42.835 --> 00:40:45.115
Like they'll invite her to their baby shower.
00:40:45.146 --> 00:40:45.536
Okay.
00:40:46.916 --> 00:40:47.965
Heterosexual couples.
00:40:48.326 --> 00:40:51.025
You're not seeing them invite the surrogate to the baby shower?
00:40:51.501 --> 00:40:52.190
Interesting.
00:40:52.251 --> 00:40:57.291
It's, I think one question of getting my head around is what can you actually stipulate?
00:40:57.291 --> 00:41:02.181
So I'm guessing every situation is different because my question is do you move in together?
00:41:02.181 --> 00:41:05.690
Do you, for example, my thing would be I definitely want her to eat organic.
00:41:05.690 --> 00:41:06.775
I definitely want X, Y, Z.
00:41:06.835 --> 00:41:08.215
I'm like, she still has a life, right?
00:41:08.409 --> 00:41:11.048
The reason that we have these three sessions.
00:41:11.798 --> 00:41:17.619
the psychologist and it's offered to the intended parents also, is to get around this, you have to let down your control.
00:41:17.978 --> 00:41:18.579
Okay?
00:41:18.639 --> 00:41:26.978
So people will write in their contracts that they want the circuit to have organic food, no cheeses, blah, blah.
00:41:27.878 --> 00:41:29.739
The thing is, then they have to pay for it.
00:41:29.798 --> 00:41:35.418
So then, okay, so you have to go to Whole Foods, which is the organic food place, and it costs more money.
00:41:35.478 --> 00:41:47.028
So show your receipt, you get reimbursed for that more money, which means your whole family has to eat that way because you can't just go make your little strawberries that are organic and let the family eat the pesticide ones.
00:41:47.358 --> 00:41:48.079
That's in it.
00:41:48.079 --> 00:41:58.849
I'd say that a, my attorney colleagues do a very good job of educating everyone about the limits of the legal system when it comes to surrogacy.
00:41:58.878 --> 00:41:59.208
Okay?
00:41:59.418 --> 00:42:05.778
Because bottom line, the only thing that they can actually change is they can't keep the baby.
00:42:06.184 --> 00:42:06.454
Okay.
00:42:06.693 --> 00:42:12.483
They can't, no way they can keep the baby because they've done a pre-birth order before the baby is born.
00:42:12.784 --> 00:42:15.063
The baby is not genetically related to them.
00:42:15.114 --> 00:42:16.853
I'm talking about the usual ones.
00:42:17.153 --> 00:42:24.324
And so hence when they go to the hospital, they have this paper that says, is Sue and Sam's baby.
00:42:24.503 --> 00:42:30.143
And when the baby comes out, Sue and Sam take the baby and they put the little ba bracelets on them that said, this is your baby.
00:42:30.143 --> 00:42:31.853
And all the little gadgets they do.
00:42:31.943 --> 00:42:36.103
So the baby doesn't walk off the the baby doesn't crawl off the unit and it's not the surrogates.
00:42:36.164 --> 00:42:36.583
Okay?
00:42:36.733 --> 00:42:40.153
So most of the time when they stay in the hospital, she doesn't even go to the postpartum floor.
00:42:40.333 --> 00:42:43.543
She goes to a DYN floor or something like that.
00:42:43.543 --> 00:42:45.583
So she's not around the babies or whatever.
00:42:45.704 --> 00:42:48.523
And the intended parents get a room, okay?
00:42:48.614 --> 00:42:50.713
They get a room and they room in with their baby.
00:42:50.873 --> 00:43:01.384
It always makes me think of you, you the British kinds, like when I went to Sterling Castle with Mary Queen of Scot's, and they showed the room where she was born and that everybody was around the room watching the baby be born.
00:43:01.563 --> 00:43:06.094
And I'm sitting here thinking I wouldn't really want 50 people watching me deliver a baby, but okay.
00:43:06.423 --> 00:43:08.224
And it's so that there was no bait and switch.
00:43:08.253 --> 00:43:08.434
Okay.
00:43:08.434 --> 00:43:12.003
So then you think now with surrogacy, there's literally a bait and switch.
00:43:12.172 --> 00:43:12.713
Yeah.
00:43:12.784 --> 00:43:16.653
baby comes out of this person and then Sue and Sam walk out the door and go look at our baby.
00:43:16.954 --> 00:43:17.074
I
00:43:17.182 --> 00:43:18.233
Interesting concept.
00:43:18.244 --> 00:43:18.304
go.
00:43:18.833 --> 00:43:19.373
Interesting.
00:43:19.643 --> 00:43:24.813
So in terms of, are you seeing a lot of cross border surrogacy?
00:43:24.833 --> 00:43:25.793
Is that unusual?
00:43:26.929 --> 00:43:36.094
What I'm seeing now, which is a new phenomenon, is people come to the United States and they want this US egg donor because there's so many, there's thousands of egg donors.
00:43:36.164 --> 00:43:36.454
Okay?
00:43:36.454 --> 00:43:37.789
So there's so many choices.
