1 00:00:01,080 --> 00:00:05,319 Speaker 1: It's late April twenty twenty four. The Center for Reproductive 2 00:00:05,360 --> 00:00:09,480 Speaker 1: Health is closed. The clinic itself is dark, the door 3 00:00:09,520 --> 00:00:13,960 Speaker 1: is locked. Doctor Vazkaz is no longer allowed to handle 4 00:00:14,000 --> 00:00:17,119 Speaker 1: patient records or anything else involving the clinic. 5 00:00:17,880 --> 00:00:19,200 Speaker 2: The state has taken. 6 00:00:18,920 --> 00:00:22,960 Speaker 1: Over CRH, and a receiver, a third party appointed by 7 00:00:22,960 --> 00:00:28,560 Speaker 1: the courts, takes responsibility for what's left behind. The first 8 00:00:28,640 --> 00:00:33,080 Speaker 1: priority is the cryogenic tanks. The clinic has five of them, 9 00:00:33,280 --> 00:00:37,360 Speaker 1: filled with frozen embryos, eggs, and sperm, what the fertility 10 00:00:37,360 --> 00:00:42,360 Speaker 1: industry refers to as genetic material. The receiver hires an 11 00:00:42,400 --> 00:00:46,040 Speaker 1: embryologist to come to the shuttered CRH several times a 12 00:00:46,080 --> 00:00:49,280 Speaker 1: week just to monitor the tanks and make sure there's 13 00:00:49,360 --> 00:00:53,360 Speaker 1: enough liquid nitrogen in them. That is, until the receiver 14 00:00:53,479 --> 00:00:56,840 Speaker 1: can find another clinic willing to take in all of 15 00:00:56,880 --> 00:00:58,120 Speaker 1: this genetic material. 16 00:00:58,920 --> 00:01:02,240 Speaker 2: But this isn't a simple task. Digging into the. 17 00:01:02,160 --> 00:01:07,360 Speaker 1: Files, the receiver discovers how truly disorganized they are. The 18 00:01:07,400 --> 00:01:12,200 Speaker 1: Center for Reproductive Health kept three separate inventory systems, one 19 00:01:12,240 --> 00:01:16,000 Speaker 1: on paper and two electronic, and none of them match 20 00:01:16,080 --> 00:01:21,160 Speaker 1: up perfectly. Meanwhile, patients are desperately waiting for news. 21 00:01:22,120 --> 00:01:23,240 Speaker 2: In May they get a. 22 00:01:23,240 --> 00:01:26,560 Speaker 1: Letter from the receiver reassuring them that the tanks are 23 00:01:26,560 --> 00:01:30,320 Speaker 1: being cared for, but there's no timeline for moving them, 24 00:01:30,920 --> 00:01:34,760 Speaker 1: no concrete path forward at all. All they can do 25 00:01:34,880 --> 00:01:43,360 Speaker 1: is wait. May June July, Nashville shifts from spring to summer. 26 00:01:44,280 --> 00:01:48,680 Speaker 1: The receiver files monthly reports, all with the same information 27 00:01:48,760 --> 00:01:52,560 Speaker 1: about the genetic material. We're still trying to move the embryos, 28 00:01:53,080 --> 00:01:57,480 Speaker 1: Thanks for your patients, etc. The air outside grows heavy 29 00:01:57,560 --> 00:02:02,400 Speaker 1: and humid. Finally, in August, around four months after the 30 00:02:02,440 --> 00:02:06,000 Speaker 1: Center for Reproductive Health shuts down, the receiver finds a 31 00:02:06,000 --> 00:02:10,480 Speaker 1: clinic willing to accept the genetic material, the Tennessee Fertility 32 00:02:10,560 --> 00:02:15,120 Speaker 1: Institute or TFI. This is the news patients have been 33 00:02:15,160 --> 00:02:17,880 Speaker 1: waiting for the chance to start again. 34 00:02:18,480 --> 00:02:21,519 Speaker 3: Precious genetic material that was at the Center for Reproductive 35 00:02:21,520 --> 00:02:24,600 Speaker 3: Health moved down I sixty five to Franklin last week. 36 00:02:24,880 --> 00:02:28,280 Speaker 3: The fertility clinic that accepted that tissue. From what I've learned, 37 00:02:28,360 --> 00:02:30,200 Speaker 3: still has their work cut out for them. 38 00:02:30,600 --> 00:02:34,520 Speaker 1: But any excitement is quickly dampened because the records are 39 00:02:34,560 --> 00:02:39,040 Speaker 1: such a mess. A full audit is required. Every embryo, 40 00:02:39,240 --> 00:02:42,680 Speaker 1: egg and vile of sperm needs a paper trail showing 41 00:02:42,720 --> 00:02:46,079 Speaker 1: who it belongs to, how it was created, and how 42 00:02:46,120 --> 00:02:50,440 Speaker 1: it's been stored. The Tennessee Fertility Institute has to comb 43 00:02:50,480 --> 00:02:55,120 Speaker 1: through crch's record keeping systems and verify that everything is 44 00:02:55,200 --> 00:02:59,079 Speaker 1: properly linked to the right patient before anything can be released. 45 00:03:00,080 --> 00:03:03,560 Speaker 1: This won't be easy. In total, there's almost twelve hundred 46 00:03:03,560 --> 00:03:08,480 Speaker 1: embryos to sort and identify. So the patients wait again. 47 00:03:09,600 --> 00:03:13,960 Speaker 1: They hope the audit will finally bring clarity. Instead, it 48 00:03:14,040 --> 00:03:19,480 Speaker 1: exposes just how unstable crch's operations really were and how 49 00:03:19,560 --> 00:03:27,560 Speaker 1: much trust had already been broken. I'm Melissa Jelson from 50 00:03:27,639 --> 00:03:31,600 Speaker 1: School of Humans and iHeart Podcasts. This is what happened 51 00:03:31,600 --> 00:03:35,440 Speaker 1: in Nashville episode for the audit. 52 00:03:44,600 --> 00:03:47,840 Speaker 4: Great anxiously waiting this letter the day on This is 53 00:03:48,280 --> 00:03:52,680 Speaker 4: October second, twenty twenty four, and you know the SICH 54 00:03:52,760 --> 00:03:55,400 Speaker 4: closed in April, so this is a long time coming. 55 00:03:56,040 --> 00:03:59,600 Speaker 1: This is Kristen Wall. She and her wife Diana are 56 00:03:59,600 --> 00:04:02,720 Speaker 1: both for more patients of the Center for Reproductive Health. 57 00:04:03,600 --> 00:04:06,840 Speaker 1: When the clinic closed, they were new parents to a 58 00:04:06,880 --> 00:04:10,920 Speaker 1: baby conceived through IVF, one of the two thousand children. 59 00:04:11,240 --> 00:04:14,040 Speaker 1: Doctor Vaskaz boasted of bringing into the world. 60 00:04:14,600 --> 00:04:15,640 Speaker 5: We just had our baby. 61 00:04:15,680 --> 00:04:19,480 Speaker 4: We were enjoying it soaking that in and we had 62 00:04:19,480 --> 00:04:22,080 Speaker 4: her embryos frozen at CRCH. 63 00:04:22,720 --> 00:04:23,599 Speaker 5: We hadn't even. 64 00:04:23,880 --> 00:04:27,520 Speaker 4: Talked about our thought about starting to grow our family again, 65 00:04:27,720 --> 00:04:30,240 Speaker 4: just because we were very much in the throes of 66 00:04:30,279 --> 00:04:33,279 Speaker 4: a newborn baby, and so it really wasn't even a 67 00:04:33,279 --> 00:04:36,080 Speaker 4: blip on our radar at the time. And then I 68 00:04:36,120 --> 00:04:39,960 Speaker 4: saw that news article and my immediate thought was, our embryos. 69 00:04:40,000 --> 00:04:43,000 Speaker 4: They're not viable like they are. 70 00:04:43,960 --> 00:04:47,359 Speaker 5: Something's happened to them, and I was terrified. 71 00:04:47,960 --> 00:04:52,480 Speaker 1: The information trickling out doesn't ease those fears. First, there's 72 00:04:52,520 --> 00:04:57,359 Speaker 1: the report after the state inspection where authorities described observing 73 00:04:57,480 --> 00:05:01,479 Speaker 1: a dirty lab and Vaska's A currently struggling to service 74 00:05:01,520 --> 00:05:06,120 Speaker 1: the tanks. Then news breaks that Ferrera Dyer isn't a 75 00:05:06,200 --> 00:05:09,920 Speaker 1: licensed doctor. Kristin and her wife are stunned. 76 00:05:10,920 --> 00:05:14,680 Speaker 4: He was our first contact point at ERH. He introduced 77 00:05:14,720 --> 00:05:17,520 Speaker 4: us as doctor Dyer. Everyone referred to him as doctor Dyer. 78 00:05:18,200 --> 00:05:20,320 Speaker 4: He had a white coat on, brought us in to 79 00:05:20,400 --> 00:05:21,200 Speaker 4: his office. 80 00:05:21,720 --> 00:05:24,920 Speaker 1: They had met with dire as they navigated fertility treatments 81 00:05:24,960 --> 00:05:28,920 Speaker 1: at the clinic, although he didn't perform IVF procedures at 82 00:05:29,200 --> 00:05:33,360 Speaker 1: RH such as egg retrievals or embryo transfers. He was 83 00:05:33,400 --> 00:05:36,719 Speaker 1: the one who they said, reviewed test results with them, and, 84 00:05:36,800 --> 00:05:39,280 Speaker 1: as far as they could tell, seemed to come up 85 00:05:39,320 --> 00:05:42,960 Speaker 1: with their treatment plan. Kristin and Diana had picked the 86 00:05:43,000 --> 00:05:47,479 Speaker 1: Center for Reproductive Health because it offered reciprocal IVF, a 87 00:05:47,560 --> 00:05:51,160 Speaker 1: process that allows both women to participate in the experience, 88 00:05:51,880 --> 00:05:55,680 Speaker 1: one by donating the eggs, the other by carrying the baby. 89 00:05:56,560 --> 00:06:00,640 Speaker 1: In their case, Diana underwent an egg retrieval and Kristin 90 00:06:00,720 --> 00:06:05,839 Speaker 1: planned to carry. Their first embryo transfer resulted in a miscarriage. 