If you have time to read only one thing today, read this:

“I Am the ‘Other’ in ‘Mother’.” Electric Literature. 2024.

Obviously, I think you should read these next two as well:

“Center of Gravity.” The Rumpus. 2025.

“Surrogacy Changed Our Marriage.” SELF. 2026.

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Ava Kofman. “The babies kept in a mysterious Los Angeles mansion.“ The New Yorker. 09 Feb 2026.

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Sarah Kliff. “A Surrogacy Firm Told Parents-to-Be Their Money Was Safe. Suddenly, It Vanished.“ The New York Times. 10 Dec 2025.

Ben Foldy. “Surrogacy Is a Multibillion-Dollar Business. Sometimes the Money Goes Missing.“ The Wall Street Journal. 21 Oct 2025.

According to this WSJ article, there have been several cases this year. Among them:

• “In May, surrogacy agency owner Lillian Markowitz was sentenced to two years in prison after pleading guilty to fraud. Prosecutors said she embezzled more than $150,000 from clients between 2019 and 2021 to cover other business and personal expenses, including for her side business, a yoga studio with flotation chambers.”

• “In August, Darryl Kauffman was sentenced to three years in prison after pleading guilty to six counts of wire fraud stemming from his surrogacy escrow business. Prosecutors accused him of stealing client money for his business and personal expenses, including for buying bitcoin.”

• In September “Destiny Combs was sentenced to more than four years in prison after pleading guilty to wire fraud. Prosecutors said she embezzled $2.7 million from IARC Surrogacy, a Minnesota-based surrogacy agency, and a related law firm where she worked as the accounting manager. Combs used the funds to pay off her online gambling debts.”

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MaryBeth Lewis’s desire to be a new mom again, at 65 years old, led to a custody battle like no other.

David Gauvey Herbert. “The Woman Who Wouldn’t Stop Having Children.” New York Times. 02 Nov 2025.

This excellent article appeared in Sunday’s New York Times. I just wanted to share it. It raises so many questions.

The documentary features four guests:

Toronto lawyer Salima Fakirani, who decided to freeze her eggs at age 31

Lucy van de Wiel, a senior lecturer in global health and social medicine at King’s College London

(Read her excellent book, Freezing Fertility: Oocyte Cryopreservation and the Gender Politics of Aging )

Marcia Inhorn, an anthropologist at Yale University

(Read her excellent book, Motherhood on Ice: The Mating Gap and Why Women Freeze Their Eggs)

Katie Hammond, a law professor at the Lincoln Alexander School of Law at Toronto Metropolitan University

(Read her excellent paper, Evaluating Elective Egg Freezing Consent Materials From Canadian Fertility Clinics)

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You can listen to the documentary here:

https://www.cbc.ca/listen/live-radio/1-23-ideas/clip/16176987

or on your favourite podcast app.

This item was originally published in HeyReprotech on 20 April 2021.

Twenty years ago this month I had my first child. Two years later, I had a second. I now have two amazing young adult daughters, and it's not lost on me that what I write about these days has more to do with them than it does with me.

Occasionally, when people hear that I write about assisted reproduction, they joke about my daughters getting the inside scoop. I can tell them how many eggs to freeze and which fertility trackers are best and what's the status of artificial wombs. True, I do go on about these things.

But if there's one thing I've learned from writing about assisted reproduction, it's that infertility is common. So my actual advice to my daughters is more about how, if possible, to avoid assisted reproduction altogether. Here's what I tell them.

6 minute read

What I tell my daughters

Birth control is hard, but sometimes getting pregnant is harder. That has been the big surprise of my generation. The Pill tricked us all into believing that mastery of one part meant mastery of the other. Not so.

Still, use birth control. Definitely use birth control.

And while we're on the topic... Condoms. STIs lead to a lot of infertility.

Meet lots of people, sure, but if you want to find a life partner, make it a priority early on. That's another thing my generation lost sight of. We were so busy exercising the freedoms that our foremothers won for us — challenging stereotypes, forging careers, busting through glass ceilings — that some of us missed out on finding someone. This is major. If a life partner is something you want, don't leave it to chance.

(But here's an axe to bust through that ceiling while you're looking.)

If you find a great partner and you both know you want kids, don't wait forever. There is truly never a "good" time. It will always be hard. But regardless of whether you go about this the old-fashioned way or with assistance, if you're younger it will be easier than if you're older.

I mean, not too young.

But fifty is not the new thirty. Forty isn't even the new thirty. Thirty is still thirty.

(I know, it sucks.)

Maybe you don't find a partner, but still want kids. Plenty of single parents make it on their own. Parenting is harder than it looks, though, and I honestly think it's not a bad idea to share the endeavour if you can. Maybe there's another single parent, or a small group of them. Be open-minded about ideas of family. Nuclear may not be the best model anyway.

Don't freeze your eggs and think you're sorted. It's not an insurance policy, it's a gamble. And it's an expensive gamble, one that commits you to medical interventions like IVF (ICSI, in fact) if you want to use these eggs to have your kids. Lots can go wrong. A freezer accident. A mixup. They don't thaw well. They don't fertilize well. They don't implant. Even more likely is that you'll keep thinking you can put it off and put it off, and then you'll look up one day and realize you've just put it off too long. You won't be the first. See the comment up top about prioritizing your relationships. I think it's the same sort of thing. Is it important? Then why not do it?

But maybe you'll still see freezing as your best option, and I'll support you if you do.

Please think very, very carefully before agreeing to become an egg donor. I would worry about your health. I would worry about how you'd be treated. And about how you'd feel about it when you got older. And to be honest, I would feel bereft not knowing my own biological grandchildren.

But if you decide to do it, I will support you. Please, please agree to be known.

Never think of IVF as a good backup plan. It's not. It's a last-ditch option. A lot of the time it doesn't work. It's expensive, it's hard on your body and it's hard on your relationships. I hope you never need it.

If you do, though, tell me how I can help.

If you do go down the path of IVF, don't let them hoodwink you with fancy add-ons. You will be pressured to part with a lot of money, for naught. Do your very best to stay hard-headed. That's not easy.

Consider adoption too.

If you involve anyone else in your reproductive project, be transparent. Don't keep secrets. Especially, don't keep secrets from your kids.

Your kids won't be perfect. They will have flaws like we all do. Don't test for perfect. Don't expect perfect. Don't even hope for perfect. Imperfect is how people are. It's all good.

One last thing: it's okay to not want to have kids. It's also okay to want them intensely. Either way. You'll likely know what you want, and that's okay with me. Follow your gut.

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I didn't have any sons. Still, sometimes I find myself talking to them. The conversation goes a little differently.

What I tell my imaginary sons

Don't give your sperm away to any woman you don't intend to have kids with. That's right, you heard me: once it's in her body, it's hers. It's not fair, but it's the way it is. Shared children could tie you to the mother for life. Estranged children could break your heart.

Don't give your stuff away.

Don't give it away by mistake.

Don't be tricked into giving it away.

Don't be induced into giving it away.

Please think very, very carefully before agreeing to become a sperm donor. I worry about how you'll feel about it when you're older. Also: grandchildren. I want to know mine.

If you do become a sperm donor, do it for someone you know. At the very least, be willing to be known, because your genetic children might care. Be ready to answer their questions. Don't kid yourself that you can be anonymous anyway — heard of genetic tests? Insist on knowing how many kids are out there. Or just do the math. Speaking of math, it's not really that much money, considering what you're selling.

Your sperm is amazing. Each sperm holds within it the family genes.

Any child born from your sperm will be just as related to you as the children you raise. Think about that.

So use condoms. (I'll pay.)

Bad news. Men have a biological clock too. We don't talk about it much, but it's true: older men's sperm isn't as good. Wait too long and you might cause your kids unnecessary problems.

Here's something I told your imaginary sister, but I'm going to tell you too: if you want a life partner, make it a priority. Don't think you have all the time in the world. If you're heterosexual and you want to be with someone of your own generation, someone you can relate to, then your partner's reproductive limits are your limits too.

If you're gay and you want kids, this is totally something you can do. It may be the most magnificent social advance of my lifetime. Go forth! There are trailblazers out there who can help you. But remember, you will need the help of women. Treat the women who give you eggs or lend you their wombs with the respect and decency and care they deserve.