00:43:38.059 --> 00:43:49.338
And then they're shipping their embryos to Mexico, Guatemala, Argentina, because the cost of surrogacy is literally a third.
00:43:49.818 --> 00:43:50.418
Okay?
00:43:50.478 --> 00:43:57.498
So they can go and spend their money on getting the best egg donor for them without having to spend$175,000.
00:43:57.798 --> 00:43:58.068
Okay?
00:43:58.068 --> 00:44:09.128
So they'll spend half that and they'll go and they have some, and then they have some excellent clinics in Mexico, Columbia, I don't know about, but I do know that Argentina has some excellent clinics.
00:44:09.369 --> 00:44:10.389
And so hence.
00:44:10.824 --> 00:44:12.083
It's a win-win.
00:44:12.083 --> 00:44:16.853
And I'm wondering when the American IVF cleanser and go, wait a minute, what are y'all doing?
00:44:17.313 --> 00:44:21.534
Because they're gonna start siphoning off that population,
00:44:22.288 --> 00:44:22.677
Interesting.
00:44:22.677 --> 00:44:26.367
And it's all business at the end of the day, so there's a incentive.
00:44:26.367 --> 00:44:26.998
So once again,
00:44:27.474 --> 00:44:27.893
right?
00:44:28.347 --> 00:44:37.527
in terms of when you do see cross-border couples, what are complications in terms of, citizenship, birth certificates, exit permits?
00:44:37.527 --> 00:44:38.188
What else do you need?
00:44:38.188 --> 00:44:39.657
You exporting a baby, what do you do?
00:44:40.554 --> 00:44:45.293
The worst thing, seriously, say you're an English couple, okay?
00:44:45.293 --> 00:44:50.344
And you've come over and you go to a New York City IVF clinic, and it's your eggs and your husband's sperm.
00:44:50.344 --> 00:44:50.554
Okay?
00:44:50.824 --> 00:44:51.934
So we're all good.
00:44:51.934 --> 00:45:00.123
So we don't have any genetic weird stuff, but there's no, you can't get insurance without paying about$28,000 for the baby.
00:45:00.498 --> 00:45:06.048
Okay, so when the baby is born, because remember, you've already severed your parental, right?
00:45:06.103 --> 00:45:07.903
The surrogate's already severed or parental rights.
00:45:08.083 --> 00:45:12.643
So when the baby comes out, the moment the umbilical cord is cut, it's those people's baby.
00:45:13.304 --> 00:45:18.164
if there's any complications from then on, or the baby needs to go to the nicu, they have to pay for it.
00:45:18.494 --> 00:45:21.134
So you have to get insurance policies, right?
00:45:21.224 --> 00:45:26.443
And you can't get one'cause you're not a citizen or a legal resident, okay?
00:45:26.713 --> 00:45:34.574
So hence you have to go through a third party, which is Lloyd's of London, and they charge a$28,000 deductible.
00:45:36.074 --> 00:45:41.018
So when you say deductible, that's not the premium, that's the risk of what you pay if something happens.
00:45:41.134 --> 00:45:43.233
is that's your premium, okay?
00:45:43.429 --> 00:45:45.108
Pay$28,000.
00:45:45.889 --> 00:45:54.219
And the the policy doesn't start paying until you have accrued$28,000 worth of care.
00:45:54.668 --> 00:45:58.539
So at$29,000, it will start paying, okay?
00:45:58.778 --> 00:46:06.759
So when people from overseas say they want twins, I'm like, no, I don't out, because no one will insure you for choices.
00:46:06.759 --> 00:46:17.759
They will, it'll just cost you,$50,000 they don't want, so healthcare in the United States is so massively expensive when it shouldn't be that you can't just go I'll just pay.
00:46:18.088 --> 00:46:20.068
Because the clinics are like no, you have to pay.
00:46:20.458 --> 00:46:32.188
So I have seen before, right at COVID, before COVID hit, we would do a lot of Asian couples and they would, did not wanna pay these outrageous prices, but then they would have$150,000 bill and they'd skip out on it.
00:46:32.608 --> 00:46:37.114
But the good news was they couldn't put the bill on the surrogate, because remember, she's not the.
00:46:38.614 --> 00:46:40.818
So the 28,000, that's the deductible.
00:46:40.818 --> 00:46:42.978
How much would the premium be out of interest?
00:46:42.978 --> 00:46:44.358
How much are you paying upfront?
00:46:44.409 --> 00:46:45.099
It's the same.
00:46:45.099 --> 00:46:47.804
So the premium is 28,000 the deductible.
00:46:47.954 --> 00:46:48.764
It's all in one.
00:46:49.034 --> 00:46:50.233
So you pay 28,000.
00:46:50.414 --> 00:46:53.173
Now, let's say that you had a normal vaginal delivery.
00:46:53.204 --> 00:46:53.503
Okay?
00:46:53.804 --> 00:46:54.764
Normal vaginal delivery.
00:46:54.793 --> 00:46:59.414
The baby comes out, it's eight pounds, it's crying, it's gonna be able to go home in 24 hours.
00:47:00.403 --> 00:47:04.934
bill, if you were gonna pay cash, would probably be less than$5,000.
