Becoming a Parent Through Embryo Donation with EM•POWER with Moxi
Today we’re talking about becoming a parent through embryo donation. I’m interviewing Gina Davis, Jen Vesbit, and Maya Grobel from EM*POWER with Moxi. They’ve been on before, talking about everything you need to know about donating embryos, but I want to still give you a little bit of background on why they’re here.
In early 2019, the three of them came together as mamas on a mission to transform the landscape of embryo donation in a way that’s never been seen before. They each had their own fertility journey that had a connection to embryo donation and wanted to make it better understood, more inclusive, and more accessible. They also wanted to bridge the gap between reproductive medicine and child wellbeing.
I’m so excited to have them back on to talk now about being a parent through this process.
Dr. Aimee: Let’s talk about the recipient of a donated embryo. That would be you, Maya, as you’re a mother through embryo donation. What does that journey look like?
Maya Grobel: Yes. Thanks. It’s a really different journey for different people, I think. Everybody has a really unique experience with pursuing embryo donation.
My personal journey started the way a lot of people’s IVF or fertility journeys start, with trying to figure out what was going on when the old-fashioned way wasn’t working, and timed intercourse, whatever that means, and all of the stuff. Then I was diagnosed with diminished ovarian reserve at 32, so we jumped straight to IVF, and then I had no embryos. It’s sort of interesting that I never created embryos. I never had to think about what I might do with remaining embryos because I didn’t make any.
When you go through something like that where you’re having to think outside the box of how to have a family, it puts you in a very specific state, for most people. Again, everybody is different. For me, I was very determined to solve this problem, to resolve this crisis. It makes you both just on a mission and very vulnerable.
I think a lot of people come to the end of the journey of using their own eggs or sperm, using their own genetic material, with a sense of, “How did I get here? Where am I? How am I going to get out of this?” Get out of this means how am I going to have a family. A lot of people are really over being a fertility patient. It’s this in between identity. You just want to be pregnant for a little bit of time and then be a parent.
For people who are going on that type of journey, I think you come to embryo donation from a place of a lot of confusion, frustration, and loss, and grief, and genetic grief, and financial losses. You’ve lost time, so you’re grieving the time it has taken to get there. You’re grieving not being able to do this in a bedroom. You’re grieving having to embrace other people’s genetic material. There’s a lot of grief and sadness, and yet you’re still trying to create a family and have a child, which is supposed to be one of the happiest, most beautiful experiences.
It’s being able to hold space for some of that potential grief and sadness, and yet also embracing that there are different ways that families come together, and that what’s most important is love and openness and connection in a family, rather than just genetics. I’m not saying genetics aren’t important, but if you can shift that perspective a little bit and zoom out a little bit and kind of stay focused on what do we want, we want to parent together, then you really decide what’s most important, and the idea of becoming a parent through embryo donation can be a very beautiful, amazing, and exciting thing. You just might have to hold space for both of these things.
Now, other people who come to embryo donation, for example, a single mom by choice of advanced maternal age, they might have a different journey, a different process. But for the most part, I think most people come to being a recipient or a parent through embryo donation after certain things in their lives didn’t go as expected.
Jen Vesbit: I want to add my recipient story because it’s slightly different from Maya’s, but also the same in the journey to becoming a parent through embryo donation.
My recipient knew that she would be a single mom by choice. She was very smart and froze her eggs in her 30s. She had a lot of frozen eggs after that process, I think around 18 to 20. The reason that she knew about embryo donation is because she assumed one day she would be an embryo donor, because she assumed that after her process she would have remaining embryos. What ended up happening, however, is after going through the process of getting a sperm donor and transferring the remaining embryos, she ended up pregnant and then had a miscarriage with no remaining embryos.
She was somebody who had thought, “I planned ahead of time, I’m going to become an embryo donor myself,” and then found herself looking to become a parent through embryo donation after a lot of research, early education, and support.
Dr. Aimee: Maya, can you talk a little bit about what you did? You talked about the emotional shift that people make. How did you make that emotional shift to consider embryo donation for your journey?
