The best time to freeze your eggs is probably when you can least afford to do it.
Women who undergo the procedure in their mid-30s or earlier are at a significant advantage. The younger they are, the more likely they’ll retrieve a large number of eggs and need fewer to achieve a healthy pregnancy, per Fertility IQ.
Yet just one cycle of egg freezing can cost approximately $4,500-$8,000, and the injectable medication comes with an additional $4,000-$6,000 price tag, The New York Times reported — that’s before the cost of egg storage, which can exceed $500 per year.
“There’s amazing science and technology that makes egg freezing possible,” Lauren Makler, co-founder of fertility startup Cofertility, says, “yet it’s so inaccessible for so many people because of the cost.”
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Makler’s journey to co-founder began when was diagnosed with a rare condition that required abdominal surgery in 2018. Unsure if she’d be able to conceive in the future, she researched the egg-donation space and was disappointed by the “icky” and “antiquated” approaches she found.
Makler did end up getting pregnant naturally, but she was still determined “to build something in reproductive health.”
So she connected with angel investor Halle Tecco, who’s passionate about fixing the healthcare system. But it would turn out that Tecco, who’s battled infertility herself and says not freezing her eggs in her 20s is one of her “biggest regrets in life,” was actually better suited to be a co-founder.
In need of a brand-oriented expert to round out their founding team, the duo recruited digital-marketing veteran Arielle Spiegel. “I was 28 when I started trying to conceive,” Spiegel says, “and I didn’t even know what ovulation was. That’s a big problem. But the lack of proactive fertility awareness, education and preservation options in this country really comes down to accessibility.”
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The trio wanted to find a way to increase access to egg freezing and change egg donation for the better. So, in October 2022, they launched Cofertility: a “human-centered fertility ecosystem” that offers a destigmatized, scalable approach to egg donation.
The company matches women who want to freeze their eggs with families who could not conceive otherwise, and by donating half their frozen eggs, the women can access egg freezing for free.
“We want to bring more awareness to why egg freezing is something women might want to consider,” Makler says. “Even if they don’t know if they want to have kids someday. Having your options available to you and being able to pursue whatever you want in life, and not having to worry about that, [is key].”
She was overwhelmed by the cost of egg freezing — then saw an Instagram ad
Kristen, a 27-year-old Boston-based professional in business analytics and consumer insights who wasn’t sure when — or if — she and her husband would want kids, started to consider freezing her eggs once she turned 25 and felt secure in her career.
But, like so many women, she was deterred by the exorbitant price tag.
“I had heard of a lot of my friends starting to think about freezing their eggs,” Kristen says, “and I had started to research it myself, and I was like, ‘Oh my gosh, $20,000 — I don’t have $20,000 to put towards something that I’m not positive if I’ll need or want in the future.’ So it just seemed overwhelming and something I couldn’t prioritize at the moment.”
Kristen was also interested in donating her eggs. Her younger brother is adopted, so she’s “familiar with nontraditional ways to build a family,” she says. She revisited the possibility several times over the years, but the process never seemed quite right. It “felt super anonymous” and “really focused on the monetary aspect.”
Then, in October 2022, Kristen was scrolling on Instagram when she stumbled across an ad for Cofertility. “I was like, ‘Wow, I’ve never heard of anything like that,'” she recalls.
This felt so much better than getting paid.
The off-putting layer of anonymity was removed: It wasn’t long before Kristen was emailing Cofertility’s co-founders directly.
She’s since matched with intended parents and expects to complete her egg retrieval by the end of this month.
“It makes sense that someone gets paid for it or gets something in return,” Kristen says, “but this felt so much better than getting paid because then I would actually be able to prioritize my own fertility health.”
Related: COVID-19 Is Changing How Women Think About Their Fertility
There’s still a stigma attached to egg donation, especially in certain communities
At its core, egg donation is someone doing something good: The donor is giving a life-altering opportunity to a family, Makler says. But the process still carries some stigma, which creates “issues on multiple fronts.”
“It’s discouraging a woman from helping a family grow,” Makler says. “It leaves intended parents without options and resources, and it especially hurts the LGBTQ community that is clearly relying on a donation for their family planning.”
According to Makler, a lot of that stigma stems from the cash compensation model.
Though the amount an egg donor is paid varies, a typical fee ranges from $5,000-$10,000, according to Egg Donor America, which states the figure can increase if the donor has cycled previously or possesses “exceptional qualities.”
“That makes it feel really transactional, impersonal and icky for everyone involved: the donor, the intended parent and the donor-conceived person down the line,” Makler says.
Sixty-two percent of people who were donor-conceived felt the exchange of money for the donor eggs leading to their conception was wrong, according to one study authored by researchers from several leading universities, including Harvard Medical School.
The “transactional” quality inherent in traditional egg donation is a real concern for many — especially when it becomes a bargaining chip for desired genetic or socioeconomic markers.
“Sometimes, the more specific you get with what you’re looking for, the higher the cash compensation can go,” Makler explains. “So if you want someone who has a specific heritage or a specific level of education, intended parents often pay more. We don’t believe in that.”
A lack of diversity among egg donors also complicates the situation. In certain U.S. regions, Black, Asian, Indian and Jewish donors may be difficult to find, possibly due to marketing and demand, religious or cultural observances, systemic issues and more, per Anja Health.
