I took an international trip with my frozen eggs to learn about the fertility industry

Like me, my eggs were flying system class. We—my canine Stewie and I—were successful spot 8D, portion 12 of my cryopreserved oocytes, 4 straws of 3 eggs each, had a model spot further back. They were ensconced successful a cryogenic retention flask, known arsenic a dewar, which was packed into a rolling metallic suitcase the size of a tiny carry-on. This was wedged upright connected the level of the spot adjacent to Paolo, the courier overseeing their transition from a fertility session successful Bologna, Italy, to the session successful Madrid, Spain, wherever I would beryllium undergoing successful vitro fertilization (IVF) successful respective weeks’ time. 

That morning, I’d watched a squad of embryologists and their colleagues astatine the Bologna session walk assorted papers backmost and distant to Paolo, who would flash these documents astatine the airdrome to guarantee that the oocytes didn’t get x-rayed connected their mode done security. The dewar was lined with a sponge that absorbs liquid nitrogen and dilatory releases it, typically for a week to 10 days (depending connected however ample the suitcase is), keeping immoderate is wrong astatine –196 ºC oregon cooler. 

Made imaginable by advances successful cryogenics and cold-chain technology, the shipping of gametes and embryos astir the satellite is simply a increasing portion of a booming planetary fertility sector. As radical person children aboriginal successful life, the request for fertility attraction increases each year. The quality to determination eggs, sperm, and embryos crossed borders allows tens of thousands of patients to entree this aesculapian attraction if it’s unavailable successful their ain state due to the fact that of ineligible restrictions oregon prohibitive pricing. Couriers alteration would-be parents to assemble each the indispensable components for a babe successful the aforesaid place, whether those components travel from their ain bodies oregon are provided by a donor.    

There are galore reasons wherefore radical mightiness request to vessel eggs, sperm, and embryos from 1 spot to another: cost, regulatory arbitrage, entree to a circumstantial enactment of donor gametes, oregon conscionable beingness changes, specified arsenic a cross-country oregon overseas move.

Consider that a rhythm of ovum freezing costs betwixt $10,000 and $15,000 successful the US, and one-third to one-half that successful Bologna oregon Madrid. Commercial gestational surrogacy, successful which a pistillate carries a genetically unrelated kid to word connected behalf of paying clients known arsenic “intended parents,” is ineligible successful immoderate US states but not others; it tin outgo $100,000 to $200,000, compared with $50,000 to $60,000 successful Ukraine (until precocious a planetary surrogacy hub) oregon adjacent Georgia. Donor eggs are abundant successful places wherever compensation is permitted and scarce wherever it is not. 

An estimated 2.5 cardinal assisted reproduction cycles are performed globally each year. Mark Sawicki, the CEO of Cryoport, a institution headquartered successful Tennessee that provides acold concatenation logistics for biopharmaceutical, IVF, and carnal wellness organizations astir the world, believes that astir 100,000 of these cycles impact transport of frozen reproductive material.

In my case, I had frozen eggs successful Bologna successful 2016, and again successful Madrid 2 years later, due to the fact that it would person taken maine respective much years to prevention up for a rhythm successful New York. After paying for retention costs for six and 4 years, respectively, astatine 40 I was acceptable to effort to get pregnant. Transporting the Bolognese batch served to virtually enactment each my eggs successful 1 basket.

Special delivery

Once upon a time, quality reproduction was a proximate endeavor. Those progressive had to inhabit the aforesaid place, astatine the aforesaid time, for a sperm compartment to fertilize an ovum cell. It was the palmy cryopreservation of quality sperm cells around the mid-20th century that eventually enabled the banking of sperm and its shipment from 1 spot to another. Advances successful dewar exertion (named aft James Dewar, who invented a double-walled, vacuum-insulated solid flask successful 1892) and cryogenics successful the 1950s made it imaginable to transport materials astatine debased temperatures.

Another cardinal innovation, ovum freezing, was successful portion a effect to the regulatory and taste situation successful Italy, wherever Catholic attitudes—the Catholic Church views embryos arsenic afloat persons—informed the country’s aboriginal IVF laws. In Italy, IVF practitioners for galore years were restricted successful however galore excess embryos created during an IVF rhythm they could frost (a akin instrumentality remains connected the books successful Germany, limiting patients to conscionable 3 embryos—or 3 chances astatine a pregnancy—per IVF cycle, driving galore to question attraction elsewhere.) Unfertilized eggs would not airs the aforesaid problem. Meanwhile, scientists astir the satellite were besides searching for a mode to frost eggs for different reasons, specified arsenic to sphere fertility up of crab treatment

NICK LITTLE

Eggs, however, proved harder to frost and thaw successfully, owing to their structure: a large, azygous compartment made up mostly of water, which tin make crystal crystals that harm the egg. Advances successful freezing techniques—first a method called dilatory freezing and aboriginal a process called vitrification, which rapidly cools the eggs earlier crystal crystals tin form—led to a trickle of unrecorded births by the precocious 1980s. Although the occurrence complaint with frozen eggs varies by session and by the property of the diligent astatine the clip of freezing, immoderate clinic-specific studies amusement occurrence rates of IVF utilizing frozen eggs comparable to those with caller eggs.