00:47:04.934 --> 00:47:06.134
'cause they didn't do anything.
00:47:06.193 --> 00:47:06.673
Okay?
00:47:06.824 --> 00:47:10.184
The baby sat in a bassinet and they checked it a couple of times.
00:47:10.423 --> 00:47:10.693
Okay?
00:47:11.474 --> 00:47:13.423
You've just paid$28,000
00:47:14.923 --> 00:47:15.733
Just in case.
00:47:15.773 --> 00:47:16.523
hours stay.
00:47:16.643 --> 00:47:16.864
Wow.
00:47:17.019 --> 00:47:19.329
So that's where, I see both sides.
00:47:19.329 --> 00:47:26.619
You don't, as a hospital, they don't wanna be stuck with this massive bill because the baby was in the NICU for four months.
00:47:26.980 --> 00:47:29.079
The other hand, it's not fair to the intended parents.
00:47:29.079 --> 00:47:30.719
'cause now they're paying, all this money
00:47:31.398 --> 00:47:34.518
And you have to take out the insurance if you do in the us
00:47:34.840 --> 00:47:39.750
If you don't, then you have to have some sort of, here's my credit card that has$50,000 on it
00:47:40.219 --> 00:47:40.489
Yeah.
00:47:40.639 --> 00:47:41.028
Okay.
00:47:41.028 --> 00:47:43.188
He's five credit cards to have whatever might be.
00:47:43.219 --> 00:47:43.489
Okay.
00:47:43.998 --> 00:47:51.039
You've mentioned previously to me when we were chatting, there's a rise in affluent single men commissioning Surrogacy with Donor X.
00:47:51.039 --> 00:47:51.938
Tell me about that.
00:47:52.688 --> 00:48:00.798
So one of the things that's really struck me is, especially in today's world where there was dating apps and this, and now those are falling off in favor.
00:48:01.039 --> 00:48:08.409
We're seeing, and I'm saying in the last maybe 18 months, an increase in single men over 50.
00:48:09.759 --> 00:48:14.438
Really wanting to have a baby with a surrogate and an egg donor.
00:48:14.889 --> 00:48:16.298
And they're real cagey.
00:48:16.298 --> 00:48:17.559
They don't wanna talk about why.
00:48:17.708 --> 00:48:19.898
I've had two that would talk about it.
00:48:19.898 --> 00:48:26.349
One said he'd seen his brother go through a horrible divorce and lose custody of his kids, and he didn't want that.
00:48:26.349 --> 00:48:27.909
So he was just gonna have baby on his own.
00:48:28.329 --> 00:48:35.588
And then another one basically said, I haven't found the right woman, and it's time is ticking and I wanna have a baby.
00:48:35.889 --> 00:48:46.139
So my question is, I find it weird, but on the other hand, none of us bat an eyelash if a single woman wants to have a baby with an egg donor and she's 45.
00:48:46.318 --> 00:48:46.588
Okay?
00:48:46.588 --> 00:48:47.969
So we're all like, oh, okay.
00:48:48.018 --> 00:48:51.438
But I think it's different because she can actually gest state the baby.
00:48:51.438 --> 00:48:56.509
And there's not, but this is I'm outsourcing, a partner.
00:48:56.509 --> 00:49:01.159
I'm outsourcing someone who I'm gonna love and cherish and we're gonna have a baby together.
00:49:01.938 --> 00:49:03.588
I don't know, I guess I'm old school.
00:49:03.588 --> 00:49:04.539
It just grosses me out.
00:49:05.043 --> 00:49:07.079
There's also a question who's raising it, right?
00:49:07.079 --> 00:49:12.239
If you're the birth mother, whether it's your own ex or otherwise you, the hormones are different.
00:49:12.239 --> 00:49:14.128
The society expectation is different.
00:49:14.128 --> 00:49:17.068
There's a lot of the chance of you actually taking care of the babies.
00:49:17.068 --> 00:49:21.958
Probably higher then if you don't have that again, I dunno what the situation is, but, okay.
00:49:21.958 --> 00:49:22.858
Very interesting point.
00:49:22.974 --> 00:49:26.364
it's, it goes back to my whole child versus family theory.
00:49:26.728 --> 00:49:27.028
Yeah.
00:49:27.324 --> 00:49:27.534
this?
00:49:27.534 --> 00:49:31.014
Because, and one of the things I've found is everybody's picky.
00:49:31.074 --> 00:49:31.853
Everybody's picky.
00:49:32.304 --> 00:49:34.554
These people are the pickiest of the picky.
00:49:34.824 --> 00:49:35.123
Okay?
00:49:35.123 --> 00:49:45.233
So they want the five 11, huge tall girl who's also model worthy, who went to a top 20 school who majored in a hard subject.
00:49:45.233 --> 00:49:47.034
They don't want somebody who majored in psychology.
00:49:47.034 --> 00:49:48.893
They want somebody who majored in chemistry.
00:49:48.983 --> 00:49:49.313
Okay?
00:49:49.583 --> 00:49:54.143
They want all those things in this girl and it's like really?
