1 00:00:02,520 --> 00:00:10,520 Speaker 1: Bloomberg Audio Studios, podcasts, radio news. This series features conversations 2 00:00:10,600 --> 00:00:15,280 Speaker 1: about pregnancy, complications and loss. Please take care while listening. 3 00:00:17,360 --> 00:00:20,080 Speaker 1: The day Elizabeth decided to start trying for a baby, 4 00:00:20,520 --> 00:00:23,680 Speaker 1: she was thirty eight years old. She and her husband 5 00:00:23,760 --> 00:00:27,200 Speaker 1: had been happy as they were traveling, building their careers 6 00:00:27,240 --> 00:00:33,279 Speaker 1: in Chicago, enjoying their freedom. But something was shifting. Her 7 00:00:33,280 --> 00:00:36,920 Speaker 1: mom was sick, the years were passing. There was the 8 00:00:36,960 --> 00:00:38,960 Speaker 1: sense that maybe they'd regret not trying. 9 00:00:39,800 --> 00:00:42,560 Speaker 2: It just kind of felt like, you know, that opportunity 10 00:00:42,560 --> 00:00:45,880 Speaker 2: to have kids, the window could be closing. I had 11 00:00:46,240 --> 00:00:48,440 Speaker 2: kind of naively really thought that it was going to 12 00:00:48,520 --> 00:00:51,200 Speaker 2: work quickly for us, and then it didn't. And after 13 00:00:51,320 --> 00:00:55,760 Speaker 2: trying for months, we were talking to our obi and 14 00:00:55,920 --> 00:00:57,680 Speaker 2: then she was saying, you know, at your age, you 15 00:00:57,680 --> 00:00:58,080 Speaker 2: don't have. 16 00:00:58,040 --> 00:00:58,520 Speaker 3: To try it. 17 00:01:00,000 --> 00:01:03,000 Speaker 1: Spoken with dozens of women like Elizabeth during my investigation 18 00:01:03,080 --> 00:01:05,800 Speaker 1: of kind Body, and there's this moment that comes up 19 00:01:05,800 --> 00:01:09,000 Speaker 1: again and again, this pivot point where they decide to 20 00:01:09,000 --> 00:01:14,720 Speaker 1: seek help with fertility. It's vulnerable, intimate, and it often 21 00:01:14,760 --> 00:01:18,920 Speaker 1: comes with the clock ticking somewhere in the background. Elizabeth 22 00:01:18,959 --> 00:01:21,759 Speaker 1: and her husband had tried naturally for seven months before 23 00:01:21,760 --> 00:01:25,759 Speaker 1: her doctor recommended she look into fertility treatment, so Elizabeth 24 00:01:25,800 --> 00:01:30,000 Speaker 1: started looking into specialists covered by her insurance. Kind Body 25 00:01:30,080 --> 00:01:31,039 Speaker 1: was one of her options. 26 00:01:31,720 --> 00:01:34,120 Speaker 2: I saw it and was like women doctors and the 27 00:01:34,160 --> 00:01:36,760 Speaker 2: way they made it seem like it was just so 28 00:01:37,360 --> 00:01:40,760 Speaker 2: easy to do and seamless. Right away, I just was like, oh, yeah, 29 00:01:40,760 --> 00:01:42,360 Speaker 2: this is the easiest choice I've had to make. 30 00:01:43,200 --> 00:01:45,560 Speaker 1: She and her husband got an appointment right away at 31 00:01:45,560 --> 00:01:47,120 Speaker 1: a kind Body clinic in Chicago. 32 00:01:47,760 --> 00:01:50,080 Speaker 2: I had heard from friends that it can take a 33 00:01:50,080 --> 00:01:52,680 Speaker 2: long time to get into clinics sometimes, and so I 34 00:01:52,760 --> 00:01:55,160 Speaker 2: was excited and pleasantly surprised that we were able to 35 00:01:55,160 --> 00:01:57,760 Speaker 2: get in right away. I see it as a red 36 00:01:57,760 --> 00:02:00,000 Speaker 2: flag now, However, at the time, I was very excited 37 00:02:00,480 --> 00:02:02,120 Speaker 2: to be able to just jump right in. 38 00:02:02,880 --> 00:02:06,040 Speaker 1: Elizabeth had several friends who had gone through fertility treatments before, 39 00:02:06,400 --> 00:02:09,400 Speaker 1: so she knew a little bit about her options. Because 40 00:02:09,440 --> 00:02:13,560 Speaker 1: IVF is expensive and invasive, Elizabeth wanted to start. 41 00:02:13,360 --> 00:02:16,760 Speaker 2: Slow, and so I was interested to hear about other 42 00:02:16,800 --> 00:02:20,960 Speaker 2: things like i UI or using clomid and different things 43 00:02:21,000 --> 00:02:21,320 Speaker 2: like that. 44 00:02:22,760 --> 00:02:27,360 Speaker 1: I UI stands for intrauterine insemination. It's when sperm is 45 00:02:27,360 --> 00:02:31,360 Speaker 1: injected directly into the uterus. Clomid is a medication that 46 00:02:31,440 --> 00:02:36,200 Speaker 1: stimulates ovulation. Unlike IVF, these treatments don't require an egg 47 00:02:36,240 --> 00:02:40,880 Speaker 1: retrieval and so patients don't need as much medication. In IVF, 48 00:02:41,400 --> 00:02:45,280 Speaker 1: patients often take multiple medications to stimulate the ovaries to 49 00:02:45,360 --> 00:02:49,240 Speaker 1: produce eggs, and there's also painkillers required for an embryo transfer. 50 00:02:49,960 --> 00:02:53,280 Speaker 1: Doing IUI or taking clomid can be a much cheaper option. 51 00:02:55,400 --> 00:02:57,919 Speaker 1: Elizabeth liked the doctor she met with that kind body. 52 00:02:58,560 --> 00:03:02,240 Speaker 1: She felt she was knowledgeable, reasonable, but something didn't feel 53 00:03:02,280 --> 00:03:04,639 Speaker 1: right about the way the doctor laid out the treatment options. 54 00:03:05,240 --> 00:03:08,120 Speaker 2: They didn't mention anything about clomate or other drugs like that. 55 00:03:08,160 --> 00:03:12,120 Speaker 2: They had like a slide maybe briefly talked about an IUI, 56 00:03:12,480 --> 00:03:14,960 Speaker 2: but then really just the whole most of the hour 57 00:03:15,000 --> 00:03:20,000 Speaker 2: long kind of presentation was about IVF. So we just said, yeah, 58 00:03:20,040 --> 00:03:22,200 Speaker 2: you know, we're just a little nervous about doing IVF, 59 00:03:22,280 --> 00:03:24,600 Speaker 2: let's just hear about the other steps. I can't remember 60 00:03:24,639 --> 00:03:27,360 Speaker 2: her exact verbiage, but something along the lines of, you know, 61 00:03:27,800 --> 00:03:31,080 Speaker 2: given my age and the fact that we've been trying 62 00:03:31,120 --> 00:03:33,119 Speaker 2: now for a while, she kind of presumed that I'd 63 00:03:33,120 --> 00:03:36,040 Speaker 2: want to jump right in and do IVF. My initial 64 00:03:36,120 --> 00:03:40,120 Speaker 2: reaction was that it seemed like they were pushing IBF. 65 00:03:42,720 --> 00:03:46,160 Speaker 1: IVF is the most expensive procedure that kind Body offers, 66 00:03:46,920 --> 00:03:49,280 Speaker 1: and the number of patients who go through IVF has 67 00:03:49,320 --> 00:03:53,840 Speaker 1: a huge impact on kind Body's bottom line. What Elizabeth 68 00:03:53,840 --> 00:03:56,480 Speaker 1: didn't know at the time was that kind Body was 69 00:03:56,560 --> 00:04:01,040 Speaker 1: quickly running out of money. Behind closed doors, executives were 70 00:04:01,080 --> 00:04:04,960 Speaker 1: freaking out and facing tough questions from investors, including private 71 00:04:04,960 --> 00:04:08,400 Speaker 1: equity backers. I heard from people in these meetings that 72 00:04:08,520 --> 00:04:11,640 Speaker 1: investors were worried that the company wasn't hitting its targets 73 00:04:11,840 --> 00:04:15,920 Speaker 1: and would need more money. In an effort to boost profits, 74 00:04:16,240 --> 00:04:19,680 Speaker 1: kind Body came up with the plan, one that pushed 75 00:04:19,720 --> 00:04:24,039 Speaker 1: patients into more aggressive treatments, treatments that left some women 76 00:04:24,080 --> 00:04:30,720 Speaker 1: asking was this really necessary? From Bloomberg and iHeart podcasts, 77 00:04:31,240 --> 00:04:45,440 Speaker 1: this is IVF disrupted the kind Body story. I'm Jackie Devalos, 78 00:04:47,000 --> 00:04:49,880 Speaker 1: So how did we get here to a point where 79 00:04:50,000 --> 00:04:53,159 Speaker 1: kind Body, which had been a femtech darling for venture 80 00:04:53,200 --> 00:04:57,200 Speaker 1: capital and private equity investors, was now scrambling for money. 