#55: The Fertility Convo That's Long Overdue ft. Margaret Wang

0:00Rachel Lim: Hi everyone, welcome back to another episode of the Who We Are podcast. Today's conversation is about something many of us only think about when it feels urgent. Our relationship with our bodies, our fertility and our future. My guest is Margaret Wang, CEO of GenPrime and Rear Fertility. Margaret brings a rare blend of clarity, compassion and vision. She's leading one of Asia's most innovative reproductive health platforms. But what moves me most about her and her journey is how she never lets the science or the technology overshadow the humanity. In this episode, we'll talk about why fertility isn't just a woman's issue, but a societal one.

0:41Rachel Lim: We'll also explore why we often stay silent until there's a problem, and what it might look like to build a future where healthcare feels softer, clearer, and more human. This isn't about urgency or fear. It's about awareness, agency, and learning to listen to our bodies today, not someday. So welcome to the episode, Margaret. Oh, thank you for having me, Rachel. I'm excited to be here. Yes, we're so honored to have you on the show with us today. So before we dive right into your journey, for those of us who may not be as familiar with you, could you share with us a little bit about yourself and what brought you to where you are today?

1:18Sure, Rachel. So I mentioned some originally from the United States, born and raised there. I moved to Singapore about three and a half years ago. I come from a family of actually all health care professionals.

1:30Rachel Lim: Well, so you run into your blood. You run into my blood. My parents met in medical school. They immigrated to the United States. I was supposed to be a doctor. And so grew up really just surrounded by this. I mean, I was my mother had a dental practice and I was her chair side assistant and front desk receptionist while going to school. Well, yeah, in elementary school and middle school. And so moving here to Singapore, actually, one of the first things I'd looked to do was to freeze my eggs here in Singapore. And this was three and a half years ago and I moved here alone. And so it wasn't possible for me to do that here in Singapore then.

2:03And so, you know, that stuck in my mind. I had been with my previous firm, which is Bridgewater Associates, moved here to open and run that. First time living abroad in a meaningful way. And so now I get to build something that's quite exciting here. It's really meaningful. I'm very grateful for the opportunity.

2:19Rachel Lim: Well, I can't wait to dive right into that. But also, you know, I'm curious, what was the aha moment or turning point for you, which made you realize that, okay, you know, you needed to do something different to fertility care here? Sure. So I mentioned that moment when I came and looked for a solution for myself, actually, right? And when I started asking around, I realized it was not a topic that was openly talked about. And this was how many years ago? Three and a half years ago. Yes, this was even recently, right? Yes, very recently. And whereas actually in the States, I had frozen my eggs in New York five years ago, you know, with all of my best friends at the same clinic.

2:51We did it all together. And there it's, you know, it's almost you turn into your early 30s and you already start thinking about it. It's what you said at the outset, right? You start anticipating what you might want to check or need in the future. So when I moved here, you know, one thing that I learned was I had to actually coordinate my own care, right? Find the right doctors, triangulate that information, possibly even go to different markets to seek out the services that would be available to me. And I thought that was a really hard challenge.

3:19Rachel Lim: And it sounds very fragmented, everything. Very fragmented. A bit of misinformation out there as well. And then, of course, you know, it's already such an emotional and anxiety inducing experience, right? We're in the space of hope, right? It's like I hope to one day build a family. I hope to one day have children and I need to do this thing for myself so I have a better chance of that option of doing so. So I'm holding that in my mind while also navigating this and working full time, right? Building the new office for the company I was with. And so that led me to believe there are probably people out there similar to me, right?

3:54Either other women or men and individuals or couples who might be going through something like this. And so my business partner and I, once we started exploring some opportunities to create something meaningful here, decided this was a space we wanted to start with. But we think about healthcare in that full spectrum way. But here with fertility, it seemed like a place where, especially in the region as a whole, it would be one in which we can really make a difference.

4:18Rachel Lim: And, you know, often I think, and I can only imagine also having gone through a little bit of the process, it can be a very lonely journey. You know, I recently just found out that, you know, one of my colleagues is actually going through fertility treatments. And I think a lot of times the pressure and the load falls on the woman, right? And I'm thinking also as a society, how can we also make this a shared responsibility in a sense where it's also, let's talk about fertility being a topic that's important for both men and women's well-being, not just the women, which is traditionally how it's spoken about.