00:49:54.193 --> 00:49:56.864
You want a baby or is this a science project?
00:49:58.364 --> 00:50:00.559
It helps to have the major in chemistry anyway.
00:50:01.409 --> 00:50:07.739
Speaking of, let's look at genetic testing and embryo screening, particularly around promise versus overreach.
00:50:07.739 --> 00:50:08.789
There's a couple of terms.
00:50:08.789 --> 00:50:12.148
There's P-G-T-A-P, G-T-M-P-G-T-P.
00:50:12.268 --> 00:50:12.898
What are these?
00:50:14.398 --> 00:50:14.818
Okay.
00:50:14.818 --> 00:50:17.668
So they're all pre-implantation genetic testing.
00:50:17.668 --> 00:50:19.318
It's just a matter of what you're testing.
00:50:19.559 --> 00:50:20.898
So and they keep changing names.
00:50:20.929 --> 00:50:25.608
I'm telling you that every three weeks they're going, now we have PGDQ, and it's what is that?
00:50:26.478 --> 00:50:29.929
The bottom line is PGT is pre-implantation genetic testing.
00:50:29.929 --> 00:50:34.534
It's looking for chromosomal abnormalities in the embryo and or genetics.
00:50:34.534 --> 00:50:38.869
Now remember, everyone's already had their genetics tested, but there's outliers.
00:50:39.018 --> 00:50:43.009
So some people may say, my husband and I both have.
00:50:43.873 --> 00:50:45.284
Cystic fibrosis in our family.
00:50:45.583 --> 00:50:51.954
So it means that we have a one in four chance of having a child that is cystic fibrosis or could be a carrier.
00:50:52.164 --> 00:50:55.463
So what they're gonna do is they're gonna do a single gene look.
00:50:55.463 --> 00:50:58.373
They're gonna look at the chromosomes and they're gonna go, okay, so here's a single gene.
00:50:58.373 --> 00:51:09.503
We're gonna do a probe, and then we find out that three of your embryos have cystic fibrosis, and so we're gonna discard those and then you can rest assured that you can c create a baby without that.
00:51:09.954 --> 00:51:16.224
Now, when we start getting into this other stuff, I read this fascinating article on the airplane today.
00:51:16.313 --> 00:51:16.494
Yeah.
00:51:16.523 --> 00:51:21.773
Two days ago that was about these new companies that are coming out with this.
00:51:21.824 --> 00:51:43.074
We can find out that embryo with the most athletic ability, whatever, and what they're doing is, and I'm simplifying it like my progesterone simplification, is they've run algorithms that say, here's all these people's DNA, and this is the people that were five 11 who went to a top 20 school that majored in chemistry and are Olympic level athlete.
00:51:43.193 --> 00:51:43.554
Okay.
00:51:43.643 --> 00:51:44.603
There's three of them.
00:51:44.813 --> 00:51:44.963
Okay.
00:51:44.963 --> 00:51:50.063
But nonetheless, we now have this algorithm that shows their DNA looks like this.
00:51:50.244 --> 00:51:55.253
So when you've made this embryo, now we're gonna go and look and see which ones match that.
00:51:56.574 --> 00:51:59.034
So a lot of controversy about it.
00:51:59.034 --> 00:52:00.713
This was in MIT quarterly.
00:52:00.713 --> 00:52:03.804
I thought I was like crazy person buying this at the airport, MIT quarterly.
00:52:03.804 --> 00:52:14.994
I look so smart sitting on the airplane, but I did it because it was all about this and then I'm reading it and my favorite scapegoat is deeply embedded in this, which is private equity.
00:52:15.324 --> 00:52:20.523
And so I see it as this whole thing where I had these people who go, she has to be five 11, da.
00:52:20.764 --> 00:52:22.173
Now they can just go, that's great.
00:52:22.173 --> 00:52:25.384
We're just gonna go we'll pick this donor and then we're gonna pick the embryo.
00:52:25.384 --> 00:52:26.074
That's the best.
00:52:27.273 --> 00:52:29.434
Everybody wants the best for their child.
00:52:29.643 --> 00:52:40.054
When I first got into this business, and there would be people that I would say were just normal looking, maybe even a little bit on the homely side, they would pick the most gorgeous egg donor.
00:52:40.384 --> 00:52:45.094
And I remember doctors going, why are those people picking that girl?
00:52:45.094 --> 00:52:46.563
They don't look anything like her.
00:52:46.864 --> 00:52:49.384
And I thought to myself, know what?
00:52:49.384 --> 00:52:51.844
If you're driving a Toyota.
00:52:52.264 --> 00:52:55.173
You really wanna drive A BMW, you know what I'm saying?
00:52:55.173 --> 00:52:57.813
It's like you want the BMW, you want the best.
00:52:58.204 --> 00:52:59.313
So I don't blame'em.
00:52:59.313 --> 00:53:00.634
They want the best for their kid.
00:53:00.813 --> 00:53:02.373
Maybe they didn't like being homely.
00:53:02.373 --> 00:53:03.603
Maybe they want a pretty child.