Maya Grobel: It’s a good question. Again, I think it’s a really individual experience. I had been working as a therapist, not in the field of reproductive medicine, but just as a therapist, so all of my friends are therapists, so I did have a lot of support. I think one of the biggest shifts happened after…
Because I had diminished ovarian reserve, we ended up getting five eggs when we did IVF and no embryos. It was expensive. We were in our early 30s, we didn’t have the money to do this five times. We had no coverage. I just knew that doing multiple rounds wasn’t going to be in our cards. So, I had to really let go of my genetic contribution early. When my sister offered to donate eggs, I thought this is great, she’s a doctor, she’s smarter than I am, aside from her quirks, whatever, this and that. I felt really lucky to have that choice. When that didn’t work, I was really not in a good place.
It’s not that this emotional shift happens in this really seamless beautiful way where you’re like, “That didn’t work, I’ll just do this.” It is deeply dark for a lot of people. Myself included. Even though I am a therapist, and I was a therapist at the time, that doesn’t mean I wasn’t really upset, and sad, and confused, and frustrated about how expensive these things cost. I just didn’t know what to do.
We ended up transferring three embryos from my sister’s egg donation cycle. Then we had one, we called him The Lone Ranger, this one last embryo, it was a day six, but it was a blastocyst. When those things didn’t work, I just went, “What am I going to do here?” We sat with that. I’m very Type A, I’m going to problem-solve this.
We started down the adoption path and we were very comfortable and open to that, but it’s not easy and it’s not inexpensive. It’s fairly expensive and you have to have a little bit of juice left to start down the adoption process, marketing yourself and creating these things. I didn’t have that juice. I was really broken and I really wanted the experience of pregnancy. I was okay to let go of my genetics, I already had when I was embracing my sister, but I just felt like I really want to do that, I want to have that. After being pregnant and having the experience that I had, I don’t know that I would say that again. It was quite challenging for me.
I started looking for eggs that were less expensive, so frozen egg banks. My path just was windy. I didn’t quite know about embryo donation. I ended up at a clinic in a different state that had donated embryos. It was an “anonymous” program at the time. Again, I didn’t know, I wasn’t educated. I was like, “There are babies that I can have.”
That’s where I was at, and that’s why I’m so zealous, for lack of a better word, about know your options, know what they mean, because I didn’t know what it meant up front. I just knew that this was probably the best chance that we had for me to try and carry. I didn’t know if I could. I thought maybe there was something wrong with my uterus, maybe my uterus was in my butt or something. I was like, “I don’t know what’s going on here, but I have to get out of this lifestyle, I just want to be a parent.”
My husband wasn’t fully ready in the same way that I was. He didn’t have any sperm issue, but we were going to let go of his genetics as well, obviously, when you’re embracing an embryo. I wanted to give him the time and space to make that shift. And we did. It took probably six months from when I located the embryos that would eventually be our daughter and for him going, “Maybe if we took a loan out, we could get an egg donor.” I was like, “What is it about your genetics that you’re so connected?” He’s real cute, I love him to death. He came to this moment where he just said to me, “I think this is about ego. What do I care? We want a family. I want to be a dad.”
So, it just takes a little time to wrap your head around this because it’s not what you expect. Then once you make that shift to “we’re going to love and parent whatever child comes to us,” we’re going to cross our fingers that she’s intelligent, hopefully cute, and whatever.
Actually, I landed on a set of embryos, there were two embryos that were remaining that had the same ethnic background as I did, and it just felt like a good connection. It was from where my husband grew up, at a clinic in Seattle, he grew up in Washington. You just sometimes feel something. I was just so desperate and then I landed on these embryos and I went, “Okay. Mama intuition, thems my babies.” I just had this feeling. My husband is just slower than I am, so I was like, “Listen, just do what I say.” But in all fairness, we can’t push people until they’re ready. I pushed as hard as I could.
Now it’s very validated that I make really good decisions and he should just do everything that I say. So, it really worked out in multiple ways. We have the most incredible 7-year-old who is just the most beautiful human on Earth, and I’m always right.
Dr. Aimee: You mentioned it was anonymous. Is it still anonymous in your situation?
Maya Grobel: It is, ish. Again, this is why EM*POWER with Moxi exists. We don’t have a consensual way to connect to the embryo donors themselves. The embryo that resulted in my daughter was created with an egg donor initially, so it was an egg donor and then the husband of this couple who was experiencing fertility challenges.