81 00:04:58,279 --> 00:05:00,719 Speaker 1: I want to take you to an important meeting in 82 00:05:00,760 --> 00:05:04,520 Speaker 1: the summer of twenty twenty three when kind Body directors 83 00:05:04,600 --> 00:05:07,320 Speaker 1: gathered for their quarterly meeting at a luxury hotel in 84 00:05:07,360 --> 00:05:11,080 Speaker 1: the Hamptons. I saw the minutes and talked to people 85 00:05:11,120 --> 00:05:13,960 Speaker 1: who were there, and they said there was a feeling 86 00:05:14,000 --> 00:05:17,520 Speaker 1: of desperation at this meeting. The company had been talking 87 00:05:17,560 --> 00:05:22,039 Speaker 1: to investment bankers to explore an initial public offering IPO, 88 00:05:22,520 --> 00:05:25,919 Speaker 1: a move that could potentially transform the founder's equity stakes 89 00:05:25,960 --> 00:05:31,600 Speaker 1: into enormous wealth. But first they needed better numbers, more revenue, 90 00:05:31,800 --> 00:05:36,280 Speaker 1: less spending, or maybe both, and at that moment, the 91 00:05:36,320 --> 00:05:41,880 Speaker 1: situation didn't look good. Kind Body had merged with Bio's 92 00:05:41,920 --> 00:05:46,719 Speaker 1: Fertility Institute over a year earlier, doubling their clinic count. Overnight, 93 00:05:47,440 --> 00:05:50,240 Speaker 1: they had a new CFO, had raised millions of dollars 94 00:05:50,240 --> 00:05:54,560 Speaker 1: from big investors, including JP Morgan, and despite multiple rounds 95 00:05:54,560 --> 00:05:59,400 Speaker 1: of layoffs, they were still burning through cash. Internal documents 96 00:05:59,400 --> 00:06:02,920 Speaker 1: I saw and did a rough picture. The company had 97 00:06:02,920 --> 00:06:06,680 Speaker 1: spent nearly sixty million dollars in twenty twenty three through September, 98 00:06:06,960 --> 00:06:09,800 Speaker 1: and was losing an average of roughly seven million dollars 99 00:06:09,839 --> 00:06:13,920 Speaker 1: each month. According to the documents, of the startup's thirty 100 00:06:13,920 --> 00:06:19,280 Speaker 1: three clinics, only six were profitable, so kind Body executives 101 00:06:19,400 --> 00:06:22,440 Speaker 1: laid out their plan to try to improve the company's finances. 102 00:06:23,080 --> 00:06:25,920 Speaker 1: It would set specific quotas for their physicians in an 103 00:06:25,920 --> 00:06:29,159 Speaker 1: effort to hit revenue targets. One of the metrics that 104 00:06:29,240 --> 00:06:32,359 Speaker 1: kind Body tracked was the number of retrievals they performed. 105 00:06:32,839 --> 00:06:37,280 Speaker 1: It's a key step in IVF. Retrievals are when doctors 106 00:06:37,279 --> 00:06:41,520 Speaker 1: attempt to extract eggs from the ovaries. The procedure involves 107 00:06:41,520 --> 00:06:45,520 Speaker 1: blood tests, ultrasounds, and hormone injections, and it's one of 108 00:06:45,560 --> 00:06:50,560 Speaker 1: the most lucrative procedures. Kind Body offers. Retrievals make up 109 00:06:50,600 --> 00:06:53,880 Speaker 1: about half of the revenue collected from one round of IVF. 110 00:06:55,080 --> 00:06:59,120 Speaker 1: In a presentation outlining its turnaround plan to investors, kind 111 00:06:59,120 --> 00:07:02,160 Speaker 1: Body ranked all of its doctors only by the average 112 00:07:02,240 --> 00:07:05,760 Speaker 1: number of monthly egg retrievals they were performing. Those who 113 00:07:05,800 --> 00:07:09,360 Speaker 1: fell beneath the benchmark average of twenty three were labeled 114 00:07:09,360 --> 00:07:13,000 Speaker 1: as falling below expectations. If it was going to turn 115 00:07:13,040 --> 00:07:16,080 Speaker 1: a profit and go public, the doctors at kind Body 116 00:07:16,080 --> 00:07:18,720 Speaker 1: would need to raise the number of monthly egg retrievals 117 00:07:18,760 --> 00:07:22,760 Speaker 1: they performed. Some doctors would have to double their retrievals. 118 00:07:23,840 --> 00:07:26,760 Speaker 1: I was told many physicians didn't feel comfortable with the 119 00:07:26,800 --> 00:07:31,640 Speaker 1: new targets, and over the next three months, four doctors resigned. 120 00:07:32,880 --> 00:07:36,080 Speaker 1: Angie Beltzos, who was kind Body's chief physician when it 121 00:07:36,160 --> 00:07:39,679 Speaker 1: introduced the quotas, didn't respond to a request for comment 122 00:07:39,760 --> 00:07:44,240 Speaker 1: for the series. This push to do more IVF cycles 123 00:07:44,360 --> 00:07:47,280 Speaker 1: was invisible to Elizabeth when she had her first consultation 124 00:07:47,400 --> 00:07:51,080 Speaker 1: at kind body Chicago clinic, but for the people treating her, 125 00:07:51,800 --> 00:07:56,040 Speaker 1: the pressure was on to start. Elizabeth and her husband 126 00:07:56,040 --> 00:07:58,840 Speaker 1: tried clom it and then an IUI, and when those 127 00:07:58,840 --> 00:08:03,800 Speaker 1: treatments didn't work, they decided to finally try IVF in Chicago. 128 00:08:04,200 --> 00:08:08,400 Speaker 1: Kindbody's prices started at fourteen thousand, five hundred dollars per cycle, 129 00:08:08,960 --> 00:08:12,560 Speaker 1: and that price doesn't include genetic testing or embryo transfers. 130 00:08:13,200 --> 00:08:16,800 Speaker 1: Although she had some insurance coverage, Elizabeth was still on 131 00:08:16,840 --> 00:08:19,080 Speaker 1: the hook for about six thousand dollars in out of 132 00:08:19,120 --> 00:08:22,520 Speaker 1: pocket costs when she finally decided to pull the trigger. 133 00:08:23,360 --> 00:08:25,560 Speaker 1: Elizabeth says she had trouble getting a hold of the 134 00:08:25,560 --> 00:08:28,440 Speaker 1: people who were supposed to guide her through the process 135 00:08:29,040 --> 00:08:32,920 Speaker 1: during IVF. Timing is everything missing. Even a single dose 136 00:08:32,960 --> 00:08:36,920 Speaker 1: of medication can derail an entire cycle. Wasting thousands of 137 00:08:36,920 --> 00:08:39,120 Speaker 1: dollars and pushing treatment back by months. 138 00:08:39,880 --> 00:08:43,040 Speaker 2: It's all very very strict in that regard, at least 139 00:08:43,040 --> 00:08:44,920 Speaker 2: that's how they described it to me. 140 00:08:45,880 --> 00:08:50,720 Speaker 1: Once Elizabeth's insurance authorized her IVF medications, she called kind 141 00:08:50,720 --> 00:08:52,560 Speaker 1: Body to make sure the clinic had put in the 142 00:08:52,640 --> 00:08:57,079 Speaker 1: order to the pharmacy. Knowing Memorial Day was approaching, Elizabeth 143 00:08:57,120 --> 00:09:00,960 Speaker 1: tried calling a few days before to avoid delays. No answer. 144 00:09:02,080 --> 00:09:04,920 Speaker 1: On the Friday before the holiday weekend, she started to panic. 145 00:09:05,720 --> 00:09:10,160 Speaker 1: She called their national helpline. No one could help. Her husband, 146 00:09:10,320 --> 00:09:13,160 Speaker 1: desperate left work early to drive to the clinic and 147 00:09:13,200 --> 00:09:13,960 Speaker 1: bang on the door. 148 00:09:15,040 --> 00:09:18,920 Speaker 2: So the fact that I wasn't getting these answers or responses, 149 00:09:19,000 --> 00:09:21,679 Speaker 2: I mean, my anxiety levels were through the roof. It 150 00:09:21,800 --> 00:09:24,640 Speaker 2: felt like the strange gas lighting or something where I 151 00:09:24,720 --> 00:09:27,319 Speaker 2: was just like confused. 152 00:09:29,040 --> 00:09:31,560 Speaker 1: But behind the scenes at kind Body, there was a 153 00:09:31,600 --> 00:09:34,840 Speaker 1: financial reason Elizabeth might not have been able to connect 154 00:09:34,840 --> 00:09:39,240 Speaker 1: with her providers by phone. Documents I saw laid out 155 00:09:39,360 --> 00:09:44,000 Speaker 1: kind Body's policy to quote bill all visits to do this. 156 00:09:44,679 --> 00:09:47,680 Speaker 1: Employees I talked to said they were instructed to encourage 157 00:09:47,720 --> 00:09:51,000 Speaker 1: patients to come into the clinic in person or hold 158 00:09:51,120 --> 00:09:55,040 Speaker 1: virtual video visits. The goal was to bring down the 159 00:09:55,120 --> 00:09:58,560 Speaker 1: number of phone calls that they couldn't bill. In theory, 160 00:09:58,720 --> 00:10:02,199 Speaker 1: this policy makes sense. Many patients told me they liked 161 00:10:02,200 --> 00:10:06,040 Speaker 1: seeing their doctors in person, but in practice, they said 162 00:10:06,080 --> 00:10:09,840 Speaker 1: it made the IVF process more stressful. It was really 163 00:10:09,840 --> 00:10:13,360 Speaker 1: difficult to get an appointment with doctors after an initial consultation, 164 00:10:14,080 --> 00:10:17,120 Speaker 1: and because of kind Body staffing problems, they would be 165 00:10:17,160 --> 00:10:19,920 Speaker 1: seen by an ever changing set of nurses or patient 166 00:10:19,920 --> 00:10:24,000 Speaker 1: coordinators Instead. One on one time with the doctor was rare. 167 00:10:25,040 --> 00:10:29,480 Speaker 1: For Elizabeth. The costs continued to pile up on top 168 00:10:29,520 --> 00:10:32,280 Speaker 1: of the six thousand dollars she was spending for the procedure. 