00:53:04.958 --> 00:53:07.659
Okay, so let's move on to the ethics questions.
00:53:07.659 --> 00:53:08.018
Actually.
00:53:08.018 --> 00:53:10.958
You previously mentioned about telling the kids.
00:53:10.958 --> 00:53:12.403
What's your opinion on that and why?
00:53:13.903 --> 00:53:18.074
I think that secrets are bad about your genetic origins.
00:53:18.074 --> 00:53:24.884
And I think that people there's so many children that have been born through donor egg, through surrogacy now, donor sperm.
00:53:25.063 --> 00:53:27.224
We all know what happened with the donor sperm thing.
00:53:27.313 --> 00:53:27.583
Okay?
00:53:27.583 --> 00:53:28.273
At least we should.
00:53:28.994 --> 00:53:32.893
People that were conceived with donor sperm, say in the last.
00:53:33.119 --> 00:53:35.789
I don't know, maybe 40 years ago, 30 years ago.
00:53:36.028 --> 00:53:38.318
They have hundreds of siblings.
00:53:38.588 --> 00:53:38.949
Okay.
00:53:39.278 --> 00:53:42.278
And I think that's very discombobulating for people.
00:53:42.278 --> 00:53:45.789
It's one thing to say I have all these relatives out there that are my fourth cousin.
00:53:45.969 --> 00:53:47.679
No, these are your half siblings.
00:53:47.949 --> 00:53:48.159
Okay.
00:53:48.159 --> 00:53:49.268
That's a whole different ballgame.
00:53:49.389 --> 00:54:03.838
And so by not telling people all this bad stuff could happen, and I think people get real caught up in the cons, guity, oh my God, my kid will have two heads because I, they accidentally married their half, brother not really.
00:54:03.838 --> 00:54:09.148
You'd have to have, it had to be like Egypt and they had to keep doing that for, a millennia before you'd start getting the two-headed baby.
00:54:10.034 --> 00:54:16.003
But on the other hand, I do believe that people need, it's ethical to tell them their origins.
00:54:16.244 --> 00:54:19.244
And I believe that's what I mean, we preach it to everybody.
00:54:19.273 --> 00:54:21.884
Start early and often with your child.
00:54:22.123 --> 00:54:25.934
That doesn't mean secrecy, it means privacy.
00:54:26.054 --> 00:54:29.983
Privacy means this is our family story, not the kindergarten story.
00:54:29.989 --> 00:54:32.898
And it's a little bit easier to teach kids about that.
00:54:32.898 --> 00:54:39.389
There's books out there and you start very early with, one of my favorites has rabbits in it,'cause they proliferate, have a lot of rabbits.
00:54:39.599 --> 00:54:42.179
And there's this, and a friend of mine wrote the book and it's so cute.
00:54:42.179 --> 00:54:42.719
And it's Mr.
00:54:42.719 --> 00:54:43.018
And Mrs.
00:54:43.018 --> 00:54:47.789
Rabbit, one of the baby and this lovely other rabbit handed them this, little Connie.
00:54:47.958 --> 00:54:52.608
And they took it home and they gestated it, and then they had their own little baby.
00:54:52.789 --> 00:54:54.108
Okay, so you start out with that.
00:54:54.259 --> 00:55:02.418
Okay, somebody gave us a gift by the time they get 10 or 11, 12 years old, then you can really dig into why we did this and what happened.
00:55:02.418 --> 00:55:06.188
There's a a woman who I'm to complete groupie of, and she's English.
00:55:06.188 --> 00:55:11.248
Her name is Elizabeth Gba, and she works at Cambridge or Oxford, one of those.
00:55:11.548 --> 00:55:23.309
And and she does all these studies on donor conceived children, surrogacy conceived children, and she's very much like the kids that have no issues about this or the ones that knew from the very beginning with people.
00:55:23.309 --> 00:55:26.608
Wait till they're 16, you've opened up Pandora's box.
00:55:27.492 --> 00:55:28.092
Identity.
00:55:28.333 --> 00:55:39.713
I think there's also in this day and age where we are going more into genetic tests and I'm actually doing quite a bit of work in the Middle East, which is genetically an interesting as we've mentioned genetically an interesting place.
00:55:40.568 --> 00:55:42.608
It's actually quite helpful, your family history.
00:55:42.757 --> 00:55:50.797
So obviously if you do have a 26 pace questionnaire on this is my genetic mother, father, whatever it might be, that's actually quite helpful down the line.
00:55:51.047 --> 00:55:51.438
Okay.
00:55:51.498 --> 00:56:00.092
And what both with egg donors and surrogacy, what are the patterns of regret and relief that you're seeing?
00:56:01.592 --> 00:56:03.088
With egg donation.
00:56:03.338 --> 00:56:05.197
The biggest regret I see.
00:56:05.248 --> 00:56:06.268
I don't see it with donors.
00:56:06.358 --> 00:56:13.228
I really, I, I don't, and I've actually had donors, I've been doing this for so long, that those donors that I knew years ago are now in their forties.
00:56:13.257 --> 00:56:13.438
Okay.
