Hey there. Welcome back to Fertility Cafe. I’m your host Eloise Drane. Welcome to Episode 76 of fertility cafe. In this episode, we’re exploring the question that often comes up in people’s minds when exploring their fertility options, but that are few to dare to ask, what are we doing with all the left over frozen embryos? And a recent article published by Fortune magazine after the overturning of Roe v Wade earlier this year, there are more than 1 million frozen embryos sitting in storage in the US. With the recent overturning of Roe v Wade, and the growing number of available embryos, new focus is being put on these embryos and what can be done with them. There are many questions surrounding these embryos like what is the difference between embryo donation and embryo adoption? Can anyone pick an embryo and use it to have a child? What is the matching process like? And what will the genetic, social and psychological ramifications be for a child born from that process? All of this can be a bit mind boggling to think about. But we can’t shy away from the tough conversation. To help me with that today. I have two repeat special guests on the show, Maya Grobel and Gina Davis of Empower with moxie. Ladies, welcome, and thank you so much for being here.
Maya Grobel and Gina Davis
Thank you for having us.
Eloise Drane
So first, let’s start with a quick introduction of yourselves again for our listeners who don’t know who you are yet. So Maya, do you want to go first?
Maya Grobel
Sure. My name is Maya. And I’m Maya Grobel. And I’m a licensed clinical social worker and psychotherapist primarily working in the fertility space with people who are either going through fertility challenges or trying to build their family in alternative ways. And I have a child, a daughter through embryo donation. And after that experience, it led me to two wonderful, beautiful humans, Gina Davis, who’s here today and Jennifer Vesbit who’s not here today. And we created Empower with moxie, which is primarily an education organization. But we also have a matching platform and some other great, great things community for embryo donation families, specifically. Because we saw a real big lack in education and understanding and access for embryo donation. So I am a co founder of Empower with moxie. And I always forget to mention that I made a documentary with my husband, which feels like years ago called One more shot, which is now on Vimeo on demand, which chronicles our five year journey to creating a family. Was it five years, my gosh, so yeah, that’s me. And Gina is my lovely partner.
Gina Davis
Yeah, hi. So I’m Gina Davis. And, you know, my credential started with being a genetic counselor in infertility. And that was the hat I wore for a really long time. Until I went through my own journey in fertility, I have been working at an academic medical center, really loving life, loving what I was doing helping fertility patients every day. And I had to go through my own fertility journey and found out what it was really like on the other side. And at first I thought that was just, it was like, I approach it like this is a learning experience. I’m just gonna see what this is about for like patients. But then of course, I got into the weeds of it and really experienced what it was like. We went through our own IVF cycle eventually. And unlike Maya I come from the other side, I made too many embryos in my IVF cycle. And I say too many because realistically, I could not have a football team of children.
Gina Davis
And so I had to make a decision. I mean, some people could do that. But that was not in my blood was not in my nature. And so we have two children. Now I have a gosh, he’s 11 now, 11 year old son and a seven year old daughter, and they’re amazing. But you know, shortly after my daughter was born, I realized I was like, I think this is it. This is my bandwidth. This is how much I can handle. And to be a good mom to them. Because I had to, you know, I had to think about what I wanted to do. So we ended up thinking about, you know, what are we going to do, and with all my experience working with fertility patients, I could just could not let that go. I could not let go of how many people it was just not fair that so many people didn’t come to the same end of their fertility cycle, their fertility treatment, and even though I knew it was a hard decision, I decided I wanted to donate our embryos and see what this next chapter could lead to. And it was a hard decision, a very hard decision about what to do with these remaining embryos because I knew it wasn’t simple. It wasn’t just a simple thing of like, okay, I’ll never know about that again. No, these are people that are going to have their own needs probably if they transfer works.
Gina Davis
So anyway, through that experience, I went through a lot of soul searching and really had to tangle with the fact that the fertility industry just at the time, you know, there wasn’t a lot of support. And so I, you know, found that I needed a lot more support and found Jen, our partner, who’s also an embryo donor, who was running embryo donation support groups at the time, and then found Maya and all three of us just realized we had something that we really needed to share in this space. So I’ve donated two batches of embryos, the first batch led to the birth of a little girl who’s almost four, an amazing spunky little thing that I just got to see this weekend. And the other embryo batch didn’t result in any pregnancies. Unfortunately, our second recipients didn’t have a term pregnancy, we still have some remaining trying to figure out what to do next up, I mean, we know we’re gonna be donating. But this has been such a long journey. And obviously, with the building of Empower with moxie, which I’m a co founder of, we’ve just been a little bit distracted. Oh, the other thing is, I’m still a genetic counselor. So I run a team of Genetic Counselors at Advocate genetics. And so we, you know, work with people across the United States and helping people make decisions with fertility clinics all over the place. You know, I have that too. And yeah, we’re just pretty busy.
Eloise Drane
Awesome, perfect. Well, you guys were already on on episode 36. And we talked a lot about basics of embryo donation and the embryo donation landscape. This time, though, I want us to dive into the issue of embryo donation, specifically with recent legal developments. But actually, first, let’s get into the language a bit more here. Even though we often think of donation as the giving process and adoption as the receiving process, we typically steer clear of saying embryo adoption in the fertility industry. What’s your stance on the linguistic nuance of that?
Gina Davis
It’s kind of tricky, because we understand that a lot of people like want to find something comfortable and familiar to like use as a kind of a stepping stone to understanding what embryo donation is. But unfortunately, it really puts people in a tricky place, because adoption of children comes with a lot of legal complexities and procedures that really are burdensome to fertility patients looking to build their families in alternative ways. So we don’t use the word embryo adoption, we stick with embryo donation. We also like the term embryo sharing, because the reality is we’re kind of sharing genetics here, sharing family building like tools and resources. And we just think of this as like, this doesn’t have to be so complicated. But adoption is a tricky, tricky thing. And we don’t prefer that language, because we think it just puts a lot of barriers between people. Now, that said, a lot of people find comfort in the language, and especially when they’re talking about it and trying to share this with lay people. And so we’ve still see a lot of that language being used in our communities. And we’re just kind of on the fence about like, how can we shift that language into a new place so that people have this understanding of how it really is different?