4:53Rachel Lim: So what do you hope to also rewrite and change in terms of the narrative around this topic? Well, I would wholly agree with you that fertility should not just be born. It's not an issue that should just be born by only women, right? I mean, men and male fertility are the other half of that equation, right? You need both, frankly, to be able to bring a baby into this world. And so often we think about the stress and the anxiety and all the issues as it relates to fertility as being on the women's shoulders. But actually, we think about it, again, in a much more holistic way, where the male part of that is just as important for men to understand their health, to understand their influence on the process, and also to be supportive in a way that is much more equitable and part of that conversation.

5:33I think one part of the work that we do actually is alleviating some of that stigma, right, by just creating more awareness and talking about it in a way that feels less like there's a barrier of, you know, can I say this thing, right? Is it okay if I share this about me? Once I started working in this space, it's incredible how people have opened up to me about their own personal journeys on this front, right? So for your colleague to share that with you, that they're going through that, it's a very personal thing.

6:00Rachel Lim: Yeah. And it's also, sometimes there's some form of shame attached to that and that conversation of bringing it up. And I think there's so much more that we can do as a society, you know, shining a light on these conversations. In 2023, Singapore legalized elective egg freezing. However, I think there are still a lot of limitations around that and not as much awareness as there should be around it. What are your thoughts around, you know, Singapore and the progress that we have made? Yeah, so the regulatory framework here in Singapore has opened up a bit more and evolved a bit where now, so for example, an unmarried woman can freeze their eggs here to your point.

6:37But it is capped at the age, right?

6:39Rachel Lim: Yes, 21 to 37. That's right. I'm looming on to my 38th birthday, actually the day after tomorrow. And so this couldn't be more top of mind for me right now. Wow. So literally you only have two days left legally in Singapore. That's right. Wow. And then there's a separate process for a case by case assessment that you have to put forth to say, hey, I want to freeze my eggs here in Singapore. I'm unmarried. Right. And then the clinic helps you do that. And so, you know, again, when I think about our, you know, the patients that we serve or I think about women and men in this space, really, this is a lived experience that I've personally had.

7:13And so that empathy is rooted from there. But I think you're right in terms of, you know, the regulations have evolved and yet there's always, you know, there's always more to be done on this front, right? And even just awareness of that regulation evolving too is part of the work.

7:28Rachel Lim: And how about, for example, groups like, you know, our LGBTQ +, or even non-traditional families that are not able to subscribe to that available in Singapore. How are you perhaps designing pathways that would also include them? Sure. So each country in this region, and I mean, we also have a clinic in the United States as well. So each country has a different regulatory framework, different rules around these very topics. Right. So same sex marriage was just legalized in Thailand, for example, in the United States. Also also there as well. For us, it's really a story about inclusion and belonging for these patients.

8:04But because their constraints and possibly their own respective markets, we often have to support them across markets to be able to achieve the goals that they want to achieve in family building. And so, you know, even in the United States, I have good friends who are married to each other who have had to seek out third party donor or surrogacy or other ways in which that they can build families that are frankly, a lot of it's not available here in this region. But in the global context, I would say this is something that, you know, every country is different. But at the same time, you know, people are, you know, the very human need of or desire of wanting to build a family is probably one of the most universal things that we could possibly support on this front.

8:45And so we created pathways through this multi-market model in order to support patients in that way.

8:51Rachel Lim: And I want to ask you also, because, you know, it also clearly sounds like as compared to our counterparts in the US, we are not as advanced in that sense, right, in Asia. And I think a lot of it, would you say so at the moment? Because I think a lot of it might also be some cultural assumptions or taboos that we have in Asia. So what are some of these that you have come across and are aware of that you would also like for us to perhaps challenge more of? You know, the United States, so in some ways, I would agree with you in saying that it is a much more open conversation in the United States today.