Either way, straight or gay, if finding a life partner is important to you, focus on it. Raising kids is easier with more hands.

Maybe you find you are infertile. It's more common than you think. It can be more devastating than you imagine. But don't let it undermine your sense of worth as a man. You can still be a father. Seek out other men to counsel and support you. Too many men sit alone with this.

You might find that you are afraid to take the step into parenthood. Many men these days seem to struggle with this. I said this to your sister, but there is never a "good" time. Don't let fear paralyze you.

One last important thing: fathers make just as capable parents as mothers. Don't be pushed aside. Don't let anyone tell you you can't do it.

Unless you choose not to. I'm okay with that too.

5 minute read

An older couple is having trouble conceiving. They go to a fertility clinic. Their doctor advises them to test their embryos for chromosomal abnormalities, so they do, at great expense. When the test results come back, however, the news is grim: every last embryo is deemed abnormal.

Ironically, if they had not done testing, they could have transferred any of those embryos. But their clinic's policy is to not transfer embryos known to have chromosomal problems, so, many thousands of dollars in, the couple is left without a single usable embryo to pin their hopes on.

Over the last decade or so, the use of "preimplantation genetic testing for aneuploidy," or PGT-A, has dramatically increased. In the US, according to the Society for Assisted Reproductive Technology (SART), some 32 percent of all IVF cycles used PGT-A in 2017, up from 13 percent in 2014. In Canada, according to the Canadian Assisted Reproductive Technology Register (CARTR), 26 percent of patients used PGT-A in 2020, up from just one percent in 2013.

The hypothesis behind testing is that chromosomal abnormalities are a leading cause of miscarriage and failure to implant. So if only you can figure out which embryos have these abnormalities and then exclude them, success rates will go up.

Sadly, despite all the hype and promise and expense, there is still debate about this. The UK's Human Fertilisation and Embryology Authority (HFEA) still gives PGT-A a red light, because, it says, there is no good evidence that it improves the chance of having a baby. A recent paper in the New England Journal of Medicine found that for people with three or more high-quality embryos, testing did not improve outcomes.

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Some doctors have been skeptical of PGT-A for some time. In 2014, the Center for Human Reproduction, a fertility clinic in New York, started cautiously transferring embryos that had been deemed through testing to be abnormal. In 2015, they reported five pregnancies. The same year, an Italian group reported six births. Since then, around the world, hundreds of babies have been born after the transfer of embryos that had previously been condemned as faulty.

Over the past few years, 69 patients have shipped 444 abnormal embryos to the Center for Human Reproduction — where, despite their designation as abnormal, they could be used — from clinics elsewhere in the US or in Europe — where they could not. Fifty women, working with the New York clinic, opted to go through transfers. The clinic followed those attempts prospectively. Last month, they published a paper in Human Reproduction about the outcomes.

The findings raise questions yet again about whether testing is leading us to avoid or even destroy perfectly good embryos, and if so, if the technology is in some cases doing more harm than good.

After five to seven days of development, an embryo has about 250 cells. When it undergoes preimplantation genetic testing, up to ten of those cells are collected using a tiny pipette. Importantly, they are taken from a part of the embryo that will go on to form the placenta, not the fetus. The cells are sent away for testing, usually at a specialized lab, while the rest of the embryo is frozen for the two or so weeks it takes for the results to come back.

The testing is looking for chromosomal abnormalities. Healthy cells will contain 46 chromosomes, in pairs, but sometimes a cell can have three copies of a chromosome, or only one.

Different labs make different calls on what the anomalies mean. Often, if fewer than 20 percent of the cells taken from an embryo have abnormalities, the embryo is designated good, or "euploid." If more than 80 percent are abnormal, it's considered bad, or "aneuploid." Anything between those two thresholds will be deemed "mosaic."

A central shortcoming of PGT-A is that it is sampling the future placenta ("trophectoderm"), not the future baby ("inner cell mass"). Even if all the cells sampled from the trophectoderm are aneuploid, it does not mean that the inner cell mass is. It does not even mean that all the cells in the trophectoderm are — a sample is just a sample.

An ongoing concern is that embryos are being wrongly labelled.

What's more, we know that aneuploid embryos often self-correct later in development. We also know that at term, placentas belonging to euploid fetuses are often mosaic.

Still, many fertility clinics refuse to transfer aneuploid or even mosaic embryos. So after doing PGT-A, many patients find themselves without any embryos to transfer.

Fifty of the 69 patients who shipped their rejected embryos to the Center for Human Reproduction, and who had no good embryos to transfer, decided to transfer mosaic or aneuploid embryos. They were advised against transferring embryos with certain kinds of anomalies — ones that could lead to known disabilities, such as Down syndrome or Klinefelter syndrome.

In all, there were 57 transfers, involving 141 embryos, the researchers report. Nineteen of the 50 patients — 38 percent — got pregnant. Eleven had miscarriages. Eight — 16 percent — had live births.

These were poor-prognosis patients, say the researchers — they were old at retrieval, they had an average of three failed IVFs each behind them, and they had had low pregnancy rates and high miscarriage rates in the past. All had been advised to do egg donation. "These IVF cycle outcomes, therefore, must be considered surprisingly good," the researchers write.

The average age at retrieval for women in the study was 41 years. According to SART, in 2019, 13.4 percent of women aged 41 to 42 using their own eggs achieved a live birth after IVF (one retrieval and all transfers).

At birth, the children in this study appeared to be healthy. (One had a heart problem, since corrected, that was unconnected to the aneuploidy.)

The researchers also tested nine of the 11 "products of conception" that were lost to miscarriage. Four, they discovered, were euploid, despite having had an abnormal result from PGT-A. One was aneuploid, but not in the way that PGT-A had indicated. Just four of nine were consistent with the PGT-A diagnosis.

"This study demonstrates that, even in poor prognosis patients, transfer of chromosomal-abnormal embryos resulting in a normal pregnancy is possible," they write. "Even older women, who are often told that all their embryos are chromosomal-abnormal, still appear to have a reasonable chance of normal pregnancy.

"That conclusion alone would rescue many such women from having to prematurely advance into third-party egg donation cycles and rescue large numbers of human embryos from non-use or even disposal."

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This item was originally published in HeyReprotech on 19 Mar 2019.

3 minute read

Not so long ago, children born via sperm donation were told that the donors who had helped create them would never want to know them — or even know about them. The Nice Man had given his seed and that was the end of it. Getting in touch might ruin his real life.

Times have changed. Not only have many donors embraced the offspring-donor connection made possible through the Donor Sibling Registry and low-cost genetic testing, they are reforming what that relationship looks like. Some donors and offspring exchange emails and photos. Some set up closed Facebook groups. Some meet for large extended-family shindigs. And at least one, it turns out, is making donor kids shareholders in the company that he built himself and has worked in all his life.

"I think of them as close biological relatives," says Kirk Maxey. "I wanted to provide a positive influence in their lives without being a true social parent."

Maxey launched his biochemical company, Cayman Chemical, in the early 1980s, while he was completing medical school. The company, which produces research biochemicals, forensic drug standards for law enforcement, and generic medicines to prevent blindness, now has over 400 employees and is currently valued at around $350 million USD. Maxey is now in his sixties, and has begun to think seriously about his legacy — not only about what he wants to happen to the company assets, but also about what he wants to contribute to the lives of his various biological offspring.

But exactly how many biological offspring he has is not known. Through marriage, he has five social children. Through known donation, there are eight more. But Maxey also donated sperm through a local fertility clinic for several years, starting when he was a student, and he can only estimate how many children were born as a result of those donations. "I did the math," he says, "and depending on your assumptions, there could be 400 offspring out there." He thinks it's probably closer to 200 or 250, but he says he's prepared: "If 400 come forward, I won't be disappointed."

Maxey met the first "anonymous" donor offspring in person more than a decade ago. He's now been in touch with about a dozen of them. He was interested in bringing the donor offspring together in a semi-organized way, so that they would have an opportunity to meet each other; they live all over, and otherwise wouldn't have cause to meet. His company already had a tradition of giving employees ten shares to honour their 15-year work anniversary, and that got Maxey thinking. Could the shareholders' meeting be the coalescing event?