Eloise Drane
Yeah, I think part of that, just to piggyback on Gina is, it’s about conceptualization in a lot of ways, conceptualization of an embryo. What is an embryo and then conceptualization of your family? As a parent through embryo donation, I don’t conceptualize my daughters being adopted. But I think some people do because it’s really hard to wrap your head around. Well, how do I conceptualize giving birth or having a child that is not genetically related to myself or my partner, if there is one, right, and so I think there’s some work to be done in terms of language. And we’re actually doing a research study with a rhetoric Professor right now at University of Wisconsin. And we’re going to be digging into language of donor conception, specifically embryo donation, because it is a new family form in a lot of ways. And so we just don’t have the language. What do you call genetic siblings who are full genetic siblings, raised in different homes with different parents? It’s clunky when you define it in that way. And it’s challenging when you’re trying to talk to somebody who isn’t in this world, like we’re all in this world, we talk about this stuff every day. So we have the language to describe things, but if you’re at the supermarket, and you’re not, you know, and you’re not a fertility counselor, or you know, agency owner or genetic counselor of some sort, it’s different.
Eloise Drane
So I think it’s really supporting people in conceptualizing, you know, how do they imagine, what did they think of in terms of their family? What did they think of in terms of an embryo? And I do think that’s been complicated with genetic testing, you know, and things like that. But the challenge or what Gina was really touching on is adoption is a legal process that’s specific for people who are born already. Yeah. And in terms of the legals I’m not a lawyer, but the legality is, in embryos considered property with special status and how that’s defined is, you know, again, another challenge. And I know we were talking earlier about just like what are all the challenges, but assigning personhood to the embryo can be really challenging because it could threaten fertility treatments in general. And the idea of having remaining embryos can be really challenging. But we know that from sort of a moral and spiritual or religious standpoint, for a lot of people, they have really strong feelings about what the meaning of an embryo so we respect all of those different ways.
Eloise Drane
And I’ve wanted to just kind of piggyback off of what you’re talking about right now and the impact of the legalities specifically in regard to Roe v. Wade, and what that is going to have on embryo donation. You know, unfortunately, and I’ve been saying this, but unfortunately, I feel like these politicians who are changing all of these laws and changing how we are living in a society, quite frankly, have no clue. They have no clue. They don’t know what they’re talking about. They don’t know what they’re doing. And as I’ve been saying, like, they all need to just be fired. And we just need to start from scratch. But let’s get back on the topic at hand. So what is your thoughts on what the impact of the overturning of Roe v Wade is going to be on embryo donation?
Gina Davis
Well, I think it’s definitely going to have a chilling effect. I think that it’s making everybody nervous about what this is going to mean, we don’t entirely know yet. Because right now, except for one state, IVF patients have full dispositional control of their embryos, there’s only one state that has a law on the books, and that’s from 1986. So I’m not really worried about anything that’s happened yet, but it is a chilling effect. It’s very concerning about how patients will even conceptualize, you know, going into their IVF cycles, what are their rights going to be, depending on how different states interpret and make additional laws that might grant personhood status to embryos, but realistically, it’s like, many, many people need to use infertility treatment to conceive, and especially in this world today, where a lot of people are putting off having children until they’re more stable financially and mentally, which is all a good thing for a society, it’s a good thing for mature adults to be having children, and to be raising the next generation.
Gina Davis
So I think it’s very problematic. But right now, you know, we’re on this place where we’re like, trying to figure out which way it’s gonna go. We personally want to make sure everybody still has full dispositional control of their embryos, we want to make sure these decisions are made by people that want to make these decisions. People should not become embryo donors, just because they made more embryos than they could use. Because not everybody is meant to be an embryo donor, not everybody can handle being an embryo donor, there’s effects, mental health wise and on the family dynamic, on the children that are going to be raised. So I personally find it to be really appalling, just like you that we’re in this space. And I hope they start listening, because this is our reality, like many people waiting to have children will get into this place where they need to make conscientious decisions about their children, and it’s a gamble, who’s going to be successful, who’s not with IVF. And it’s not fair, some people end up with too many embryos for their family building needs, and some people end up with not enough and financially, it’s just this huge gamble. And I think we’re in this place where it could be really, really discriminatory to people that need to use fertility treatment.
Maya Grobel
And I would just add that, you know, generally research shows that people generally take about five years after they feel their family is complete, to make a decision about what to do with their embryos. So that’s sort of like a rough estimate of time. And I think with feeling panicked about, you know, reproductive autonomy and rights, and will we be able to make decisions about remaining embryos, and what does this mean, and all these kinds of feelings that a lot of people have, they might be trying to make decisions sooner, rather than later. And so part of that, and I think that’s part of why, you know, we do a lot of virtual events around what to do with remaining embryos, and then different things like that at Empower and part of that is because we want people to still make the right decisions for themselves, right. So don’t make a panic decision, but really being able to get the information they need to move forward in one way or another. But right now, nothing has changed in terms of fertility treatments, and things like that. I think it just, it’s just scary when certain rights are taken away, and you’re like, how are you making choices for my body and my family and future family and all of that. So I think that’s what freaks people out. But for now, nothing has really changed.
Gina Davis
There’s a couple things I’ve seen in the community. One is people going oh my gosh, should we move our embryos to a safe state somewhere where they’re unlikely to be, the risk is unlikely to be there that they’re going to make this illegal that we could dispose of our embryos the way we want to. And right now, ASRM, that’s the American Society for Reproductive Medicine if you don’t know that already, but they are advising people not to do that they say, it’s really premature. There’s risks associated with, you know, moving them for no reason. And you don’t necessarily even know which state is going to be safe, necessarily. So it just doesn’t seem like it’s necessary at this point, that things might shift and change depending on laws that are enacted. But the other thing I’ve seen is people, we’re thinking it’s gonna have a little bit of an effect on decision making about embryo donation, you know, who’s going to be controlling the decisions about any remaining embryos, after you know, a recipient is done with the embryos?