00:56:13.438 --> 00:56:14.038
Mid forties.
00:56:15.478 --> 00:56:24.117
I've had probably 10 or so come back to me after, in their forties and they got married and now they need an egg donor.
00:56:24.898 --> 00:56:26.358
And I knew them.
00:56:27.123 --> 00:56:32.313
when I first started out I was smaller and I knew every single donor really well and they don't really have any regrets.
00:56:32.342 --> 00:56:34.922
'cause they said, my DNA's out there in the world somewhere, so I'm good.
00:56:35.193 --> 00:56:37.172
But I wish I hadn't waited so long.
00:56:37.393 --> 00:56:41.652
And it wasn't because they were an egg donor, it was because they were 43 and now they're trying to have a baby.
00:56:42.052 --> 00:56:46.552
We get a lot of girls who say they never want a baby and then they show up.
00:56:46.552 --> 00:56:54.893
Like we have one, one of my favorite donors about two years ago, she was like in her mid thirties and she did a donor six times and she was a fabulous donor and she couldn't get pregnant.
00:56:54.893 --> 00:56:57.322
And we're, I'm like, oh honey, I thought she didn't want a baby.
00:56:57.322 --> 00:56:59.753
And she goes, oh, I met this guy now I want a baby, blah, blah.
00:57:00.023 --> 00:57:01.793
And so we helped her navigate it.
00:57:01.793 --> 00:57:04.103
We helped her get to the right doctor and this and that and the other.
00:57:04.103 --> 00:57:06.862
We found her free medication because we wanted to help.
00:57:06.862 --> 00:57:07.552
We thought you helped.
00:57:07.552 --> 00:57:09.023
So many people have their dream.
00:57:09.293 --> 00:57:12.733
So when she had her baby shower, we sent her a stroller, we went all out.
00:57:12.733 --> 00:57:15.253
We bought her a stroller, a buggy or whatever you call it, a pram.
00:57:15.612 --> 00:57:17.682
And she was like, oh my God, it's the biggest gift I got.
00:57:17.682 --> 00:57:19.932
We were so happy for you that you had this baby.
00:57:20.202 --> 00:57:30.672
I actually even had an egg donor who ended up going through IVF'cause her husband had mail issue and she ended up with all these extra embryos and she donated them to us and said, can you find somebody?
00:57:30.913 --> 00:57:37.242
We found somebody that we knew that had run outta options and they, so we, it was like, oh my gosh, this is so wonderful.
00:57:37.242 --> 00:57:38.443
This is the reason we do this.
00:57:38.623 --> 00:57:45.432
So she donated her leftover embryos to somebody who had gone through everything and now was out of time, money and effort.
00:57:45.672 --> 00:57:48.822
And she got to have a baby and be pregnant and have her own baby.
00:57:48.822 --> 00:57:56.472
And they actually know each other and they have communicated, I wouldn't say they're best friends, but they're, they are talking to each other so that there's not a lot of regret on the donor side.
00:57:56.922 --> 00:57:59.443
The regret on the intended mother side.
00:57:59.443 --> 00:58:05.152
I'm gonna talk about, heterosexual couples is that they waited so long that they dilly ded going, should I do it?
00:58:05.152 --> 00:58:06.682
Should we do another IVF cycle?
00:58:06.893 --> 00:58:11.103
And the fact that they were at 42, 43 or getting one embryo.
00:58:11.813 --> 00:58:15.472
Look, I could have spent this time being a mother on the surrogate side.
00:58:15.472 --> 00:58:19.612
I don't see the surrogate intended parents ever having regrets.
00:58:20.333 --> 00:58:25.552
surrogates end up having some regrets about the people they chose to carry for.
00:58:25.853 --> 00:58:28.132
I think they think this is magical experience.
00:58:28.132 --> 00:58:35.063
Everyone calls it a journey in the parlance of fertility, and I think they think it's this magical journey.
00:58:35.902 --> 00:58:43.233
egg donors are given a lot of information because they're, it's a big procedure, not that having, carrying a baby in, but it's a little different with egg donors.
00:58:43.443 --> 00:58:45.932
So they really walk in prepared, I know it's gonna do this.
00:58:46.413 --> 00:58:50.313
The surrogates think it's all gonna be, Disneyland and it's not.
00:58:50.313 --> 00:58:53.072
Sometimes the intended parents are not very communicative.
00:58:53.342 --> 00:58:55.322
Sometimes they are too demanding.
00:58:55.322 --> 00:58:57.063
Sometimes they just ghost them.
00:58:57.362 --> 00:58:59.483
So that's the whole ball and wax.
00:58:59.483 --> 00:59:02.152
But I don't see regret on the side of intended parents.
00:59:02.152 --> 00:59:03.592
At least I haven't seen it myself.
00:59:04.407 --> 00:59:05.097
Interesting.
00:59:05.143 --> 00:59:06.373
I'm getting goosebumps, actually.
00:59:06.373 --> 00:59:08.253
Some very interesting anecdotes.
00:59:08.612 --> 00:59:10.112
Any last words of wisdom?