169 00:10:33,160 --> 00:10:35,720 Speaker 1: Elizabeth says kind Body was trying to sell her add 170 00:10:35,720 --> 00:10:39,840 Speaker 1: on services. There was genetic testing which cost over four 171 00:10:39,880 --> 00:10:43,240 Speaker 1: thousand dollars per embryo, and other treatments that she'd never 172 00:10:43,280 --> 00:10:43,600 Speaker 1: heard of. 173 00:10:45,840 --> 00:10:50,680 Speaker 2: My good friend who went through another clinic, she kept 174 00:10:50,760 --> 00:10:52,360 Speaker 2: kind of mentioning, like, because I was like, so did 175 00:10:52,360 --> 00:10:55,560 Speaker 2: you pay for the extra However, couple hundred bucks for 176 00:10:55,600 --> 00:10:58,320 Speaker 2: embryo glue? She was like, embryo glue, Like I never 177 00:10:58,360 --> 00:11:01,120 Speaker 2: heard of embryo glue. And I was like, go, like, 178 00:11:01,520 --> 00:11:03,760 Speaker 2: we just paid four hundred bucks this round you for 179 00:11:04,360 --> 00:11:07,040 Speaker 2: embryo glue and all of these like add ons. That 180 00:11:07,160 --> 00:11:11,679 Speaker 2: was like thousands of dollars per retrieval these add ons. 181 00:11:12,240 --> 00:11:15,559 Speaker 1: The idea of embryo glue is to help an embryo 182 00:11:15,640 --> 00:11:18,559 Speaker 1: implant on the wall of the uterus. A doctor k 183 00:11:18,640 --> 00:11:22,120 Speaker 1: kindbody told Elizabeth that she should also consider a medication 184 00:11:22,280 --> 00:11:24,200 Speaker 1: that would encourage the embryo to implant. 185 00:11:25,200 --> 00:11:27,120 Speaker 2: So was this we had to go in a few 186 00:11:27,200 --> 00:11:30,680 Speaker 2: days before the transfer date and do this like nupigin wash, 187 00:11:30,720 --> 00:11:33,920 Speaker 2: which was a couple hundred bucks or seven hundred bucks 188 00:11:33,920 --> 00:11:36,720 Speaker 2: out of pocket. And again I'm just telling my friend 189 00:11:37,080 --> 00:11:39,360 Speaker 2: and she is just like shaking her head, like I 190 00:11:39,360 --> 00:11:40,920 Speaker 2: don't like, what is this? 191 00:11:42,160 --> 00:11:45,560 Speaker 1: Experts I spoke to see. The science behind embryo glue 192 00:11:45,600 --> 00:11:50,000 Speaker 1: and nupagin wash is shaky at best. It's not definitively 193 00:11:50,080 --> 00:11:53,960 Speaker 1: proven to improve chances of getting pregnant. But in that moment, 194 00:11:54,480 --> 00:11:57,319 Speaker 1: Elizabeth went through with it despite her doubts. 195 00:11:57,720 --> 00:12:01,440 Speaker 2: But again didn't want to question the doctor. If she 196 00:12:01,440 --> 00:12:03,600 Speaker 2: said this is going to improve our chances, then you know, 197 00:12:03,679 --> 00:12:05,960 Speaker 2: let's go for it. We've got the one embryo. Let's 198 00:12:06,000 --> 00:12:08,720 Speaker 2: like do whatever it takes. It just it's like a 199 00:12:08,760 --> 00:12:12,960 Speaker 2: situation where you're going in making these calls for this 200 00:12:13,040 --> 00:12:15,760 Speaker 2: round of IVF and you're already you know how invasive 201 00:12:15,800 --> 00:12:17,480 Speaker 2: it's going to be, and you know how hard it's 202 00:12:17,520 --> 00:12:19,160 Speaker 2: going to be on your body, and you know how 203 00:12:19,200 --> 00:12:21,960 Speaker 2: much money insurance is paying for it, and that you're 204 00:12:22,040 --> 00:12:23,520 Speaker 2: then going to be paying for it. So you're not 205 00:12:23,559 --> 00:12:27,280 Speaker 2: going to cut corners. If your doctor says I recommend this, 206 00:12:27,520 --> 00:12:30,000 Speaker 2: it's going to increase your chances by five percent or 207 00:12:30,000 --> 00:12:32,240 Speaker 2: whatever it may be, Like, that's not the time to 208 00:12:32,280 --> 00:12:33,920 Speaker 2: be like, no, I'm going to save this four hundred 209 00:12:33,960 --> 00:12:36,720 Speaker 2: bucks or whatever is. So you just you know, you 210 00:12:36,880 --> 00:12:40,120 Speaker 2: have to trust the person of authority there. You have 211 00:12:40,160 --> 00:12:42,720 Speaker 2: to trust the doctors making those recommendations. 212 00:12:43,480 --> 00:12:47,000 Speaker 1: By the fall of twenty twenty four, two IVF cycles 213 00:12:47,000 --> 00:12:52,400 Speaker 1: had left Elizabeth emotionally and financially drained. In total, she 214 00:12:52,480 --> 00:12:55,240 Speaker 1: spent more than twelve thousand dollars on the IVF treatment 215 00:12:55,320 --> 00:12:59,840 Speaker 1: and add ons. Her disappointment and frustration were compounded by 216 00:12:59,840 --> 00:13:02,000 Speaker 1: the fact she said she was also getting bills in 217 00:13:02,040 --> 00:13:04,960 Speaker 1: the mail for things kind body had assured her recovered 218 00:13:04,960 --> 00:13:09,200 Speaker 1: by insurance. I spoke to nearly fifty patients and nearly 219 00:13:09,240 --> 00:13:12,800 Speaker 1: all of them had what they called surprise costs during 220 00:13:12,800 --> 00:13:18,600 Speaker 1: the treatment and after. Eventually, Elizabeth and her husband ended 221 00:13:18,679 --> 00:13:21,760 Speaker 1: up moving to another fertility practice after switching their insurance. 222 00:13:22,600 --> 00:13:25,439 Speaker 2: It's literally night and day the difference. 223 00:13:26,240 --> 00:13:29,959 Speaker 1: Elizabeth said, her new doctor doesn't try to upsell her. Instead, 224 00:13:30,000 --> 00:13:32,120 Speaker 1: she told her she could skip genetic testing of her 225 00:13:32,160 --> 00:13:33,120 Speaker 1: embryos altogether. 226 00:13:33,720 --> 00:13:36,439 Speaker 2: I was like, I remember my SHAW was dropped because 227 00:13:37,040 --> 00:13:41,120 Speaker 2: I was so I don't know, indoctrinated into it, being like, 228 00:13:41,600 --> 00:13:45,680 Speaker 2: you are over thirty six, you wild genetic test, but 229 00:13:45,720 --> 00:13:48,640 Speaker 2: genetic testing is a huge out of pocket cost. It 230 00:13:48,720 --> 00:13:50,480 Speaker 2: took me a while to wrap my head around because 231 00:13:50,480 --> 00:13:52,480 Speaker 2: again I just thought there was no way if not 232 00:13:52,600 --> 00:13:55,400 Speaker 2: through genetic testing. But the way she described it to 233 00:13:55,480 --> 00:13:59,880 Speaker 2: us was that that is not something we like need doing. 234 00:14:00,520 --> 00:14:02,800 Speaker 1: She says it makes her look back on her time 235 00:14:02,840 --> 00:14:06,800 Speaker 1: at kind Body differently. Even though she genuinely liked the 236 00:14:06,840 --> 00:14:11,120 Speaker 1: doctor she had there, she has doubts. 237 00:14:10,600 --> 00:14:12,480 Speaker 2: At kind Body and my heart of hearts, I do 238 00:14:12,520 --> 00:14:14,920 Speaker 2: not want to think that the doctor that we worked 239 00:14:14,960 --> 00:14:17,880 Speaker 2: with for months there is just trying to get us 240 00:14:17,880 --> 00:14:20,760 Speaker 2: to do more IVF rounds. Just don't want to think that. 241 00:14:20,920 --> 00:14:23,440 Speaker 2: But when you just look at all the pieces and 242 00:14:23,440 --> 00:14:25,240 Speaker 2: how they're all kind of adding up. It's just really 243 00:14:25,320 --> 00:14:27,640 Speaker 2: hard not to come to that conclusion in my mind. 244 00:14:29,280 --> 00:14:35,920 Speaker 1: We'll be right back. I spoke with dozens of current 245 00:14:35,960 --> 00:14:38,560 Speaker 1: and former employees who worked at kind Body around the 246 00:14:38,560 --> 00:14:41,840 Speaker 1: time Elizabeth was having her treatment, and they told me 247 00:14:42,360 --> 00:14:45,400 Speaker 1: there was this intense pressure to sell services that made 248 00:14:45,440 --> 00:14:49,400 Speaker 1: many clinical staff, including doctors, deeply uncomfortable. 