I made an assumption that was incorrect, which was this is anonymous, but once there’s a baby, I’ll just send a letter to the clinic and the clinic will give it to the donors and let them know that we exist. Because how can you have full genetic siblings that exist and not let them know about it? That was just a total assumption, I was like they can’t do that, that seems crazy. Right? Because I wasn’t educated.
When I went back to the clinic and I was like, “We have this great baby. I’d love to send pictures to the donor.” I feel like an idiot now. They said, “We’re not able to do that.” I said, “What do you mean?” They said the donors aren’t allowed to know if a pregnancy happened and a child is born. I was like, “ But she has a brother.”
What’s really interesting is that I happen to be now living in the same area, on an island that has one high school on the entire island. Anybody who would utilize fertility treatments would generally go to this one clinic in the city. What if there are a lot of people related to my daughter?
It dawned on me that there has to be a better way to do this. I thought, “What if they want to know?” Maybe in the beginning that was all that was offered to them, “Do you want to donate your embryos?” Generally, what happens is people will “relinquish custody,” give legal custody of their embryos to the clinic to then distribute how they see fit. However, somebody like Gina who had something like 16 remaining embryos, if she gave that to a clinic, and the clinic gives one embryo to each person, if she is in a small geographic area… What? This is actually problematic.
To answer your question about anonymity, yes, initially it was anonymous. However, I did do 23&Me or one of those, or I think both, with my daughter. Again, that can be, I don’t want to say controversial, but some people feel like you shouldn’t do that too early. I struggled with it. I decided if somebody is able to connect early and have a relationship and that is best for the children, I’d like to see if that option or opportunity is there. If not, I’m not pushing anybody.
But I did connect over time in kind of an interesting way, but it’s too long of a story. I did connect to the egg donor, and I found out that she donated six times to a shared egg bank, she has three of her own children, and she’s lovely. There’s no reason for her to have to be anonymous. I usually write her once a year.
She has shared a lot more information about their medical, the children’s medical. Also, the medical history changes. You are getting a donor in a moment in time. She was really open about a lot of things that weren’t on that one-page profile that says her age, her height, her this and her that. Her kids have developed over time, she’s learned things about her genetics in different ways, and was open to sharing.
That felt like such a relief to me. I felt like such an, I don’t want to say irresponsible, but it did feel that way. I’d go to the pediatrician, and I knew how tall everybody was, but I didn’t know if there was a family history of this, that, and the other. You’re sitting in the doctor’s office, you’re a new parent, you already feel crappy if your milk isn’t coming and whatever else, there’s all these things, and you’re like, “I don’t know any information about her genetic history.” It doesn’t feel good.
This idea when I met Jen and Gina, I was like, “Wait a minute.” Gina as a genetic counselor does these pedigrees, she does genetic counseling sessions, she does a whole workup. She showed me this one day, and I literally felt like I was going to start crying because I was like, “You give that to people?” She gives these to the donor and recipient matches, she gives this information, analyzing or assessing the whole history that they can, what’s available of the donor family, so that the recipient family and donor-conceived child can have this information about who has cancer and who has this, because then you can make informed decisions for your child’s medical history and future. I didn’t know that was a possibility.
I wouldn’t make any different choices with the child that I have, but I wish that clinics provided more and that this was better understood for the child’s life and identity and health. That’s the mamas on the mission.
Dr. Aimee: I love that. When I do embryo donation, I don’t allow patients to relinquish their embryos to me. They actually want to because they want less work, but I actually tell them it’s so important that you control your embryos, every single one of them, from the very beginning, and every donation you are part of. Part of the psychological part, part of the legal part, and make a separate contract for each one. That’s really important to me.
You brought up genetic counseling. Gina, can you talk to how does genetic counseling factor into donated embryos and people considering them?
Gina Davis: Yes. If the donors are in the picture and have not just signed a form and disappeared, oftentimes it’s a really great opportunity just to sit with a genetic counselor, review the family history, see if there is anything that would be helpful to the people that are already in the family right now, to help them in terms of their medical care, more tailored medical care. Beyond that, identifying where their risk factors are so that we can share that information with the recipient family so that their child can make the best medical decisions that they can in the future.