Gina Davis
What if, you know, should we do testing on the embryos, so that we know, at least if somebody’s going to transfer in a state where abortion has become illegal? Will they have the option to terminate a pregnancy if there is a genetic issue. So things like the testing of embryos, if it hasn’t been done already, maybe some people would be like, you know, I think I want to do the testing. Because you know, even if my risk is low, maybe I want to make sure that I’m not going to get in this tricky situation where my recipient is going to have their full options. It just complicates things. And I think it also highlights, sometimes different conceptualizations, it highlights that between recipient and donor. If your donor or recipient feels differently about what is the status of an embryo, it suddenly really highlights that as a critical issue that you kind of have to talk about. And sometimes it can be uncomfortable. And people need support in engaging in those kinds of conversations, because a lot of people just have strong feelings one way or another. And when you have another party involved, it changes things.
Eloise Drane
Oh, yeah, that it does.
Eloise Drane
So let’s talk about embryo disposition, donation and the selection process. First, for people who don’t know what embryo disposition is, it’s the process of deciding what to do with your leftover embryos, once intended parents have completed their family, and don’t plan to have any more children. So what is this process like for the intended parents? You know, obviously, both of you have gone through different sides of the experience. So would you mind sharing kind of like, what does that process look like The Good, the Bad, and The Ugly observation of it
Maya Grobel
We started just even chatting before we started recording and the the term problems or challenges came up. And I think when we’re talking about the process, I think we might have to start and I hate to start with problems. But we might have to start with some of the challenges. And I think part of the challenge is that there really isn’t an exact process to embryo donation from the recipient, slash intended parents side of things. The processes oh my gosh, either I’ve been through X, Y, and Z. And I have to mentally and emotionally switch gears to really embrace the genetics of somebody else, you know, there’s certain emotional and mental tasks to complete, right? Just within yourself or your partnership. And then there’s well, okay, how do I do this? Where do I find an embryo? How do I find something that matches for me whatever matching might mean for you? What does it cost? Do I need a legal contract? There are all these questions that come up.
Maya Grobel
And honestly, it’s done very differently at different places at different clinics. And that’s part of the main challenge, I would say with embryo donation is that there’s not a cohesive strategy or process across clinics across the country. And that’s part of what you know, at Empower, we’re trying to really support clinics in creating a better process for patients, because some clinics, for example, may have remaining embryos that were relinquished, which is like the custody of those embryos have been given to the the clinic to do whatever they want with. That model isn’t working anymore. Because of 23 and me and a lot of other things, but primarily because you know, donor conceived people have strong opinions, and they should, and part of the opinion is, you know, their full genetic siblings that are related to us that we don’t get to know or know of, and it’s really problematic in a lot of ways. So, my daughter is actually from a program like this that was quote unquote, anonymous, and I don’t believe it’s up and running anymore in the same capacity. So, you know, just in the last seven, eight years, things have shifted a bit. But you know, and that’s kind of why we’re doing our open platform where people can meet and match and connect so you know where your embryos going, and you know the outcome and that was not how it has been done traditionally. However, there are still clinics that do that, that is anonymous program.
Maya Grobel
So I guess, trying to answer your question in a clear way, there are different pathways to embryo donation. And the process of embryo donation, one pathway is to go through a clinic, possibly an agency or like a concierge program. And those, you know, they’re not a ton. But there are some clinics, you know, that may have an embryo donation program or that quote, unquote, do embryo donation. The other pathway is to find and connect with a donor or recipient on your own through, again, sometimes through an agency, they allow that open matching or concierge through a platform like ours at Empower or there are some other I don’t know if it’s platform, but like companies that help to connect people. And then Facebook, social media, like people sometimes meet in that way, as well. So then you find your donor recipient, and then you navigate the next step process, which includes psychological consultations for both parties, and then jointly generally, which includes legal contracts, again, with both parties, and then jointly, and then hopefully, genetic consultations with both parties. But again, a lot of these things aren’t always required, and different clinics have different ways of dealing with it. So sometimes, if you’re going with a clinic there may not be a legal contract, they’ll just have you sign some kind of consent form. So it’s a little bit up in the air, in terms of everybody’s process may look a little bit different. But yeah, I don’t know, Gina, do you have a better way to explain that?
Gina Davis
Yeah, I mean, from the donor perspective, there’s a lot of different ways you can go as well. And so you have those same options. Many people, when they have remaining embryos, kind of sit on that decision for quite a few years, trying to make a decision of what they want to do. And the options do not just include donation, other people, many people end up discarding their embryos, if that feels like a more peaceful decision for them. Sometimes people decide to donate them to research. And there are a few programs that are accepting embryos for research right now. And sometimes they decide to do some kind of memorial events or, you know, there’s some rare things that people sometimes do. Occasionally doctors will allow people to do compassionate transfer, which is transferring an embryo in a time where they’re unlikely to become pregnant, because they don’t want to become pregnant. But they also want to, you know, do something more natural.
Gina Davis
And then finally, embryo donation, which is where we focus, because it’s so complicated, and we think people need support, and we have that information, we want to share it with the world. But from a donor perspective, I mean, sometimes people just decide to donate to their clinics, like Maya mentioned that that’s kind of an older school method. And there are still some programs that are doing it. But honestly, it doesn’t meet the needs any longer. For you know, what families need these days. And the reality is that, most likely, at some point, these genetic connections will know each other. And so starting off on the right foot just feels a lot better to people. Now, some people prefer going in and not knowing a bunch, and they want to kind of remain more distant. And that’s totally fine. There are ways to do that. But it’s really a good idea to start with, at least having some sense of what that is going to look like down the line in terms of any kind of consensual communication. And so the things that are popping up now are really more platforms or companies like ourselves that we can facilitate that and other kind of concierge services that can kind of match people and see, you know, make sure that the needs are met.