9:26But actually, in terms of quality and level of care, Singapore and actually this region, just as great of quality and just as great of outcomes. I mean, Singapore, for us, we really see as a hub of innovation, hub of excellence. And so really, then you're talking about exactly what you're saying, which is the social or cultural aspects around it. and it is more nascent in that way in terms of being an open topic of conversation right I think there's tremendous pressure frankly on young people to find a partner build a family right and have children right and that it's I mean I grew up actually with very traditional Chinese and Asian values that way that's how my parents had the expectations of me right and so I'm now in my mid to late 30s right and I'm unmarried without children absolutely that is on the mindset, right?

10:15And how do I openly talk about that with my peers here in Singapore?

10:18Rachel Lim: Yeah. Right. How do I openly talk about that with people who may be married, right? And already have, and maybe, you know, already down a path, right? Or somebody who may want that very same desire as I do, but maybe we're just afraid of saying it to each other. I'll share one story. One of our advisors, she told me she was, you know, what led her to, she co-founded Fertility Support Singapore. What she shared with me is, yes, excellent organization. Amazing. And so we work very closely with them. And she told me the story about how she knew somebody, you know, a friend, you know, a friendly colleague of hers.

10:49And they were both sitting in the same waiting room at a clinic together. They did not speak to each other in that waiting room. Then they saw each other, you know, they bumped each other a few days later. And it did not come up as a conversation. Right. And, you know, that's the thing that sometimes happens. Right. And if you think about that, when we talk about we want to help people feel less alone. We want to help people feel a greater sense of belonging and that they too, should they have this dream and want to build this family, have the resources to do so. How do we help them just feel a little bit more held and more supported throughout that journey?

11:24But it goes to that very emotion, right? Like, can I turn to you and say, wow, me too. Or, hey, like, I'm going through this as well. Like, let me tell you what I'm experiencing. Deepening that level of conversation in this region, you know, to go back to your question of what would I hope to be different, that's absolutely the work and the impact that we hope to have.

11:43Rachel Lim: But how tangibly do you think, what are the steps that's needed for us to get to a better space in that sense? Because to your example, I mean, this is not just lunch conversation where it comes up or doesn't come out. We're literally sitting side by side in a clinic, in a fertility clinic. And yet, you know, we are still unable to get past that barrier, that emotional and mental barrier. Yeah. Well, I guess a little bit meta, But I think, honestly, conversations like this help a lot, right, because just even naming it and even telling the stories that others have experienced, that helps. I mentioned community groups like Fertility Support Singapore.

12:16In other countries, they have similar groups like this as well. And, you know, in the United States, there's a group called Resolve. It really is a collective effort on that front. But then three, I do think as regulations evolve, right, to the earlier questions that we talked about there, as regulations evolve, as also these types of services are also offered by or support for them rather offered by companies. So there's actually a big corporate benefit push as well. Right. So if you talk about, I mean, I paid just a few hundred dollars out of pocket for what would have cost me$12 ,000. The cost?

12:48My company and my insurer both covered the majority of that cost. Now that's still relatively nascent here in Southeast Asia, right? I mean, you know, certain companies will, you know, tech companies, law firms, finance firms, right, are starting to think about this as an employee benefit. That shifts the conversation because now you have also colleagues at work starting to talk to each other about this very thing or it becomes normalized in a way that wasn't before. For me, I think that also will unlock a whole different set of depth of conversation, but also level of awareness too.

13:22Rachel Lim: And you know, in this whole topic of fertility care, it's interesting because growing up, we were taught in schools by our parents how not to get pregnant, right? But there's no, literally no aware. Okay, in my opinion, there's little awareness around, you know, how about how the fertility process actually works and what it takes to get pregnant until there's a crisis or until it becomes urgent. What are your thoughts around this? And what do you wish people knew more of? No, you're right. It's like a switch flips almost. There's that tension of don't get pregnant. And all of a sudden it's like, please go have children.

13:55Yes, exactly.