It would be ideal, obviously, to have this be a dynamic thing that people can share throughout the years. But if that’s not something that starts with a consensual way to connect down the line, there’s still a lot of value in gathering a really good family history on the front end with a genetic counselor that can explain the details. Then you can make informed decisions about some of the things that might factor into medical decision making down the line.
Also, you can make a decision if there is a genetic piece in there that makes you uncomfortable, thinking through “does this impact my decision to choose this embryo or this set of embryos?” I think that’s an important piece that can give people a lot of agency and autonomy when they’re already at a place where they’re like, “I’m shifting gears here,” but they still have choices. Having the ability to look through the family history and say these are things I’m prepared for and I think we have some experience with, or this is something new and I need to learn a little bit more about what that might entail if a child has a condition.
The fact is that we all have genetic risk. None of us are perfect. We all have family history of something. Just understanding what that looks like and how you can make use of that information can be very powerful and empowering for the families.
Dr. Aimee: You guys do an amazing job supporting people in so many ways. Can you tell us some more ways that you support people?
Maya Grobel: With EM*POWER with Moxi, we’ve created two platforms with the same goal, and that is to provide education, support, and community.
One of our platforms is solely education. Right now, we have a basic free version of everything you need to know about embryo donation, we have a 20-page guidebook, we have our EMPOWER Method, which is sort of the steps to a successful embryo donation process and arrangement, we have videos, we have some different blogs that we’ve interviewed people that have been donors and recipients.
We have an interview with Susan Golombok, who is a researcher on different family forms and things like that. There’s some writing that we’ve done ourselves as well. So, we have a pretty complete basic education course, and it’s both visual and written in different ways so that you can engage self-paced, engage as you want to, as you see fit, and in the way that you learn best at your own pace. We have that there.
Then we have education + community, which includes our community platform. The community platform is just getting started. It’s exciting because we’re starting to see people show up. Again, we’re a very small operation. It’s the three of us and we’re now adding a few more people into the fold to help us provide this support. The community platform, there are just these different spaces where people can ask questions and share and connect in a way that feels normal, authentic, and safe.
I think a big part of this is a lot of people get information through places like Facebook or other sources, and sometimes it just doesn’t always feel that good, for lack of a better way to identify the issues or the challenges. Embryo donation is specific, so we can answer questions in an educated way, not just somebody’s opinion on this, that, or the other.
We’re also unbiased. We don’t believe everybody needs to donate their embryos or that this is the best way to become a parent. We believe that if you educate yourself and understand what this means for you, your embryos, your family, then you can make a good decision for yourself. We’re here to support whatever that decision is. Some people decide not to donate their embryos, and we can create the support that is needed.
The community really is about the extended community as well, whether that’s grandparents, siblings, the children of donors, donor-conceived families. There are all of these different stakeholders in embryo donation. We have a professional community where professionals can learn best practices as well. I think a lot of people are trained in third-party reproduction and they do egg donor consultations and evaluations and sperm and things like that, but embryo donation is specific, it has specific dynamics, specific relationship dynamics. We really have been working towards creating these supports not just for patients, but for the ancillary professionals and clinics, too. We want to educate clinics. That’s a big piece of our different platforms.
Really unique and specific is Moxi Matching, which is the matching platform. Again, people meet on Facebook in this way where I think the clinics don’t like when people meet on Facebook because then they show up at the clinic like, “What do we do now?” The whole thing with Moxi Matching is that you can meet and make decisions for yourself, but we will educate you and guide you and help you navigate some of this, and normalize that the first person you connect with might not be your match. People have all of these feelings, “What if I need to say no? What if they want this?” We create that space.
Jen is doing individual consultations if you want to talk through, “I like this person, but I also…,” whatever. Group support. Then we’re doing events and we’re doing different education events and journal clubs for professionals, and just all kinds of things.
As I say that, I’m literally feeling gray hairs spawn from my head because there’s just so much. What do they say? We’re trying to boil the ocean.
Gina Davis: I wanted to add two things. One is we also offer genetic counseling funded through our grant support. We have a study right now, so if somebody is interested in embryo donation and wants to take advantage of more genetic information, we have a way to do that through our program right now that’s funded through the grant.