249 00:14:51,240 --> 00:14:54,120 Speaker 4: At your white coat ceremony, which is the first thing 250 00:14:54,160 --> 00:14:57,120 Speaker 4: you participate in before you start mid school, you take 251 00:14:57,160 --> 00:15:00,800 Speaker 4: that oath, and that oath is first no harm. 252 00:15:01,560 --> 00:15:04,640 Speaker 1: This is Lauren again. She's a former kind Body medical 253 00:15:04,640 --> 00:15:08,400 Speaker 1: staffer who asked not to be identified, so we've given 254 00:15:08,440 --> 00:15:10,880 Speaker 1: her a pseudonym and are having a voice actor read 255 00:15:10,920 --> 00:15:14,360 Speaker 1: what she told me. Lauren said that from the beginning 256 00:15:14,360 --> 00:15:18,040 Speaker 1: at kind Body, doctors had metrics that were closely tracked 257 00:15:18,120 --> 00:15:21,520 Speaker 1: to measure their performance. One of these metrics was the 258 00:15:21,600 --> 00:15:23,560 Speaker 1: number of cycles they performed. 259 00:15:23,560 --> 00:15:26,400 Speaker 4: So that could be an egg freeze cycle or embryo 260 00:15:26,480 --> 00:15:30,480 Speaker 4: creation and then the actual transfer of the embryo to 261 00:15:30,600 --> 00:15:32,359 Speaker 4: hopefully create the pregnancy. 262 00:15:33,440 --> 00:15:36,640 Speaker 1: There were also other procedures that counted toward a doctor's metrics. 263 00:15:37,080 --> 00:15:39,480 Speaker 1: Some of these were part of the IVF process, but 264 00:15:39,560 --> 00:15:44,240 Speaker 1: not always. For example, mock cycles. A mock cycle is 265 00:15:44,240 --> 00:15:48,440 Speaker 1: like a trial run. It simulates an embryo transfer. The 266 00:15:48,480 --> 00:15:51,240 Speaker 1: goal is to see how the body reacts and allow 267 00:15:51,280 --> 00:15:54,000 Speaker 1: the doctor to work out the kinks before the actual procedure. 268 00:15:55,120 --> 00:15:57,800 Speaker 1: Doctors tell me they can be helpful for patients who 269 00:15:57,800 --> 00:16:00,800 Speaker 1: have had trouble getting embryos to implant, but they aren't 270 00:16:00,840 --> 00:16:05,640 Speaker 1: necessary for everyone. Lauren told me that kind body doctors 271 00:16:05,760 --> 00:16:09,280 Speaker 1: often recommended mock cycles, which can add hundreds of dollars 272 00:16:09,320 --> 00:16:09,760 Speaker 1: to the bill. 273 00:16:10,400 --> 00:16:13,880 Speaker 4: Well, there was one in particular that would have patients 274 00:16:13,920 --> 00:16:18,680 Speaker 4: do mock cycles, or multiple mock cycles, or different types 275 00:16:18,720 --> 00:16:22,960 Speaker 4: of procedures, because essentially that would increase her numbers in 276 00:16:23,000 --> 00:16:28,840 Speaker 4: regards to her cycles, which then essentially increased her revenue. 277 00:16:30,640 --> 00:16:33,760 Speaker 1: Lauren told me that another closely watched metric was a 278 00:16:33,800 --> 00:16:38,120 Speaker 1: doctor's conversion rate. This measured how often a patient who 279 00:16:38,160 --> 00:16:41,240 Speaker 1: came in looking to learn about fertility services was then 280 00:16:41,280 --> 00:16:45,440 Speaker 1: turned into a pain customer. And to Lauren, measuring that 281 00:16:45,600 --> 00:16:48,400 Speaker 1: rate sometimes created the wrong kind of incentive. 282 00:16:49,160 --> 00:16:51,800 Speaker 4: So you know, if I had in a month, say 283 00:16:51,840 --> 00:16:54,800 Speaker 4: twenty patients who are twenty two years old, and they're 284 00:16:54,840 --> 00:16:57,000 Speaker 4: coming to me freaking out, saying, oh my god, do 285 00:16:57,080 --> 00:17:00,000 Speaker 4: I have to do egg freezing this month because otherwise 286 00:17:00,160 --> 00:17:03,080 Speaker 4: I'm never going to have kids. And I do my job, 287 00:17:03,280 --> 00:17:05,560 Speaker 4: and I go through the information and tell them and 288 00:17:05,920 --> 00:17:09,480 Speaker 4: educate them about biology and about what this means, and 289 00:17:09,640 --> 00:17:12,960 Speaker 4: about their own statistics at that age, and so on 290 00:17:13,000 --> 00:17:16,240 Speaker 4: and so forth, and then they decide to not do 291 00:17:16,320 --> 00:17:22,840 Speaker 4: egg freezing. That's account against me. Whereas some providers would 292 00:17:22,960 --> 00:17:26,879 Speaker 4: use scared tactics to essentially make these patients want to 293 00:17:26,920 --> 00:17:30,720 Speaker 4: go through cycles and get revenue, I was never ever 294 00:17:30,800 --> 00:17:34,240 Speaker 4: going to do that. I'm not a salesperson. When it 295 00:17:34,280 --> 00:17:35,480 Speaker 4: comes to medical care. 296 00:17:36,440 --> 00:17:42,679 Speaker 1: Doctors were incentivized to do more cycles, former employees told me. 297 00:17:43,119 --> 00:17:45,880 Speaker 1: Kind Body gave year end bonuses to doctors with high 298 00:17:45,960 --> 00:17:52,080 Speaker 1: rates of converting consultation into IVF. Former executives, doctors, and 299 00:17:52,200 --> 00:17:56,760 Speaker 1: other employees stressed that steering patients toward more lucrative services 300 00:17:57,240 --> 00:18:01,560 Speaker 1: was a direct result of kind Body's funding structure. To them, 301 00:18:02,000 --> 00:18:05,280 Speaker 1: the decisions made to appease private equity and venture capital 302 00:18:05,320 --> 00:18:09,679 Speaker 1: backers had an effect on clinical care. This isn't just 303 00:18:09,840 --> 00:18:13,440 Speaker 1: kind Body, though experts told me. It happens to some 304 00:18:13,520 --> 00:18:16,280 Speaker 1: degree among a lot of fertility clinics that are backed 305 00:18:16,320 --> 00:18:20,680 Speaker 1: by big outside investors like private equity. The advantage of 306 00:18:20,760 --> 00:18:24,639 Speaker 1: private equity investment is that it lets IVF clinics expand 307 00:18:24,680 --> 00:18:30,840 Speaker 1: their footprints and treat more people, which increases access. What's 308 00:18:30,880 --> 00:18:35,119 Speaker 1: the effect of private equity on IVF. Well, there's a 309 00:18:35,160 --> 00:18:38,800 Speaker 1: twenty eighteen study done by Alex Borsa, a researcher from 310 00:18:38,840 --> 00:18:43,480 Speaker 1: Columbia University. His study found that IVF clinics with any 311 00:18:43,520 --> 00:18:47,720 Speaker 1: sort of big institutional investor like private equity, do more 312 00:18:47,800 --> 00:18:52,120 Speaker 1: IVF procedures than others. He looked at all the clinics 313 00:18:52,119 --> 00:18:55,800 Speaker 1: in the US, just fifteen percent had a private equity affiliation. 314 00:18:56,640 --> 00:19:01,440 Speaker 1: It's a relatively small slice, but those did almost a 315 00:19:01,520 --> 00:19:08,000 Speaker 1: third of all IVF cycles in the country. Like a 316 00:19:08,000 --> 00:19:11,240 Speaker 1: lot of parts of medicine, private equity has entered the 317 00:19:11,280 --> 00:19:15,000 Speaker 1: fertility field in a big way in the last ten years. 318 00:19:15,840 --> 00:19:18,960 Speaker 1: One reason they've been particularly drawn to the space is 319 00:19:19,000 --> 00:19:24,000 Speaker 1: because it's less regulated than many other fields. I spoke 320 00:19:24,000 --> 00:19:26,600 Speaker 1: about the way this investment has impacted the industry with 321 00:19:26,680 --> 00:19:31,480 Speaker 1: Travis McCoy, a doctor at Piedmont Reproductive Endochronology Group, which 322 00:19:31,520 --> 00:19:35,159 Speaker 1: operates six clinics in South Carolina and neighboring states. 323 00:19:35,600 --> 00:19:39,040 Speaker 5: I came out of fellowship and training in twenty ten. 324 00:19:39,560 --> 00:19:42,320 Speaker 5: There may have been some private equity groups, but none 325 00:19:42,320 --> 00:19:45,120 Speaker 5: that I had ever heard of, And so your choices 326 00:19:45,119 --> 00:19:48,040 Speaker 5: were really to take an academic role at a university 327 00:19:48,680 --> 00:19:50,680 Speaker 5: or go into private practice. 328 00:19:51,200 --> 00:19:55,040 Speaker 1: These days, doctor McCoy says he frequently gets offers from 329 00:19:55,119 --> 00:19:57,840 Speaker 1: private equity firms eager to acquire the practice. 330 00:19:58,680 --> 00:20:01,440 Speaker 5: I bet we at least get one at least once 331 00:20:01,480 --> 00:20:04,400 Speaker 5: every two weeks. And sometimes it's companies you've heard from. 332 00:20:04,400 --> 00:20:05,680 Speaker 5: Mostly it's companies you haven't. 333 00:20:06,040 --> 00:20:08,520 Speaker 6: There's big dollars that are dangled, and. 334 00:20:08,520 --> 00:20:12,840 Speaker 1: That's doctor Edward Tarnawa. He also works at Piedmont Reproductive 335 00:20:12,840 --> 00:20:17,000 Speaker 1: with doctor McCoy. Both doctors said they've resisted selling to 336 00:20:17,040 --> 00:20:20,560 Speaker 1: private equity because they're afraid of what strings become attached. 