Eloise Drane
So what specifically are the steps? Okay, so I’m home, I have embryos. I mean, you know, you went through this, right? So you finally decided, Okay, I’m done. I have my two children, and I still have these embryos, obviously, I don’t want to discard them. I don’t want to donate them to science. I do want to donate them to, you know, another family. How in the world do you go about even starting that process?
Gina Davis
Well, we recommend you start with Empower with moxie.
Maya Grobel
And part of that is education. I think you know, as like, again, yeah, the EM -power is education. Like you have to educate yourself and make sure you understand the implications of this choice. For someone like Gina who has 16 remaining embryos
Eloise Drane
Oh my gosh I didn’t realize you had that much
Maya Grobel
I know, she won the lottery with her embryos. And yeah, and she was two for two with her children. And so they were, you know, pretty good quality embryos, even though they weren’t tested. But the first thing is to understand well, how many people do want to divide this amongst? How many children feel okay for you having your genetic combination that you have? And, you know, so I think there’s that part where the first step in anything is education, and that’s why we created this whole education platform to really go through it to ask yourself and your partner if there is one, you know, how do you feel about this? How do you conceptualize this and things like that? Once the decision is yes, this feels like the right choice for us, then Gina
Gina Davis
Then you go, somehow you decide how to match and honestly matching, I’ve done it in multiple ways now. And it’s interesting to me. But a lot of times, like we always say that it’s a little bit like online dating, because you’re probably going to date a few different people and start to explore a few different matches before you land on one that actually goes through. And so I’ve actually matched in a variety of ways I’ve matched on Facebook, in the groups. That’s actually the reason we started Moxie matching. Part of the reason is that it’s just not the best place to do this. But I’ve matched that way with some of my recipients. And, you know, it actually turned out great because I have all the knowledge that I need. And like I was able to facilitate a lot of things. But I’ve also matched with a family member. So actually our first recipient turned out to be a family member. And that was actually because I had already matched with somebody from Facebook, and was trying to get all the process organized when I reached out to my family to get updated medical history, because that is if I can provide anything to a child that’s genetically related to me, it’s going to be a good family history as a genetic counselor.
Gina Davis
And so I reached out to family members and learned that one of my uncles and his wife had been trying to conceive and weren’t having luck. And were kind of turning to embryo donation as the next step. And they were like, where do we get an embryo, they were on the other side exactly. At the time that we were finally ready to donate. So it was kind of perfect. But in any case, I’ve also matched through an agency. And you know, it’s just a different experience, depending on what you’re looking for. Personally, I really prefer matching myself, because I want to have those conversations and make sure that we’re all on the same, the expectation is always like, it’s direct, that we actually are talking to each other, that there’s no intermediary that’s kind of trying to share information back and forth. For me, it just didn’t work very well, when we had, you know, an agency between us. So personally, that’s why the way we like to match is actually having conversations, but it’s going to be different, everybody’s different in terms of what they prefer. And so depending on how you want to, Empower with moxie, our education platform, goes through all of those options. And people can kind of decide what makes sense to them, ask them questions in the community space, and then lands on how do they want to match. And then we do have a matching platform that really puts front and center the things that we think are important in helping people to engage in a way that they want to.
Eloise Drane
So Maya, can you touch on okay, let’s say we’re on this matching platform, and there’s people that are saying, Okay, we have embryos that we want to donate, how in the world do you go about selecting as the recipient, who’s embryos to accept like, you know, okay, I would probably consider them like, alright, well, maybe since I’m a black woman, I may want embryos that have genetics of, you know, African American descent or something like that. That’s easy. I feel, how do you then go into detail on the other things and some of the things that you have no idea about?
Maya Grobel
Well, one, we want to normalize that this is a little bit like dating, and it’s sort of like a joke. I’m like, it’s like you’re sniffing butts, right? You’re sort of like, is this gonna work? I think we have our initial ideas about, you know, what we’re looking for. And it comes down to matching your eye color and hair color and ethnicity or race when it comes down to these simple things in the beginning, and I think that’s the model of egg donation that has been around for longer. Well, I shouldn’t say it’s been around longer than embryo donation but more popular, you know, right, that when you look for a donor, you’re looking for some kind of match. But when you’re connecting with embryo donors, I think is a little bit different. And Gina can probably speak to this better than I can, but your children are full genetic siblings, and you’re oftentimes as a recipient having to embrace the genetics of some other couple or you know, embryos can be donated when they’ve been created with an egg or sperm donor if the egg and sperm donor have consented, and you know, but there’s this, it’s a little bit different when you’re having like a full embryo as opposed to an egg or sperm donor and you’re trying to find a match that fits for you for various things that are important to you.
Maya Grobel
But I think also you’re trying to find family that your family can feel connected to down the line. Again, you don’t have to be best friends or donate within your family or go on family vacations, but chances are high that children may be interested in each other. They may be curious about their full genetic siblings who are raised in different homes or about their donors in general. So you want to connect with somebody that maybe share similar values or activities or you may want to match with somebody who either lives close to you. I know people that do that, oh, I want to find somebody who lives in my area so that our children can get to know each other or opposite. I want to match with somebody who’s across the country, so I never see them at the supermarket, because that’d be weird for me. Right? So it’s different for each person. I think there’s also as a recipient, I tried to think that I did not match in an open way. I matched in what’s the easiest, put something up my body and let something like alive come out. I don’t care if it’s a koala bear, or, you know, I don’t care, I was so desperate and vulnerable. And not the best space probably to be doing.
