The Cost of IVF and the Future of Reproductive Healthcare with Jessica Schaefer

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3:15When I started my fertility journey almost a decade ago now, I froze my eggs and I documented it for Good Morning America. So it was all out there. The crying, the pinching my stomach, the giving myself shots. It was all very much out there and very much public. I am currently eight months pregnant and I have been keeping this moment in my life, mostly private. Maybe I'll talk about it more. Maybe I won't. I do not know. But I do feel like I may talk about it someday because there's a lot at the intersection of money and fertility. And I've struggled with this a lot. But fertility, parenting, women's health is all top of mind for me now, both because of what's going on in my personal life, but also what's happening in the world.

3:53The election is next week. And as we all think about what it means to vote with our values on Tuesday, we're also reflecting on the last couple of months of the presidential campaigns. One of the issues that has been front and center on the campaign trail is reproductive health care. Of course, there was the overturning of Roe v. Wade in 2022, but in the time since then, there's been more limitations placed on reproductive health care from abortion to IVF, pretty much everything in between. My process of freezing my eggs was both empowering and really intimidating. When a doctor hands you over what's pretty much a bucket full of needles and hormones, you feel like you're in complete control of your health and future, But also, at least for me, I felt like I needed a medical degree for all of this.

4:33It is amazing that we have access to this kind of medicine, but there is certainly room for improvement to better benefit people going through the IVF process. And Jessica Schaefer agrees with me. Jessica and I talked before her startup Lushy officially launched, and I actually knew I was pregnant during this interview, but I wasn't telling anyone yet, which is pretty perfect because my husband and I revealed our pregnancy news to our friends by telling them that we were launching a startup. So Jessica and I were both kind of undercover working on launches of different kinds during this interview.

5:02Anyway, you'll hear at the end of the episode that she gives us a little sneak peek, but I can tell you about it now. Lushy will offer treatments, clinics and wellness platforms tailored to their female patients to help transform the IVF conception experience for American women. But Jessica hasn't always been in the health care space. Jessica is the founder of Bevel, a tech and VCPR firm that she built into an eight figure revenue business that was acquired in 2023. Today, Jessica talks to me about her own experience with IVF, the mistakes she made through the process, and what resources are out there to make IVF more affordable.

5:37Jessica Schaefer, welcome to Money Rehab. Thanks for having me. All right, let's get right into it, sister. How did you decide that you wanted to freeze your eggs? I had just sold my first baby, Bevel. This PR firm that I started and ran for seven years and had basically dedicated my entire life to work. And I had also just gone through a divorce. And so it seemed like something that was 100 % necessary to do. Although I wish I had done it 10 years prior. Yeah. And what was the experience like for you? The shots, the retrieval, all of that. Did anything surprise you in the process? You've frozen your eggs, right?

6:22You've been through the process. Yeah. So you go into the clinic and they don't really share the cost of the variables, the fertility drugs, which can be quite high depending on how your body reacts to the stimulants, right? And so they basically say, oh, it's a fixed cost of$10 ,000, but then the cost of the fertility drugs can be anywhere from five to 10 ,000. And then if you need to do it multiple times, then you're sometimes looking at close to 100 ,000 just to freeze your eggs. And what I thought was absolutely insane, we have Botox and fillers and IVs. But for one of the most important things, which is preserving your option to have a family, you are self-administering the shots, which I just thought it was a little bit insane.

7:09And then they send you to a link to a video from the 80s. And you're kind of like, I have no idea what I'm doing. Yeah, I had the same experience too. I was like, how is it legal to give me all of these things? This accoutrement. Even the tub, the little red disposable thing. I was like, oh, I am not a hospital. What am I doing right now? You know, this could injure other people. I live in New York City. You know, you bring your trash out on the street. Who knows what was happening after that? So yeah, it's not cheap for sure. It can go from around 10 ,000, as you mentioned, with multiple rounds.

7:46And by the way, it's like half of an IVF cycle. So you still have to do something with those eggs later. And that's not cheap. So how much did you end up spending on the process so far? I would say my journey isn't over. So I ended up actually taking the trigger shot early, which was triggering, which means I was supposed to have 28 eggs, but then I only was able to retrieve five. And that's just not enough for a live birth. And so I'm planning to do it a couple more times. Thankfully, my AMH levels, which basically you can test how fertile you are. And my doctor's, oh, you have the fertility of a 26 year old, you should just go get pregnant.

8:31And I said, that's not actually the point. It's not that I can't get pregnant, is that I haven't found the person that I want to get pregnant yet with. So the first egg freezing, it was 15 ,000. But again, I'll have to do it a few more times. Okay, so for anyone who hasn't gone through this process, can you explain what a trigger shot is? Why you took it early? Like when you're supposed to take it? Sure. So when you're going through the process, you have to take anywhere from one to three shots a night. So it can be very confusing and you have them all in your refrigerator. And so I accidentally took the trigger shot, which releases the eggs.