Today, couriers often determination betwixt countries oregon cities with highly developed IVF sectors, immoderate of which specialize successful a fixed attraction oregon indispensable components (such arsenic Spain, which has a comparatively unchangeable and abundant proviso of donor eggs compared with the remainder of Europe). Until Russia’s invasion, Ukraine was a predominant destination for radical looking to marque usage of the country’s comparatively affordable surrogacy services and its precocious availability of donor eggs. 

The scholars Anika König and Heather Jacobson picture these dynamic and shifting transport routes arsenic “reprowebs” that respond to regulatory and different changes, specified arsenic covid-19. This elasticity successful the planetary reproductive manufacture recalls the mode covering brands displacement their manufacturing operations astir the world, chasing favorable labour and concern climates portion sourcing the cheapest earthy materials from sprawling planetary proviso chains.

Jurisdictional and outgo arbitrage are not the lone reasons courier businesses are thriving. As the Australian sociologist Catherine Waldby points out, these services marque it easier for prospective parents to prime from circumstantial donor pools connected the ground of desired carnal oregon radical characteristics. 

“You tin spot radical importing familial qualities from different parts of the satellite that successful their minds are the benignant of familial qualities that they privation for their family,” Waldby says. For example, successful her research, women who wanted achromatic donor eggs from the US but couldn’t spend the $10,000 to $15,000 terms tag mightiness alternatively take a donor of European descent from South Africa with akin skin, hair, and oculus coloring, for astir $2,700 USD. “Very often it’s astir seeking definite phenotypic, fundamentally racial, qualities,” she says—and uncovering them astatine a little price. 

When I archetypal met Helle Sejersen Myrthue astatine a large fertility league successful Barcelona successful 2018, she was staffing Cryos International’s booth, astatine the halfway of which were Viking hats with horns. Cryos, the world’s largest sperm bank, is headquartered successful Aarhus, Denmark with sites successful the US and Cyprus. The institution dispatches sperm and eggs to implicit 100 countries. Visitors to the booth were encouraged to effort the horns connected for selfies; they were a motion to the company’s estimation for providing blond-haired, blue-eyed “Viking sperm.” 

Myrthue, present Cryos’s CEO, noted that arsenic societies successful Asia and South America person go somewhat much accepting of azygous and lesbian motherhood, request for donor sperm has grown there. To conscionable this demand, Cryos indispensable root from donors with phenotypes (observable characteristics specified arsenic carnal appearance) that are little communal successful Denmark. And customers are rather circumstantial astir what they want, she added: “A Chinese doesn’t privation a Japanese [donor] oregon a Japanese doesn’t privation a Filipino oregon idiosyncratic from South Korea.” 

Even though clients tin store from immoderate of their locations (subject to nationalist regulations—some countries bash not licence the import of donor eggs, for example, oregon person circumstantial requirements astir the anonymity of sperm donors), Myrthue acknowledged, they whitethorn person to compromise if they cannot “find the donor of their dream.”

Precious cargo

John Loewen met his Japanese woman erstwhile they were assemblage students successful Canada, and moved to Tokyo with her. Both had household histories of cancer; Loewen froze his sperm astatine a Tokyo fertility session portion inactive successful his aboriginal 20s arsenic a precaution. By the clip they were acceptable to go parents, astir 2009, his woman had been diagnosed with cancer. They decided to prosecute surrogacy successful Thailand utilizing a Thai ovum donor. Loewen tried to find a work to vessel his frozen sperm; erstwhile helium couldn’t find one, helium decided to bash it himself. 

He researched the transport of carnal sperm online, and completed a palmy signifier tally with rodent sperm, moving the illustration from a rodent probe halfway adjacent Mount Fuji to a laboratory successful Tokyo. His adjacent effort was to instrumentality his ain frozen sperm from the session successful Tokyo to its counterpart successful Bangkok. He bought respective kinds of dewars—cheap ones, costly ones—to spot whether they’d enactment acold for much than a fewer hours. He filled them with liquid nitrogen, and saw helium could support samples frozen astatine the indispensable temperature. 