91 00:06:06,560 --> 00:06:10,520 Speaker 1: On the second attempt, Doctor Vazki has transferred two embryos 92 00:06:10,600 --> 00:06:15,839 Speaker 1: to Kristin's uterus, both implanted until one stopped developing. 93 00:06:16,800 --> 00:06:18,239 Speaker 5: I became pregnant with twins. 94 00:06:18,920 --> 00:06:19,400 Speaker 6: Wow. 95 00:06:19,640 --> 00:06:25,839 Speaker 4: Yeah, And as you probably know IVF, pregnancy with twins 96 00:06:25,960 --> 00:06:32,120 Speaker 4: is definitely a very high risk pregnancy, and unfortunately I 97 00:06:32,320 --> 00:06:36,440 Speaker 4: lost one of the twins, so I miss carry one 98 00:06:36,440 --> 00:06:39,800 Speaker 4: of them. I have what's called vanishing twin syndrome, and 99 00:06:40,400 --> 00:06:43,880 Speaker 4: it was awful and I'm still, you know, kind of 100 00:06:43,920 --> 00:06:48,000 Speaker 4: dealing with it today. But on the good side, I 101 00:06:48,080 --> 00:06:51,159 Speaker 4: did carry the other one to full term and we 102 00:06:51,279 --> 00:06:56,520 Speaker 4: do have a child, which is wonderful, but I am 103 00:06:56,760 --> 00:07:03,240 Speaker 4: still really reeling from that because I had worked through 104 00:07:03,240 --> 00:07:06,839 Speaker 4: my own emotions around it, and then when this CRCH 105 00:07:06,920 --> 00:07:09,840 Speaker 4: thing happened, it just threw me right back to it. 106 00:07:10,360 --> 00:07:15,679 Speaker 4: I immediately just started questioning everything. And when Kristin and Diana 107 00:07:15,840 --> 00:07:19,160 Speaker 4: finally get their medical records from the clinic, they become 108 00:07:19,400 --> 00:07:23,600 Speaker 4: even more alarmed by the state of things. In Diana's file, 109 00:07:23,960 --> 00:07:28,520 Speaker 4: they find information that shouldn't be there. I was scrolling 110 00:07:28,560 --> 00:07:32,360 Speaker 4: and all of a sudden, I see another woman's name, 111 00:07:32,640 --> 00:07:33,080 Speaker 4: and I'm. 112 00:07:32,920 --> 00:07:34,040 Speaker 5: Like, who is this. 113 00:07:34,040 --> 00:07:37,400 Speaker 4: This is a woman that had an ank retrieval at CRCH, 114 00:07:38,040 --> 00:07:39,920 Speaker 4: and I looked at the date and she had it 115 00:07:40,000 --> 00:07:43,520 Speaker 4: the day after my wife did, and it's lumped right 116 00:07:43,560 --> 00:07:45,520 Speaker 4: in the middle of my wife. 117 00:07:45,640 --> 00:07:49,480 Speaker 1: Kristin's own records are no better. She says, there's no 118 00:07:49,600 --> 00:07:53,840 Speaker 1: documentation of her second embryo transfer, the one where Vazka 119 00:07:53,880 --> 00:07:57,560 Speaker 1: has transferred to embryos and which resulted in the birth 120 00:07:57,600 --> 00:07:58,320 Speaker 1: of their child. 121 00:07:59,080 --> 00:08:04,640 Speaker 4: My record had absolutely no indication or record that I 122 00:08:04,800 --> 00:08:07,840 Speaker 4: had to transfer with two embryos. I just felt really 123 00:08:07,880 --> 00:08:12,680 Speaker 4: invalidating because it felt like I didn't even go through 124 00:08:12,680 --> 00:08:13,400 Speaker 4: that process. 125 00:08:13,480 --> 00:08:16,240 Speaker 5: I just I I was like. 126 00:08:16,200 --> 00:08:18,600 Speaker 4: You couldn't even take the time to document it or 127 00:08:18,680 --> 00:08:19,960 Speaker 4: put that in my records. 128 00:08:20,800 --> 00:08:24,800 Speaker 1: Other patients are also receiving their medical records and sharing 129 00:08:24,840 --> 00:08:28,840 Speaker 1: their reactions on the Facebook page Sydney created. It turns 130 00:08:28,880 --> 00:08:33,880 Speaker 1: out the inconsistencies that Kristen and Diana discovered aren't unique. 131 00:08:34,559 --> 00:08:41,160 Speaker 1: Patients report missing test results, entire procedures omitted. Each discrepancy 132 00:08:41,200 --> 00:08:44,720 Speaker 1: adds to a growing sense of panic. If the paperwork 133 00:08:44,760 --> 00:08:46,560 Speaker 1: is wrong, what else might be. 134 00:08:48,240 --> 00:08:51,640 Speaker 4: The more information we found out, just the less hopeful 135 00:08:51,720 --> 00:08:54,400 Speaker 4: we got. It was just like a blow every single 136 00:08:54,440 --> 00:08:56,120 Speaker 4: time we found out new information. 137 00:08:56,840 --> 00:09:01,040 Speaker 1: The receiver releases regular status reports to update patients on 138 00:09:01,120 --> 00:09:06,599 Speaker 1: what's happening behind the scenes. Kristin, like many patients, carefully 139 00:09:06,679 --> 00:09:10,160 Speaker 1: reads through each report, and some of the details she 140 00:09:10,280 --> 00:09:11,720 Speaker 1: learns are shocking. 141 00:09:12,960 --> 00:09:15,800 Speaker 4: I read the receiver discovered evidence that at least two 142 00:09:15,840 --> 00:09:20,080 Speaker 4: patients received the incorrect embryos for their frozen embryo transfer procedures, 143 00:09:20,400 --> 00:09:23,480 Speaker 4: and I immediately was like, holy shit, Like this is 144 00:09:23,920 --> 00:09:25,640 Speaker 4: that is my biggest fear. 145 00:09:26,320 --> 00:09:29,679 Speaker 1: The report does add that neither of these embryo transfers 146 00:09:29,760 --> 00:09:33,559 Speaker 1: led to a pregnancy, but that doesn't help quash Kristen's fear. 147 00:09:33,800 --> 00:09:37,079 Speaker 1: That maybe she'd received an embryo that wasn't made from 148 00:09:37,080 --> 00:09:42,080 Speaker 1: her wife's egg, but from some other woman's instead. Kristin 149 00:09:42,400 --> 00:09:45,560 Speaker 1: and all the other patients must now wait for the 150 00:09:45,559 --> 00:09:49,920 Speaker 1: official embryo audit by the Tennessee Fertility Institute, the one 151 00:09:49,920 --> 00:09:53,920 Speaker 1: that requires going through three sets of incomplete records to 152 00:09:54,080 --> 00:09:54,959 Speaker 1: understand more. 153 00:09:56,040 --> 00:09:58,679 Speaker 4: That same week, we get our letter in the mail 154 00:09:59,040 --> 00:10:01,880 Speaker 4: and it says you have been identified as a former 155 00:10:01,920 --> 00:10:05,600 Speaker 4: patient of the Center for Reproductive Health with cryogenically stored 156 00:10:05,640 --> 00:10:08,480 Speaker 4: genetic material. And then they said they did a physical 157 00:10:08,520 --> 00:10:12,120 Speaker 4: inventory audit and says please see below for the results, 158 00:10:12,640 --> 00:10:16,640 Speaker 4: and it says you have ten of ten embryos identified 159 00:10:16,679 --> 00:10:20,199 Speaker 4: in the inventory audit of the CICH doers. The account 160 00:10:20,200 --> 00:10:23,880 Speaker 4: of your genetic material matches your ch patient record. 161 00:10:24,760 --> 00:10:27,880 Speaker 1: This might seem like reassuring news ten out of ten 162 00:10:27,920 --> 00:10:32,880 Speaker 1: embryos identified everything with its own matching record, but it's not. 163 00:10:33,600 --> 00:10:35,080 Speaker 5: What we should have is eight. 164 00:10:35,400 --> 00:10:39,280 Speaker 4: So I'm reading in a receiver's report that they're talking 165 00:10:39,360 --> 00:10:42,439 Speaker 4: about women receiving the wrong embryos. And then I get 166 00:10:42,440 --> 00:10:44,560 Speaker 4: this letter that says we have ten and we're only 167 00:10:44,559 --> 00:10:45,400 Speaker 4: supposed to have eight. 168 00:10:46,480 --> 00:10:52,000 Speaker 1: The couple originally had eleven. Embryos. They transferred three, which 169 00:10:52,080 --> 00:10:55,360 Speaker 1: means they should have had eight left, but the letter 170 00:10:55,400 --> 00:10:59,360 Speaker 1: says they have ten embryos in the tanks. This is 171 00:10:59,440 --> 00:11:02,079 Speaker 1: exactly what what Kristin had been worried about. 172 00:11:02,320 --> 00:11:04,679 Speaker 5: I mean, I about shut down. 173 00:11:05,440 --> 00:11:10,200 Speaker 4: My immediate thought was, we have two embryos that aren't ours, 174 00:11:11,080 --> 00:11:13,880 Speaker 4: or you transferred somebody else's embryos to me. 175 00:11:15,320 --> 00:11:18,240 Speaker 1: Kristin and her wife reach out to a lawyer who 176 00:11:18,280 --> 00:11:22,800 Speaker 1: contacts the receiver, and after an additional review, the couple 177 00:11:22,880 --> 00:11:28,400 Speaker 1: gets another letter retracting the original count. Actually there are 178 00:11:28,600 --> 00:11:33,400 Speaker 1: only eight embryos in storage. The receiver doesn't explain why 179 00:11:33,440 --> 00:11:36,880 Speaker 1: the mix up happened. Was it because of corh's messy 180 00:11:36,960 --> 00:11:41,600 Speaker 1: record keeping? Was it a miscommunication? It doesn't make Kristin 181 00:11:41,679 --> 00:11:42,600 Speaker 1: feel any better. 