00:59:10.112 --> 00:59:21.847
Anything that you think other practitioners if other practitioners or people who are entering this space should know and could benefit from your 25 years of experience?
00:59:23.347 --> 00:59:33.353
I'd say if I could limit it to one, I would say that when people are going to pursue third party parenting, and I'm gonna say egg donation, okay.
00:59:33.382 --> 00:59:41.007
'cause it's much bigger than surrogacy is, not get caught up in the nuances of every little thing about the donor.
00:59:41.483 --> 00:59:47.693
I had a patient one time who told me, but her ear lobes are not attached, and I'm like, what are attached ear lobes?
00:59:47.697 --> 00:59:47.978
What?
00:59:48.172 --> 00:59:48.592
What is that?
00:59:48.623 --> 00:59:49.492
And they're like, oh.
00:59:49.583 --> 00:59:50.603
Oh, okay.
00:59:51.083 --> 00:59:59.773
So I think that people need to go, someone's giving me a gift if this person, because remember you have her picture, lots of her pictures.
00:59:59.952 --> 01:00:05.773
If I could put this person in a family portrait like at Christmas time where people go, oh my God, who's that?
01:00:05.952 --> 01:00:07.842
Or they go, no big deal.
01:00:07.842 --> 01:00:09.043
Okay, she just fits in.
01:00:09.373 --> 01:00:10.182
That's it.
01:00:10.273 --> 01:00:12.163
Remember, you are growing the baby.
01:00:12.373 --> 01:00:13.603
You nurtured the baby.
01:00:13.813 --> 01:00:15.282
You are the one that will teach it.
01:00:15.733 --> 01:00:17.293
How to go potty, okay?
01:00:17.293 --> 01:00:18.733
You'll be potty training this baby.
01:00:19.182 --> 01:00:26.612
So don't think that, this donor has over influence on, it's not, the donor is not gonna influence your child's life.
01:00:26.882 --> 01:00:31.592
She influenced it at the moment of conception and from then on, she's a donor and you are the mom.
01:00:33.092 --> 01:00:44.043
Do you think it's easier to have an egg donor and carry the baby yourself from a woman's point of view, or to use your own eggs and have someone else carry it?
01:00:44.072 --> 01:00:47.342
Or like even have donor eggs, have someone else carry it and then be a mom?
01:00:48.688 --> 01:00:55.108
Okay, so there's actually a study done in the late, I guess I'd say maybe 40 years ago, right?
01:00:55.108 --> 01:01:00.507
When they started doing donor egg and they asked women, it was from the University of Iowa, car and country, right?
01:01:00.748 --> 01:01:06.027
And it was just a, the questionnaire was you had your choice.
01:01:06.237 --> 01:01:21.737
You could carry the baby with an egg donor baby, or someone else could carry your genetics, and it ended up being almost equal so people were divided, The interesting thing was women who'd had a baby.
01:01:22.157 --> 01:01:24.347
In other words, so they'd had a baby on their own, right?
01:01:24.617 --> 01:01:28.398
They were just, these were not fertility patients, they were just random OB, GYN patients.
01:01:29.237 --> 01:01:31.668
who had a baby said, oh, a hundred percent.
01:01:31.668 --> 01:01:33.047
I always wanna carry the baby.
01:01:33.498 --> 01:01:36.737
People who didn't have a baby were all like, oh no.
01:01:36.797 --> 01:01:37.938
I'm good with that.
01:01:38.327 --> 01:01:39.887
I just wanna make sure it has my DNA.
01:01:40.188 --> 01:01:47.748
So I do think there's something to be said for the process of pregnancy that makes you have a connection to that child no matter what.
01:01:47.987 --> 01:01:53.117
And one of the things in surrogacy is that they have to sever that connection, but they've thought of it the whole time.
01:01:53.327 --> 01:01:57.527
This is not like you're pregnant, you think you're gonna go home with a baby, and then somebody snatches it away from you.
01:01:57.708 --> 01:02:00.318
You've known going into this, that this is, you're babysitting.
01:02:01.068 --> 01:02:01.668
So that's it.
01:02:01.668 --> 01:02:02.447
That's what I see.
01:02:03.038 --> 01:02:03.938
This is interesting.
01:02:03.938 --> 01:02:10.057
How are you seeing fathers getting more or less attached, say in natural pregnancies?
01:02:10.057 --> 01:02:18.588
So they've been there for gestation, it is their DNA versus, the various different options of who donated what to whom, et cetera.
01:02:18.588 --> 01:02:26.387
But they're still there for the gestation versus the whole thing is surrogacy again, could be their DNA, could be someone else's, DNA, obviously that's a lot of different cases.
01:02:27.568 --> 01:02:28.858
I would say that okay.
01:02:28.947 --> 01:02:32.068
With the surrogates, their partners are not very involved.
01:02:32.217 --> 01:02:32.757
They're just there.
01:02:32.998 --> 01:02:33.297
Okay.
01:02:33.418 --> 01:02:35.068
You don't, they're there as a helper.
01:02:35.068 --> 01:02:38.818
They come, they'll be at the delivery, they'll do this, but they're just there.
