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By Ruchel Louis Coetzee
Posted On Aug 01, 2017

Ruchel Louis Coetzee

For 40-something entrepreneur, Penelope Gallant, the recent demise of her fiancé was a bitter pill to swallow. It was not so much about the failed relationship that was devastating, as it was the time invested to emotionally disengage from the coupling and find another mate that could qualify as husband material. “It can take years to meet someone you ‘click’ with, let alone someone with whom you would consider procreation, but I did not have years to hunt for a husband, as I wanted children and I knew that my age would limit a lengthy match-making process, so before I had even ended my engagement, I called the fertility clinic to discuss my options,” she explained.

Knowing that she always wanted to have children, why did she leave it so late in life to make that decision? “Already stressed by the fact that I did not have a proper mate, for me, the process was very daunting and confidence-shattering,” said Gallant. Fertility care has traditionally been very isolating and expensive for any woman wanting to freeze their eggs or consider In Vitro Fertilization (IVF). Starting around $14k for egg freezing and $20K for a single cycle of IVF (and most women require more than one), fertility expenses have also rarely been covered by insurance.

Claire Tomkins, CEO, Future Family

What Tomkins set out to do with Future Family was offer a very different approach to the traditional fertility rout of lengthy visits to doctors and expensive specialists. With one in eight couples in the U.S. experiencing fertility challenges today and with more and more women delaying childbirth until their 30s, the industry was long overdue for an overhaul. Future Family is the first company to offer an affordable, consumer-friendly Fertility Age Test™ and a comprehensive suite of fertility services, all encompassed in one easy-to-use online platform. “We are really the only company out there that has built a network of fertility experts that provide free consults for women and couples whenever they want them,” said Tomkins. “When you do finally pursue treatment or a fertility service on our platform, whether it’s a preventative measure, which we think more and more women actually need to do, or seeking care for a fertility challenge that you face, we provide a supportive care program which we call our concierge care program. Also, all our customers are matched with a registered nurse that is also a fertility expert and has the ability to obtain the kind of help, support, and assistance as they go through their journey.”

Not having anyone to confide in about the process was one of Gallant’s greatest fears. “Your male doctor will remind you regularly of your ‘advanced maternal’ age so not to get your hopes up – as if to remind you that you’re already a reject because you’re single, not married, and waited too long to have children,” said Gallant. And even though egg freezing for single women is still an early trend, Tomkins predicts that this number will rise. “When we did this national survey, we learned that as many as 30% of women are actually considering freezing their eggs, which of course is a huge number considering that today, there are 85 million women between the ages of 25 and 44,” she added. When asked what the average age was, Tomkins said that it stood at thirty-three. She is encouraging women who are going through graduate school programs or just planning ahead to at least get a fertility test and learn about their options.

Future Family’s unique Fertility Age Test™, designed for women ages 25 – 40, measures three hormones (FSH, Estradiol 2, and AMH) and allows women to gain insight into their current and future fertility. Prior to Future Family, taking such a test required a visit to the doctor and then referral to a specialist, a separate trip to the lab, and out-of-pocket expenses up to $600. Now, anyone can easily order their Fertility Age Test™ online to receive health results in a matter of days, along with a personal Fertility Concierge to answer questions and provide counsel on next steps. The Fertility Age Test™ is available for $149, which is a significant savings, and with the test results arriving at your doorstep, the privacy benefits are priceless.

When it comes to the actual process of freezing your eggs, the procedure takes about two weeks. Typically a woman will go on stimulating medicine both oral and injectable that will essentially “stimulate” the number of follicles she has in each cycle. Each follicle produces an egg but in normal ovulation, only one egg will mature before it is ovulated. With medication, all the stimulated follicles will produce mature eggs and depending on her age, a woman can get six, seven, or seven to sometimes thirty eggs in one session. The patient does not have to be at the clinic for the full two weeks as the oral medication is taken each evening at their home and is combined with several visits to the clinic for ultrasound checks on the progress of the stimulation. “At roughly the end of the two-week period, you go in for what’s called, retrieval,” says Tomkins. “You will take a mild sedative and the doctor will use a very thin needle to go in through the vaginal wall to extract the eggs. The eggs are then frozen using a technique called Vitrification and you are usually cleared to go back to work the next day.”