We also are doing research with other professionals. So, there’s a lot more that we’re doing. We have a research project that we’re working on in the language of embryo donation so that we can understand with a rhetoric professor. We’re thinking about long term implications of how to support these families and do it in a way that is evidence-based, that’s really taking in the collective brain power of all the people that are trying to understand this space.
Jen Vesbit: I just wanted to add that even though this segment is really dedicated to becoming a parent through embryo donation, so much of what Maya shared earlier about going into and really not knowing and understanding is relevant from the donor side. Like you said, Dr. Aimee, I think a lot of embryo donors just want to donate and not think about it. What we’re learning now is they might want more information down the road or they might want to have more knowledge.
So, our platforms are for both donors and recipients, and it’s really pre and post donation education. We have the pre education to better inform the decision making, and then we have the post donation education to better inform raising children and larger family functioning and what’s in the best interest for the children. There’s really that spectrum of, hopefully, education and support that we’re offering.
Let me just add to that. Hopefully, one of the unique things that we’re doing because we’re educating on both the donor and recipient sides is if I go into Moxi Matching as a donor, I know that my potential recipient has also been educated and vice versa. What I’ve seen a lot is one side might come with a lot of knowledge and the other might now, so I know that an educated recipient is very desirable to a donor and vice versa. So, that’s what we’re really trying to do.
Dr. Aimee: What I’d love is a certification program. I do a lot of counseling and I talk so much to my patients, but I would love a situation where I tell my patient, “You have to get EM*POWER with Moxi, you get your certificate and you bring it back to me, then we start the process on both sides.”
Maya Grobel: We have these cute stickers and we’ve been really thinking about that. We want empowered clinics, we want empowered professionals, we want empowered patients. I think it would be great to do that. Any of your patients that want our cute sticker, they can have one.
Dr. Aimee: I think it should just be part of the process. You do your psych education, you do your legal contract, but even before you start the one-on-one psych, you just go through EM*POWER and you get your cute sticker.
Awesome. I think we covered a lot. Is there anything else you guys would like to add about embryo donation?
Maya Grobel: Just hearing you talk about how you go about the process of embryo donation at your clinic makes me want to figure out how to clone you and distribute you around the country, because it really starts with the doctors a lot. I think that’s part of our mission, it’s a harder part of our mission, to convince the clinics and doctors that embryo donation is important. Somebody has called it the ugly stepchild of reproduction the other day, and I thought that sounds about right. It’s not. It’s a beautiful potential.
If doctors are going to help people make embryos, you all need to help people figure out what to do with the ones that are remaining, and that’s part of it. But I know it doesn’t make clinics a lot of money and it’s complicated. I think we’re trying to take some of the complications out of it as best as possible. This is an issue that has to be figured out, so we hope that we can provide that support for both patients and professionals to really allow embryo donation to be more understood and more accessible for everybody.
Dr. Aimee: I already have three podcast interviews that you guys are going to be doing when you start your podcast. I’m sure you’ve already thought about this, but families through embryo donation just sharing their stories. I was thinking I could just refer all of my families that have gone through this process on both ends, and they could do a session where they’re talking about their journey, their relationships, as part of a session for all of the Moxi members to learn from.
The embryo donations that I’ve done over the years have been so special for me. I’m friends with everyone on Facebook, a lot of them, and I get to see them on each other’s page celebrating all of the children’s birthdays. It’s just an amazing thing to see how people are connected in this way.
Gina Davis: It can be so beautiful. I think that is the thing, we would love to see more fertility clinics embrace it and say, “It’s complicated, but it also can be really beautiful.” Maybe at the end of a journey, they get to see how their patients have had success through IVF can have some resolution that makes them very happy. On the other side, people that have not had success maybe with their first foray into fertility treatment have their family another way and they find a way to experience it and make that beautiful.
Dr. Aimee: Thank you guys for all of the information that you’ve shared today. I really hope that anyone who is interested in becoming a parent through embryo donation or donating embryos reaches out to you right now.
Learn more about EM*POWER with Moxi here. You can catch more of me and fertility topics like this through The Egg Whisperer Show. The episodes are live-streamed on YouTube, Facebook, and Instagram. Subscribe to the podcast too! Sign up for my next class at the Egg Whisperer School.
Originally published at https://www.draimee.org.