337 00:20:21,480 --> 00:20:25,640 Speaker 1: Doctor McCoy said that by staying independent, Piedmont can control 338 00:20:25,680 --> 00:20:28,240 Speaker 1: how it's staffs clinics in a way that wouldn't be 339 00:20:28,280 --> 00:20:31,320 Speaker 1: possible if a private equity firm was scrutinizing expenses. 340 00:20:32,200 --> 00:20:37,919 Speaker 5: Is payroll a huge expense for our practice? Absolutely? Payroll's 341 00:20:37,960 --> 00:20:42,400 Speaker 5: the biggest expense, and so could we make it tighter 342 00:20:42,480 --> 00:20:46,400 Speaker 5: and more and more profitable. Yes, so you would start 343 00:20:46,400 --> 00:20:50,879 Speaker 5: consolidating jobs, which means you start to increase the workload 344 00:20:50,960 --> 00:20:53,359 Speaker 5: on each of our staff members. Well, everybody knows it 345 00:20:53,359 --> 00:20:56,520 Speaker 5: doesn't take a genius to know that leads to burnout. 346 00:20:56,960 --> 00:20:59,480 Speaker 5: The patients see when I don't have as many nurses 347 00:21:00,119 --> 00:21:03,400 Speaker 5: and people answering the phone and taking care of their 348 00:21:03,440 --> 00:21:06,760 Speaker 5: portal messages. They see that and they get frustrated with that. 349 00:21:07,359 --> 00:21:10,800 Speaker 5: The embryology labs, those are a little higher paid staff, 350 00:21:11,119 --> 00:21:14,560 Speaker 5: and so hey, if I can pare them down, then 351 00:21:14,640 --> 00:21:17,919 Speaker 5: you know I'm cutting profits, I'm cutting out salaries. But 352 00:21:17,960 --> 00:21:20,800 Speaker 5: then you start to get into the safety issues. I 353 00:21:20,800 --> 00:21:24,719 Speaker 5: would rather have a payroll that's a little fat and 354 00:21:24,800 --> 00:21:27,000 Speaker 5: plumped up and you know, a little tougher to me. 355 00:21:27,640 --> 00:21:29,480 Speaker 5: But we know we're doing the right things for our 356 00:21:29,520 --> 00:21:30,560 Speaker 5: patients by doing that. 357 00:21:31,880 --> 00:21:35,120 Speaker 1: Doctor Tarnaas said that inviting private equity into a practice 358 00:21:35,560 --> 00:21:38,080 Speaker 1: has profound implications for patient care. 359 00:21:39,000 --> 00:21:41,800 Speaker 6: If there's somebody sitting behind a desk that you've never met, 360 00:21:41,840 --> 00:21:44,960 Speaker 6: that's looking at, you know, a spreadsheet and wondering why 361 00:21:45,000 --> 00:21:48,399 Speaker 6: the revenue depths, they're going to ask for other ways 362 00:21:48,440 --> 00:21:51,240 Speaker 6: to get that revenue. Hey, speed this person up to 363 00:21:51,320 --> 00:21:56,760 Speaker 6: treatment that they might not be quite ready for. Push IVF. 364 00:21:56,800 --> 00:21:58,960 Speaker 6: I never want to push IVF. I mean, our field 365 00:21:59,000 --> 00:22:02,040 Speaker 6: is about options, and that is a that is a 366 00:22:02,080 --> 00:22:04,879 Speaker 6: two way discussion between us and the patients in terms 367 00:22:04,880 --> 00:22:08,159 Speaker 6: of pros and cons and experience and how they value efficiency, 368 00:22:08,200 --> 00:22:11,000 Speaker 6: what have they done before, what is their tolerance for disappointment, 369 00:22:12,119 --> 00:22:14,959 Speaker 6: cost insurance, those things all matter. And that's a complex 370 00:22:15,200 --> 00:22:19,680 Speaker 6: equation and it's not IVF for all, which I know 371 00:22:19,800 --> 00:22:21,400 Speaker 6: some sinners would would like. 372 00:22:21,359 --> 00:22:21,679 Speaker 7: It to be. 373 00:22:21,800 --> 00:22:25,560 Speaker 8: There's some fertility centers out there that offer nothing but IVF, 374 00:22:25,640 --> 00:22:30,480 Speaker 8: and that's mind boggling to me because there's there's other options, 375 00:22:30,480 --> 00:22:33,399 Speaker 8: and that's just trimming it down to a service that 376 00:22:33,400 --> 00:22:34,320 Speaker 8: they're trying to sell. 377 00:22:34,520 --> 00:22:35,840 Speaker 6: And I don't like that. 378 00:22:36,600 --> 00:22:39,680 Speaker 5: And I think most of us recognize that our patients 379 00:22:39,720 --> 00:22:43,639 Speaker 5: are at an extremely fragile place and we know that 380 00:22:43,680 --> 00:22:47,520 Speaker 5: they will do anything. They are very vulnerable, and unfortunately 381 00:22:47,560 --> 00:22:51,400 Speaker 5: that makes them that vulnerable population to that could be exploited. 382 00:22:52,800 --> 00:22:56,159 Speaker 1: It wasn't just their clinic. I called over a dozen 383 00:22:56,280 --> 00:23:00,520 Speaker 1: veteran fertility doctors around the country, from big corporate to 384 00:23:00,520 --> 00:23:03,119 Speaker 1: to mom and pop size clinics to ones that belonged 385 00:23:03,119 --> 00:23:08,440 Speaker 1: to academic institutions. Many had various performance targets, but nothing 386 00:23:08,520 --> 00:23:11,879 Speaker 1: quite like the retrieval quotas doctors at Kindmody told me about. 387 00:23:12,920 --> 00:23:15,880 Speaker 1: There's one thing that makes Kind Bodies stand apart from 388 00:23:15,960 --> 00:23:20,120 Speaker 1: all these other fertility businesses with private equity investment. When 389 00:23:20,160 --> 00:23:24,040 Speaker 1: private equity got involved with these other practices, their clinics 390 00:23:24,080 --> 00:23:26,840 Speaker 1: were already built. Here's doctor McCoy. 391 00:23:27,359 --> 00:23:30,639 Speaker 5: Because the ultimate goal for a private equity group is 392 00:23:30,640 --> 00:23:34,040 Speaker 5: to buy your practice, make sure it's profitable, make it 393 00:23:34,119 --> 00:23:36,840 Speaker 5: pretty for a certain number of years, so I can 394 00:23:36,880 --> 00:23:39,200 Speaker 5: sell it to somebody else at a higher rate. 395 00:23:40,200 --> 00:23:45,200 Speaker 1: But when Gina Bartesy was wooing investors, there was nothing built, 396 00:23:46,600 --> 00:23:51,560 Speaker 1: just a vision. A few other fertility companies have tried 397 00:23:51,640 --> 00:23:54,960 Speaker 1: building from the ground up like this, but Kind Body 398 00:23:55,359 --> 00:23:59,600 Speaker 1: was the fastest growing by far. Building fertility clinics is 399 00:23:59,680 --> 00:24:03,040 Speaker 1: comp located, but the company's plan was to roll them 400 00:24:03,040 --> 00:24:05,760 Speaker 1: out like they were a chain of coffee shops. 401 00:24:06,200 --> 00:24:10,239 Speaker 4: When they started this company, you know, one of the 402 00:24:10,240 --> 00:24:13,920 Speaker 4: things they said was they wanted to be the Starbucks 403 00:24:14,000 --> 00:24:15,399 Speaker 4: of fertility. 404 00:24:15,440 --> 00:24:16,359 Speaker 1: This is Lauren again. 405 00:24:17,040 --> 00:24:21,360 Speaker 4: They wanted a clinic on every corner. Medical care is 406 00:24:21,400 --> 00:24:24,480 Speaker 4: not like that, physicians are finite. 407 00:24:25,240 --> 00:24:29,840 Speaker 1: In other words, a specialized medical practice isn't scalable, or 408 00:24:29,880 --> 00:24:32,119 Speaker 1: at least not in the same way that a retail 409 00:24:32,240 --> 00:24:36,080 Speaker 1: chain might be. But the pressure on kind Body intensified 410 00:24:36,119 --> 00:24:39,960 Speaker 1: with each funding round. Lauren remembers a sobering moment in 411 00:24:40,000 --> 00:24:43,600 Speaker 1: twenty twenty three, after kind Body raised one hundred million dollars. 412 00:24:45,760 --> 00:24:48,240 Speaker 4: There was just this huge in the company, kind of like, 413 00:24:48,440 --> 00:24:51,600 Speaker 4: oh my gosh, we have one hundred million, so amazing, 414 00:24:51,720 --> 00:24:54,800 Speaker 4: We're doing so great. I mean, it was in every meeting, 415 00:24:55,000 --> 00:24:58,240 Speaker 4: it was in everything. And then the CFO at the time, 416 00:24:59,080 --> 00:25:02,360 Speaker 4: he was very hon and he basically yeah, right at 417 00:25:02,359 --> 00:25:05,760 Speaker 4: the meeting to the everyone basically said that you know, 418 00:25:06,320 --> 00:25:09,240 Speaker 4: I know this sounds like a lot of money, but 419 00:25:09,359 --> 00:25:14,119 Speaker 4: this is not we're rolling in the money. He literally said, like, 420 00:25:14,400 --> 00:25:16,960 Speaker 4: this is a debt we have to pay back, so 421 00:25:17,080 --> 00:25:19,440 Speaker 4: we have to be judicious about what we're doing. 