Shareholders are all notified by mail of the meeting, where they can learn about the company, and vote. "I thought it would be cool if all of the donor kids got the same letter," he says. "They could all meet each other and many of my social kids — who are much more significant shareholders — plus the people who have worked here for years."

Not only would it create a sort of mini-convention, bringing together many key facets of his life, it would also answer some of the questions from his donor offspring. "They were curious," he says. They were intrigued that their biological father had created a successful company, and they wanted to know more about that. "This was a way to give them a seat at a two-hour event, where the CFO goes all through the departments and subsidiaries and staff, and they really get schooled in what the company is."

Like many founders of successful companies, Maxey has thought long and hard about succession and what it should achieve. Most of his wealth will go to his social children — but leaving them everything, he believes, would handicap their work ethic and autonomy. Transferring small but significant share holdings to the donor offspring both recognizes their ancestry and gives them a small financial boost, he says. "The donor offspring's share is an amount that could provide a year of college tuition or the down payment on a house," he says, "and could significantly enhance their lives at a time when they are just putting the big pieces in place."

Last year, two new donor offspring attended the shareholder meeting. "I tried to put one up to nominating the other as a director," Maxey jokes. "They didn't do it, but there was some snickering. We had fun. It was a good meeting." Afterwards, they had dinner at his house. "It turned out exactly as I hoped."

Updates:

Maxey now has six social children. Thirteen others were conceived through known donation, and a still-unknown number through clinic donation.

Of the 26 donor offspring he has been in touch with, 20 have so far have accepted shares. He tells me he is still offering shares to donor offspring who come forward. What's more, he has written it into his estate planning that any Trustee of the estate has to respond to and offer shares to anyone who is a biological match.

Maxey turned 70 this year.

"The majority of people contacting us fall into these other categories," said Frances Shapiro Munn, at Nelligan O'Brien Payne, the firm that handled the lawsuit against Barwin. "The implications and fallout are just as severe for these people as for those conceived through Barwin's sperm."

The total settlement, agreed in 2021, was $13.375 million. In the end, there were 276 approved claims through the class action. Payouts to class members varied based on the type of claim.

Below I list the many ways in which people have been affected.

This item was originally published in HeyReprotech on 16 October 2018.

4 minute read

Among the wronged

Men who deposited sperm with Barwin, who had children they believed were their biological children, who learned the children were from a sperm donor

Men who deposited sperm with Barwin, who had children they believed were their biological children, who learned the children were conceived with someone else’s sperm, not yet identified

Men who deposited sperm with Barwin, who had children they believed were their biological children, who learned the children were the biological children of another patient in Barwin's clinic

Men who deposited sperm with Barwin, who had children they believed were their biological children, who learned the children were the biological children of Barwin

Men who deposited sperm with Barwin, who had multiple children they believed were their biological children, who learned that one of their children was their biological child and another was conceived with someone else’s sperm

Men who deposited sperm with Barwin, who had multiple children they believed were their biological children, who learned the children were each conceived using different sperm, none his

Men who deposited sperm with Barwin prior to infertility-inducing cancer treatment, who had children they believed were their biological children, who learned they were not biologically related

Men who deposited sperm with Barwin, whose sperm was used to father children in other people's families

*

Women who had multiple children, whose children were to be full siblings, from the same sperm donor, whose children were found not to been conceived using the same sperm donor

Women who were in a same-sex relationship, who each carried a child, whose children's only biological connection to each other would be through the sperm donor, but whose children were not conceived using the same sperm donor

Women who were to be inseminated with sperm from a specified donor, who were inseminated with someone else's sperm, not yet unidentified

Women who were to be inseminated by their husband's sperm, but who were inseminated with someone else's sperm, not yet identified

Women who were to be inseminated by their husband’s sperm, but who were inseminated with a sperm donor’s sperm

Women who were to be inseminated by their husband’s sperm, but who were inseminated with another patient’s sperm

Women who had two offspring who were to be conceived with their husbands' sperm, who discovered only one was conceived with the husband’s sperm, the other being conceived with someone else’s sperm

Women who were to be inseminated with sperm from a specified sperm donor, but who were inseminated with Barwin's sperm

Women who were to be inseminated with their husband's sperm, but who were inseminated with Barwin's sperm

*

Offspring who were supposed to be conceived using specified donor sperm, but who found out they were conceived using sperm from another donor, now identified

Offspring who were supposed to be conceived using specified donor sperm, but who found out they were conceived using someone else’s sperm, not yet identified

Offspring who were supposed to be conceived using specified donor sperm, but who found out they were conceived using the sperm of another patient in Barwin's clinic

Offspring who were supposed to be conceived using specified donor sperm, but who found out they were conceived using Barwin's sperm

Offspring who grew up believing they were full siblings, conceived using the same sperm donor, who found out they were conceived with different donors

Offspring who were supposed to be conceived using their father's sperm, who grew up believing their father was their biological father, who have found out that they were conceived using a donor's sperm

Offspring who were supposed to be conceived using their father's sperm, who grew up believing their father was their biological father, who do not know who their biological father is

Offspring who were supposed to be conceived using their father's sperm, who grew up believing their father was their biological father, who have found out that they were conceived using the sperm of another patient in Barwin's clinic

Offspring who were supposed to be conceived using their father’s sperm, who grew up believing their father was their biological father, who have found out they were conceived using Barwin’s sperm

Offspring who grew up believing they were half-siblings, connected through their sperm donor, who found out they were conceived with sperm from different men

Offspring who grew up believing they were full siblings, conceived using the same sperm donor, who found out that their biological fathers are different, and one of them is Barwin

Offspring who grew up believing they were full siblings and that their father was their biological father, who found out only one of them is the biological child of their father and the other does not know who their biological father is

Related links

Alison Motluk. "Lawsuit claims fertility doctor used his own sperm to inseminate patients." Globe and Mail. 02 Nov 2016.

Alison Motluk. "And that's why everything is different." The Current. 02 Nov 2016.

Alison Motluk. "Uncommon ancestry." Hazlitt. 07 Mar 2017.

Aviva Coopersmith. "The Lie That Made Me." Toronto Life. 22 Feb 2022.

This item was edited lightly from the original for improved clarity.

The annual meeting of the Canadian Fertility and Andrology Society (CFAS), a group that comprises doctors, lawyers, counsellors, researchers and various other parties interested in assisted reproduction, took place last week in Montreal, and once again I had the pleasure of attending. This year's theme was "Controversies in Assisted Reproduction."

The controversy I will start with is cross-border reproductive care — in other words, when people leave their own countries to seek reproductive services elsewhere. Much has been written and broadcast about Canadians who go out of country — to get better prices, to access services that aren't allowed here, or to pay for things that in Canada must be done for free — but a little less has been said about people who come to Canada from abroad to access in our country what they can't get at home.

Below, I report on a talk presented by Karen Busby, a law professor at the University of Manitoba. Busby was one of the first researchers to draw attention to the fact that many surrogates did not report feeling "exploited" by surrogacy. Her talk this year, however, based on work she did in collaboration with Pamela White, at the Kent Law School in the UK, looked at a different issue: how Canada has become a top pick for international surrogacy, and whether that's a title we desire.

8 minute read

Here's an arresting statistic: almost half of the babies born to Canadian surrogates in the province of British Columbia in 2016 and 2017 were for intended parents who lived outside the country. That's 45 of the 102 babies born to surrogates there — 44 per cent.

What's the national tally on such outbound babies? We don't know. Rather, we aren't told. The number could presumably be calculated, since individual physicians carry out the procedures and bill for them, and provincial vital statistics offices issue birth certificates. But the information is not publicly available. Then again, we should hardly be surprised, because neither is the total number of babies born in Canada to surrogates for any parent, Canadian or otherwise. I and others have been asking around for some time now.

Those BC numbers come to us thanks to the hard work of Pamela White, of Kent Law School in the UK, who had to put in an access to information request with BC's keeper of vital statistics. She tried the province of Ontario, too, but they said they don't collect data on residency. In the US, such information is mandatorily collected and published by the Centers for Disease Control and Prevention.