Maya Grobel
But you know, I did my own IVFs, IUIs, my sister donated eggs to me, we’d been through it. So for a lot of people, by the time you get to embryo donation, you’re a little bit broken in some ways, you’re a little bit like, okay, you know, but you got to find a way to kind of recharge and forecast a little bit, okay, if I’m gonna have a potential relationship, I don’t have to have a relationship now necessarily with these donors. But if down the line, what’s important to me, what are my deal breakers? Is it political affiliation? Is it religion? Is it location? And I think also what can be really challenging and, you know, as a therapist, I work with a lot of people who are looking for, I do these third party consultations with people and, you know, finding a, quote, unquote, match in terms of ethnicity and race can be really challenging for a lot of people, because it just doesn’t exist, you know, and I think that’s part of what we really want to try to do at Empower is reach out to different populations and normalize this and introduce this, you know, in different ways, but I work with a lot of people of color, and they’re like, I can’t find something that works. So it’s more to just hair and eye color, I think in general, but especially with embryo donation, you want to make sure that your match feels like a good match, like somebody you can have an open, honest dialogue with. That’s key in so many ways.
Eloise Drane
Well, and I think too, though, that that also is assuming that it’s going to be an open donation, because unfortunately, for a lot of the fertility clinics that are still kind of doing this, it’s still very much anonymous, and some fertility clinics, matter of fact, they won’t even allow you to do any embryo donation, if you were not previously a patient of their practice, or willing to be a patient of their practice, which is really a shame, because I feel that quite frankly, it’s about your bottom line. It’s not about you know, the families that you’re really assisting. I’m curious, though, do intendant parents, are they given the option to select frozen embryos? So for instance, you’ve gone through, like you said, you’ve gone through rounds of IVF, and you’ve tried donor eggs, and nothing was successful, was it something that was shared with you like, Hey, have you ever considered embryo donation? Or was it because of your background and the knowledge that you have of saying, Oh, yes, you know, maybe this is something that I should now consider instead of trying to do another fresh cycle or donor eggs or whatever.
Maya Grobel
I mean, the bottom line, as you’re saying is that embryo donation does not make clinics a lot of money, right? You cannot buy an embryo. And you cannot sell an embryo. It’s a little different than when you’re you know, it’s called egg donation and sperm donation, but there is exchange of compensation in those processes that’s different from embryo donation.
Eloise Drane
And why is that real quick? Why can’t you buy embryos?
Maya Grobel
Gina?
Gina Davis
Well, they’re given special status, that is the whole legal thing that they are property with special tests. And the other thing is, I don’t even know that really they consider it buying eggs either or buying sperm either, because it’s really compensation to the donors for their time and, you know, efforts and all that stuff. And the costs for the banks or agencies that are putting things out. But at the same time, embryo donors cannot be compensated for those things, because they already have done it for their own reproductive purposes. They can’t be compensated for their own IVF cycle that they had to create these embryos, they can be, in some cases, reverse back, you know, storage costs and stuff. Not everybody asked for that most people do not as far as I know, but anything going forward into the future and specifically for the embryo donation. Yeah, the recipients can cover the cost, but it’s a very different line than for egg donation and sperm donation where somebody is doing this expressly for somebody else to have a child and they didn’t, you know, create these gametes for their own reproductive purposes.
Maya Grobel
And so, Eloise you asked if intended parents can choose and I think it’s important that people remember that they do have a choice. When you’re an intended parent, especially at the end of your line, the way I was, it doesn’t feel like there are a lot of choices. And you kind of just like, I don’t know, there’s desperation that comes across, sometimes for people. But the matching platform that we have and a lot of others, it’s very mutual, you have to both select each other. So, yes, there’s sometimes this feeling of oh, I hope the donors pick me, but it kind of goes both ways. And in working with Jen and Gina, it’s became really evident, like, that’s what matching means that you both mutually agree that this is a good fit for us. As intended parents, if you’re going through a clinic, sometimes they have, you know, X Y and Z available, sometimes they have these programs where you can look on like a database, like certain clinics have a database, and it really is there’s not a lot of information.
Maya Grobel
And it just like there’s four embryos, this is the, you know, height and race and blah, blah, blah, right? There’s just a little bit of information. And then yes, the intended parent can just say, Okay, I want those and, you know, it kind of feels like these, like de identified baby seeds that just like in these databases, and you know, they don’t really consider that these embryos, if they’re successful, they do have genetic connections to other humans and other people. And, you know, so, but anyways, but yeah, there’s choice in that. But I think there’s choice in all of it. It’s also, it just choice, though, among what’s available. And embryo donation is not the most popular disposition option, you know, so what’s available is what’s available. So it’s trying to just like understand that and make the best choices that that you can
Eloise Drane
Do you find that intended parents generally struggle to accept the embryo that does not have their genetic material, or you found the opposite.
Maya Grobel
You know, we see, I think people are just different. And so sometimes people come to the table, like, oh, my gosh, Thank gosh, I can let go of my genetics and, you know, blah, blah, blah. But other times, there’s a lot of genetic grief and genetic loss that people feel. Sometimes it’s just about transitioning and kind of changing the goal from, you know, my eggs or my sperm and you know, my body essentially to I want to parent, I want to get out of this fertility patient lifestyle, and I want to parent and move on to this other stage. People come from so many different places, in the last couple of weeks, I would say we’ve had a lot of inquiries from single women who are pursuing embryo donation as single moms by choice who are like over the age of, you know, 40 something. And I think that’s a really, embryo donation is a wonderful choice for that population. But historically, embryo donation hasn’t really been available to single people.
Maya Grobel
And the history of embryo donation is a whole other podcast. But you know, it hasn’t been super inclusive and accessible for different compositions, you know, different people. So, we’re really hoping to support those ingle moms by choice and being able to help them match and choose and, you know, there’s choice, but it’s choice among what’s there, what’s available. And, you know, because you can kind of go about this in different ways. I think part of this is really thinking about both as a donor and recipient, how. That’s what Gina was really talking to, how do I want to do this? Do I want to have more control over the situation? Do I want to know the outcome of my donation? Do I want to have contact, do I want my kids to be able to have contact whatever side that might be on?
Eloise Drane
Can we talk real quick on donor conceived children?