The side effects, according to Tomkins, can range from nothing to some bloating and/or some vaginal bleeding after the procedure. Gallant, who considers herself a very health-conscious and athletic woman, felt that the process was very unnatural. “I put on 15+ pounds during the course of my treatment,” she said. “I was unable to do any sport, could barely walk and it was painful to wear clothes due to the expansion of my ovaries with the overdevelopment of my follicles.” Gallant also questioned the long term impact of the drugs on her body. “That’s a fair question,” said Tomkins. “We don’t have good data from this but so far, generally speaking, people feel that they are quite safe. There certainly haven’t been any short-term effects that have been reported and I think part of it is you’re getting a single cycle. That’s very different exposure than if you have to do this multiple times. We love to reach women when they could perhaps just go through this once.”

So what is the most frequently asked fertility question? “A lot of women ask us, ‘when should I freeze my eggs?’” said Tomkins. “Obviously, it’s a personal decision and we’re kind of here to provide information and support. Also, as you age, the eggs, just like all other cells in your body undergo chromosomal damage so the younger you freeze them, the less chromosomal damage you’re likely to have experienced, the larger the number of eggs you’re likely to collect, and the less likely you are to have to go through the procedure more than once.” For Gallant, she counted herself one of the lucky ones. After a series of hormonal injections, she developed a large number of follicles which resulted in a high number of quality eggs. “My doctor was shocked at the collection from someone of my advanced age and if you have a decent collection, it is possible to biopsy the eggs to determine quality, although that does not guarantee anything,” she said.

When it comes to doing biopsies on the eggs, Tomkins feels it is an area scientists will improve on over the next several years. The reason to do genetic testing on an embryo is if the woman is older or if they have any known genetic diseases. “Typically, they will take a cell out of the embryo and take a look at it, and for the cases we are discussing, it definitely can make some sense,” she adds. Lifestyle also plays an important role in the cellular health of eggs. Women who smoke have a faster decline in their ovarian reserve and new research is also showing that alcohol may play a detrimental part. “Fertility is not just age driven, it’s really sort of genetics and biology as well as lifestyle,” said Tomkins. “We have clients on our platform who are in their mid to late twenties and they have indicators for sort of pre-menopause or in some cases, Diminished Ovarian Reserve (D.O.R.) and those are women who we’re helping think about preventative action like egg freezing.”

Today, very few women and couples have fertility coverage under their insurance. Fertility age tests and egg freezing are considered elective procedures and are generally not covered under most plans, so infertility benefits are still so rare. Tomkins recognized this financial challenge and looked to her experience running Solar City, a consumer finance business in clean energy, to model a new plan for women who simply could not afford those exorbitant upfront costs. “These are women and couples who are very responsible, have great credit scores, but coming up with $25,000 to get fertility treatment is still very intimidating,” she said. Thanks to the foresight of Tomkins, Future Family is now the first and only company to offer all-inclusive, zero down financial packages for egg freezing and IVF. A woman freezing her eggs with Future Family can pay as little as $75/month, which includes all clinic costs, medications, and storage in year one and a couple undergoing IVF can pay as little as $125/month, all inclusive.

One of the most important criteria in Gallant’s initial research was to find a reputable doctor affiliated with a teaching hospital. With so many unknowns, she felt that at minimum the doctor had to be on top of his game. And although Gallant could afford the upfront costs of a private clinic, what she regrets not experiencing in her journey was a clinic that works with single women, a female doctor to help encourage her, and a friend who she could trust to help her through the process. Future Family has set out to achieve all that in spades. Each woman is paired with her own Nurse Concierge who is reachable 24/7 on email and available via video appointment and text to guide and answer questions along the way. All concierges are registered nurses with fertility expertise who provide compassionate support including matching you with a clinic near your home or office. And as for Gallant’s number one priority, the Ivy League pedigree, Future Family works very closely with Stanford University School of Medicine in California. “Our medical advisor on the team at Future Family, is a Professor and Doctor at Stanford Medicine,” adds Tomkins.

So with all the boxes marked as checked, Future Family is at the very least, worth exploring. Knowledge is power and the earlier a woman can assess her fertility health, the more informed she is likely to be on when and how she would like to start a family. “I think the biggest challenge we really face is the education and awareness piece of the puzzle,” said Tomkins. “We really want to bring this topic into the light and have it become something women and men take responsibility of until they have tools to manage their planning for their future family.” Tomkins would also like to help every woman and couple who struggles, but recognizes that, at this time, her company can only help those who meet certain financial requirements such as credit scores etc. She is, however, determined to grow and reach everyone.

So what would both Tomkins and Gallant tell their younger self today?

Tomkins – “This is just one more area of healthcare where ultimately, you have to take responsibility for your own body and your own wellness. Future Family is giving you those tools.”

Gallant – “Throw away the birth control pills and get pregnant. If you’re responsible enough to have intercourse, have a baby when it’s natural.”

The decision lies with you.

(Today Tomkins’ daughter is 2.5 years old, pictured above.)