White, a former Statistics Canada director and data analyst, argues that Canadians deserve that level of transparency, too. She is absolutely right. Without real data, available for scrutiny, how can we make informed public policy decisions? We can’t.

Anecdotal reports and incomplete data suggest that the number of intended parents (IPs) from outside Canada has been growing in recent years. At the annual meeting of the Canadian Fertility and Andrology Society (CFAS) last week, Karen Busby, a professor in the faculty of law at the University of Manitoba, who co-authored a forthcoming paper on the topic with White, discussed why Canada is becoming an international surrogacy magnet and whether it is desirable.

The backdrop, says Busby, is that worldwide demand is huge. Many people want to be parents and can't do so without surrogacy, but they live in countries where surrogacy is either prohibited entirely, or prohibited for them. China, Japan, and many European and predominantly Muslim countries have restrictions, she says. People in such places who decide to pursue surrogacy must look beyond their own borders.

Coupled with this growing demand is shrinking supply. In the last few years, India, Nepal, Thailand and Mexico — former international surrogacy hotspots — have closed their doors to non-residents.

So why Canada? For one thing, says Busby, Canada is one of the few jurisdictions left in the world that both allows surrogacy and allows foreign participation in surrogacy. Countries such as the UK, South Africa and Israel, she says, permit surrogacy, but not for foreigners. The only other places that allow people from outside the country to access surrogacy within their borders are Greece, Ukraine, Russia, Georgia and a few US states, she says. [This has changed since first publication.]

For a number of reasons, Canada stacks up well against these others. Russia and Ukraine, for instance, only allow married heterosexual couples to participate. So if you are a single person, or not straight, those places are of no help to you. Canada, by contrast, does not allow discrimination on the basis of marital status or sexual orientation, says Busby.

Canada is also fairly efficient about granting legal parental rights. It varies by province, but generally speaking, IPs can be declared legal parents without a lot of hassle in just a few days, and they can be issued a birth certificate within weeks. Also, any child born in Canada has the right to citizenship, so a passport can be issued, and in short order, the families can head home and start their new lives.

Financially, Canada also compares well, says Busby. Women in Canada enjoy high quality, publicly funded health care throughout the pregnancy, during the delivery and after the birth. This is as true for women carrying babies for someone from France or China as it is for women carrying for themselves. Our neonatal care is also top-notch — and also publicly funded. Another perk is that if a Canadian surrogate has a job, then she will also qualify for employment insurance benefits following birth — to a maximum of $6,500.

Here's another interesting twist. In Canada, it's illegal — a criminal act, according to the Assisted Human Reproduction Act — to pay a woman to carry a baby for you, or to pay someone else to arrange for a woman to do so. Since the law first passed in 2004, this prohibition has caused enormous handwringing for Canadian would-be parents looking to form their families with the help of a surrogate. They rightly fear that they could be prosecuted for paying a surrogate, and the penalty is steep: up to 10 years in prison and $500,000 in fines. The prohibition has reportedly driven some Canadian families to leave the country to seek surrogates elsewhere.

Ironically, this prohibition, which was designed to deter commercial surrogacy, may actually be stimulating it — and may favour foreign IPs over domestic ones. Domestic IPs may be reluctant to offer money or will only offer it under the table, but because the law is not applied to acts committed outside the country, says Busby, foreign IPs can offer money openly, so long as it changes hands somewhere else. It's conceivable that, given the choice between being paid and not being paid, Canadian surrogates — who are legally allowed to accept the money — may prefer to be paid. So foreign IPs may actually be more attractive to Canadian surrogates than domestic IPs. (There’s no data on that, of course, since there’s no data.)

It is true that foreign IPs coming to Canada will still be subject to our other prohibitions, such as paying for local egg or sperm donations or performing sex selection. But, as Busby points out, most Canadians live near the US border and have easy access to the services offered there. This ability to enjoy the "best" of both systems only adds to Canada's appeal.

All of these factors help to explain why Canada has become a go-to place for surrogacy. I'll add one more that Busby did not mention. There are Canadian doctors, lawyers and agencies who actively recruit IPs from around the world. If foreign parents weren't already aware of Canada's considerable merits, representatives of the industry are more than happy to point them out.

And they are right: for all of the above reasons, Canada is a great place to do surrogacy. Loads of people already want to come here and we can only expect that number will grow.

Not everything about this picture is rosy, however. A big question is whether Canadians need to think about recovering medical costs. Pregnancy care, even for an uneventful pregnancy, costs money. So does birth. The average uncomplicated birth in Canada rings in at between $3,000 and $6,000, depending on whether it's a vaginal or surgical delivery. Complications can increase that figure considerably. Neonatal care can also be pricey. For instance, according to the Canadian Institute of Health Information, care for a baby born at 29 weeks weighing under 1 kilogram costs an average of $91,946. One baby.

"I am pretty sure that if you asked the average Canadian whether or not the Canadian health care system should pay for any of the health care costs incurred in order to produce a child for a non-resident IP, the answer would be no," Busby told the meeting. "In fact I think it would be an emphatic no." I suspect she's right.

As far as Busby is aware, no province has put in place laws or policies to recover the cost of surrogate pregnancy care. (A few Ontario hospitals have started charging for infant care, if the infants are for out-of-province parents.) Busby says governments could consider measures like asking IPs for money up front or not issuing a birth certificate or passport until the bill is settled.

That's a lot of work. It would involve coordination across departments and even, in some scenarios, levels of government. Another option, she says, would be to follow the lead of other countries and create residency restrictions, stipulating that only people who live in Canada can work with a surrogate here. That option would, in one fell swoop, alleviate the shortage of surrogates available to work with Canadians and eliminate the cost recovery conundrum.

That would be a tidy solution, and, all things considered, maybe the most workable one. The cost recovery issue is challenging. Access to surrogates by Canadians is challenging too. There are other problems. Our country is struggling under a 14-year-old law that still hasn't rolled out its regulatory details. [Regulations were finally introduced in 2020]. We are woefully lacking in transparency about surrogacy — and assisted reproduction in general. Finally, although preliminary findings are reassuring, we have not yet done nearly enough research to establish that Canadian women who act as surrogates are not exploited.

I am not hopeful, given Canada's track record in this sphere, that we will crack these tough problems any time soon, or ever. But let’s imagine we did — no cost to the Canadian public, adequate numbers of surrogates to work with Canadian families, effective laws for and public scrutiny of the process, and confidence that women were treated fairly. Then, it seems to me, Canada would be an excellent place for international surrogacy. Surely the ideal is for surrogates and babies to have quality medical care, for IPs to be free from discrimination, for parentage issues to be resolved quickly.

If we did somehow get our house in order, I would be the first to ask: if you believe that surrogacy is a legitimate way of achieving parenthood, what is the argument against welcoming it here?

"Desperately Seeking Surrogates: Thoughts on Canada's Emergence as an International Surrogacy Destination," by Karen Busby and Pamela White, will be published in autumn 2018 as a chapter in Surrogacy in Canada: Critical Perspectives in Law and Policy (Irwin Law), edited by Vanessa Gruben, Alana Cattapan and Angela Cameron.

13 minute read

What made you want to get into this business?

It was maybe 12 years ago now. I was working at a clinic in Wimpole Street in London. And we started to receive packages that were supposed to be hand delivery, but they were showing up in FedEx packaging. So these patients were paying for full X-ray exemption, so that there was no potential for DNA damage to the cells, yet they would have been X-rayed going onto a plane.

Wow.

So I decided that it would be good to have an IVF scientist looking after this — someone who knows and respects what they're carrying. I thought it would bring a lot of peace of mind to patients.

Yeah.

And the way I really began was just telling all of my embryology colleagues. I just mentioned to them that, look, I'm starting this service, hand delivery, full X-ray exemption. And it took off very, very quickly, simply by word of mouth. And that's actually how I've maintained it. I don't really have an online presence.

Are you solo, or do you have other people working for you?

I have two full-time people in London looking after about 40 UK cases on average a month. They sometimes come in to help when we're busy internationally, but otherwise it's myself, and I have two freelance couriers who can jump in most of the time if I need it.