His maiden voyage to Thailand was a success, and their archetypal kid was followed by twins, besides calved with the assistance of a Thai surrogate. Upon his instrumentality to Tokyo, helium enactment up a website, told a fewer clinics astir his services, “and that’s however it started,” helium says. 

On his 3rd oregon 4th trip, helium learned a invaluable acquisition astir liquid nitrogen: Don’t instrumentality it connected planes without archetypal letting it soak into a sponge that volition merchandise it dilatory implicit time. A coolant utilized for everything from cryopreservation to high-tech manufacturing to crystal cream, it tin besides cold-burn the tegument connected contact, and it shouldn’t beryllium taxable to the aerial unit changes that tin hap connected flights. He was already respective hours into an overnight formation to Bangkok erstwhile helium heard a hissing dependable and saw fume rising from the dewar that helium was keeping upright connected the level betwixt his legs. 

Fortunately, everyone astir him was sleeping, truthful helium discreetly opened the lid to fto a small spot of unit out. The illustration survived, but Loewen suffered airy burns connected his legs (and couldn’t slumber for the remainder of the flight).

Because his Tokyo-based company, CryoSend Ltd, is 1 of the fewer serving the region, the bulk of his shipments statesman successful Asia—Japan, Taiwan, Hong Kong, Cambodia, Malaysia, Singapore. The samples are typically destined for the US, Georgia, Russia, Mexico, Kyrgyzstan, and Cambodia (and, until this year, Ukraine), each countries with robust surrogacy sectors and antithetic terms points. 

The coronavirus pandemic initially dampened concern arsenic fertility clinics astir the satellite temporarily shuttered oregon importantly reduced diligent loads. But aft clinics reopened, borders remained shut, starring to accrued reliance connected courier companies similar Loewen’s. 

Loewen reconfigured his operations to conscionable the caller logistical reality. Instead of relying connected a azygous courier to hand-carry a shipment from 1 state to another, helium utilized a web of trusted section couriers successful cities astir the world, positive a premium bearer work offered by airlines: the biomaterials are booked arsenic aesculapian cargo, usually connected a nonstop flight. 

Couriers connection a assortment of options for moving biomaterials from spot to place. But Stefano Monaco of FlyVet Europa, which hand-transports eggs, sperm, and embryos, believes that manus carrying is acold and distant the champion option. “It’s an artisanal business, not an concern one,” says Monaco, who founded the concern successful 2016 aft learning from his brother, a gynecologist, that biomaterials delivered to his fertility session successful Milan often arrived successful suboptimal condition, damaged during transport. 

Depending connected what’s being carried and however overmuch they tin pay, the diligent oregon patients progressive volition take either a hand-carry service, a commercialized bearer specified arsenic DHL oregon FedEx, oregon thing successful between, specified arsenic the operation of commercialized flights and section couriers that Loewen relied connected during the pandemic. The outgo of transporting my eggs with FlyVet Europa was 1,300 euros, oregon astir $1,400 astatine the time. That includes the terms of 2 one-way tickets for Paolo and the ovum suitcase, and a fewer incidental expenses. (When I told Monaco however galore eggs were traveling, helium quipped, “Uno squadro di calcio!”—a shot team.)

CryoStork, the part of Cryoport devoted to the fertility sector, offers each 3 tiers of service—commercial carriers for thing that tin beryllium easy replaced (sperm, successful different words), a middle-tier work utilizing section couriers and aerial freight, and a door-to-door hand-carry service—for prices ranging from a fewer 100 dollars to arsenic overmuch arsenic $7,000 oregon $8,000 for an planetary hand-carry trip. 

Ultimately, the pandemic boosted concern for Loewen. Today, helium and a squad of 8 colleagues, fractional employees and fractional moving connected a per-shipment basis, grip astir 30 to 40 IVF-related shipments each month. Similarly, erstwhile the warfare successful Ukraine began, Loewen and different colleagues received frantic requests from clients hopeless to determination their biomaterials retired of the capital, Kiev, wherever astir of the country’s IVF clinics and surrogacy agencies are based, and concern shifted to adjacent Georgia. But by September, Loewen was readying to erstwhile again present biomaterials to Ukraine. “People privation to person babies—conflict oregon not,” helium says.

The close stuff

What does it instrumentality to beryllium a insubstantial courier, and however does 1 get into the field? Everyone I spoke to said that to succeed, you indispensable emotion traveling, person a calm property (in case, arsenic happened to Loewen, you’re ever surrounded by a knot of equipped Belarusian soldiers astatine the airdrome and accused of trafficking quality organs), and beryllium adept astatine problem-solving. 

Loewen looks for radical with acquisition successful the question sector, who tin navigate caller cities and won’t beryllium rattled by a formation cancellation oregon a grumpy customs official. Mark Sawicki of Cryoport has respective erstwhile pilots present moving arsenic couriers; their information clearances alteration them to determination done airports much easy than civilians. 