Gina Davis
Actually can I jump in real quick? I think that is the piece that is going to change the whole dynamic is that many donors or people that have remaining embryos are becoming more interested in the impact on donor conceived people and on just like the long term decision making. So what we’re finding is that people that have been traditionally not kind of excluded from embryo donation based on an older model, are not going to be necessarily because there’s this whole new, if they’re willing to be open, if recipients are willing to be open, there’s a lot of donors that are out there looking for open relationships, and that can mean a variety of things for people. So your feeling of choice may be different depending on where you put yourself, How comfortable are you with knowing who the contributors, you know, your genetic contributors are to your child. And so it’s really more of a choice of like, what am I comfortable with? And that really opens up new doors or new possibilities for how you can match what is available to you. So I just wanted to bring that in. But you had a great question, which I’m sorry, I cut you off and what were you going to ask
Eloise Drane
Let’s talk about donor conceived and because that is now becoming a very huge thing now in the fertility industry. And rightfully so. You know, these people who were being brought into the world, and I think that everybody needs to stop. And even though you’re going through fertility, care and having all of these issues, what we’re doing is bringing a human life into the world who ultimately has every right to know how he or she is made up. And that child that we keep thinking about, Oh, baby, when I want a baby and a newborn, and all these other things, he or she is going to one day or they are going to become an adult, who has a right to this information. So you know, we’ve been talking about it on the egg donor side and even touched on it on the sperm donor side. But how do you even do that now even under embryo donation, because now, you know, that there are children out there from these donations. And now you know, okay, there are full siblings. Typically, when you’re talking about donor sperm or donor egg, it’s a half sibling. Now you’re talking about a full on sibling? How do you move forward with that?
Maya Grobel
Well, and that’s the issue. And that’s what you know, I was honestly, my experiences my own specific personal experience. So I can’t speak to everybody having, you know, kind of a generalized experience like this. But I didn’t understand what anonymous meant till when I was going through this. And again, front end education, informed consent, right, like understanding what your decisions are from the beginning, but I just really didn’t, I assume that once if it worked, that I could write a letter, and the clinic would help connect us or would, you know, share my information or whatever else? And then I learned that the embryo donors aren’t, weren’t allowed to know if a pregnancy occurred. And that kind of blew my mind because like, I knew it was like, anonymous, but I didn’t understand that part. So what do you mean, they’re not allowed? Don’t they want to know that? That was my question. And the instant answer was, Oh, well, it’s you know, they’re part of this anonymous program. And this is what it is, and they kind of relinquish the rights to these embryos. And then, and that’s it, and I went, I was like, oh, like I was, I felt so stupid, because I just assumed that, oh, once there’s a pregnancy, everybody’s like, cool or something, and that’s why being able to have choice, or to at least understand what’s happening is so important for people.
Maya Grobel
But yeah, my child has multiple siblings, half siblings, full sibling, that we may or may not get to know. And part of my job as her parent is to be able to navigate that with her. And it creates some challenges for parents. And as she gets older, I mean, she’s well aware, you know, she’s seven, she’s known from the very beginning, I think being open and honest, is number one, and if people need support, there are more and more resources now about how to talk to a good donor conceived kids about your family narrative, I really take a family diversity approach to it in talking about that families are created in different ways. And this is how our family came together. And so she’s well aware of all this, it’s just funny to see how it, like, connects through the ages, right? Now she’s seven, like she really wants to be a single mom by choice. She has all of her plans. And, you know, this is what I do for living so this is all she hears.
Maya Grobel
But yeah, I think just being open and honest, and understanding how your early decisions, form your family narrative. I think that’s a really important thing. And that’s what I talk to clients about when I work with people about this. I worked with somebody the other day, and one of the partners said, Well, does it matter if I like the donor or not? And I said, I don’t know, what’s your family narrative gonna be? Is it like, I just found somebody who was tall? And then they were like Oh, okay. Because there’s a story for this child that’s different than we you know, had a glass of wine and this happened, or whatever, right? Like there’s an actual very intentional process that people are going through. And I think, you know, not that a child needs to know the details of that process, but that it was thought about and of course, I’ve lost sight of your original question. Because we’re such talkers, and I’m aware of time as well. But yeah, I don’t know. Gina Do you have?
Gina Davis
Well, yeah, I wanted to jump in from the donor perspective. I mean, it’s similar concerns and thoughts and fears and things that run through your mind of like, you know, yeah, there could be a person on the other end of this, who may not like this as a choice, they might feel a million different ways about this. And we don’t have any control over the narrative that’s going to be shaped in their household. You can have some insight, and if you align with them on the front end, if you talk as a family and how we’re talking about this and things so that we can have some general kind of understanding. I think it’s been honestly my experience in this has been like, I don’t know how to replicate it. It’s amazing. Because both of our families, the way that we talk about this is so beautiful, and in my mind is beautiful. I feel like this has been such a gift for both of our families and the uniting of our families in different ways. And it’s just oh, gosh, it’s so beautiful.
Maya Grobel
She’d have much fewer toys.
Gina Davis
I can’t even say like this chapter of my life, I would not have asked for this chapter of my life, like going in saying, oh, yeah, I want to have this issue happen so that I have to make the difficult decision. And then we’ll do soul searching. And then, but then in the end, oh my gosh, it’s like a richer experience of life having, you know, and I can’t put it into words, at least not in an articulate concise way. But it has been transformative. And that’s what I try to talk to my children about. It’s like, yes, there’s the mechanics of it, egg and sperm and all of that. But there’s also all this beauty of like, what is family? What it doesn’t mean to be related to people in this way? You know, what would it have meant if we had decided to have a football team of children? My daughter, and I just talked about that two days ago, and we were talking about, like, if we decided to transfer all the embryos, What would her life look like then? And you know, what would our lives look like?
Gina Davis
I know, right? She’d be changing some diapers. But anyway, there’s this part that I’m like, Yeah, it’s like, our worlds have just shifted, and our definition of family has broadened, in just an interesting way. And I think that donor conceived people deserve the respect to be treated that way and to be thought of responsibly, like, Okay, what is that narrative going to be for my family, for your family? How are we going to talk about this as a whole, and it is going to shift all of us because families are not, it’s not like, there’s one way of starting a family. And that’s actually not how human society has ever been. It’s just that like, the 50s and 60s kind of set up, like this whole norm of a nuclear family that, I think that we’re trying to really try to unpack, because I mean, I’ve been like looking at a lot of like anthropological stuff of like, how tribes and stuff when they’re finding people.