And so what is the process? A patient just contacts you and says...?

The clinics would have a list of couriers that they would have third party agreements with, and they would suggest those to their patients. And then, yes, they would contact us directly.

So someone might email you and say, 'My embryos are here in Toronto, but I want them in Georgia. Can you take them?'

Yes.

Can you describe what your work might involve, from start to finish, for just one job, if I can call it that?

Well, for example, next week, I've got a case from Dubai to New York. It's a return client. Originally their clinic put them in touch with me in Dubai. I send them information about how I look after the case, which is that it's hand delivery by personal courier door-to-door, all X-ray exemptions in Dubai, and again in New York, with a full CDC customs clearance. And once they agree to that, we give them a quote.

We then start to liaise directly with the clinics. When I say clinics, I actually mean the labs in particular, because the embryologists in the lab, they're the ones storing the material and they're the ones that will be receiving it. So I need to be in touch with them to agree dates that we can work on. That's the next phase whilst the patient is sending back our contract.

Once the labs have agreed dates, we will start to schedule. We'll look at tickets, timings, how long it takes to get from A to B. We'll give the clinics times that we can be there and that we can be on the other side to deliver.

You're doing all of this coordination yourself?

Myself. I feel like if I gave this up, I'd be an amazing travel agent. I just feel like I've got the logistics down completely. I know exactly what I'm looking for.

So what are you looking for? Do you have favourite airlines? Favourite airports? Do you need a certain kind of seat? Where do you put the tank?

It's not that I have favourite airlines as such. For me to carry one of these dry shippers on board, it usually is one of the major airlines. Somewhere down the line, someone will know what we're talking about when we say we're carrying embryos. They'll be able to look after us, they'll be able to honour our requests.

I mean, the container itself, it can't go in an overhead bin. It needs to be vertical at all times. And that's simply to maintain its temperature holding capacity for the duration of the journey. These things tend to last for about two weeks if they're looked after optimally. So we try to keep it vertical.

What about turbulence? Do you secure it to the floor somehow?

No, it's not secured. I actually carry it in a basic carry-on bag. It's nice and sturdy. It stays in that bag. And airlines tend to put it in a closet for me, where it fits absolutely perfectly so that it can't fall. It can kind of move up and down, but only a bit. And I've never experienced turbulence. It's probably safer there than it is in a truck on the ground, traveling around London.

You must spend an enormous amount of time on airplanes.

Yeah. I really do. But I consolidate the travel. But that means it's extremely hard when I'm on the road. Because I will manage a month's work in eight days or so.

Like how?

Okay, so a group of eggs were coming out of Georgia. Then I had another one to pick up in Paris. I think I came through Madrid, and I had another one to pick up in London. I was traveling via LA around to Australia. So the London one had to go to San Diego. And then once I got to Australia, oh sorry, the stop in London also meant two pickups to go to Australia too. And once I got to Australia, I had to take the eggs that I picked up from Georgia to three different clinics across Australia — Melbourne, Sydney and Perth. I also had two things to pick up in Brisbane to come across to Greece, and then a couple more to bring out of Melbourne that had to go to the UK. And what was the other one... Oh, sorry. And three other ones that came out of Melbourne, two to go back to Georgia and one to go to the UK.

Wait. Tell me about that itinerary. Where did you start?

I started in Madrid, where I live, but I went to London first because I had to get the correct vessel for the quantity of samples that I was going to collect. It was simply logistics — all my vessels were in the UK — so I had to go and pick it up and start my journey from there.

So from London, to Georgia, to Paris. I had to come back to Madrid for a day actually, and then back to London to get everything to go to Los Angeles. I drove down to San Diego, back to LA, flew directly into Melbourne. I had a day in Melbourne. Late that night, I flew to Sydney. The next afternoon, I flew to Brisbane, then I got a night flight out to Perth. I finished the jobs in Perth in Australia, then made my way back through Singapore, Frankfurt, London. We had to take material on to London and to Crete. But I came back to Madrid after that. And my colleague took them out to Georgia, the ones that were supposed to go out.

Wow. And so that means that at each point, you're opening the vessel and either putting something in or taking something out.

Each of these tanks weighs nine kilos. I can't carry six of those on board a plane. It's not possible. So we agree with the patients that we will be sharing the shipments.

Some of them are worried about it, because they're like, 'Oh, what if it gets mixed up?' But I explain to them that where they're stored right now — not to make your heart pound — but there are thousands of other samples in there. But the way the these things are identified, it's very rigid. There needs to be double witnessing with a patient's cells coming out. So two embryologists looking at at least three identifiers on each straw. All this stuff is really important.

So what do you charge people?

It's kind of standardized over the years. I've got a client I just quoted today to go London to San Diego. It's around £1800. So that's basically everything — that's our time, our management fee, our admin fee, the vessel, flights, ground travel. We're not going to charge them more.

That's just getting it there. If it's an egg going to San Diego and an embryo coming home, they're going to have to pay another fee to come back.

Yeah, yeah. I know how much patients have to fork out for treatment. And if they have embryos created, and they want them coming back as well, then I let them know if they hang on until this day, like two weeks down the line, I've got something I'm taking there, and I could just pick theirs up on the way and we save a little money that way. This saves me an extra trip as well. So I always try to offer that discount.

Have you ever had trouble getting material into a country?

I was stopped a few times going into Greece. This was during the pandemic. And they said, 'No, you can't bring this in.' And when I show them the regulations — it's customs people who stop you — they say no. I'm always like, 'Okay, I understand there's an issue here, but show me what to do. Let's find a solution. Let's see if we can get this resolved.' And they never gave me anything. So I wondered if they wanted something under the table.

Have you ever had to do that? Pay a bribe?

I've been in situations where it was as clear as day that this is what they want. But I don't get involved at all. I know some couriers do. But I think it's just way too risky.

The first time it happened to me was in India. I landed at two in the morning, and I was really tired. I had a permit from the ministry to come in and they said no. And I said, 'I'll wait for your boss. I'll just wait for your boss for another seven hours, whatever.' And that's what I did. At 8:30 a.m., they started to say to me, 'It's okay, you can go.' And I said no. I said, 'If there's a problem, I want to know for the future. I can't be sending people here and risking people's potential babies with this kind of nonsense. So let's sort out.' And they all got scolded by the big boss in the end. And that was that.

So have you ever not been able to take something where you needed to take it? Because some kind of bureaucracy prevented it?

The closest to that happening was in the US. They're like, 'What you're doing is illegal.' And I'm like, 'Well, can you call this person, because she's with the CDC. And this is who cleared me last time.' And they say, 'No, no, we can't take information from you.' It was that kind of vibe. So that was a little stressful because they wanted to take the tank from me and give it to the airline to hold in their cargo depot.

So I spoke to the patient, and I said, 'This is the situation I'm in, what should I do? What would you like me to do? I can put a tamper-proof padlock on it. I've made friends with the airline people, because they're telling me that the customs guys are being ridiculous. I'm happy to hand it to that person only and to receive it back from that person.' And he said he trusted me.

I think I landed in the morning. And by 3pm, I was driving around LAX [ LA airport], and trying to find all these CDC offices they were telling me about. In the end, I actually ended up at the customs office, and the head guy happened to start his shift as I walked in. I showed him the paperwork, and I said, 'I'm having this problem. I've never had this problem before. Can you give me some guidance?' And he looked to his agents and said, 'We need to sign this out immediately. Let him go.'

He didn't explain anything to me. He just signed it out. And he knew the importance of it. By 4pm, I just drove straight to the Air New Zealand cargo, within 10 minutes of him signing it off. And that was it. That was the closest that I guess I've come to not being able to do it.

So why do they trust that what you're carrying in there is actually biological material? What if you were a really clever drug runner? Do you know what I mean? Because they can't open it and examine it.

They can. I tell patients I can guarantee they won't X-ray something, but I can't guarantee that they won't want to just peer inside.

Oh. Okay.

And that does nothing to the integrity of the shipper and the temperature. I can show them inside.

Does that happen?

Occasionally. Completely randomly.

But how do they know it's not illicit material? Like, how would they even know what embryos look like?

The standard protocol for anything coming through that doesn't get X-rayed is that they do that swab test on it, the ETD for narcotics and explosives.