182 00:11:43,679 --> 00:11:47,640 Speaker 4: So they were like, sorry, clerical air. And I'm like, well, okay, 183 00:11:47,720 --> 00:11:50,280 Speaker 4: so you have a clerical air. How am I supposed 184 00:11:50,320 --> 00:11:52,600 Speaker 4: to trust that the audit, the full audit you did, 185 00:11:52,920 --> 00:11:58,080 Speaker 4: was accurate. Then these receivers reports, You're just naming all 186 00:11:58,200 --> 00:12:01,720 Speaker 4: these discrepancies in the record. So I just had zero 187 00:12:01,880 --> 00:12:04,280 Speaker 4: trust that this was right. 188 00:12:05,679 --> 00:12:11,240 Speaker 1: Kristin isn't alone. The audit uncovers widespread problems According to 189 00:12:11,280 --> 00:12:14,280 Speaker 1: a report filed by the receiver, out of a total 190 00:12:14,320 --> 00:12:17,560 Speaker 1: of six hundred and sixty four patients, one hundred and 191 00:12:17,600 --> 00:12:21,000 Speaker 1: fifty four had genetic material in storage that did not 192 00:12:21,240 --> 00:12:24,840 Speaker 1: match up with their records. That's nearly twenty five percent. 193 00:12:25,520 --> 00:12:28,719 Speaker 1: Some women like Kristin are told they have more embryos 194 00:12:28,760 --> 00:12:33,400 Speaker 1: than they thought, others fewer. One woman who believed she 195 00:12:33,520 --> 00:12:38,079 Speaker 1: had none discovers she has three. And then there are 196 00:12:38,160 --> 00:12:43,400 Speaker 1: other issues eighty seven patients with genetic material in storage 197 00:12:43,520 --> 00:12:47,240 Speaker 1: but no mailing address on file, and twelve specimens with 198 00:12:47,440 --> 00:12:51,240 Speaker 1: missing or indecipherable labels, which means there's no way to 199 00:12:51,320 --> 00:12:57,240 Speaker 1: verify who they belonged to. I asked the receiver for 200 00:12:57,320 --> 00:13:01,240 Speaker 1: more information on the audit, including details on the two 201 00:13:01,400 --> 00:13:05,600 Speaker 1: instances where patients received the wrong embryos during a transfer. 202 00:13:06,559 --> 00:13:10,319 Speaker 1: The receiver clarified that the two embryo transfers use the 203 00:13:10,400 --> 00:13:15,080 Speaker 1: correct person's genetic material, just not the intended embryo for 204 00:13:15,160 --> 00:13:18,839 Speaker 1: the transfer, but they declined to provide more details about 205 00:13:18,840 --> 00:13:24,360 Speaker 1: the other inconsistencies the audit discovered for patients. The audit 206 00:13:24,440 --> 00:13:29,160 Speaker 1: results are deeply unsettling, and I can understand why, speaking 207 00:13:29,240 --> 00:13:33,400 Speaker 1: from experience. When you put embryos in storage a service 208 00:13:33,440 --> 00:13:37,800 Speaker 1: it's worth noting you pay for you expect meticulous care, 209 00:13:38,520 --> 00:13:44,000 Speaker 1: every label confirmed, every detail exact, every record air tight. 210 00:13:44,559 --> 00:13:46,760 Speaker 4: My wife and I both agreed that if we couldn't 211 00:13:46,840 --> 00:13:50,080 Speaker 4: be one hundred percent certain that these embryos are ours, 212 00:13:50,120 --> 00:13:54,079 Speaker 4: we would not feel comfortable using them. I was angry, honestly, 213 00:13:54,120 --> 00:13:55,040 Speaker 4: and frustrated. 214 00:13:55,800 --> 00:13:59,920 Speaker 1: The whole audit and how the results are communicated leaves 215 00:14:00,120 --> 00:14:03,240 Speaker 1: patients like Kristen and Diana feeling abandoned. 216 00:14:03,800 --> 00:14:06,480 Speaker 4: I felt like we deserved a phone call from somebody. 217 00:14:07,640 --> 00:14:10,000 Speaker 5: I just felt like we deserved more. 218 00:14:10,880 --> 00:14:15,440 Speaker 4: It's already just an emotionally hard process, and for a 219 00:14:15,480 --> 00:14:18,400 Speaker 4: lot of people, they're not coming to IVF because they've 220 00:14:18,400 --> 00:14:20,240 Speaker 4: had success. 221 00:14:19,680 --> 00:14:20,720 Speaker 5: In getting pregnant. 222 00:14:21,040 --> 00:14:25,400 Speaker 4: These people just don't seem to understand or care, or 223 00:14:25,400 --> 00:14:26,720 Speaker 4: they're just trying to cover their. 224 00:14:26,560 --> 00:14:38,480 Speaker 1: Butts covering the fallout from the Center for Reproductive Health's closure, 225 00:14:38,960 --> 00:14:42,680 Speaker 1: and going through infertility myself, I keep coming back to 226 00:14:42,760 --> 00:14:48,040 Speaker 1: the same theme time with fertility. It's always a race 227 00:14:48,080 --> 00:14:48,840 Speaker 1: against time. 228 00:14:49,600 --> 00:14:52,360 Speaker 7: Probably one of the better predictors of how likely a 229 00:14:52,440 --> 00:14:55,080 Speaker 7: treatment is to be successful is the age the woman 230 00:14:55,240 --> 00:14:57,600 Speaker 7: is when the procedure is performed. 231 00:14:58,120 --> 00:15:03,280 Speaker 1: This is doctor Allan Penzius, a reproductive endocrinologist an associate 232 00:15:03,320 --> 00:15:05,960 Speaker 1: professor at Harvard Medical School, just. 233 00:15:05,920 --> 00:15:11,720 Speaker 7: A biological fact that as women get older, reproductive capacity 234 00:15:11,920 --> 00:15:12,520 Speaker 7: goes down. 235 00:15:13,320 --> 00:15:16,720 Speaker 1: The numbers tell the story. If you go through IVF 236 00:15:16,800 --> 00:15:19,400 Speaker 1: when you're under thirty five, you have a more than 237 00:15:19,480 --> 00:15:22,880 Speaker 1: fifty percent chance of having a baby after just one 238 00:15:22,960 --> 00:15:27,880 Speaker 1: egg retrieval. Those are great odds, But the older you get, 239 00:15:28,080 --> 00:15:32,440 Speaker 1: the lower your chances. Forty percent when you're thirty five 240 00:15:32,560 --> 00:15:37,240 Speaker 1: to thirty seven, twenty six percent between ages thirty eight 241 00:15:37,320 --> 00:15:42,720 Speaker 1: and forty, thirteen percent in your early forties, and once 242 00:15:42,760 --> 00:15:46,680 Speaker 1: you're over forty two, you have just a four percent 243 00:15:46,880 --> 00:15:50,560 Speaker 1: chance of having a baby after a single egg retrieval. 244 00:15:51,560 --> 00:15:56,760 Speaker 1: So biology sets the clock, that often money sets the ceiling. 245 00:15:57,640 --> 00:16:01,280 Speaker 1: Each cycle can cost tens of thousands of dollars, and 246 00:16:01,360 --> 00:16:05,240 Speaker 1: most insurance doesn't cover it. Every failed round isn't just 247 00:16:05,280 --> 00:16:10,720 Speaker 1: another heartbreak, it's another bill or series of bills. This 248 00:16:11,000 --> 00:16:16,520 Speaker 1: is the cruel math of infertility. Biology, time and money 249 00:16:16,880 --> 00:16:20,680 Speaker 1: all working against you at once. And that's what made 250 00:16:21,040 --> 00:16:26,920 Speaker 1: crh's closure so catastrophic. It didn't just delay treatment, it 251 00:16:27,040 --> 00:16:30,600 Speaker 1: robbed patients of time they could never get back and 252 00:16:30,680 --> 00:16:36,840 Speaker 1: drained the limited resources they had, Wasted time, wasted money. 253 00:16:37,360 --> 00:16:42,880 Speaker 1: This isn't supposed to happen. Fertility clinics, like other medical practices, 254 00:16:43,480 --> 00:16:46,400 Speaker 1: are expected to have protocols in place if they need 255 00:16:46,440 --> 00:16:51,400 Speaker 1: to close, whether for retirement, emergencies or natural disasters. 256 00:16:53,400 --> 00:16:56,600 Speaker 7: We know that hurricanes sometimes happen, and if there's a 257 00:16:56,680 --> 00:16:59,920 Speaker 7: hurricane that's threatening to go past where an ivy F center, 258 00:17:00,400 --> 00:17:04,040 Speaker 7: sometimes it's necessary to take precautions to lock things down 259 00:17:04,119 --> 00:17:06,240 Speaker 7: and to make sure that the tanks are toped of. 260 00:17:06,960 --> 00:17:11,280 Speaker 1: In addition to treating patients at Boston IVF, doctor Allan 261 00:17:11,359 --> 00:17:14,680 Speaker 1: Penzius is also a former board member of the American 262 00:17:14,760 --> 00:17:20,119 Speaker 1: Society for Reproductive Medicine or ASRM, an organization dedicated to 263 00:17:20,200 --> 00:17:23,800 Speaker 1: the advancement of the science and practice of reproductive medicine. 