Gina Davis
I read this one interesting thing about how they look at like, who was living together, and they found, you know, these tribes of people that had like, no genetic relationship, but very, very, very closely related clearly by their living circumstances. And I just think that shows that human society, humans have a way of finding, you know, a way to live together and be together. And I don’t think that we just have one definition of what that should look like. And I think that that’s what we should learn from donor conceived people of like, how do we incorporate both genetic identity, which is real, which is a real question and concern, and you know, your social identity, who you are, and like unite those two in a way that’s conducive to your mental health. It’s actually enriching for your life. And I think that’s what Empower is about because we’re like, you know what, it takes Moxie to make these decisions intentionally. But it doesn’t necessarily mean that that’s going to be hard or negative. It’s just a different experience of life.
Maya Grobel
And I think, you know, for a lot of intended parents or donors, you’re making the best decisions that you can, and you’re starting the narrative, but I think that one of the biggest things, is to kind of get out of the way for the child as well, as they develop and allow space for that narrative to develop for them as an individual person, what does it mean to them? Like we can, you know, parents I hear all the time say it’s love that makes a family. Yes, love makes a family, but there might be other things, they might have strong genetic feelings, or connections to other people, and I think that’s okay. And if we can just as intended parents, at least not feel threatened by that, or not see that as rejection or something and just understand that that’s how they’re understanding who they are. And that’s beautiful. And there are other people that contributed to who they are and being able to embrace that can be hard for intended parents, at least in the beginning, you know, and thinking back I think that probably would have been hard for me in some ways, had I known the donors to really fully embrace that other people are contributing because you’re so kind of in this space of like, I just want to, you know, like mine and is this gonna work and there’s all these fears and stuff.
Maya Grobel
But once it’s there, you look at this person and you know, my child’s very athletic and praise the egg donor, right? Because she’s got like, long legs, and she’s a great swimmer. And like, you know, and so there are certain things where, and we talked about that in a way that’s just inclusive, that we’ve embraced, you know, the donor helpers, what we call the donors, but specifically the egg donor. I know, she was very tall and athletic, and they had other things that I am not. And so, you know, it’s like, when she’s got her attitudes, like, oh, that’s mama right there, you know, but that dive that you just did that’s not me. But at the end of the day, we can’t pinpoint who belongs to, she’s her own unique individual, but how she understands and embraces that other people have maybe contributed to who she is in some way, all we can do is see that as like a really beautiful thing. But I have to not feel either threatened or protective, or whatever. Also, you know, if intended, parents have those feelings, and just getting the support to work through them, and really feeling confident in you being the parent, regardless of where they came from, will help you give space to that child to embrace different elements of their own identity or genetic identity,
Eloise Drane
I would also add to that, that your children are going to feed off of you, what you put out is what they’re going to receive, if you put out that it was something dirty, it was something hidden, it was something that you don’t want anybody to know. And it was something that, you know, you don’t even want your children to know, that’s what they’re going to glean from it. Oh, I must be a dirty person, I must have not been wanted, I don’t deserve to be here. But if you change that narrative, and you talk about how much they were wanted, and how many people like literally the whole thing of it takes a village, it did absolutely take a village for you to get here. And how much love and care and all of the things that came from so many different people to bring you here, you are very much, you probably more wanted than when we had the wine night and all of a sudden now Oopsie.
Gina Davis
So that is really, really important. And something that I felt it viscerally this weekend, you know, we were with our recipient family. And all of a sudden it just really came upon me that all of these people have come together to make her. And without all of us, without all of the elements, she could not be who she is. And she’s so amazing. When I look at her, and I think I didn’t have the patience to have her. And I mean, honestly, I would not have had the patience to have her and let her be fully her in the same way that I want to be as a mom and her mom is amazing at letting her be fully her. And that’s the thing like, I had to recognize my limitations and say, This is not the best thing for her. I think there’s something better for her out there. And I didn’t know she was a girl or any of that stuff back then. But for the entire cohort of members, that was what I was really, you know, weighing was like, I think that I have it in me to be really open minded and see family in a bigger way. But I don’t have it in me to raise a football team. And I also don’t want to discard them because I know how many people out there could be amazing, amazing parents and that it’s just not fair, the way that it works. It just the dice work, you know, essentially in this gambling thing.
Gina Davis
And so there was all this piece, and I feel that every time and I hope that that’s the narrative that our kids will see that this magical experience could never have been another way, it couldn’t have been another way and then still have the same experience of life. And I hope that that’s a good thing. But you know, I mean, we can’t control that narrative, and we have to let them come to their own understanding of it. And sometimes they might think, well, it wasn’t enough to be wanted, I also want this and that’s okay, I have some real objections the way I was raised too. So I think it’s okay to also have negativity and that’s okay, we need to accept it and hear it and hear people and you know, accept our responsibility and things. So that’s what I’m preparing myself for in the long run. She might not agree. And my kids might not agree, my daughter still might say I want more siblings, but in the end, all I can do is be who I am and be human and be real and be honest about my feelings and show up as much as I can. And that’s what I’m just you know, taking right now is I’m having that Moxie to just do it and to be here in the present moment.
Eloise Drane
Yep, absolutely. So final question, since we’re all in the fertility industry, what shift do we need to make in the fertility industry for embryo donation, for donor conceived people, for women who want to be donors, for men who want to be sperm donors, for all the things because I definitely feel that we in the fertility industry have a responsibility also to these people. What is your final thoughts?