13:55Rachel Lim: And you hear so many of us talking about, oh my God, you know, you've always thought that it's easy to get pregnant. Yes, exactly. However, when you are actually in the process of trying to get pregnant, it's a lot tougher than most of us had imagined. That's right. There's a real tension there. There is. And so, you know, for us, we talk about often how important it is to really learn about your own health early on. Right. And so, you know, it's actually very it's not unlike actually any other type of health focus. So when you talk about cancer right now or oncology, you talk about why early detection is so important.

14:28Right. And early testing.

14:29Rachel Lim: Yeah. To be honest, when we talk about fertility, just knowing more about how your body works and also how, you know, you could be, you know, what your state is early on helps so much. I remember a good friend of mine. I was probably in my late 20s at the time. And she was like, just go. She goes, have you gotten your follicles counted? she just asked me, she was, have you, have you counted? She was on your last OB checkup. Did they count your follicles for you? And I, I was like, no, I, I didn't even know that that was a thing I should be asking for. And again, I grew up in a house of doctors in a family of people who are focused on right.

15:04Healthcare services. And I was embarrassed by not even knowing these things that I could be asking about in order to best prepare myself, right. For my own, well, just management of my own health on forward. And so even when, you know, when I look inward that way. I'm like, how, if I'm not even aware of this, right, how can I expect, right, if somebody's even further from that sphere of it, right, how can I expect they would know? And so, so much again of our work is to encourage people to start just asking those questions of their doctors, start getting curious on their own, right, in terms of that research, in terms of just understanding from themselves.

15:37And as we were saying earlier, having those conversations with each other too, right, and just start supporting each other.

15:43Rachel Lim: For example, that friend, you know, And thank God for her to be able to raise that. But I think so few of us even know what to ask. That's right, yeah. So where should we start? And let's say for someone who is listening in today, what should we be asking ourselves? And imagine if they're in their 20s, 30s, 40s, what should we be asking ourselves? Yeah, I mean, I think there's a lot of self-inquiry on this front, right? I think you almost start at the place of what matters to you, right? If you want to build a family, right? If building a family is something that you would even consider as... In the future.

16:12Right, exactly. If you want that option, right, in 20s, 30s, 40s, right, each step, each actually phase, you have different considerations there. But there's certain things you can check today, right? Hormone levels, right, follicle counts, things like that. And just starting to ask your doctor or even starting the conversation from that way too, right? I'm thinking about this in the future. How can I best prepare myself? And that simple question just opens that door, right? And I mean, I use ChatGPT for everything now too, right? I mean, on our website, we also put in a lot of content as well.

16:41But I would just say that asking your own doctor or even just talking to a friend who may have gone through it type thing already starts opening the door of, you know, you're a little bit more vulnerable, right? It's you're opening up this, I have this desire, I have this want. How do I even start asking that first question? And that first step is almost like all you need to take.

17:00Rachel Lim: Amazing. And what do you think if someone had taken that first step earlier on, what would the difference it would have made to her journey? So I would say if I if I if I talk to myself, my 20 some year old self, right, I came out of actually a place when it did become much more urgent. So I'm I'm the example you gave earlier, right, in which I wish I told my younger self to get my hormone levels checked or think about egg freezing earlier or things like that. It actually took this might be a little personal. I was in a long relationship. We were engaged for two years. Right. We knew we wanted to have children.

17:34And so it didn't you know, it didn't occur to me to think about any other option plan. And so even when I went to the clinic, my doctor was like, okay, you want to freeze embryos? That's where we went in, right? We said, we want to freeze embryos because we know we want to have children, not now, but later. And so she said, but Margaret, you shouldn't just freeze embryos. You should also freeze some eggs too. And I said, this is definitely the father of my children in the future. I said, no question. Now what ended up happening is actually we did end up, you know, we were engaged and then we ended up splitting up.

18:02Rachel Lim: Okay. So Margaret, did you freeze your eggs then? Well, I froze my eggs after we broke up. Well, COVID happened. And so actually we paused it. Yes, exactly. But that's right. And so, but only because she asked that question, do we pause that process? And then COVID hit. And then, you know, we ended up breaking up and I thought, thank goodness this doctor actually thought to ask me this question. Otherwise I wouldn't have even thought about the different optionality there. And so when I think back to that, I'm like, oh, if I, if that doctor hadn't asked me that, if I hadn't also had friends who had gone through the process, I would have felt even more anxious and alone and vulnerable in that experience.

