What it's like to transport eggs and embryos around the globe

It's not uncommon these days for assisted reproduction to involve a lot of travel — at least for the reproductive materials. A courier gives me the lowdown on how it works.

I've been interested in how embryos travel around the world for some time now, but I haven't written much about it. I started interviewing people a while back with the intention of doing a general piece, but I found this one interview quite fascinating, so have decided to present it as a straight Q&A.

There will be more to come on this topic, but below I interview Sunil Gossai, formerly a fertility clinic senior andrologist and lab manager, who now runs Cryozoom, a global hand-carry courier service for reproductive material.

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 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 it 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 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 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.