264 00:17:24,440 --> 00:17:27,040 Speaker 7: Sometimes you have to actually move the embryos from one 265 00:17:27,040 --> 00:17:29,680 Speaker 7: location to another to keep them safe. So those are 266 00:17:29,720 --> 00:17:32,920 Speaker 7: all the obligation of the fertility center to make sure 267 00:17:32,960 --> 00:17:36,960 Speaker 7: that they've been entrusted with these very important biological materials, 268 00:17:37,040 --> 00:17:38,680 Speaker 7: to make sure that we take care of them properly. 269 00:17:39,240 --> 00:17:42,800 Speaker 1: There are roughly five hundred fertility clinics in the US. 270 00:17:43,760 --> 00:17:47,280 Speaker 1: Doctor Penzius notes that when one has to close, which 271 00:17:47,320 --> 00:17:50,919 Speaker 1: happens from time to time, there's a well established protocol 272 00:17:50,960 --> 00:17:51,520 Speaker 1: to follow. 273 00:17:52,160 --> 00:17:55,520 Speaker 7: So in the case of a program that knows they 274 00:17:55,600 --> 00:17:59,320 Speaker 7: might be closing for one reason or another, Let's say 275 00:17:59,320 --> 00:18:02,760 Speaker 7: a solo practice has had a great practice, it's going 276 00:18:02,800 --> 00:18:05,400 Speaker 7: to retire, and they know that in six months they're 277 00:18:05,400 --> 00:18:08,080 Speaker 7: going to be closing the practice. What do they do? 278 00:18:08,320 --> 00:18:11,360 Speaker 7: Will they notify all their patients in advance. They make 279 00:18:11,440 --> 00:18:14,760 Speaker 7: sure that anybody who has stored materials knows that they 280 00:18:14,800 --> 00:18:17,240 Speaker 7: can have the right to use them, or that they 281 00:18:17,320 --> 00:18:20,040 Speaker 7: can tell them where they're going to be sent to. 282 00:18:20,840 --> 00:18:24,400 Speaker 7: Maybe they've even made an arrangement with another fertility program 283 00:18:24,480 --> 00:18:29,000 Speaker 7: to transfer anything that's left over for long term story 284 00:18:29,359 --> 00:18:32,119 Speaker 7: and notified those patients to the abst of their ability. 285 00:18:33,880 --> 00:18:38,200 Speaker 1: And this isn't unique to fertility treatment. Continuity of care, 286 00:18:38,720 --> 00:18:42,040 Speaker 1: meaning there's no interruption in your access to medical treatment, 287 00:18:42,680 --> 00:18:46,280 Speaker 1: is one of the core obligations of medicine. In fact, 288 00:18:46,440 --> 00:18:50,440 Speaker 1: Tennessee law requires physicians to notify patients if they're retiring. 289 00:18:51,040 --> 00:18:54,240 Speaker 1: Anyone seen in the past three years must be contacted, 290 00:18:54,720 --> 00:18:57,320 Speaker 1: urged to find a new provider, and told how to 291 00:18:57,320 --> 00:18:58,760 Speaker 1: obtain their medical records. 292 00:18:59,400 --> 00:19:01,320 Speaker 7: Those are all the kind of things that would happen 293 00:19:01,400 --> 00:19:04,639 Speaker 7: under a normal circumstance where a clinic knows that they're 294 00:19:04,640 --> 00:19:08,760 Speaker 7: going to close and is obligated to ethically as a 295 00:19:08,840 --> 00:19:12,280 Speaker 7: practitioner or do no harm. Make sure you're transparent, make 296 00:19:12,320 --> 00:19:15,960 Speaker 7: sure you notify people, and it's very important stuff. That 297 00:19:16,000 --> 00:19:19,399 Speaker 7: would be very unusual for somebody to all of a 298 00:19:19,440 --> 00:19:22,920 Speaker 7: sudden have a problem that arose overnight that would require 299 00:19:23,359 --> 00:19:26,679 Speaker 7: just the door to be padlocked and nobody be available 300 00:19:26,960 --> 00:19:30,560 Speaker 7: that I can't imagine a circumstance where that would be reasonable. 301 00:19:31,200 --> 00:19:35,840 Speaker 1: When your dentist office closes, it's inconvenient, maybe you put 302 00:19:35,880 --> 00:19:38,439 Speaker 1: off a filling, live with a toothache for a while 303 00:19:38,600 --> 00:19:41,359 Speaker 1: until you can find a new provider. But when a 304 00:19:41,440 --> 00:19:46,480 Speaker 1: fertility clinic shuts down overnight, there can be much bigger consequences. 305 00:19:47,400 --> 00:19:51,680 Speaker 1: In addition to precious time lost, there's the psychological and 306 00:19:51,840 --> 00:19:54,320 Speaker 1: emotional toll of not knowing when. 307 00:19:54,359 --> 00:19:55,800 Speaker 2: Or if you'll ever. 308 00:19:55,600 --> 00:19:56,880 Speaker 5: Be able to have children. 309 00:19:59,800 --> 00:19:59,960 Speaker 8: Yeah. 310 00:20:00,040 --> 00:20:03,000 Speaker 9: One thing that is interesting is that the American Medical 311 00:20:03,040 --> 00:20:07,359 Speaker 9: Association only recognized infertility as a disease of the reproductive 312 00:20:07,359 --> 00:20:12,280 Speaker 9: system in twenty seventeen, So that's really quite recent. 313 00:20:13,240 --> 00:20:17,679 Speaker 1: This is Maria Polyyakova, an economist and associate professor of 314 00:20:17,760 --> 00:20:21,639 Speaker 1: health policy at Stanford School of Medicine. She studies the 315 00:20:21,680 --> 00:20:24,200 Speaker 1: impacts of infertility on patients. 316 00:20:24,640 --> 00:20:27,800 Speaker 9: What we were curious about is what happens to people 317 00:20:27,840 --> 00:20:30,439 Speaker 9: who go through this process in other areas of the 318 00:20:30,680 --> 00:20:33,919 Speaker 9: life and in the londrun. I think we underestimate the 319 00:20:34,359 --> 00:20:37,440 Speaker 9: psychological aspects of this experience. 320 00:20:38,200 --> 00:20:42,399 Speaker 1: Much of the impact of infertility remains hidden. People going 321 00:20:42,440 --> 00:20:45,600 Speaker 1: through it don't always talk about it publicly, and even 322 00:20:45,680 --> 00:20:50,240 Speaker 1: understanding how common it is isn't simple. The US doesn't 323 00:20:50,280 --> 00:20:53,440 Speaker 1: really have a system that tracks who undergoes fertility treatment 324 00:20:53,920 --> 00:20:58,880 Speaker 1: or what happens afterward, but Sweden does. In a study 325 00:20:59,080 --> 00:21:02,000 Speaker 1: released in twenty two twenty four by the National Bureau 326 00:21:02,119 --> 00:21:07,320 Speaker 1: of Economic Research, Polyakova and her colleagues used nationwide health 327 00:21:07,320 --> 00:21:11,400 Speaker 1: and pharmacy records to follow one point eight million Swedish 328 00:21:11,400 --> 00:21:16,040 Speaker 1: women of child bearing age, offering a rare window into 329 00:21:16,119 --> 00:21:21,360 Speaker 1: how widespread infertility is and how profoundly it shapes people's lives. 330 00:21:21,920 --> 00:21:24,600 Speaker 9: We found that basically one in eight women have some 331 00:21:24,640 --> 00:21:27,880 Speaker 9: sort of interaction with you know, in fertility treatment. That's 332 00:21:27,920 --> 00:21:30,639 Speaker 9: as common as breast cancer in the US, and we 333 00:21:30,680 --> 00:21:32,680 Speaker 9: don't have the data for the US, but I don't 334 00:21:32,680 --> 00:21:36,080 Speaker 9: think there is any reason that that wouldn't be applicable 335 00:21:36,240 --> 00:21:36,840 Speaker 9: to the US. 336 00:21:37,320 --> 00:21:40,520 Speaker 1: And while many infertility journeys do end with a child, 337 00:21:41,080 --> 00:21:45,640 Speaker 1: not everyone is so fortunate. When Professor Polyakova dug into 338 00:21:45,680 --> 00:21:49,800 Speaker 1: the data, she found that among women who started fertility treatment, 339 00:21:50,240 --> 00:21:54,520 Speaker 1: about three quarters had a child within eight years, but 340 00:21:54,680 --> 00:21:59,840 Speaker 1: even after all that time, nearly a quarter didn't. For 341 00:21:59,840 --> 00:22:04,439 Speaker 1: women who remain childless after treatment, Polyakova found they are 342 00:22:04,480 --> 00:22:07,720 Speaker 1: also likely to experience other harmful effects. 343 00:22:08,160 --> 00:22:12,800 Speaker 9: They're much more likely to be taking various mental health medications, antidepressants, 344 00:22:12,880 --> 00:22:17,399 Speaker 9: anxiety drugs. They are more likely to experience separations the 345 00:22:17,560 --> 00:22:23,240 Speaker 9: family partnership falls apart. Basically in fertility experience itself results 346 00:22:23,280 --> 00:22:24,359 Speaker 9: in poor mental health. 