422 00:25:20,880 --> 00:25:24,000 Speaker 1: After the break, the pressure to sell a kind Body 423 00:25:24,560 --> 00:25:26,080 Speaker 1: wasn't just limited to IVF. 424 00:25:26,840 --> 00:25:30,520 Speaker 9: So I was like, I just went through two weeks 425 00:25:30,520 --> 00:25:33,720 Speaker 9: of medications and traveled here and spent thousands of dollars 426 00:25:33,760 --> 00:25:36,520 Speaker 9: for this procedure, and you're telling me I didn't need 427 00:25:36,560 --> 00:25:37,040 Speaker 9: to do it. 428 00:25:38,480 --> 00:25:45,640 Speaker 1: We'll be right back. Before Lacey Michelson came to Kind 429 00:25:45,680 --> 00:25:48,879 Speaker 1: Body in twenty twenty three, her attempts at becoming a 430 00:25:48,960 --> 00:25:54,199 Speaker 1: mother had already been really traumatic. Nearly every step of 431 00:25:54,280 --> 00:25:58,200 Speaker 1: IVF had been a struggle for Lacey. She has endometriosis, 432 00:25:58,600 --> 00:26:02,160 Speaker 1: which causes painful infla animation and can make conception difficult. 433 00:26:02,960 --> 00:26:06,640 Speaker 1: She was also extremely sensitive to fertility medications and had 434 00:26:06,640 --> 00:26:12,520 Speaker 1: severe reactions, debilitating headaches, stomach cramps, and sweats, and one 435 00:26:12,560 --> 00:26:16,480 Speaker 1: complication from an early pregnancy caused her fallopian tube to rupture. 436 00:26:17,359 --> 00:26:18,160 Speaker 1: She almost died. 437 00:26:18,760 --> 00:26:21,960 Speaker 9: You know, I had friends and family members, people really 438 00:26:21,960 --> 00:26:25,800 Speaker 9: close to me asked me like, why. 439 00:26:24,440 --> 00:26:26,639 Speaker 7: What can you just stop? Please stop? 440 00:26:27,280 --> 00:26:31,600 Speaker 9: And my desire for this ended the relationship I had 441 00:26:31,680 --> 00:26:34,000 Speaker 9: with what I would you know, describe as the love 442 00:26:34,040 --> 00:26:36,720 Speaker 9: of my life because I just this was so important 443 00:26:36,760 --> 00:26:36,960 Speaker 9: to me. 444 00:26:37,720 --> 00:26:40,520 Speaker 7: I couldn't put anything else before it. 445 00:26:41,760 --> 00:26:45,320 Speaker 1: But even after nearly dying, Lacy wasn't ready to give up. 446 00:26:46,600 --> 00:26:49,240 Speaker 9: It's just for as long as I can remember, since 447 00:26:49,280 --> 00:26:51,600 Speaker 9: I was a little girl, it's all I ever wanted. 448 00:26:51,920 --> 00:26:54,720 Speaker 7: I never cared about getting married, I. 449 00:26:54,720 --> 00:26:57,440 Speaker 9: Never gave a bit about that. All I ever wanted 450 00:26:57,600 --> 00:26:59,800 Speaker 9: was to be a mom. It just kind of took 451 00:26:59,840 --> 00:27:02,840 Speaker 9: the life of its own at at some point. It 452 00:27:02,960 --> 00:27:05,280 Speaker 9: was just something that I just had to keep fighting for. 453 00:27:07,359 --> 00:27:10,159 Speaker 1: When I met Lacey in twenty twenty four, she was 454 00:27:10,200 --> 00:27:12,359 Speaker 1: in her early forties and had been trying for a 455 00:27:12,400 --> 00:27:16,199 Speaker 1: baby for nearly four years. Unlike many women who had 456 00:27:16,280 --> 00:27:19,400 Speaker 1: husbands are a partner by their side, Lacey was going 457 00:27:19,400 --> 00:27:22,679 Speaker 1: at it alone. She'd gone to clinics in LA and 458 00:27:22,760 --> 00:27:26,760 Speaker 1: Texas and spent tens of thousands of dollars. She briefly 459 00:27:26,800 --> 00:27:29,159 Speaker 1: went to a Kind Body clinic in Austin, which she 460 00:27:29,200 --> 00:27:32,199 Speaker 1: really liked, but when she moved to Virginia, she had 461 00:27:32,200 --> 00:27:33,880 Speaker 1: trouble finding a clinic she trusted. 462 00:27:34,520 --> 00:27:37,199 Speaker 9: I think there's three or four that I tried, and 463 00:27:37,280 --> 00:27:41,760 Speaker 9: I just wasn't getting proper care, wasn't getting return phone calls. 464 00:27:42,280 --> 00:27:45,240 Speaker 1: In the spring of twenty twenty three, Lacey found Kind 465 00:27:45,240 --> 00:27:46,359 Speaker 1: Bodies DC clinic. 466 00:27:47,080 --> 00:27:49,880 Speaker 9: I did a consul with one of the doctors there, 467 00:27:50,000 --> 00:27:54,040 Speaker 9: who I loved. She was just so great, so personal, 468 00:27:54,240 --> 00:27:58,280 Speaker 9: so like compassionate, and I was really comfortable with her. 469 00:27:58,480 --> 00:28:00,119 Speaker 9: When I met her in person, she just gave me 470 00:28:00,160 --> 00:28:03,400 Speaker 9: a giant huggy, you know, and she acknowledged so many times, 471 00:28:03,480 --> 00:28:06,000 Speaker 9: like everything that I had been through. So I felt 472 00:28:06,080 --> 00:28:11,000 Speaker 9: relieved to be working with somebody that understood my journey 473 00:28:11,480 --> 00:28:15,280 Speaker 9: and was really rooting for me. 474 00:28:15,840 --> 00:28:16,040 Speaker 4: You know. 475 00:28:17,680 --> 00:28:21,439 Speaker 9: I thought that everything, all the other crap that I 476 00:28:21,480 --> 00:28:23,399 Speaker 9: had been through was behind me, and that I was 477 00:28:23,440 --> 00:28:26,360 Speaker 9: on the right path now and working with the right 478 00:28:26,400 --> 00:28:27,680 Speaker 9: doctor and the right clinic. 479 00:28:28,600 --> 00:28:31,439 Speaker 1: Lacy had six eggs shipped from her previous clinic in 480 00:28:31,560 --> 00:28:35,720 Speaker 1: LA to kind Body, and those resulted in two viable embryos. 481 00:28:36,119 --> 00:28:39,040 Speaker 1: That summer, she had one transferred, but it didn't result 482 00:28:39,040 --> 00:28:39,760 Speaker 1: in a pregnancy. 483 00:28:40,280 --> 00:28:43,640 Speaker 7: I was down to one embryo left. At this point. 484 00:28:43,800 --> 00:28:47,120 Speaker 9: It was clear that I was not a really good 485 00:28:47,160 --> 00:28:50,160 Speaker 9: candidate for IVF because of my reactions to the medication. 486 00:28:51,360 --> 00:28:54,440 Speaker 9: I had kind of been thinking like this next frozen 487 00:28:54,440 --> 00:28:57,720 Speaker 9: embryo transfer that I do was essentially my last shot 488 00:28:57,800 --> 00:29:01,200 Speaker 9: at biological motherhood. At this point, I wanted to do 489 00:29:01,240 --> 00:29:05,680 Speaker 9: an unmedicated transfer. My body is exhausted and I've just 490 00:29:05,760 --> 00:29:09,560 Speaker 9: had so many horrendous side effects from all these hormones. 491 00:29:09,720 --> 00:29:13,400 Speaker 9: I was just going to do a natural frozen embryo transfer, 492 00:29:14,120 --> 00:29:15,479 Speaker 9: or as natural as they'll do it. 493 00:29:15,520 --> 00:29:20,400 Speaker 1: Basically, there was one more hurdle Lacey needed to clear. First, 494 00:29:21,520 --> 00:29:26,440 Speaker 1: Lacey's doctor suggested she do what's called an endometrial receptivity analysis. 495 00:29:27,400 --> 00:29:32,280 Speaker 9: An EER test basically takes a biopsy from your uterus 496 00:29:32,360 --> 00:29:34,400 Speaker 9: to see if there's any active infection. 497 00:29:35,560 --> 00:29:37,680 Speaker 1: The test is supposed to show if the uterus is 498 00:29:37,720 --> 00:29:40,720 Speaker 1: in good shape to have an embryo im plantation. Experts 499 00:29:40,760 --> 00:29:43,800 Speaker 1: told me the test isn't that common. It also requires 500 00:29:43,840 --> 00:29:46,520 Speaker 1: a lot of preparation. She'd need to take two weeks 501 00:29:46,520 --> 00:29:50,440 Speaker 1: of medications. It wasn't ideal, but Lacey wanted to have 502 00:29:50,480 --> 00:29:54,600 Speaker 1: the best chance for her last embryo to stick. A 503 00:29:54,600 --> 00:29:56,800 Speaker 1: couple of days before she went in for the procedure, 504 00:29:57,280 --> 00:30:00,959 Speaker 1: kind body called to collect payment about fifty teen hundred dollars. 505 00:30:01,640 --> 00:30:05,320 Speaker 9: Leading up to the procedure, I was getting a lot 506 00:30:05,360 --> 00:30:09,240 Speaker 9: of like different communications from the clinic. 