9:11And so basically I had 28 eggs. And then when my doctor figured out what had gone wrong, he basically was like, okay, you can just do the entire process all over again. And I thought, that's crazy. One, One, I had spent a lot of money, but two, more importantly, it was my body and my time. And so it just felt like it was a bit of a cattle call. Oh, well, let's just go in for round two. They just turn around and do it all over again. It's a little defeating. For sure. So you did the process after you got divorced. You have said that the whole thing was very lonely. Can you tell me a little bit about that?

9:49Sure. I had a lot of girlfriends who had done it and they were all, oh, I'll come to your house and help you with the shots. And I thought that was just a little bit strange. Like one, not that I didn't trust them. I just felt like a doctor should be doing it. I shouldn't be doing it. They shouldn't be doing it. So that was a little bit strange. But also you reach this peak of your career, but then you think that you're going to be married or you think that things are going to be different and now you're freezing your eggs. And so I think the process, there's a lot of community around it. And there's so much opportunity to just change the way that it is now.

10:27Yeah, absolutely. I remember the first time I got, I've done the process twice and I got the shots the first time, which was like the most expensive package I've ever received in the mail. And one of my girlfriends came over and it took two hours to read through the instructions and figure out what liquid to put in what powder. And the whole thing is for sure wild. One time I documented it for TV, so I was really public about it. The second time I was really private about it. But as you know, this is a really intense process that you put your body through. Some days I was sick, as I'm sure you were.

10:59I had tons of doctor's appointments throughout the process. It's really hard to work, especially if you're a person who likes working 24-7. It can definitely make you unavailable during that time. So I struggled really, let me know if this was your experience, but I struggled telling colleagues that I was going through this process. How did you handle that? Yeah, it was an interesting time in my career because I had just sold my company and I had an earn out. So basically you're expected to stay. And that time when you sell a company, it's very intense. And now I had a boss for the first time and I can't tell you how long.

11:38So I for sure was not used to that. And he didn't act, you know, he didn't really understand the egg freezing process. So it's not something that feels natural to talk about. But I think that as women, we should be able to talk about it, we should feel more comfortable talking about it. And I think the workplace should make it so that it's not such a stigma and potentially give time off when you're going through this process because you're also not supposed to be stressed. It decreases the quality of the eggs. And it's very hard to do this because it's so time intensive and to work as hard as you're used to working.

12:17For sure. What advice would you give someone on how to tell their boss or business partner that they're going through this? I think employers need to start. Actually, we need to turn the conversation so that we feel comfortable being able to go to your employer with this. 50 % of companies now actually do offer fertility benefits, but it's still not the norm, I would say, especially for smaller companies. Some of the larger tech companies like Amazon and Google are offering it. But actually, I think it's one step further. When you are going through this process, you should be able to take time off.

12:53You should be able to realign your schedule so that you can go and do it the appropriate way. Something that I personally struggled with was the fact that I was really anxious that people, if they knew, especially in the workplace about the procedure, they would ask me how it went. And when I went through it the second time, my husband and I tried to make embryos and we weren't successful doing that. So I was devastated. And I just, I didn't know how it would go. That was not the outcome that I expected at all. But if I had colleagues asking me how it went and I'd have to keep that conversation going over and over again, that would have felt so difficult for me.

13:33Did people follow up and say, Jessica, how did your procedure go? It's a lot. Yeah, it's a lot. How did you handle work when you were going through this process? Did you end up opening up to people? Yeah, I shared that I was doing it. I had a lot of women at the company. We were majority women executive team. And so I thought it was also important that they freeze their eggs. There are so many women I know who have dedicated their life to their careers. And I think at least my generation, you were told, oh, you can do it all. And I think you can do it all, but you can't do it all at the same time.

14:12And so really analyzing, do I want to dedicate my 20s to my career and then 30s to my family or flip it? But these are things that people need to think about because you, God forbid, you have the conversation like I wanted to have kids and I just didn't know that you could freeze your eggs or I didn't know that much about the process. And a lot of women wait until it's too late. And did you change the way you worked during this process? Like you mentioned that stress is obviously a big factor for all fertility stuff. For me, we used to tape this podcast twice a week. We changed it during that time to one longer day.

14:52so that I could take more time and recover. Did you use any of those strategies to optimize your work for your health? I stopped traveling, which is very rare for me. I was supposed to speak at all these conferences and travel on the weekends or even I decreased the amount of movement and kept my mornings open so that it wasn't as stressful. But the doctors were like, oh, you can still travel and do all this stuff. But I'm like, it's just not worth it. I think if you're going to do this, you really need to focus on it and invest the time and do it the right way. So you don't have to do multiple cycles.