Have they ever done that to you?

Oh, I request it. As soon as I get to security, I ask for the security manager and say I need an ETD done. I tell them these are embryos. But the validation comes from the clinical paperwork, from a clinic with contact details. If they want to call them, they can call them. It's also got my ID.

And do you have any kind of special clearance?

No. But I have a list of email addresses from airports all over the world, and I can send them information ahead of time, so they're expecting me.

Do you get through quicker?

I'm pretty much in the same queue as everyone else. The only bonus is that with so much travel, you get the highest status with all these airlines. So you kind of go through fast track all the time. And sometimes you get pre-boarding when you're carrying embryos.

How long do you think you'll want to keep doing this? It's pretty gruelling work, right?

It is. I could easily travel 50,000 miles a month. You've got to be switched on all the time. The only time I'm switched off is actually when I'm in the air.

What's it like when you're not travelling?

The first couple of days back are difficult. But I just go into home schedule. I've got a six year old, and she needs to go to school, she's got extracurricular stuff. What doesn't stop if I'm on the ground is emails, calls.

Planning for the next trip.

Correct.

Do you miss the clinic?

I miss face-to-face contact with patients. I mean, there is contact with patients now, of course — phone calls and whatnot. But it's not the same. But in terms of dealing with logistics and being busy, although it's simpler, it feels more active. And that's better. And everything in embryology these days, especially in the UK, is just paperwork. There's just so much regulation, and this form and that form. So even your lab time is getting destroyed.

But you must deal with a lot of paperwork and regulations and forms doing what you're doing now.

I do. But in a lab, I think it's probably even more.

This interview was edited and condensed.

4 minute read

Ten years ago, if you were a woman who had donated eggs, there was a good chance you'd never met or spoken with anyone else who had done it. Sure, it felt exotic, but it could also feel isolating.

In the years after she donated eggs at a Toronto clinic in 2004, Claire Burns began to feel a need to connect with other egg donors. She contacted an infertility support group and suggested they start a chapter for egg donors. "Why would you need a support group?" she remembers being asked.

Why? Because there were a lot of thoughts and feelings to untangle, and ordinary people didn't always get it. In our first phone conversation, Burns told me she had been led to believe that she was just giving away something meaningless — like a piece of skin — but that now she was re-examining that. "It's my biological material. I am part of that family, even though I have to pretend I'm not," she said. "It's something I once thought I'd be able to dismiss. But it's haunting me." She wrote and produced a play, Hatched, about egg donation, and described it as therapy.

During our early interviews, in 2010 and 2011, Burns asked me why I didn't set up a network of egg donors. I asked her why she didn't. Not long after, she met Raquel Cool, a woman from California who'd donated, and then Sierra Falter (now Poulson), who'd donated three times in Kansas. The rest is history.

In 2013, the three women together founded We Are Egg Donors (WAED), an online forum where donors could meet, share stories, and trade information. The group now has members from around the world. Importantly, there is a secret section where women can share details about things like numbers of eggs retrieved, real side effects and clinic behaviour. "Don't be fooled," Burns told a meeting of the Canadian Fertility and Andrology Society in Halifax in 2015, "we are warning each other about substandard practices."

Running an organization like this can take a huge toll, both in time and in emotion. The founders are all in the busiest parts of their lives, establishing careers and families. Still, I was surprised to learn that a few years ago, in 2016, Poulson formally resigned from her leadership role in the group.

In a recent phone conversation, she told me it was starting to affect her mental health. "My biggest issue was medical consent, whether they were giving the full picture of the risks," she told me. "I believe you're dealing with a vulnerable class of women — I was one of them. Some of the practices take advantage of that."

Below I share the letter she wrote to the members of WAED.

Resignation Letter

I am announcing my departure from WAED. I'm a feminist. I'm pro-choice. I continue to stand strongly for a woman's right to choose what is best for her own body. I also believe in the right to procreate as a fundamental constitutional right. However, I am unable to fulfill my role as a co-founder/leader of WAED when I can't support egg donation as it is currently practiced in the United States. I am proud of the group/blog/movement we've built and know this is only the beginning for WAED. But let me explain why I'm deeply concerned about how the United States treats egg donors.

My perspective on my egg donations quickly changed after a series of events starting in 2013. First, I met Claire & Raquel - the first two donors I had ever spoken to. We had so much to say and spoke with other egg donors off the bat. We were shocked to learn that not everyone's experiences were the "rainbow and butterflies" experience that I had. We found that some people felt betrayed, commercialized, and exploited. We saw - and continue to see - cases of agencies and clinics operating unethically and, sometimes, illegally.

My concerns regarding egg donation only escalated after we began speaking with donor after donor, via Skype or in person. Not to mention, speaking with donor-conceived children made me realize that donor-conceived people may have their own set of identity issues.

These initial months of conversations left me feeling sick to my stomach with fear. And these feelings have only continued to grow with each passing month that the Secret Forum operated. My concerns over my own health grew. The best word I can use is regret. I had great regret over donating my eggs. It wasn't that I felt uncomfortable with donating my eggs per se - I don't regret the children that now exist. It was that I felt the risks had been misrepresented. I felt I had been 'duped.' As we all see through this group, OHSS is occurring far more often than it is ever reported on clinic websites or in-person during consultations. There are egg donors who have experienced hair loss, thyroid and other hormone imbalances, weight gain, sciatica pain, muscle loss, infertility, PCOS, endometriosis, cancers. Most of these donors were turned away and ignored by their clinics when they returned looking for help. Donors who were likely predisposed to PCOS but were never made aware of the extra risks to their health prior to donating and then after donating, when their PCOS symptoms emerged, the clinics refusing to see them and wholly denying any connection between their donation(s) and their current symptoms.

Unfortunately, the forum has largely become a trigger for all the foregoing reasons. Despite our efforts (and my efforts), to inform donors of the risks and the reality that the American fertility industry operates without meaningful regulatory oversight, time and time again, I watch as young women subject themselves to the process, largely trusting in a doctor or facility who does not have their best interests at heart and trusting a system and industry that is preying on the vulnerable (the infertile and young women). Time and time again, members leave retrieval with no follow-up care, only to have liters of fluid removed later from their abdomens. Time and time again, we've seen clinics marginalizing their pain, explaining it away as "normal."

It has been tiring. This has been a huge part of my life, but at this point in time taking a step back is the right choice for me. Raquel is still here for everyone as co-founder, moderator, blog editor, and advocate. Moving forward, I'll be available to assist Raquel in carrying on WAED's mission, however, that role will be in a consultant capacity only. For those who do wish to reach out, you can find me on Facebook and at [email address.]

Sincerely,

Sierra Poulson

I understand the appeal. Guaranteed packages promise a bit of certainty — a fixed price — in a very uncertain endeavour. They offer consolation — some money back —when things don't work out.

The concerns are many. Is it transparent? Is it ethical? Is it riskier? Is it even a good deal?

Below, I gather into thematic clumps some online words that are proclaiming these services.

3 minute read

Guaranteed Success Program

Guaranteed Success Plan

Success Guarantee Packages

IVF Success Guarantee Plan

GUARANTEE PROGRAMS

SHARED RISK 100% REFUND PROGRAM

Peace of Mind® Program

Guaranteed Live Birth Plan

IVF Unlimited Programme

GUARANTEED IVF PROGRAM

100% refund package

Money-Back Guarantee

IVF Refund Packages

Up to 100% Refund of Cycle Fees

100% of the deposit is refunded²

(²Exceptions apply, refer to contract for details)

Money-back guarantee if you are unsuccessful

If you do not deliver a baby, up to 100% of the IVF Refund programme fee will be refunded to you

If you have not delivered a healthy baby after a transfer of up to six (6) blastocysts, you would receive a full refund

If, for whatever reason, attempts to conceive are unsuccessful, we will refund 100% of the fee to you

Multiple IVF cycles at a significant discount, with the added security of a money-back guarantee if you are unsuccessful

Up to 4 egg retrievals, biopsy with PGT-A (Preimplantation Genetic Testing for Aneuploidies), and unlimited embryo transfers until a take home baby is achieved or 100% of your money back!