18:36Rachel Lim: And to your point, you might not even know, you know, the options that you have. Absolutely not. Yeah. Wow. And so when I think about, you know, young women today, just again, asking the question, just I think it does start from the place of reflection and self-inquiry of like, if I want, if I even believe I could possibly want to have children in the future, what do I need to know about my body now? What do I need to know about my body as I also go through, you know, these next 10 years, 20 years, right? You know, because Singapore's regulations only recently opened up for unmarried women to freeze their eggs.

19:06I meet women all the time in their late 30s, early 40s, mid 40s here in Singapore. We're like, oh, it's too late for me. I didn't freeze my eggs, so it's too late for me. That is, you think about that, right? And you think about that sense of it. And the industry is not friendly to older women in this space.

19:23Rachel Lim: When you talk about fertility, unfortunately, it is a time pressing issue, whether we like it or not. That's right. So what would you say then to the woman in her mid-40s who tell you that it's too late for her? So, and I have this conversation, to be honest, all the time because this is a space I work in. And so my friends are going through this journey. I still recommend they check their hormone levels, right? Because you're talking about a numerical age versus a biological age. Right. Yes. And so still get curious about your body, right? Get curious about that. And should you even want, again, the follicle count, the hormone levels, and then talk to your doctor about your options.

19:58because if you, again, at all have that thought. Now, again, the industry is not friendly to women above a certain age, right? Literally, there's the terminology geriatric mother. Yes. Yes, I was called that. They were like, well, you'll be a geriatric mother.

20:12Rachel Lim: They give you that term as long as you're above 35. And all that's like, yeah. Who feels geriatric at 30, you know, their mid 30s? I was also given that label, but yeah. Right. And so that already, but it's small things like that in the industry that already make a woman feel, wow do I feel courageous enough to take the next step yeah do I feel strong enough to try to learn more and again pursue this thing I might want and so to be honest I hope everybody listening to this who may want right to build a family to find out just more about you know your own just get curious the hormone tests are there they're not that expensive right just think about if you want the option and there are resources right there are absolutely resources and these resources are so accessible.

20:53Yes, they are. Yeah. I mean, certainly in the broader region, right? And so, and here in Singapore too, but absolutely.

20:58Rachel Lim: At least, you know, the information, the education around it. Yeah. I love your story because it also reminds us to really just take ownership and agency of our body and our health. Yeah, that's right. Yeah. You know, around this topic, what is perhaps one of the biggest misconceptions that you hear all the time that you want to just clarify and perhaps debunk? Well, I think we've touched on a couple of them. So I think maybe I'll I'll summarize a couple of them and I'll add a new one. So one, I do think the myth that fertility is only a women's issue is a myth, right? So really pulling in that male perspective as well, like having both at the table and really having that discourse there.

21:30Rachel Lim: I love this because then, you know, it's also beyond, it's a societal issue where it's not just also the male perspective and responsibility, but also I think what we talked about, which I really love, is also the workplace and community responsibility in that sense, where we can come together to support that. Yeah, a hundred percent. Okay, so that's one. That's one. I think, too, whenever we talk about fertility, it often comes from a place of because it can be an anxiety inducing, emotional and vulnerable. It does come from a place that often is a little bit more of a I don't know how better to put this, but a bit of a downer.

22:01Right. And so that's how a lot of it's approached. But I do think there's actually a much more positive, uplifting, empowering way of coming at fertility, which says take ownership, take agency and also just be curious and learn about it on your own. Right. As we've been talking about here, too. The new one, the new thing I would just say is that fertility, it really is not a service that's a point in time or a service on its own. I really think of it as part of a broader spectrum of health care. So everything from early diagnostics to a lot of what we talk about, like supplements and wellness today.

22:32I mean, you know, there are conversations, you know, in the broader sphere around, you know, we talk about cortisol and stress management, right? Things like that. All of it actually integrates together into how, you know, how your reproductive health system looks like. And so it really is not a singular in a vacuum or siloed type of service or care or issue. It really exists in that spectrum. And there's a lot of intersectionalities that I think, again, as people get curious, they'll learn that, wow, if I do this, this may, you know, diet and nutrition, right? Lifestyle, right? Stress management, sleep, right?