347 00:22:25,280 --> 00:22:28,639 Speaker 1: Polya Covi's theory is that it isn't the medical procedures 348 00:22:28,680 --> 00:22:32,600 Speaker 1: themselves that leave such deep scars, but the uncertainty of 349 00:22:32,680 --> 00:22:35,600 Speaker 1: not knowing what, if anything, will work. 350 00:22:36,119 --> 00:22:38,760 Speaker 9: My guess, so this is not data, This is just 351 00:22:38,880 --> 00:22:41,520 Speaker 9: purely my guess is that it's not like the actual 352 00:22:41,640 --> 00:22:45,399 Speaker 9: medical intervention. If someone told these women, look, you're going 353 00:22:45,440 --> 00:22:47,640 Speaker 9: to have to take these drugs. It will be super painful, 354 00:22:47,640 --> 00:22:49,960 Speaker 9: and we can guarantee that you come out after three 355 00:22:49,960 --> 00:22:53,320 Speaker 9: months with a child. I think that experience of treatment 356 00:22:53,359 --> 00:22:56,960 Speaker 9: per se would not necessarily have long run effects on 357 00:22:57,040 --> 00:23:02,600 Speaker 9: people's health. It's this experience of coping and then hopes 358 00:23:02,640 --> 00:23:05,720 Speaker 9: not being realized, and this uncertainty. 359 00:23:05,880 --> 00:23:10,920 Speaker 1: Her words resonated deeply with me. Even though my infertility 360 00:23:11,000 --> 00:23:15,240 Speaker 1: journey would be, by most accounts, considered easy, it left 361 00:23:15,240 --> 00:23:19,439 Speaker 1: a mark. While making this podcast, I went through three 362 00:23:19,560 --> 00:23:24,520 Speaker 1: embryo transfers trying for my second child. The first failure 363 00:23:24,720 --> 00:23:28,159 Speaker 1: was a gut punch. I spun in circles, wondering what 364 00:23:28,240 --> 00:23:31,520 Speaker 1: I'd done wrong. Was it something as small as getting 365 00:23:31,520 --> 00:23:34,639 Speaker 1: caught in the rain and coming home chilled, or the 366 00:23:34,720 --> 00:23:37,959 Speaker 1: fact that I had cried at my embryo transfer instead 367 00:23:37,960 --> 00:23:43,320 Speaker 1: of remaining calm. I knew this was unlikely, illogical even 368 00:23:43,960 --> 00:23:47,800 Speaker 1: but the urge to make sense of what happened was powerful. 369 00:23:47,960 --> 00:23:52,119 Speaker 1: The second failure hit even harder. I sank into a fog, 370 00:23:52,640 --> 00:23:56,119 Speaker 1: found a new therapist, kept myself busy with friends so 371 00:23:56,160 --> 00:24:00,280 Speaker 1: I didn't spiral into negativity. There was no reason and 372 00:24:00,280 --> 00:24:03,760 Speaker 1: why the first two transfers didn't work. My embryos were 373 00:24:03,800 --> 00:24:07,480 Speaker 1: genetically tested and highly rated. It was just a roll 374 00:24:07,520 --> 00:24:11,720 Speaker 1: of the dice. But after back to back failures, it 375 00:24:11,840 --> 00:24:13,040 Speaker 1: felt like my luck. 376 00:24:12,840 --> 00:24:13,480 Speaker 2: Had run out. 377 00:24:14,680 --> 00:24:19,359 Speaker 1: I only had one more embryo, one more chance. At 378 00:24:19,400 --> 00:24:21,800 Speaker 1: the age of forty one, I wasn't sure I'd be 379 00:24:21,840 --> 00:24:28,160 Speaker 1: able to go through IVF again. In the weeks leading 380 00:24:28,240 --> 00:24:32,320 Speaker 1: up to my final transfer, I mentally prepared for another failure. 381 00:24:33,119 --> 00:24:37,040 Speaker 1: I downloaded an app to journal about gratitude as a 382 00:24:37,080 --> 00:24:41,040 Speaker 1: reminder of what I already had as a thought experiment. 383 00:24:41,359 --> 00:24:44,480 Speaker 1: I've pictured in great detail what the future would look 384 00:24:44,600 --> 00:24:49,040 Speaker 1: like with only one biological child, and I allowed myself 385 00:24:49,080 --> 00:24:53,639 Speaker 1: to grieve the life I had envisioned. Amazingly, that third 386 00:24:53,720 --> 00:24:57,840 Speaker 1: transfer worked. I'm actually pregnant now as I record this. 387 00:24:59,320 --> 00:25:04,200 Speaker 1: Still the the whole experience leaves scars, the endless appointments, 388 00:25:04,400 --> 00:25:09,320 Speaker 1: the injections, the anxiety and uncertainty, and the quiet anguish 389 00:25:09,440 --> 00:25:13,879 Speaker 1: of nothing working. It wears you down, which is why 390 00:25:14,000 --> 00:25:17,679 Speaker 1: I feel so much empathy for patients like Mary, the 391 00:25:17,800 --> 00:25:22,680 Speaker 1: veterinary technician whose embryo transfer was canceled when CRCH shut down. 392 00:25:23,160 --> 00:25:25,040 Speaker 10: No matter where I'm at in this journey, I mean, 393 00:25:25,080 --> 00:25:28,440 Speaker 10: I've been on for forever, and I'm always an en 394 00:25:28,480 --> 00:25:32,320 Speaker 10: up somehow back at square one, and it's it's like 395 00:25:32,400 --> 00:25:34,480 Speaker 10: you're at some point you have to start and think like, Okay, 396 00:25:34,480 --> 00:25:37,080 Speaker 10: the universe is literally trying to tell you something. 397 00:25:37,160 --> 00:25:37,400 Speaker 6: Right. 398 00:25:37,800 --> 00:25:40,280 Speaker 1: As the months go by, I talk with Mary on 399 00:25:40,359 --> 00:25:43,480 Speaker 1: the phone a few times. She's worried about a lot 400 00:25:43,520 --> 00:25:46,479 Speaker 1: of things, like if she and her husband will have 401 00:25:46,600 --> 00:25:50,120 Speaker 1: enough money to start again at a new clinic. She's 402 00:25:50,160 --> 00:25:53,760 Speaker 1: worried about their embryos, which she still doesn't have access to, 403 00:25:54,920 --> 00:25:57,280 Speaker 1: but she's especially worried about time. 404 00:25:58,080 --> 00:26:01,480 Speaker 10: So now we are at the mercy of the courts. 405 00:26:02,160 --> 00:26:04,440 Speaker 10: I think we're just trying to hold out hope that 406 00:26:04,600 --> 00:26:08,719 Speaker 10: the embryos have been maintained in a tank properly and 407 00:26:08,760 --> 00:26:11,119 Speaker 10: that they are viable, and that one day we're going 408 00:26:11,160 --> 00:26:12,760 Speaker 10: to get them out and we're going to transfer and 409 00:26:13,960 --> 00:26:14,959 Speaker 10: we're going to be a family. 410 00:26:16,000 --> 00:26:19,360 Speaker 1: Mary has spent five years trying to get pregnant. Her 411 00:26:19,400 --> 00:26:22,600 Speaker 1: insurance is gone, she doesn't have enough money to pay 412 00:26:22,600 --> 00:26:26,639 Speaker 1: out of pocket either. She's banking on the two embryos 413 00:26:26,680 --> 00:26:30,040 Speaker 1: she has in storage to take her from being childless 414 00:26:30,200 --> 00:26:33,879 Speaker 1: to finally becoming a mother. But as the months drag on, 415 00:26:33,960 --> 00:26:37,040 Speaker 1: with no word from the receiver on when her embryos 416 00:26:37,080 --> 00:26:40,480 Speaker 1: will be available, Mary feels hopeless. 417 00:26:41,000 --> 00:26:41,680 Speaker 6: It feels like. 418 00:26:41,680 --> 00:26:44,240 Speaker 8: I just keep getting older and my embryos keep sitting 419 00:26:44,240 --> 00:26:44,720 Speaker 8: in a tank. 420 00:26:45,520 --> 00:26:48,280 Speaker 1: Her biggest fear is ending up in that twenty five 421 00:26:48,320 --> 00:26:52,879 Speaker 1: percent of women who pour years into fertility treatment only 422 00:26:52,920 --> 00:26:57,920 Speaker 1: to walk away with nothing. And then another option appears, 423 00:26:58,320 --> 00:27:02,320 Speaker 1: one that seems like it might all her problems. Out 424 00:27:02,359 --> 00:27:04,960 Speaker 1: of the blue, another local couple reaches out. 425 00:27:05,400 --> 00:27:08,080 Speaker 8: They had heard of our story, they had seen us 426 00:27:08,119 --> 00:27:08,679 Speaker 8: on the news. 427 00:27:09,400 --> 00:27:12,560 Speaker 1: They heard about Mary's traumatic experience at the Center for 428 00:27:12,640 --> 00:27:16,320 Speaker 1: Reproductive Health and offered a gift Mary and her husband. 429 00:27:16,520 --> 00:27:18,000 Speaker 1: They're leftover embryos. 430 00:27:18,920 --> 00:27:22,159 Speaker 8: The family that owned the embryos they were older and 431 00:27:22,520 --> 00:27:24,399 Speaker 8: they didn't want them to just sit in a tank 432 00:27:24,760 --> 00:27:25,600 Speaker 8: or go to science. 433 00:27:26,359 --> 00:27:29,520 Speaker 1: The two embryos being offered to Mary and her husband 434 00:27:29,920 --> 00:27:32,560 Speaker 1: are from an older couple who aren't planning to get 435 00:27:32,600 --> 00:27:37,840 Speaker 1: pregnant again. Genetic testing shows the embryos are what's called mosaic, 436 00:27:38,440 --> 00:27:42,600 Speaker 1: made up of both normal and abnormal sels, which means 437 00:27:42,840 --> 00:27:46,080 Speaker 1: there's less of a chance they'll result in a healthy pregnancy. 438 00:27:47,080 --> 00:27:48,520 Speaker 1: But Mary is desperate. 439 00:27:48,960 --> 00:27:51,720 Speaker 8: We didn't know if we would have our embryos, like 440 00:27:51,800 --> 00:27:55,760 Speaker 8: when they were going to be released and we had 441 00:27:55,800 --> 00:27:58,640 Speaker 8: this opportunity, and it was like do we keep waiting around? 