Cofertility wants to change that for the many hopeful parents who “don’t see their own heritage represented in the donors that are available to them.” Makler says. Cofertility’s active donors represent more than 55 ethnicities today.
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The flawed, fragmented system makes it challenging to find an ideal donor
Cofertility recognizes the current egg-donation system is broken, and its failings extend to the sensitive process of reviewing and selecting the donors themselves. A universal egg-donor database does not exist.
“Intended parents are scrolling through funky online profiles,” Makler says, “or maybe their clinic is sending them a spreadsheet of donors where every donor is a row on a spreadsheet. Or maybe they’re looking at services that are sort of over-emphasizing good looks and things like that. So it can feel really out of touch with how important the decision is.”
Chirag, an intended parent who’s using Cofertility to build a family with his husband Mark, knows the struggle of the “hodgepodge” industry firsthand.
Both professionals in venture capital who’ve been together for seven years and married for three, Chirag and Mark moved from the Bay Area to New York City as the pandemic waned and “got more serious” about starting a family in March 2022. They decided on egg donation after weighing the pros and cons of adoption and surrogacy.
But pursuing egg donation proved difficult. Chirag recalls navigating hundreds of egg-donation agencies with “different barriers to entry” and encountering “inconsistent information” across their databases of donor profiles. Some listed hobbies, SAT scores. Others didn’t. Some detailed family health histories. Others didn’t.
This sort of PDF profile on paper…could be accurate or not.
The experience was “depersonalized” and “demoralizing,” Chirag says.
Then their friend Mollie Chen — a “Brooklyn power mom who seems to know what all the cool kids are doing” — told them about Cofertility. The couple liked the idea that Cofertility’s donors give their eggs because they want to start families of their own; they also wanted to meet the person who “would be half the DNA of [their child].”
“There was no expectation on our side that there’d be a long-term relationship,” Chirag says, “but at a minimum, [we wanted to go from] this sort of PDF profile on paper, which could be accurate or not, and actually just meet somebody, have a cup of coffee with them, look them in the eye and see if there was a good fit.”
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It’s unusual for egg donors and intended parents to have contact
With traditional egg donation, it’s rare for donors and intended parents to share personal information with each other or otherwise communicate; in fact, donors almost never learn who the intended parents are, per the Egg Donor & Surrogacy Institute.
Unlike other egg-donation agencies that tend to focus solely on intended parents’ preferences, Cofertility wants to ensure donors feel good about where their eggs end up too.
“We think that women should really have a say of where their eggs go,” Makler says. “So, many of our intended parents will write their donor a letter to share more about them, to sort of even the playing field a bit. They want to make sure that the donor knows about them as well.”
It was meeting prospective parents that “sealed the deal” for Kristen. She left “confident about their values” and “the world they believe in.” “Even if I don’t one day have a child and don’t use the eggs, I feel like it’s such a good thing because I know that they’ll have a kid,” she says.
It doesn’t mean they have to be in contact all the time.
Naturally, the anonymity in traditional egg donation typically precludes a relationship between the egg donor and donor-conceived person down the line. But that’s shifting somewhat too, given the increased use of ancestry sites like 23andMe, Makler points out.
Cofertility values the potential for a “really meaningful relationship between the two parties” from the start.
“It doesn’t mean they have to be in contact all the time,” Makler explains, “but to have an understanding of where your child’s genetics are coming from or where your eggs are going can be really important for everyone involved — not to mention the donor-conceived person who ultimately is born out of this.”
Chirag and Mark aren’t opposed to having a relationship with their donor. But they also chose a donor through Cofertility over one who’s a friend or family member because they want some “flexibility.” “We could opt into something,” Chirag says, “but there was no obligation or preexisting relationship to think through or manage.”
Kristen is open to having whatever relationship the intended parents she matches with would like. “I think that they feel super grateful for me,” she says, “and I feel super grateful for them. We’re both opening up this opportunity for each other — I don’t see any world where there wouldn’t be any relationship.”
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“Choice is everything” — and women are taking control
Cofertility has already matched dozens of donors with intended parents and counts more than 150 Split members (women who are pre-qualified to match) in its database.
The company also boasts an all-women roster of investors led by Initialized Capital and Offline Ventures, with participation from Coalition Partners, Muse Capital, Arkitekt Ventures and the co-founders and CEOs of Figs, Hello Sunshine, Mented Cosmetics and more.
One thing’s certainly clear: Women want to navigate their fertility on their own terms.
“It’s a much more open-minded generation [of women] that’s doing things differently than those before,” Makler says. “They take a unique approach to their careers. They have unique viewpoints in general. Reproductive health is no different. These are women who are understanding of the fact that the way we build families is more dynamic than ever before.”
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Makler emphasizes that “choice is everything.” Cofertility exists to educate and provide options.
Now, as Makler and her co-founders look to the company’s future, they’re excited to grow — to give more intended parents the opportunity to have a family and more women the chance to freeze their eggs.
“We’re laser-focused on scaling our current offering and matching intended parents with donors,” Makler says. “It is the best part of what we do, and every time we make a match, our team is so excited. It’s the best feeling.”
Cofertility doesn’t have any babies on the way yet — but Makler says it’s “getting close to that stage.”
This story originally appeared on Entrepreneur