Maya Grobel
I think the biggest shift or the biggest need is for more education that is transparent and non bias. I just think there’s a lack of education in general, that donors understand what they’re getting into, that intended parents understand, and that there’s education around the child on the other end and donor conceived needs and things like that, so that people can make informed decisions. I can’t tell you how many people I meet with, who are working, let’s say with a sperm donor. And when I talk about half siblings, they go, Oh, my gosh, I never even thought of that. And, you know, and I think, well, you’re far down this journey. Nobody’s ever talked to you about the fact that the sperm donor may have also helped other families come to be. And also with people still thinking they can be anonymous on one end or the other, right? There’s certain things where we assume that people understand what at home DNA testing means and things like that. But there isn’t a ton of education. So specifically around embryo donation, I think the most important shift needs to be education. I think a shift to an open model is really important for everybody involved. Those are the two big ones, for me. Inclusivity to just allow space for a lot of different populations who are really underserved by embryo donation in general, to have access. I think those are maybe the three. Sorry, Gina, go ahead.
Gina Davis
Yeah, I think focus on the long term family functioning is absolutely critical. And just really being aware that this is, the narrow space that fertility clinics have in this part is just the smallest piece of this really larger family construct that’s happening, and just being aware of that responsibility, that it really cannot be policy set for the convenience of the clinic. Because it’s messy, and difficult. And we’re not adoption agencies, or we’re not social worker. I get that, you’re not. You shouldn’t be, you’re very good at your job of reproductive medicine, but policies cannot be completely inhumane, you know, at odds with what family functioning needs to be. And so a focus on that and respect for, let’s see, how does this bigger picture fit in here, understanding that you’re working with a very vulnerable population that is, like, they don’t know how to make these decisions. And we’re really the first generation having to make these kinds of decisions.
Gina Davis
This is the first time in history I mean, you know, in modern world where we could have children that are genetically not related to us that we’re carrying, or vice versa, that you’re passing your genes on to another family to raise in a different home. And I think we’re just at the start of this. It’s sort of like we should have learned some lessons from the adoption stuff in the 70s. And somehow we didn’t. And now we’re starting to learn it again, in embryo donation and egg donation, sperm donation, and I just think we need to take that responsibility and say, Okay, you have to have some forethought about what that means.
Maya Grobel
And I think they’re just so important with, you know, at the clinic level, there’s a responsibility if you’re going to help people make 30 embryos, to educate them on the front end. And we see it, we see people go, Oh, my gosh, I didn’t realize that I was going to have all these embryos or with PGT testing, like people get really excited about knowing the sex of an embryo but once you know certain information, you can’t unknow it, and then there’s a possibility that there’s a different connection to those embryos, because you’re seeing them as little girls and boys, and then it becomes very specific. So I think just being again, it’s education, but from the clinic level, being able to say, you know, we’ve retrieved 42 eggs, do you want to inseminate all of them? Or, you know, know your options, the disposition option choice is generally a checkbox that you look at and sign on the front end before you even engage in IVF. That’s not the most opportune time to be making a decision for remaining embryos, because at that beginning part, you’re like, hell yeah, I want 150? I don’t care, right? You’re so focused on that you don’t realize that there’s a dilemma on the back end.
Maya Grobel
And what happens for people who have remaining embryos, is you end up paying for storage for years, and your fertility journey isn’t resolved all the way because you have this connection to the clinic, you’re paying for it, you have like this shadow, so maybe your family feels complete, but you’re going oh my gosh, we’re paying every year for this and what are we going to do and you know it’s burdensome for some people. For some people it’s no problem, discard them. We’re done. We’re cool. Or donate them to science or whatever. But for some people, the clinics need to understand what this means for some people and give them a little bit of education and tools and perhaps, education around disposition. What we’re trying to do is provide some information for patients after their family’s complete, they don’t have connection to the clinic anymore, other than that storage bill, right. So you get this bill and you’re reminded of your journey, and that you have to do something at some point. And then, you know, the legal and political landscape in our country changes and Oh, my gosh, now we really have to do something you know, and what are you going to do? Have your children inherit your embryos? It’s like, something has to be done at some point. So I think there’s educational responsibility
Gina Davis
I think it’s like the old storage unit that you bought, you know, you had years ago, and you’ve been paying for it. And you’re like, I don’t even know what’s in there anymore.
Maya Grobel
It’s like one brown couch.
Gina Davis
I don’t know if I care about it, but I can’t let it go. Because what if it’s something? And then around that this moral or philosophical like, what exactly is that storage unit that’s full of possibilities of what my future life could be like, if I go one way or the other? And it’s just, it tortures people. I think that’s the pieces that I did not, I also went in I was like, I won the lottery. Yes, you know, and then I’m like, Oh, my gosh, just like the lottery winners, a lot of them come to regret it, because they’re like, I mean I don’t regret it anymore. But I think that there was a piece or like, a lot of lottery winners are like, it changes your life in ways you can’t expect and not always in good ones. And that’s kind of is that I made these embryos, I was like, Yes, this is awesome. And then it’s like the meaning of that it starts to really chip away and you’re like, what kind of responsibility do I have? And then you have to really dig deep to know what that means. Some people, they don’t torture themselves like me. But there are people like me that torture themselves, they want to get ahead of that and help people that are in that space.
Maya Grobel
And if you are like that, you might really consider do I want to inseminate all of these? Do I want to freeze eggs? Or do I want to freeze embryos? Or do I want to, if I do testing, do I want to know the sex of these embryos? Do I want the doctor to tell me there’s a 70% chance? I hear that all the time, you know, oh, they’re PGT tested, you have a 60% to 70% chance that they’re humans, all of a sudden that changes something for people, right? Oh, my gosh, they have a 60% 70% chance. And this is the sex of them. And you know, and it’s a lot of information you have to decide if you want that or not.
Eloise Drane
Absolutely. I can’t thank you enough for joining me today. Thank you so much for being on the show. And of course, we will be putting all of the contact information about Empower with moxie in the show notes and how they can find you guys and get all the information that they need for embryo donation. So thank you for your time. I really appreciate you.
Eloise Drane
Thank you so much for listening. If you found this episode helpful, please rate Fertility Cafe on your favorite listening platform and share this episode with anyone you think could benefit from hearing it. Thank you so much for joining me today. Until next time, remember, love has no limits. Neither should parenthood