442 00:27:59,440 --> 00:28:03,439 Speaker 8: I think at that point, I like, I didn't know 443 00:28:03,760 --> 00:28:06,119 Speaker 8: how else I was going to hit more rock bottom. 444 00:28:06,400 --> 00:28:10,159 Speaker 1: So she transfers them both and takes the chance. It 445 00:28:10,200 --> 00:28:13,600 Speaker 1: feels like the only one she has, Like, if. 446 00:28:13,440 --> 00:28:17,840 Speaker 8: This doesn't work, then yes, I'll be devastated, but I've 447 00:28:17,840 --> 00:28:21,480 Speaker 8: been devastated for five years with results. Infertility is a 448 00:28:21,520 --> 00:28:24,399 Speaker 8: lot of hating rock bottom and picking yourself back up. 449 00:28:28,760 --> 00:28:32,399 Speaker 1: In November twenty twenty four, seven months after the Center 450 00:28:32,480 --> 00:28:37,000 Speaker 1: for Reproductive Health suddenly closes, patients finally have access to 451 00:28:37,040 --> 00:28:40,840 Speaker 1: their embryos again. Now they have to decide what to 452 00:28:40,920 --> 00:28:44,120 Speaker 1: do with them. Many choose to establish care at the 453 00:28:44,160 --> 00:28:49,920 Speaker 1: Tennessee Fertility Institute or TFI, the clinic now holding the embryos. 454 00:28:50,480 --> 00:28:55,240 Speaker 1: It's the simplest option. Moving such fragile material again would 455 00:28:55,240 --> 00:28:59,920 Speaker 1: carry an additional fee and additional risk. Some women restart 456 00:29:00,040 --> 00:29:03,480 Speaker 1: treatment right away and over the next few months. There 457 00:29:03,480 --> 00:29:07,840 Speaker 1: are success stories on the Facebook support group. A handful 458 00:29:07,960 --> 00:29:10,160 Speaker 1: celebrate positive pregnancy tests. 459 00:29:10,800 --> 00:29:14,720 Speaker 3: Currently thirteen weeks Because of TFI and doctor Miller. 460 00:29:14,800 --> 00:29:18,400 Speaker 1: We transferred November fifth at TFI and it was a success. 461 00:29:19,000 --> 00:29:21,080 Speaker 5: Fingers crossed, it will be the same for you. 462 00:29:21,760 --> 00:29:23,360 Speaker 6: Just tested positive today. 463 00:29:23,600 --> 00:29:25,280 Speaker 4: I can't believe it. 464 00:29:25,280 --> 00:29:28,960 Speaker 1: It's been a crazy year sending baby dusk to all. 465 00:29:29,040 --> 00:29:31,720 Speaker 2: Don't give up hope. 466 00:29:31,960 --> 00:29:36,400 Speaker 1: But others run into unexpected issues. One woman told me 467 00:29:36,600 --> 00:29:39,720 Speaker 1: when she went in for a transfer at TFI, the 468 00:29:39,800 --> 00:29:43,920 Speaker 1: embryologist thawed the vial holding her embryo and found it 469 00:29:43,960 --> 00:29:47,680 Speaker 1: was empty. The next day, she emailed the lab asking 470 00:29:47,760 --> 00:29:50,720 Speaker 1: if her embryo had ever been there at all. The 471 00:29:50,840 --> 00:29:55,240 Speaker 1: answer it was impossible to know. She did have another embryo, 472 00:29:55,480 --> 00:29:58,680 Speaker 1: which they used and it was successful. Her baby was 473 00:29:58,680 --> 00:30:03,200 Speaker 1: born this past summer, but still an empty vial means 474 00:30:03,200 --> 00:30:07,040 Speaker 1: a missing embryo, and the audit hadn't even caught that mistake. 475 00:30:08,320 --> 00:30:11,120 Speaker 1: As I reported this story, I was shocked to learn 476 00:30:11,160 --> 00:30:15,320 Speaker 1: about the depth of the disarray behind the scenes at CRH. 477 00:30:15,520 --> 00:30:19,480 Speaker 1: This is every patient's worst nightmare. But I also began 478 00:30:19,560 --> 00:30:23,560 Speaker 1: to wonder how unique is this case really? If you 479 00:30:23,640 --> 00:30:26,720 Speaker 1: pulled back the curtain at any given fertility clinic in 480 00:30:26,760 --> 00:30:31,320 Speaker 1: the US, would you see similar problems? I asked of Fox, 481 00:30:31,680 --> 00:30:34,920 Speaker 1: a national expert on health law and bioethics. 482 00:30:35,560 --> 00:30:40,000 Speaker 11: IVF today in the United States is far less regulated 483 00:30:40,520 --> 00:30:46,320 Speaker 11: than virtually any comparable part of medical practice, or as 484 00:30:46,360 --> 00:30:50,440 Speaker 11: compared with assisted reproduction regulation in other parts of the 485 00:30:50,600 --> 00:30:52,080 Speaker 11: developed world. 486 00:30:52,680 --> 00:30:55,560 Speaker 1: Fox walked me through how IVF is overseen. 487 00:30:55,640 --> 00:30:56,320 Speaker 2: In the US. 488 00:30:57,080 --> 00:31:00,520 Speaker 1: Clinics are required to self report their success rates every 489 00:31:00,640 --> 00:31:04,040 Speaker 1: year to the CDC, which then makes the numbers public. 490 00:31:04,720 --> 00:31:07,520 Speaker 1: You can even go online look up your clinic and 491 00:31:07,560 --> 00:31:10,440 Speaker 1: see how it stacks up against others across the country. 492 00:31:11,320 --> 00:31:15,680 Speaker 1: The FDA plays a smaller role, inspecting storage facilities and 493 00:31:15,760 --> 00:31:19,719 Speaker 1: making sure donor eggs and sperm are tested for infectious diseases. 494 00:31:20,560 --> 00:31:25,040 Speaker 1: States may also do routine inspections, so from the outside 495 00:31:25,160 --> 00:31:28,560 Speaker 1: it looks like a web of oversight the CDC, the 496 00:31:28,600 --> 00:31:33,640 Speaker 1: FDA state regulators. In addition, IVF labs can choose to 497 00:31:33,640 --> 00:31:37,360 Speaker 1: be accredited by the College of American Pathologists or CAP, 498 00:31:37,840 --> 00:31:43,440 Speaker 1: a professional organization that evaluates laboratory quality and safety. And 499 00:31:43,480 --> 00:31:47,600 Speaker 1: then there are also organizations that develop guidelines for clinics 500 00:31:47,600 --> 00:31:51,360 Speaker 1: to follow, like ASRM and its affiliate, the Society for 501 00:31:51,400 --> 00:31:57,360 Speaker 1: Assisted Reproductive Technology aka SART. SART states its goal is 502 00:31:57,400 --> 00:32:01,000 Speaker 1: to establish and maintain standards so that patients received the 503 00:32:01,120 --> 00:32:04,880 Speaker 1: highest level of care. In twenty twenty one, sixty six 504 00:32:04,920 --> 00:32:08,120 Speaker 1: percent of IVF clinics in the United States were members 505 00:32:08,120 --> 00:32:13,040 Speaker 1: of SART, including the Center for Reproductive Health. We reached 506 00:32:13,040 --> 00:32:16,600 Speaker 1: out to both ASRM and SART for comment, but they 507 00:32:16,680 --> 00:32:18,560 Speaker 1: passed and opted not to talk to us. 508 00:32:19,240 --> 00:32:23,120 Speaker 11: You've got these professional organizations like the American Society for 509 00:32:23,160 --> 00:32:29,760 Speaker 11: Reproductive Medicine that sets forth these industry standards or best practices, 510 00:32:30,320 --> 00:32:34,640 Speaker 11: at least for the clinics that are members of their program. 511 00:32:34,680 --> 00:32:41,080 Speaker 11: But again that's completely voluntary, and they're routinely ignored. Professional 512 00:32:41,120 --> 00:32:45,800 Speaker 11: self regulation has a lot of limits. We would just 513 00:32:45,880 --> 00:32:48,640 Speaker 11: never accept this in other areas of medicine. 514 00:32:48,960 --> 00:32:52,640 Speaker 1: Fox explained that in the absence of robust federal oversight, 515 00:32:52,880 --> 00:32:56,560 Speaker 1: there's no built in quality control. What happens behind the 516 00:32:56,600 --> 00:33:00,720 Speaker 1: doors of most fertility clinics remains largely unknown. 517 00:33:01,320 --> 00:33:07,719 Speaker 11: In other areas of healthcare, states make hospitals monitor and 518 00:33:07,880 --> 00:33:15,480 Speaker 11: report major avoidable errors, so things like mismatched blood transfusion 519 00:33:17,000 --> 00:33:19,680 Speaker 11: surgery on the wrong body part or the wrong patient. 520 00:33:20,200 --> 00:33:23,200 Speaker 11: We call these things never events because they're things that 521 00:33:23,400 --> 00:33:28,240 Speaker 11: just should never happen, and so states require investigations and 522 00:33:28,400 --> 00:33:33,520 Speaker 11: record keeping and preventative measures in assisted reproduction. There's no 523 00:33:33,760 --> 00:33:39,200 Speaker 11: agency or authority that tracks or polices this kind of 524 00:33:39,560 --> 00:33:44,960 Speaker 11: substantial and needless error in the US when it comes 525 00:33:45,000 --> 00:33:51,120 Speaker 11: to things like you know, fertility freezer failures or donor switches, 526 00:33:51,920 --> 00:33:53,400 Speaker 11: the buck stops nowhere. 