01:02:38.998 --> 01:02:46.128
Sometimes they've, I've seen them, the four of'em have a relationship, like the two guys will talk football or whatever, but that's not it.
01:02:46.338 --> 01:02:54.407
Where I see the biggest disconnect, which always makes me the saddest, is when I call it the male partner is driving the mus.
01:02:54.588 --> 01:02:54.887
Okay.
01:02:54.887 --> 01:02:58.998
So he's the one that makes the first call and he's the one that says, no, we don't like this egg donor.
01:02:59.277 --> 01:03:02.007
And the worst is when people have an egg donor and a surrogate.
01:03:02.157 --> 01:03:05.487
The woman basically feels like I'm sitting in the backseat and no one cares about me.
01:03:06.523 --> 01:03:11.172
Yet I'm supposed to jump up when this baby is born and suddenly morph into a mother.
01:03:11.443 --> 01:03:15.523
And so that doesn't happen real often, but we, in my office, we all know who it is.
01:03:15.523 --> 01:03:19.452
It's if the guy calls first, we know that okay, it's gonna be one of those.
01:03:19.813 --> 01:03:25.422
And I think it's because sometimes the women, and it's okay, it's usually people who are under second marriage.
01:03:25.632 --> 01:03:31.003
So the woman might have already had two kids, the man never had any kids, and now they're together and she's had a hysterectomy.
01:03:31.003 --> 01:03:32.382
So she has to have a surrogate.
01:03:32.592 --> 01:03:34.063
And maybe her eggs don't work by now.
01:03:34.182 --> 01:03:34.452
Okay.
01:03:34.693 --> 01:03:37.182
So she's tuned out, she's already raised kids.
01:03:37.182 --> 01:03:38.972
She's And so then that's what they want.
01:03:38.972 --> 01:03:39.693
So that's the deal.
01:03:41.193 --> 01:03:42.902
That was a really beautiful episode.
01:03:42.902 --> 01:03:43.682
Thank you for that.
01:03:45.182 --> 01:03:45.722
Okay.
01:03:45.722 --> 01:03:59.023
I enjoyed talking about all of all this cool stuff, and I will say the United States is out there sometimes, but I do the fact that we believe in reproductive autonomy, at least for the nanosecond until it goes away.
01:03:59.023 --> 01:04:01.273
But right now we have reproductive autonomy.
01:04:01.483 --> 01:04:04.123
So you can pretty much do what you want.
01:04:04.123 --> 01:04:08.322
You can have a baby, you can not have a baby, you can use a donor, you can use a surrogate.
01:04:08.472 --> 01:04:09.583
You just have to be in the right state.
01:04:09.583 --> 01:04:12.742
But we don't have legislation nationally that says you can't do that.
01:04:14.242 --> 01:04:14.983
Thanks, Mary.
01:04:16.483 --> 01:04:17.083
Okay.
01:04:17.132 --> 01:04:17.702
It was fun.
01:04:17.822 --> 01:04:18.483
Fabulous.
01:04:24.494 --> 01:04:27.074
Thank you for joining me on this transformative journey.
01:04:27.074 --> 01:04:30.014
Your presence in this community is truly valued.
01:04:30.255 --> 01:04:33.585
Now, you may not realize it, but your words hold in men's power.
01:04:33.824 --> 01:04:35.445
They have the ability to reach others.
01:04:35.445 --> 01:04:37.965
You may benefit greatly from the wisdom shared here.
01:04:38.594 --> 01:04:44.594
If you found value in what you had, I kindly ask you to take a moment to subscribe to by Hacking Eve.
01:04:44.804 --> 01:04:50.295
Leave a glow and review on your preferred podcast platform and share by Hacking Eve with your friends and family.
01:04:50.744 --> 01:04:55.094
Your support helps spread the message of health optimization for women far and white.
01:04:55.304 --> 01:04:59.235
Lastly, I want to express my gratitude to you for investing in yourself.
01:04:59.605 --> 01:05:03.684
We're prioritizing your wellbeing, new service, and inspiration to others.
01:05:03.894 --> 01:05:09.985
I'm eagerly looking forward to bringing you many more exciting episodes, and thank you for being a vital part of our community.
01:05:10.284 --> 01:05:11.695
Live long and prosper, my friend.
01:05:15.175 --> 01:05:25.135
The Biohacking Eve Health Optimization for Women Podcast is for general informational purposes only, and does not constitute the practice of medicine, nursing, or other professional healthcare services.
01:05:25.855 --> 01:05:30.114
Including the given of medical advice and no doctor patient relationship is formed.
01:05:30.385 --> 01:05:35.340
The use of information on this podcast or materials linked from this podcast is at the user's own risk.
01:05:36.150 --> 01:05:42.750
The content of this podcast is not intended to be substituted for professional medical advice, diagnosis, or treatment.
01:05:43.019 --> 01:05:52.469
Users should not disregard or delay obtaining medical advice for any medical condition they may have and should seek the assistance of the healthcare professionals for any such conditions.
01:05:52.650 --> 01:05:57.510
In addition, the information on this podcast does not constitute investment or financial advice.