Unlimited IVF for 2 Years and moneyback guarantee if you do not have a baby

A completed Success Guarantee cycle is a successful live birth¹

⁽¹A live birth is defined as a child born who lives more than 72 hours post-delivery)

A viable pregnancy or we refund all your money

We guarantee you a 12 week continuous pregnancy or we will refund your money for the procedure

Up to three retrieval and implantation cycles

Patients have to QUALIFY for this package

Eligibility is subject to medical review

See the criteria required

Give us a call and we will provide you the details about the requirements and eligibility

Women 41 and older can participate in the Shared Risk 100% Refund Program if they are using donor eggs

Available to women aged 39 and under using their own eggs

Embryos must have been cryopreserved before the woman turned 39

Options for all patients under 38

The recipient of embryos must have a BMI <30

Using the same combination of ovum, sperm and uterus, the intended parents must have failed less than 3 IVF cycles in their history

In previous fertility treatment therapies the embryo recipient must not have demonstrated a poor endometrial response

If recipient of embryos as submucosal fibroids, they must be removed. If she has intramural fibroids they must be < 3cm

Rates subject to change at any time

Percentage refunds are based on the age of the egg provider

Medication and anesthesia costs cannot be refunded

Services not included in the plan: Anesthesia

If couple is unwilling to use donor sperm as back-up and there is no sperm found on the TESE/MESA then the SG contract will be void and a one cycle package will be charged and the balance refunded

Buy 2 get one Free!

The lab must be able to use ICSI at their discretion for optimum fertilization

A minimum of two embryos will be replaced

The couple must agree to have all embryos transferred, either fresh or thawed, before the cycle is considered complete per the plan

All treatment decisions will be taken by your doctor

Since 2022, I've been using the summer weeks to revisit some HeyReprotech posts from the past. Even though the newsletter is still on hiatus, I've decided to do that again this year.

All items will be delivered to your inbox Tuesday mornings at 10:30 a.m. Eastern time. They are free and open to all, so please encourage your friends and colleagues to sign up.

Subscribe now

HeyReprotech, written by freelance journalist Alison Motluk, explores the ripples caused by assisted reproduction.

Enjoy!

Sperm donation worries then and now

What do donor-conceived people owe half-siblings and others in their new families?

What's it like to find the donor after years of searching?

The unknowability of foreign donors

Grandparents and donor conception

An anonymous sperm donor on being found

She donated her eggs to her sister — how did it turn out?

A sperm donor and recipient fell in love

The donor who was sued for child support

When an anonymous donor discovers a genetic disease

The false hope of open-identity donors

When donor becomes dad

Anonymous Father's Day

Why do we feel bad for some people cut off from bio-parents but not others?

When the donor dies

Should donor offspring be mentioned in a donor's obit?

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As I mentioned in last week's post, after today, HeyReprotech will be pausing for a bit. I may pop back in from time to time, but for the most part, the newsletter will remain silent. All payments are paused.

I will miss spending time with you here every week. I wish you the best in 2025 and hope to be back in touch later in the year.

2025 (forthcoming)

Rene Almeling, Lisa Campo-Engelstein and Brian Nguyen, eds. Seminal: On Sperm, Health and Politics. 2025.

Julie Bindeman, ed. The Mental Health Clinician's Handbook for Abortion Care. 2025.

Kirsty Horsey, Zaina Mahmood, and Katherine Wade, eds. Future Directions in Surrogacy Law: Law and Policy Reform in the UK and Beyond. 2025.

Elizabeth Chloe Romanis. Biotechnology, Gestation and the Law. 2025.

2024

Valerie Bauman. Inconceivable : Super Sperm Donors, Off-the-Grid Insemination, and Unconventional Family Planning. 2024.

Kat Brown, ed. No One Talks About This Stuff: Twenty-Two Stories of Almost Parenthood. 2024.

Sarah Franklin and Emily Jackson. The 14 Day Rule and Human Embryo Research: A Sociology of Biological Translation. 2024.

Nell Greenfieldboyce. Transient and Strange: Notes on the Science of Life. 2024.

Marina Kamenev. Kin: Family in the 21st Century. 2024.

Natalie Lampert. The Big Freeze: A Reporter's Personal Journey Into the World of Egg Freezing and the Quest to Control Our Fertility. 2024.

Gillian Lockwood, ed. Egg Freezing in the 21st Century: A Global Perspective. 2024.

Aimee Middlemiss. Invisible Labours: the Reproductive Politics of Second Trimester Pregnancy Loss in England. 2024.

Zsolt Peter Nagy, Alex Varghese, and Ashok Agarwal, eds. Cryopreservation in Assisted Reproduction: A Practitioner's Guide to Methods, Management and Organization. 2024.

Stephen Page. International Assisted Reproductive Technology. 2024.

Manuela Perrotta. Biomedical Innovation in Fertility Care: Evidence Challenges, Commercialization and the Market for Hope. 2024.

Diane Tober. Eggonomics: The Global Market in Human Eggs and the Donors Who Supply Them. 2024

2023

Jennie Agg. Life, Almost: Miscarriage, Misconceptions and a Search for Answers from the Brink of Motherhood. 2023.

Helen Allan and Ginny Mounce. The Transition to Parenthood after IVF: An Introduction for Nursing, Midwifery and Health Visiting. 2023.

Donna Drucker. Fertility Technology. 2023.

Leah Hazard. Womb: The Inside Story of Where We All Began. 2023.

Claire Horn. Eve: The Disobedient Future of Birth. 2023.

Marcia Inhorn. Motherhood on Ice: The Mating Gap and Why Women Freeze Their Eggs. 2023.

Priya Joi. M(other) Land: What I've Learnt about Parenthood, Race and Identity. 2023.

Chris Kaposy. The Beautiful Unwanted: Down Syndrome in Myth, Memoir and Bioethics. 2023.

Laura Kelly. Contraception and Modern Ireland: A Social History. 2023.

Louise King and Isabelle Bank. Case Studies in the Ethics of Assisted Reproduction. 2023.

Rachel Lehmann-Haupt. Reconceptions: Modern Relationships, Reproductive Science, and the Unfolding Future of Family. 2023.

Tracey Lindeman. Bleed: Destroying Myths and Misogyny in Endometriosis Care. 2023.

Jesse Olszynko-Gryn. A Woman's Right to Know: Pregnancy Testing in Twentieth-Century Britain. 2023.

Vida Panitch and Elodie Bertrand, eds. The Routledge Handbook of Commodification. 2023.

Lisa Schuman and Mark Leondires. Building Your Family: The Complete Guide to Donor Conception. 2023.

Joseph Tito and Kevin Cerqueira. The Twin Diaries: Stella and Mia Meet Papa. (Children's book.) 2023.

Karen Weingarten. Pregnancy Test. 2023.

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2022

Peter Boni. Uprooted: Family Trauma, Unknown Origins, and the Secretive History of Artificial Insemination. 2022.

Lauren Burns. Triple Helix: My Donor-Conceived Story. 2022.

Sharon Covington, ed. Fertility Counseling, 2nd Edition: Clinical Guide (vol 1). 2022.

Sharon Covington, ed. Fertility Counseling, 2nd Edition: Case Studies (vol 2). 2022.

Arianna D'Angelo, Kenny Rodriguez-Wallberg, and Daniela Nogueira, eds. Long Term Safety of Assisted Reproduction. 2022.

Sam Everingham and Kerry Duncan. Surrogacy Stories: Twenty Extraordinary Journeys to Parenthood. 2022.

Abbie Goldberg. LGBTQ Family Building: A Guide for Prospective Parents. 2022.

Esmee Sinead Hanna and Brendan Gough. (In)Fertile Male Bodies: Masculinities and Lifestyle Management in Neoliberal Times. 2022.

Emma Haslett and Gabriella Griffith. Big Fat Negative: The Essential Guide to Infertility, IVF and the Trials of Trying for a Baby. 2022.

Kristin Liam Kali. Queer Conception: The Complete Fertility Guide for Queer and Trans Parents-to-be. 2022.

Maureen McTeer. Fertility: 40 Years of Change. 2022.

Petra Nordqvist and Leah Gilman. Donors: Curious Connections in Donor Conception. 2022.