527 00:33:54,680 --> 00:33:58,240 Speaker 1: Clinics aren't required to report these incidents to federal or 528 00:33:58,240 --> 00:34:03,480 Speaker 1: state agencies, and no national database tracks them. So these errors, 529 00:34:03,560 --> 00:34:08,960 Speaker 1: including more serious never events, often go unnoticed. They only 530 00:34:09,200 --> 00:34:12,400 Speaker 1: really come to the surface when there's an obvious mistake, 531 00:34:13,080 --> 00:34:16,440 Speaker 1: like one say, a white couple unexpectedly gives birth to 532 00:34:16,480 --> 00:34:21,200 Speaker 1: a baby of another race. These mistakes involving mismatched race 533 00:34:21,400 --> 00:34:26,080 Speaker 1: are more easily detected for obvious reasons, but Fox thinks 534 00:34:26,120 --> 00:34:28,360 Speaker 1: there are far more that go under the radar. 535 00:34:29,000 --> 00:34:31,200 Speaker 12: You don't see very many of at all, where like 536 00:34:31,239 --> 00:34:33,560 Speaker 12: the kids look kind of similar, they're just not the 537 00:34:33,680 --> 00:34:37,080 Speaker 12: person that was supposed to be used. Wow, all the 538 00:34:37,120 --> 00:34:40,520 Speaker 12: switches just happen to involve you know, a white person 539 00:34:40,560 --> 00:34:42,920 Speaker 12: for a black person, or an Indian person for an 540 00:34:42,960 --> 00:34:46,080 Speaker 12: Italian person or whatever. No, I think probably those are 541 00:34:46,120 --> 00:34:49,520 Speaker 12: the ones that people notice and learn about or whatever 542 00:34:50,040 --> 00:34:52,560 Speaker 12: that come out in the news, and probably it happens 543 00:34:52,560 --> 00:34:55,600 Speaker 12: more often there are just so many question marks. We 544 00:34:55,680 --> 00:34:59,080 Speaker 12: don't even know how frequent these errors are. 545 00:35:00,320 --> 00:35:04,040 Speaker 1: The audit at CRH didn't reveal the kind of headline 546 00:35:04,040 --> 00:35:09,160 Speaker 1: grabbing mixups Fox describes, but with records this chaotic, no 547 00:35:09,200 --> 00:35:12,920 Speaker 1: one can say with confidence they never happened. And for 548 00:35:13,000 --> 00:35:17,239 Speaker 1: the patients, the disorganization undermines the trust they had in 549 00:35:17,320 --> 00:35:22,040 Speaker 1: their care and in their genetic material. It also creates 550 00:35:22,120 --> 00:35:26,439 Speaker 1: significant obstacles for patients, especially those who want to move 551 00:35:26,440 --> 00:35:31,520 Speaker 1: their embryos to healthcare providers other than TFI. As the 552 00:35:31,560 --> 00:35:35,920 Speaker 1: receiver documents in a report, many fertility clinics are hesitant 553 00:35:35,960 --> 00:35:39,759 Speaker 1: to take embryos that had originated at CRH because they 554 00:35:39,800 --> 00:35:43,480 Speaker 1: couldn't verify basic records such as how they were created, 555 00:35:43,880 --> 00:35:47,719 Speaker 1: cared for, or even what testing had been done. By 556 00:35:47,719 --> 00:35:51,800 Speaker 1: the end of November, only seventeen patients managed to relocate 557 00:35:51,840 --> 00:35:56,840 Speaker 1: their embryos out of TFI. By late January twenty twenty five, 558 00:35:57,120 --> 00:36:01,880 Speaker 1: that number creeps up to just thirty nine. One patient 559 00:36:02,200 --> 00:36:05,239 Speaker 1: still looking for a new home for her embryos is 560 00:36:05,280 --> 00:36:06,000 Speaker 1: Aaron Meyer. 561 00:36:07,160 --> 00:36:10,960 Speaker 6: I'm Erin and we live in North Carolina. May have 562 00:36:10,960 --> 00:36:13,400 Speaker 6: a small farm and we grow flowers. 563 00:36:13,880 --> 00:36:18,279 Speaker 1: Aaron and her husband, Gregor, begin researching alternative pathways to 564 00:36:18,360 --> 00:36:22,239 Speaker 1: parenthood after they learned they were both genetic carriers of 565 00:36:22,280 --> 00:36:23,520 Speaker 1: the same rare condition. 566 00:36:24,080 --> 00:36:26,080 Speaker 13: There was a twenty five percent chance that we have 567 00:36:26,200 --> 00:36:30,480 Speaker 13: a child with severe publications from this genetic condition. 568 00:36:31,280 --> 00:36:34,880 Speaker 1: They decide not to have a genetically related child, but 569 00:36:34,920 --> 00:36:38,920 Speaker 1: they still want to become parents. While searching online, they 570 00:36:38,960 --> 00:36:45,240 Speaker 1: discover the American Embryo Adoption Agency or AEAA. That again, 571 00:36:45,560 --> 00:36:49,440 Speaker 1: is a program run by doctor Vasquez, which offers patients 572 00:36:49,600 --> 00:36:53,640 Speaker 1: donated eggs and embryos, often the ones left over after 573 00:36:53,680 --> 00:36:58,240 Speaker 1: another couple has completed their fertility care. Even though doctor 574 00:36:58,320 --> 00:37:03,440 Speaker 1: Vasquez's facilities are local in Tennessee, not North Carolina, Aaron 575 00:37:03,520 --> 00:37:06,160 Speaker 1: and her husband feel like this is a new way forward. 576 00:37:07,040 --> 00:37:10,120 Speaker 6: I was approaching forty, starting to feel the pressure a 577 00:37:10,160 --> 00:37:13,360 Speaker 6: little bit more and trying to say, Okay, what is 578 00:37:13,400 --> 00:37:16,359 Speaker 6: the fastest roots and to some degrade the cheapest route 579 00:37:16,400 --> 00:37:20,759 Speaker 6: right because it's still very expensive, and so adoption of 580 00:37:20,760 --> 00:37:22,879 Speaker 6: an embryo seem like a good route to go. 581 00:37:23,840 --> 00:37:27,640 Speaker 1: In August twenty twenty two, Aaron and Gregor start working 582 00:37:27,680 --> 00:37:32,359 Speaker 1: with the American Embryo Adoption Agency. They buy three embryos 583 00:37:32,440 --> 00:37:36,719 Speaker 1: for eighteen thousand dollars. According to the paperwork provided, the 584 00:37:36,760 --> 00:37:41,080 Speaker 1: embryos are highly graded. Their cell structure looks robust, but 585 00:37:41,160 --> 00:37:45,040 Speaker 1: they haven't been genetically tested, which is not that unusual. 586 00:37:45,760 --> 00:37:49,759 Speaker 1: Not all couples decide to test their embryos, but Aaron 587 00:37:49,840 --> 00:37:53,800 Speaker 1: and Gregor choose to, hoping to identify the strongest embryo 588 00:37:53,880 --> 00:37:58,040 Speaker 1: to transfer first. They're stune to learn that all of 589 00:37:58,080 --> 00:38:03,400 Speaker 1: them are genetically abnormal, none are suitable to use. Eighteen 590 00:38:03,480 --> 00:38:10,400 Speaker 1: thousand dollars down the drain as a constellation, AEAA offers 591 00:38:10,440 --> 00:38:12,960 Speaker 1: them an additional genetically tested. 592 00:38:12,600 --> 00:38:14,440 Speaker 2: Embryo for free. 593 00:38:14,600 --> 00:38:17,920 Speaker 1: Aarin is eager to do an embryo transfer, so she 594 00:38:18,160 --> 00:38:20,680 Speaker 1: and her husband drive the ten hours to the Center 595 00:38:20,719 --> 00:38:22,719 Speaker 1: for Reproductive Health for the procedure. 596 00:38:23,600 --> 00:38:24,839 Speaker 2: The transfer doesn't work. 597 00:38:26,120 --> 00:38:29,760 Speaker 6: After that failure, we couldn't for a year, really, because 598 00:38:29,760 --> 00:38:32,960 Speaker 6: I had to really rally again. I had no emotional 599 00:38:33,000 --> 00:38:38,640 Speaker 6: reserves left. I was a heap, unable to function, unable. 600 00:38:38,280 --> 00:38:39,040 Speaker 5: To get out of bed. 601 00:38:39,360 --> 00:38:43,160 Speaker 6: Eventually went and got depression medications to help pull me 602 00:38:43,280 --> 00:38:44,080 Speaker 6: through this time. 603 00:38:44,880 --> 00:38:48,319 Speaker 1: Still, Aaron and Gregor don't want to give up, and 604 00:38:48,400 --> 00:38:51,880 Speaker 1: so when they're ready, they turn once more to doctor 605 00:38:52,000 --> 00:38:55,560 Speaker 1: Vazquez's Embryo agency to see what's available. 606 00:38:55,400 --> 00:38:58,400 Speaker 6: So we had gone back to them. Really I felt 607 00:38:58,400 --> 00:39:00,880 Speaker 6: the pressure of time at this point. So I was 608 00:39:01,120 --> 00:39:05,600 Speaker 6: forty one, about to turn forty two, really frustrated at 609 00:39:05,600 --> 00:39:10,160 Speaker 6: being slowed down. My mother had, I think, felt uneasy 610 00:39:10,200 --> 00:39:13,000 Speaker 6: about this clinic and had encouraged me to look at 611 00:39:13,000 --> 00:39:15,960 Speaker 6: other clinics. But I knew that that meant establishing care 612 00:39:16,000 --> 00:39:19,000 Speaker 6: with them, and that it just the time. Really was 613 00:39:19,040 --> 00:39:20,760 Speaker 6: the pressure that I was feeling the most. 614 00:39:21,400 --> 00:39:25,240 Speaker 1: In February twenty twenty four, the couple decides to purchase 615 00:39:25,360 --> 00:39:26,520 Speaker 1: more embryos. 