507 00:30:10,080 --> 00:30:13,360 Speaker 1: Some nurses were calling her RA test a mock transfer, 508 00:30:13,880 --> 00:30:17,520 Speaker 1: which is a totally different procedure. In a mock transfer, 509 00:30:17,880 --> 00:30:20,360 Speaker 1: the doctor is just looking to see if everything looks good. 510 00:30:21,120 --> 00:30:24,280 Speaker 1: Unlike an ERA test, no tissue biopsy is done. 511 00:30:25,280 --> 00:30:28,320 Speaker 9: I thought maybe they're essentially the same thing, you know. 512 00:30:29,280 --> 00:30:34,440 Speaker 9: I got pre opt instructions from the nursing team and 513 00:30:34,760 --> 00:30:36,920 Speaker 9: they were very specific. They should show up with a 514 00:30:36,960 --> 00:30:40,960 Speaker 9: full bladder, drink thirty two ounces of water, don't empty 515 00:30:40,960 --> 00:30:41,600 Speaker 9: ear bladder. 516 00:30:42,040 --> 00:30:45,320 Speaker 1: Lacey wanted this to go well. She'd call the clinic 517 00:30:45,400 --> 00:30:49,640 Speaker 1: to double check instructions, sometimes at answer and give conflicting information, 518 00:30:50,040 --> 00:30:53,320 Speaker 1: but most of the time no one replied. Lacy didn't 519 00:30:53,360 --> 00:30:55,400 Speaker 1: think too much of it at the time and stuck 520 00:30:55,440 --> 00:30:58,080 Speaker 1: with what she had been instructed to do. At the outset. 521 00:30:58,400 --> 00:31:00,880 Speaker 1: They're professionals, she thought, they know what they're doing. 522 00:31:01,840 --> 00:31:04,880 Speaker 9: So the morning I went in for my transfer, one 523 00:31:04,920 --> 00:31:06,480 Speaker 9: of the first things they asked me to do was 524 00:31:06,520 --> 00:31:08,560 Speaker 9: give you your own sample and empty my bladder. 525 00:31:09,400 --> 00:31:11,640 Speaker 7: So I was obviously really confused by this. 526 00:31:11,840 --> 00:31:13,800 Speaker 9: I was like, okay, but I'm here for an ear 527 00:31:13,880 --> 00:31:15,640 Speaker 9: I test and I have to have a full bladder. 528 00:31:16,560 --> 00:31:19,920 Speaker 9: And the nurse was like, no, your bladder has to 529 00:31:19,920 --> 00:31:21,320 Speaker 9: be empty, and I was like, are you sure? 530 00:31:21,400 --> 00:31:24,320 Speaker 7: Can you check with my doctor with my nursing team. 531 00:31:24,960 --> 00:31:27,240 Speaker 1: Lacey was sitting on the exam table in her gown 532 00:31:27,800 --> 00:31:31,440 Speaker 1: waiting for an answer when someone came in to collect payment. 533 00:31:31,680 --> 00:31:34,720 Speaker 9: And I was like, I already paid, and she said, well, 534 00:31:34,840 --> 00:31:37,160 Speaker 9: how much did you pay? And I shouldn't you have 535 00:31:37,240 --> 00:31:39,840 Speaker 9: this information, and I had to like pull it up 536 00:31:39,880 --> 00:31:41,840 Speaker 9: on my phone and I told her how much I paid, 537 00:31:41,840 --> 00:31:44,880 Speaker 9: and she was like, oh, okay. She seemed really confused, 538 00:31:44,880 --> 00:31:46,640 Speaker 9: and she left the room and then came back and 539 00:31:46,800 --> 00:31:50,600 Speaker 9: was like, okay, so you might get like another bill 540 00:31:50,880 --> 00:31:54,200 Speaker 9: from the lab because the lab bills separately. And I'm like, okay, fine. 541 00:31:54,840 --> 00:31:56,880 Speaker 9: She's like, I think it'll be like seven hundred dollars 542 00:31:56,960 --> 00:31:59,520 Speaker 9: or something, and I'm like, okay, you guys probably could 543 00:31:59,560 --> 00:32:03,360 Speaker 9: have told me that before, but okay, yeah, I'll pay it. 544 00:32:04,920 --> 00:32:07,880 Speaker 1: A nurse came back with an update Lacy would need 545 00:32:07,920 --> 00:32:12,000 Speaker 1: an empty bladder. After all. She did as she was instructed. 546 00:32:13,120 --> 00:32:17,400 Speaker 1: When the exam finally started, it was clear something was wrong. 547 00:32:18,680 --> 00:32:20,560 Speaker 9: I had drink so much of water at this point 548 00:32:21,000 --> 00:32:23,080 Speaker 9: that I still had a full bladder when I went 549 00:32:23,080 --> 00:32:26,560 Speaker 9: in for the procedure, which ended up being a problem. 550 00:32:26,880 --> 00:32:29,880 Speaker 9: She was not able to access the part of my 551 00:32:30,000 --> 00:32:33,320 Speaker 9: uterus she needed to biopsy because my bladder was in 552 00:32:33,360 --> 00:32:37,040 Speaker 9: the way. And this procedure is generally, as it was 553 00:32:37,040 --> 00:32:41,160 Speaker 9: explained to me, it's supposed to be uncomfortable. It's not 554 00:32:41,240 --> 00:32:44,280 Speaker 9: pleasant by any means, but it's very quick. Five or 555 00:32:44,280 --> 00:32:46,720 Speaker 9: fifteen minutes. I was in there for over an hour. 556 00:32:47,280 --> 00:32:50,240 Speaker 9: I was crying in agonizing pain. I think it was 557 00:32:50,280 --> 00:32:54,440 Speaker 9: four people and they're helping to do this very simple biopsy. 558 00:32:55,000 --> 00:32:58,240 Speaker 9: The ultrasound tech was like holding me. It was awful 559 00:32:59,080 --> 00:33:01,360 Speaker 9: because she just couldn't get this biopsy that she needed. 560 00:33:01,720 --> 00:33:03,440 Speaker 7: So it was really pretty traumatic. 561 00:33:03,840 --> 00:33:06,240 Speaker 9: And in the end I was like, okay, you need 562 00:33:06,240 --> 00:33:08,640 Speaker 9: to stop, like hopefully you have the biopsy you need, 563 00:33:08,640 --> 00:33:11,240 Speaker 9: but I can't, Like this needs to end now. 564 00:33:12,840 --> 00:33:17,480 Speaker 1: When it was finally over, Lacey got dressed. Then her 565 00:33:17,520 --> 00:33:20,680 Speaker 1: doctor casually said something that stunned her. 566 00:33:21,960 --> 00:33:26,360 Speaker 9: And at some point she mentions to me that if 567 00:33:26,400 --> 00:33:29,760 Speaker 9: I'm doing an unmedicated for as an embryo transfer, the 568 00:33:29,800 --> 00:33:33,920 Speaker 9: results of an ER test are irrelevant. So I was like, 569 00:33:35,800 --> 00:33:37,440 Speaker 9: you mean I didn't need to just do what I 570 00:33:37,520 --> 00:33:41,720 Speaker 9: just did. I just went through two weeks of medications 571 00:33:41,760 --> 00:33:44,960 Speaker 9: and traveled here and spent thousands of dollars for this procedure, 572 00:33:45,680 --> 00:33:47,520 Speaker 9: and you're telling me I didn't need to do it. 573 00:33:48,480 --> 00:33:52,320 Speaker 1: Lacey's doctor explained that the test wasn't necessary, but that 574 00:33:52,480 --> 00:33:56,200 Speaker 1: useful information could still be gleaned from the biopsy. It 575 00:33:56,240 --> 00:33:58,880 Speaker 1: wasn't all for nothing, the doctor said in an effort 576 00:33:58,920 --> 00:34:00,120 Speaker 1: to calm her down. 577 00:34:00,280 --> 00:34:04,000 Speaker 9: I didn't really push the matter beyond that at that point. 578 00:34:04,080 --> 00:34:05,560 Speaker 9: I just wanted to get the hell out of there. 579 00:34:06,280 --> 00:34:08,480 Speaker 9: It wasn't until I was driving home with my friend 580 00:34:08,520 --> 00:34:12,000 Speaker 9: who had come with me for the procedure, that I 581 00:34:12,120 --> 00:34:15,680 Speaker 9: was telling her what the doctor said, and she was like, wait, 582 00:34:15,719 --> 00:34:18,440 Speaker 9: what all this happened when you left the waiting room, 583 00:34:18,800 --> 00:34:22,000 Speaker 9: And as I was talking it through with her, I 584 00:34:22,120 --> 00:34:26,120 Speaker 9: was like, yeah, yeah, that just happened. It's just like 585 00:34:26,280 --> 00:34:30,640 Speaker 9: kind of flabbergasted by the entire thing. By the time 586 00:34:30,800 --> 00:34:33,040 Speaker 9: I got home, I was extremely upset. 