Laura Katz Olson. Ethically Challenged: Private Equity Storms US Healthcare. 2022.

Jenni Quilter. The Hatching: Experiments in Motherhood and Technology. 2022.

Camilla Mork Rostvik. Cash Flow: The Businesses of Menstruation. 2022.

Jennifer Takhar, Rika Houston and Nikhilesh Dholakia. Transhumanisms and Biotechnologies in Consumer Society. 2022.

Becky Tipper, Leah Gilman, and Petra Nordqvist. Known Unknowns: Short Stories About Known Egg Donation. (Fiction.) 2022.

Stephane Viville and Karen Sermon, eds. Textbook of Human Reproductive Genetics. 2022.

Amy Webb and Andrew Hessel. The Genesis Machine: Our Quest to Rewrite Life in the Age of Synthetic Biology. 2022.

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2021

Alexandra Antipa. M is for Mother: My Journey Into Motherhood. 2021.

Mali Bain, ed. Choosing Single Parenthood: Stories From Solo Parents By Choice. 2021.

Sophie Beresiner. The Mother Project: Making It to Parenthood the (Very) Long Way Round. 2021.

Kim Bergman and William Petok. Psychological and Medical Perspectives on Fertility Care and Sexual Health. 2021.

Jennifer Berney. The Other Mothers: Two Women's Journey to Find the Family That Was Always Theirs. 2021.

Nolwenn Bühler. When Reproduction Meets Ageing: The Science and Medicine of the Fertility Decline. 2021.

Annette Burfoot and Derya Gungor. Women and Reproductive Technologies: The Socio-Economic Development of Technologies Changing the World.(Open Access.) 2021.

Samantha Busch. Fighting Infertility: Finding My Inner Warrior Through Trying to Conceive, IVF and Miscarriage. 2021.

Carol Lynn Curchoe Burton. The Thin Pink Line: Regulating Reproduction. 2021.

Marie-Josephe Devillers and Ana-Luana Stoicea Deram, eds. Towards the Abolition of Surrogate Motherhood. 2021.

Sarah Dingle. Brave New Humans: The Dirty Truth Behind the Fertility Industry. 2021.

Mona Eltahawy. Bloody Hell! And Other Stories. Adventures in Menopause from Across the Personal and Political Spectrum. 2021.

Katy Faust and Stacy Manning. Them Before Us: Why We Need a Global Children's Rights Movement. 2021.

Gabrielle Glaser. American Baby: A Mother, a Child and the Shadow History of Adoption. 2021.

Henry Greely. CRISPR People: The Science and Ethics of Editing Humans. 2021.

Daniel Groll. Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation. 2021.

Michael Grynberg and Pasquale Patrizio. Female and Male Fertility Preservation. 2021.

Jen Gunter. The Menopause Manifesto: Own Your Health with Facts and Feminism. 2021.

Joyce Harper. Your Fertile Years: What You Need to Know to Make Informed Choices. 2021.

Joan Holub and Daniel Roode. This Little Rainbow: A Love-Is-Love Primer. (Board Book.) 2021.

Walter Isaacson. The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race. 2021.

Luke Jackson, Kelly Jackson, Mara Wild. Two-Week Wait: An I.V.F Story. (Graphic Novel.) 2021.

Alex Johnston. Inconceivable: My Life-Altering, Eye-Opening Journey from Infertility to Motherhood. 2021.

Bradford Kolb and Melinda Maerker. Love Comes First: Creating LGBTQ Families. 2021.

Hasan Namir. Umbilical Cord. (Poetry.) 2021.

Sofi Oksanen. Dog Park: A Novel. (Fiction.) 2021.

Trystan Reese. How We Do Family: From Adoption to Trans Pregnancy, What We Learned About Love and LGBTQ Parenthood. 2021.

Sarah Richardson. The Maternal Imprint: The Contested Science of Maternal-Fetal Effects. 2021.

Celine Revel-Dumas. GPA, Le Grand Bluff. 2021.

Nancy Segal. Deliberately Divided: Inside the Controversial Study of Twins and Triplets Adopted Apart. 2021.

Martine Segalen and Nicole Athea. Les Marchés de la Maternité. 2021.

Shanna Swan and Stacey Colino. Count Down: How Our Modern World is Threatening Sperm Counts, Altering Male and Female Reproductive Development and Imperilling the Future of the Human Race. 2021.

Natali Valdez. Weighing the Future: Race, Science and Pregnancy Trials in the Postgenomic Era. 2021.

John Waldman. Swimming Aimlessly: One Man's Journey Through Infertility and What We Can All Learn From It. 2021.

Christina Weis. Surrogacy in Russia: An Ethnography of Reproductive Labour, Stratification and Migration. 2021.

Amber Winick and Michelle Millar Fisher. Designing Motherhood: Things that Make and Break Our Births. 2021.

Carl Zimmer. Life's Edge: The Search For What It Is to Be Alive. 2021.

Dear Readers,

Next week, I will publish a list of recent books in the field of assisted reproduction, as I have done every new year since HeyReprotech began.

Following the new books item, the newsletter will fall silent for a while. I don't know yet for how long.

After almost seven years of weekly newsletter deadlines, it's become clear to me that I need to take a break.

All payments have been paused. Payments will not be turned back on before September 2025, and I will notify you before any reactivation. In the meantime, monthly subscribers will not be charged and annual subscribers will have the clock stopped.

I may pop in during the pause, but not routinely, and only if I have something I really want you to know about. I am still here, though, if you want to get in touch.

I want to leave you with a selection of some of my favourite items from among the hundreds that I have written over the years. Thank you for being here to inspire me to get them done.

It's okay to not freeze your eggs

37-year-old single woman finds a sperm donor on Facebook

How often do 'bad' embryos lead to 'good' babies?

Is post-death conception okay?

Guaranteed Baby Success 100% Refund Package

What do donor-conceived people owe half-siblings and others in their new families?

How Canada became an international surrogacy destination

Would a test of my father's embryo have predicted the man he would become?

Anonymous Father's Day

Many thanks to my proofreaders, to the people who send tips and ideas, to the people who send their thoughts and comments, and to all of you who take the time to read and think about the stories in this newsletter. I can't tell you how much I appreciate you!

See you in 2025!

These stories will be unpaywalled until the end of the year.

What I learned from looking at one Ontario woman's $100,000+ expenditure on fertility treatment. HeyReprotech. 12 Dec 2023.

This story was about lessons learned from an Ontario woman who spent $117,684.43 on fertility treatment in Ontario, and still didn't have a child. Update: The woman and her husband did yet another round of IVF, which resulted in four good embryos. One of them became the baby that came into the world just a few weeks ago! Also, since that story published, the province announced plans to introduce a tax credit for fertility expenditures.

Does Canada's tax law discriminate against gay men who want children? HeyReprotech. 20 Feb 2024.

This is a case in Canada's Tax Court about whether a gay man who uses surrogacy to have a child should be considered a "patient" for tax purposes, and therefore get a medical expense tax credit. Update: Still no judgement.

Did someone steal our embryo? And other mysteries families should not have to solve. HeyReprotech. 21 May 2024.

A woman in her twenties discovers that her twin sisters were conceived using an egg donor — and that there's a surprise sibling out there. She helps her mother figure out how that could be possible. Update: The family is back in touch with the half-sibling. Paperwork suggests there were five embryos and all of them went to this family. The twin sisters have not yet been told.

Crown drops forgery and fraud charges against Ontario surrogate. HeyReprotech. 18 Jun 2024.

A gay couple has a child after a friend offers to be their surrogate. They have disputes over money and the surrogate refuses to sign over parentage. Update: Not everything is resolved yet, but after more than a year of uncertainty, the two men are now the legal parents and the child has a birth certificate.

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Jenny Kleeman. "The Gift." BBC Sounds. 2023, 2024.

"Without us realizing, an enormous DNA database has been created online. But what happens when online ancestry tests reveal more than you had bargained for?"

In particular, check out:

Series 1, episode 1: "Fraud."

Series 1, episode 3: "Mistakes."

Series 2, episode 3: "Sold."

Series 2, episode 6: "Superdonor."

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