Nicole Dorman, 43, has ever loved children; she jokes that her existent occupation arsenic a courier is “babysitting.” She has 3 kids, aged 14 to 22, and has been a teacher’s adjutant and a schoolhouse crossing guard, pursuing 4 years successful the US Army. When she’s location for a week oregon 2 astatine a clip with her kids successful betwixt gigs, she besides makes deliveries for DoorDash successful Clarksville, Tennessee.  

Nordisk Cryobank devised the "Sperm Bullitt" to transport samples to fertility clinics. The bicycle is fitted with a elephantine sperm compartment containing a cooler compartment truthful that metallic containers with sperm donations tin beryllium kept cold.

WENN RIGHTS LTD / ALAMY STOCK PHOTO

Dorman had begun by transporting stem cells for a Frankfurt-based courier service. When she was looking for enactment successful November of 2020, she emailed a half-dozen IVF courier companies and heard backmost from Loewen wrong 15 minutes. She has been moving for him ever since, and besides does US shipments for the Ukrainian institution ARK Cryo, arsenic good arsenic EmbryoPort, a UK-based firm. 

Dorman is connected the roadworthy astir 70% of each month; erstwhile we spoke successful mid-May, she was preparing for a weeklong travel opening with a pickup successful Indianapolis, a drop-off successful Bratislava, a bid thrust from determination to Prague for different pickup, and past a formation to Greece. Like each couriers who’ve been moving for immoderate magnitude of time, she has predominant flier status. In the 18 months since she started, she has transported much than 90 shipments. “Now I tin beauteous overmuch bash it successful my sleep,” she says. 

Until the pandemic, Paolo had been an security salesman, surviving and moving successful Varese, a tiny metropolis extracurricular Milan. When concern slowed, helium took up an connection from his relative Marco to articulation FlyVet Europa, which is however helium ended up with my shipment. 

After our accomplishment successful Madrid, Paolo showed maine a graph of the dewar’s interior temperature, which had ranged betwixt –196 and –200 ºC. All went according to plan, but I bash wonderment if the transport affected the oocytes. When it came clip to thaw them, lone 7 of the 12 from the Bolognese batch—theoretically a younger, healthier bunch, retrieved erstwhile I was 34—survived, compared with 7 retired of the 7 that were retrieved successful Madrid erstwhile I was 36. 

Peter Hura, laminitis of the Kiev-based courier work ARK Cryo, says courier companies are often blamed if thing goes wrong, erstwhile successful information the responsibility whitethorn prevarication with the embryologist who prepares the shipment. In my case, the endurance complaint was truthful overmuch little than mean for the Bolognese batch—58%, compared with a more emblematic 80 to 90%—that the Spanish embryologist who thawed each of my eggs successful Madrid thought the Bologna session mightiness person utilized an outdated vitrification protocol. 

When I asked the clinic, idiosyncratic from the embryology laboratory confirmed that the protocol was the aforesaid arsenic the 1 utilized successful Spain, and suggested that the debased endurance complaint came down to quality biology. “Cryopreservation techniques are standardized, but not the oocytes’ biology,” a laboratory idiosyncratic said. “Transport inference effects connected the cryopreserved materials person ne'er been demonstrated, and if the somesthesia logs are ok, determination is thing much that we tin accidental astir the event.” 

Although Hura, Monaco, and Loewen said they’d ne'er had a mishap, determination is not overmuch anyone tin bash if thing goes incorrect successful transport, since security for this manufacture lone covers fiscal losses incurred successful the instauration of the embryos, typically based connected bills for IVF services—small consolation for patients whose ain gametes oregon embryos person been damaged oregon destroyed. Cryoport, arsenic a ample planetary company, offers an security argumentation which covers the outgo of the transport positive a payout of $40,000 toward caller IVF cycles to regenerate the mislaid biomaterials. While the institution aims for a 0% nonaccomplishment rate, sometimes things hap that are beyond the power of a courier, specified arsenic erstwhile a vessel was sitting connected the tarmac astatine Montreal airdrome and a forklift accidentally drove close done it. 

Still, of my eggs that survived the thaw process, 13 retired of 14 were successfully fertilized, and 7 embryos made it to the five-day-old blastocyst stage. One was transferred into my uterus, and the remainder were vitrified, taking a instrumentality travel backmost to the dewar. I nary longer person a imaginable “squadro di calcio,” but it’s comforting to cognize that six much chances astatine a gestation are waiting for maine successful Spain—and that, if necessary, they tin committee a flight, chaperoned by a courier, and travel connected location to New York.