23:07All of these things that are longevity, you know, and we're talking again, biological health. All of these things can also impact reproductive health. And so it's a fascinating space. And so hopefully this encourages folks to look into it more in that way too. It is.

23:20Rachel Lim: And in this space that you have also dedicated this season of your life into, what has been the most challenging and fulfilling parts of building this? So I'll speak from a personal perspective. I'll start with a challenging one. I love how you say season of my life because I do feel it's a particular season right now. So I've been pretty open in terms of sharing. So I'm in my late 30s right now. unmarried, without children. And I do think working in the space, the expectation is that I will have children and bondage, right? And my desire is to find a partner and build a family. It is very hard to be, to be honest, working in a space where I am, I mean, you'd be surprised by what some people say to a woman leading a reproductive health company, right?

24:04They'll be like, well, you shouldn't wait so long. You should start now and just have a baby. I'm like, oh, I know I work in this space. Like, thank you for letting me know. Right. And so that is, you know, to just share a little bit more on that front. I mean, that it really does hit me here because I think it's, you know, if I'm already in the space and I know how my own patients or clients could feel. And then of course I live it day to day. And so that personal part of it, as I'm also building, absolutely, you know, challenging in that way.

24:31Rachel Lim: Yeah. On the just so fulfilling and the positive side of it. I mean, I love, I mean, I love the team that we built. I love the brands that we built. And then also I love who we get to work with in the space. I mentioned earlier how fun it is to collaborate with these other players in the space. And for us, we really are taking a very collaborative approach. I've met people across just so many, you know, the public and private and academic sectors who are eager to engage on this. And I think and they've been vulnerable with their own stories too so for me being able to engage at a deeper level level of conversation with these individuals like that we talked about um you know from my previous life at Bridgewater one of the principles was meaningful work and meaningful life right and so how I do um you know work with people who I want to work with and then also build the thing I want to build that's the harmony that I look for and so that for me is it's really the the thing that keeps me going yeah thank you for sharing and especially around the challenges you You know, it really reminds me that we are all on our own personal journeys with our own timelines.

25:35Rachel Lim: And, you know, whatever it is for you, you know, as to when you would want to start a family, have a kid, find someone. And I think it's important to remember that it's never too early to start and take responsibility for our own health and bodies. And that has been so inspiring to be able to hear all of that from you. You know, Margaret, if you had a billboard down the cities of New York or Tokyo or Singapore, what would your billboard say and why? Oh, I love this question. Wow. I think I go back to the power of curiosity and inquiry. And I think there is just the it's almost like a teaser, right?

26:14I would want it to be I have this image in my head. Maybe I'll paint it for I'm a very visual person. And so, you know, as we talk about building a brand, we talk about these images that pull or ways in which, again, you look at something and you wouldn't think that that's what that is about. Right. And then you dig deeper. And so I keep having this image of this egg and this like surrealist background of, you know, just something that pulls somebody who says, what is that? Right. Like, what is that? And then they don't know what that thing might be. But then they dig closer and maybe it's just an RFID code on there without much words.

26:41But then they scan it and then, you know, they see a story that they really resonate with in terms of somebody, again, asking themselves the questions of what matters to me? What do I want in this life? Do I want to build a family? And being able to then go from there as part of, to your point, each individual journey. And so that probably is more of like an image that resonates in terms of the billboard. But for me, yeah, I think that's what came first to mind. Wow, that's beautiful.

27:08Rachel Lim: Well, thank you, Margaret, for coming on the show and sharing so generously. For those of us who are listening and want to find out more about you and what you do, where can we find you? You can go to GenPrime.com. So G-E-N-P-R-I-M-E dot com. Or Array of Fertility, R-H-E-A. Or Google me. Or just find us that way. Amazing. Well, thank you so much for who you are and what you do for all of us and for society. We are better because of you. So thank you, Margaret. Thank you, Rachel. This was so great. Thank you.

27:41Thank you.