587 00:34:33,840 --> 00:34:36,960 Speaker 1: That night. She sent a long email to kind body. 588 00:34:37,480 --> 00:34:39,839 Speaker 9: I heard back from them within a day or two, 589 00:34:40,280 --> 00:34:44,440 Speaker 9: and they apologized. And the woman that I spoke with, 590 00:34:44,960 --> 00:34:49,280 Speaker 9: she was nice and she understood my position, and she 591 00:34:49,360 --> 00:34:53,360 Speaker 9: said that she was going to see about refunding me 592 00:34:53,600 --> 00:34:57,120 Speaker 9: the cost of the procedure, and she was gonna get 593 00:34:57,160 --> 00:34:59,440 Speaker 9: back to me like within a few days, and I 594 00:34:59,440 --> 00:35:03,160 Speaker 9: didn't hear her, so I kept following up. She eventually 595 00:35:03,160 --> 00:35:05,839 Speaker 9: came back and said, sorry, we can't do that. 596 00:35:07,480 --> 00:35:12,240 Speaker 1: The unnecessary procedure had serious consequences beyond the financial cost 597 00:35:12,320 --> 00:35:13,239 Speaker 1: and physical pain. 598 00:35:13,920 --> 00:35:16,640 Speaker 9: The hormones that I had to take in preparation for 599 00:35:16,719 --> 00:35:21,560 Speaker 9: this biopsy exacerbated my enemy triosis. I got a really 600 00:35:21,560 --> 00:35:25,040 Speaker 9: big cyst on my left ovary and I had three 601 00:35:25,080 --> 00:35:29,520 Speaker 9: months of horrible pain from taking these hormones to do 602 00:35:29,560 --> 00:35:32,799 Speaker 9: this biopsy that I didn't need to do, and there 603 00:35:32,880 --> 00:35:34,680 Speaker 9: was just no accountability anywhere. 604 00:35:35,360 --> 00:35:38,280 Speaker 1: Lacey decided to leave kind Body and transfer her embryo 605 00:35:38,320 --> 00:35:41,560 Speaker 1: to another clinic, and she says when she let kind 606 00:35:41,600 --> 00:35:45,200 Speaker 1: Body know about her decision, they did offer her something. 607 00:35:46,120 --> 00:35:47,960 Speaker 9: I will say they gave me one hundred and fifty 608 00:35:48,000 --> 00:35:52,200 Speaker 9: dollars off of that for my troubles with kind Body, 609 00:35:52,360 --> 00:35:52,879 Speaker 9: which was. 610 00:35:54,400 --> 00:35:56,000 Speaker 7: Which is just in gold. 611 00:35:56,680 --> 00:35:59,080 Speaker 1: Kind Body told me that the course of treatment and 612 00:35:59,120 --> 00:36:03,800 Speaker 1: medication was consistent with standard clinical practice to suppress endometriosis. 613 00:36:04,560 --> 00:36:07,960 Speaker 1: Thinking back, Lacy said she felt pressured from the beginning 614 00:36:08,000 --> 00:36:10,200 Speaker 1: to do the procedure and that she could never get 615 00:36:10,239 --> 00:36:12,000 Speaker 1: a straight answer about what it would cost. 616 00:36:12,760 --> 00:36:16,920 Speaker 9: I just can't see any other reason than just to 617 00:36:17,239 --> 00:36:21,040 Speaker 9: make extra money, you know, at my expense. I already 618 00:36:21,080 --> 00:36:26,880 Speaker 9: have an opinion that this particular part of healthcare fertility 619 00:36:27,880 --> 00:36:32,840 Speaker 9: is they're taking advantage of women that are quite frankly desperate. 620 00:36:33,680 --> 00:36:36,920 Speaker 9: That's why they're able to charge as much as they charge. 621 00:36:37,320 --> 00:36:39,920 Speaker 1: But the costs weren't just financial. 622 00:36:40,600 --> 00:36:42,759 Speaker 9: Everything that you have to do when you're going through 623 00:36:42,760 --> 00:36:49,319 Speaker 9: fertility treatments, every test, every exam, every phone call, every appointment, 624 00:36:49,719 --> 00:36:55,680 Speaker 9: every loss, like every single thing is hard. Is really hard, 625 00:36:56,040 --> 00:36:57,960 Speaker 9: you know, And the further along you go with it, 626 00:36:58,000 --> 00:36:58,920 Speaker 9: the harder it gets. 627 00:36:59,560 --> 00:37:02,960 Speaker 7: There's some train of thought on their end. 628 00:37:02,840 --> 00:37:07,400 Speaker 9: On somebody's end, where it's like, essentially harmless to do 629 00:37:07,520 --> 00:37:11,200 Speaker 9: this biopsy. They can get some information from it, you know, 630 00:37:12,000 --> 00:37:15,719 Speaker 9: whether or not they need that information is questionable. The 631 00:37:15,760 --> 00:37:19,440 Speaker 9: financial aspect of it aside, it is not harmless. It 632 00:37:19,480 --> 00:37:23,200 Speaker 9: was not harmless to me. And after this whole ordeal 633 00:37:23,239 --> 00:37:25,520 Speaker 9: with kind body, I wanted to be done. I wanted 634 00:37:25,520 --> 00:37:29,279 Speaker 9: to give up. I couldn't do it anymore, like physically, mentally, emotionally, 635 00:37:30,200 --> 00:37:32,120 Speaker 9: I was like, I just need to actually get to 636 00:37:32,160 --> 00:37:36,600 Speaker 9: a place mentally where I'm okay not being a well. 637 00:37:40,200 --> 00:37:43,919 Speaker 1: After nearly giving up, Lacey decided to try one last 638 00:37:43,960 --> 00:37:46,680 Speaker 1: transfer with her remaining umbrew at a different clinic in 639 00:37:46,719 --> 00:37:51,279 Speaker 1: New York. Recently, Lacey sent me a voice memo with 640 00:37:51,320 --> 00:37:51,880 Speaker 1: an update. 641 00:37:53,120 --> 00:37:55,920 Speaker 9: So, yeah, I'm not totally sure how to start this. 642 00:37:57,280 --> 00:38:00,920 Speaker 9: I had my son on September nineteenth v a C section, 643 00:38:02,560 --> 00:38:07,600 Speaker 9: and he is absolute pure joy. His middle name is Miles, 644 00:38:07,640 --> 00:38:10,640 Speaker 9: and one of his nicknames is Smiles Miles, because he's 645 00:38:10,680 --> 00:38:15,280 Speaker 9: really just the happiest little dude. I often get stopped 646 00:38:15,280 --> 00:38:19,319 Speaker 9: by strangers that remark about how absolutely perfect he is. 647 00:38:20,239 --> 00:38:23,399 Speaker 9: When I think back on my journey to get him here, 648 00:38:23,520 --> 00:38:27,560 Speaker 9: which I do quite frequently, I still can't believe that 649 00:38:27,640 --> 00:38:29,520 Speaker 9: I went through all of that and came out the 650 00:38:29,520 --> 00:38:34,719 Speaker 9: other end with this perfect little human. Periodically someone will 651 00:38:35,080 --> 00:38:38,719 Speaker 9: say like how lucky I am, and I always correct 652 00:38:38,800 --> 00:38:41,799 Speaker 9: them that luck had nothing to do with it. I 653 00:38:41,840 --> 00:38:45,960 Speaker 9: did this my blood, sweat, tears, heartbreaks, life savings, you 654 00:38:46,080 --> 00:38:48,879 Speaker 9: name it. Anything and everything I had, I poured into this, 655 00:38:49,000 --> 00:38:51,880 Speaker 9: and I made him despite all the obstacles and the 656 00:38:51,920 --> 00:38:59,120 Speaker 9: horrendous experiences. And I'm hopeful that my story and the 657 00:38:59,160 --> 00:39:06,040 Speaker 9: stories from other women can help begin a greater process 658 00:39:06,320 --> 00:39:08,600 Speaker 9: of reform in this field. 659 00:39:13,400 --> 00:39:16,800 Speaker 1: Coming up on IVF disrupted the kind body story. 660 00:39:18,239 --> 00:39:20,840 Speaker 3: I just remember she wouldn't make eye contact with me, 661 00:39:21,719 --> 00:39:23,840 Speaker 3: and the assistant was like doing a lot of the 662 00:39:23,920 --> 00:39:25,000 Speaker 3: talking too. 663 00:39:25,719 --> 00:39:28,280 Speaker 9: You can't have an employee of yours be your carrier, 664 00:39:28,760 --> 00:39:32,160 Speaker 9: because that is coercion because she will feel she can't 665 00:39:32,200 --> 00:39:32,600 Speaker 9: say no. 666 00:39:33,080 --> 00:39:35,160 Speaker 2: When it comes to who has the opportunity to work 667 00:39:35,200 --> 00:39:37,799 Speaker 2: with a surrogate. It's very clear that it's of the 668 00:39:37,840 --> 00:39:39,240 Speaker 2: discretion of the treating physician. 669 00:39:39,840 --> 00:39:43,160 Speaker 3: I was on mail duty, so I read this in 670 00:39:43,239 --> 00:39:47,920 Speaker 3: the office and my jaw hit the floor because I 671 00:39:48,080 --> 00:39:51,480 Speaker 3: was like, what do you actually mean we're doing this? 672 00:39:55,360 --> 00:39:59,240 Speaker 1: IVF Disrupted The Kind Body Story is reported and hosted 673 00:39:59,280 --> 00:40:03,560 Speaker 1: by me Jackie Devolos. The series is produced by Sean 674 00:40:03,640 --> 00:40:09,160 Speaker 1: Wen and Jildithacarley, editing by Caitlin Kenney, Jeff Grocott, and 675 00:40:09,239 --> 00:40:13,440 Speaker 1: Joshua Brustein. Blake Maples is our sound engineer and composer. 676 00:40:14,320 --> 00:40:17,360 Speaker 1: Voice acting in this episode was provided by Dana Johnston, 677 00:40:17,800 --> 00:40:22,120 Speaker 1: fact checking by Aica Robbins. Bloomberg Senior Executive Editor for 678 00:40:22,200 --> 00:40:26,600 Speaker 1: Technology is Tom Giles. Our head of podcasting is Sage Bauman. 679 00:40:27,560 --> 00:40:30,839 Speaker 1: You can reach us at podcasts at Bloomberg dot net. 680 00:40:31,400 --> 00:40:35,399 Speaker 1: IVF Disrupted is a production of Bloomberg and iHeart Podcasts.