616 00:39:26,840 --> 00:39:28,320 Speaker 2: We hadn't pulled the trigger. 617 00:39:28,760 --> 00:39:32,160 Speaker 6: Everything in IDF is a gamble, and so you know, uh, 618 00:39:32,840 --> 00:39:34,120 Speaker 6: we took this gamble. 619 00:39:34,680 --> 00:39:37,919 Speaker 1: Because that exhausted their options for loans, and their health 620 00:39:37,920 --> 00:39:41,400 Speaker 1: insurance doesn't pay for this. They make the difficult decision 621 00:39:41,520 --> 00:39:44,080 Speaker 1: to withdraw money out of their retirement fund. 622 00:39:44,719 --> 00:39:46,560 Speaker 5: It this is a one time thing. 623 00:39:46,840 --> 00:39:49,960 Speaker 6: This is the last time we're going to try. We're 624 00:39:49,960 --> 00:39:51,800 Speaker 6: going to take a chunk of money out of retirement 625 00:39:51,880 --> 00:39:55,960 Speaker 6: to be able to adopt new embryos and two embryos 626 00:39:56,200 --> 00:40:01,200 Speaker 6: and try at least once, maybe twice to cover the medications. 627 00:40:01,200 --> 00:40:03,319 Speaker 6: But this is a one time thing, because now we're 628 00:40:03,360 --> 00:40:04,600 Speaker 6: going to threaten our future. 629 00:40:06,760 --> 00:40:10,759 Speaker 1: The couple paid eleven thousand dollars for two embryos. The 630 00:40:10,840 --> 00:40:13,920 Speaker 1: plan was for Aaron to begin taking medications for the 631 00:40:13,960 --> 00:40:17,080 Speaker 1: embryo transfer in April twenty twenty four. 632 00:40:17,800 --> 00:40:19,200 Speaker 2: I had tried calling the clinic. 633 00:40:19,600 --> 00:40:20,560 Speaker 5: Nobody was answering. 634 00:40:20,800 --> 00:40:22,200 Speaker 13: The answering services. Well, I don't know. 635 00:40:22,200 --> 00:40:26,440 Speaker 6: They're out today, They're going to be back tomorrow, okay, 636 00:40:26,520 --> 00:40:28,160 Speaker 6: And I put a message through the portal saying I 637 00:40:28,200 --> 00:40:31,640 Speaker 6: have tried to reach you guys multiple ways. I don't 638 00:40:31,719 --> 00:40:34,200 Speaker 6: understand what's happening. I'm a little concerned, but I'm not 639 00:40:34,200 --> 00:40:36,920 Speaker 6: getting a response back. At that point, the message bounced 640 00:40:36,960 --> 00:40:38,280 Speaker 6: on the message portal. 641 00:40:38,880 --> 00:40:42,440 Speaker 1: That's when she learns the clinic is closed for good. 642 00:40:43,040 --> 00:40:46,160 Speaker 2: I mean my heart sank and. 643 00:40:47,600 --> 00:40:51,800 Speaker 6: Panic set in because this is these were our last 644 00:40:52,120 --> 00:40:53,520 Speaker 6: this was our last chance, Like. 645 00:40:53,520 --> 00:40:55,520 Speaker 5: This was all the money on the table that we 646 00:40:55,520 --> 00:40:56,480 Speaker 5: were going to be able. 647 00:40:56,239 --> 00:41:00,400 Speaker 6: To put and to see a clinic closed after we 648 00:41:00,480 --> 00:41:05,759 Speaker 6: had paid all of this money and had embryos sitting there, 649 00:41:07,719 --> 00:41:08,840 Speaker 6: the dream was over. 650 00:41:10,719 --> 00:41:14,239 Speaker 1: In November, Aaron and Gregor are finally notified that they 651 00:41:14,239 --> 00:41:18,200 Speaker 1: are able to access their two embryos now stored at TFI. 652 00:41:19,080 --> 00:41:22,080 Speaker 1: These are the same ones they used retirement funds to purchase. 653 00:41:22,880 --> 00:41:25,360 Speaker 1: They try to find a clinic to move the embryos to, 654 00:41:25,920 --> 00:41:27,600 Speaker 1: preferably not in Tennessee. 655 00:41:28,480 --> 00:41:31,839 Speaker 13: Going back to Tennessee is not my is not at 656 00:41:31,840 --> 00:41:34,040 Speaker 13: the top of my list, Like I don't trust the 657 00:41:34,040 --> 00:41:34,840 Speaker 13: state of Tennessee. 658 00:41:34,920 --> 00:41:36,080 Speaker 5: Can we handle my health care? 659 00:41:36,920 --> 00:41:40,239 Speaker 1: But moving the embryos is harder than they thought. They 660 00:41:40,239 --> 00:41:42,920 Speaker 1: don't have all the required paperwork, and the clinic they 661 00:41:43,000 --> 00:41:46,239 Speaker 1: want to use won't accept the embryos due to their 662 00:41:46,280 --> 00:41:50,280 Speaker 1: poor quality. This comes as a surprise to the couple. 663 00:41:50,960 --> 00:41:55,240 Speaker 13: My cynical viewpoint was that doctor Vasquez, any American embryo 664 00:41:55,280 --> 00:42:00,800 Speaker 13: adoption agency was taking any embryos the rejects other programs 665 00:42:00,840 --> 00:42:03,720 Speaker 13: were not allowing into their system. 666 00:42:04,040 --> 00:42:06,920 Speaker 5: They were accepting embryos that were not considered the. 667 00:42:06,960 --> 00:42:10,200 Speaker 13: Highest grade or the most valuable, and ones that were 668 00:42:10,239 --> 00:42:11,200 Speaker 13: best for their patience. 669 00:42:12,560 --> 00:42:16,320 Speaker 1: I asked doctor Vaskez's attorney about these claims, but haven't 670 00:42:16,320 --> 00:42:19,840 Speaker 1: received a response. Erin is now involved in the state's 671 00:42:19,880 --> 00:42:22,160 Speaker 1: consumer protection case against the clinic. 672 00:42:23,040 --> 00:42:25,359 Speaker 5: You know, we certainly haven't gotten any of the money bag. 673 00:42:26,320 --> 00:42:29,480 Speaker 2: I don't know what we're going to do yet. 674 00:42:30,320 --> 00:42:35,080 Speaker 1: Aaron's fertility journey moving forward is uncertain. She's not sure 675 00:42:35,120 --> 00:42:38,640 Speaker 1: what to do with the two embryos in Tennessee at TFI. 676 00:42:39,760 --> 00:42:42,560 Speaker 1: She and her husband are out of money and can't 677 00:42:42,600 --> 00:42:46,680 Speaker 1: buy more embryos, and every day that goes by, she's 678 00:42:46,719 --> 00:42:47,440 Speaker 1: getting older. 679 00:42:48,680 --> 00:42:51,960 Speaker 2: Dasquez took our last chance to try and have children 680 00:43:02,640 --> 00:43:03,280 Speaker 2: next time. 681 00:43:03,640 --> 00:43:09,760 Speaker 1: On What Happened in Nashville, Long before the clinic's abrupt closure, 682 00:43:10,080 --> 00:43:11,640 Speaker 1: cracks were already forming. 683 00:43:11,960 --> 00:43:13,960 Speaker 2: A patient who sued the Center for. 684 00:43:13,960 --> 00:43:18,280 Speaker 1: Reproductive Health a year before it shut down shares their story. 685 00:43:18,800 --> 00:43:23,200 Speaker 11: It's been the wildest of experiences of feeling isolated and 686 00:43:23,360 --> 00:43:28,160 Speaker 11: disregarded and then learning that we're not. 687 00:43:28,160 --> 00:43:32,120 Speaker 7: The only ones and they have their own horror stories. 688 00:43:32,760 --> 00:43:37,080 Speaker 1: Plus newly uncovered FDA reports revealed just how deep the 689 00:43:37,160 --> 00:43:37,879 Speaker 1: problems ran. 690 00:43:38,440 --> 00:43:40,600 Speaker 5: It was like, okay, like there's not going to be 691 00:43:40,600 --> 00:43:43,640 Speaker 5: anybody left to hold this clinic up, Like it's going 692 00:43:43,719 --> 00:43:45,920 Speaker 5: to fall. We could see it coming. 693 00:43:48,440 --> 00:43:50,960 Speaker 1: What Happened in Nashville is a production of School of 694 00:43:51,040 --> 00:43:55,240 Speaker 1: Humans and iHeart podcasts, written, reported, and hosted by me 695 00:43:55,239 --> 00:44:00,680 Speaker 1: Melissa Chelson. Our producer is Etaly's perez Ing. Your producer 696 00:44:00,760 --> 00:44:04,600 Speaker 1: is Amelia Brock, with additional production by Emily Seiner and 697 00:44:04,680 --> 00:44:09,440 Speaker 1: Carl Catle. Theme song by Jesse nice Swanger, Sound design, 698 00:44:09,520 --> 00:44:13,120 Speaker 1: scoring and mixing by Jeremy Thal and Jesse nice Swanger. 699 00:44:13,760 --> 00:44:17,839 Speaker 1: Fact checking by Savannah Hugh Lee and Austin Thompson. Our 700 00:44:17,880 --> 00:44:22,480 Speaker 1: production manager is Daisy Church. Voice acting by Grace Walker, 701 00:44:22,760 --> 00:44:27,520 Speaker 1: Nicky Speak and Daisy Church. Executive producers are Jason English, 702 00:44:27,640 --> 00:44:30,760 Speaker 1: Virginia Prescott, Brandon Barr, and Elsie Crowley. 703 00:44:31,440 --> 00:44:33,759 Speaker 2: If you're enjoying the show, tell everyone you know. 704 00:44:33,920 --> 00:44:36,120 Speaker 1: And don't forget to leave a rating in your favorite 705 00:44:36,160 --> 00:44:39,600 Speaker 1: podcast app. Tune in again next week for what happened 706 00:44:39,640 --> 00:44:41,920 Speaker 1: in Nashville