15:28I ended up needing to work during the first time I did it and got like a doctor's note to go through with all the shots and stuff. And I remember like having the shots with the ice and stuff like that, but also bringing like yogurt and other snacks with me. And when I got through the conveyor belt, I realized like that it was a bigger yogurt and you're not supposed to take the bigger sizes. And the guy just looked in the bag and saw all the shots and all the craziness and looked at the yogurt. And he's like, you're going through something. Enjoy the yogurt. And it's never a good time. I remember when I first did it, I happened to be on the day of the cycle that you're supposed to start that day that I went in.

16:08I'm like, whatever. We'll figure it out. I figured out harder things in life. Might as well do it today. But yeah, if you go through the process and you're working full time, it's definitely taxing a lot to juggle. You've worked with a lot of startups, of course. And as you were going through this earn out process, I'm sure it was really stressful. Are you seeing startups more than the Googles and the Amazons and stuff of the world give fertility leave? I was surprised that you said 50 % do. What size companies are you seeing do this? Are there any sectors that are giving more robust fertility healthcare packages?

16:41So it's the much larger companies and those in the healthcare industries. I actually haven't seen many smaller tech companies. So late stage companies where they have the ability to, but I also think it's not that much more to add it on to your employment policies. So I think we'll start to see a lot more employers offer this and the younger generation, they're expecting it. One other thing that people can do is you can actually take your HSA and your savings and you can contribute. it rolls over. Let's say you're 21 and you're getting your first job in tech. I would just recommend that women start to contribute to that and think about it almost as their family planning and not just focusing on your 401k.

17:28And then it's not as cost prohibitive as many people think. There are a lot of startups that are trying to make it more affordable. I'm a little concerned with how much VC or PEA has gone into this space to make it more affordable. I wonder, Are they cutting costs around some of the healthcare that is required, that is costly, ORs and whatnot, in order to hit those growth KPIs that, as you'll forget more than I will ever know about those, are really, really intense when you start taking on growth capital. And we are starting to see that. I've spoken with a lot of doctors who have left some of the players you might be thinking about.

18:07And the reason is they're seeing 30 to 50 patients a day, which is just insane. You don't have enough time with your doctor. And then right now the process is you take the shots at night, you have to call. Let's say you have a question. Your doctor is not available. There's no one to speak to at night. And so I think the process is fundamentally flawed right now. And to your point, there are some VC-backed fertility companies that are cutting corners basically to reach their growth targets. And you'll see in their success outcomes and what has led to a live birth. they're just not hitting where they need to be.

18:53Hold onto your wallets. Money Rehab will be right back. And now for some more Money Rehab.

19:06As an entrepreneur, it means you're a problem solver by nature. So how do you think we fix this process as it is right now, where there is interest from investors, which could be a good thing, but in a space where you can't and you shouldn't cut corners, but still ideally make it more affordable? Yeah, I think there are opportunities to use technology to help. There is no reason that someone like myself should have taken the trigger shot accidentally. You could get updates on your app or you could get basically be meeting with a nurse or a fertility specialist more often via telehealth, which is not happening right now.

19:46I think there's also ways to incorporate AI into the process. There are so many questions that you have just because you're anxious, right? You said you were suffering from a lot of anxiety. I was suffering from a lot of anxiety during this process. And I would want to know just answers to the most basic things to make sure I was doing it correctly. So you can actually program AI based on the doctor's responses so that at night, if you have questions, they can be answered. And so there are ways where we could provide a concierge, really custom, high-level model to this industry without cutting corners and make it so that it's profitable.

20:25And I don't think that a lot of the fertility companies out there right now are doing that. So most of them are started by doctors. And I think doctors, they're used to being around needles. They're used to being around these like ugly red bins with the crazy, you know, danger sign on them. We're not. And so I think if someone were to come in from outside of the industry who has gone through the process, who was a patient, who has a focus on marketing technology and can apply some of those resources, we could provide a much different experience. And you're putting your money where your mouth is, right?

21:02Your next move is investing in this space. Where are you seeing the opportunities? Are there specific companies that you're liking? Yeah, so I'm investing in this space and I'm also working on a company in stealth in this area. But we're basically investing in AI, a technology platform that will transform the industry in the way that is being done now so that someone like me never has the experience that I had before. But at this point, I've spoken to close to 200 women just through customer research to make sure we get the product right. And every single person has the same experience. I have not met one person who had done the cycle one time, who didn't experience anxiety, who didn't feel alone, not one person.

21:51Yeah. After my last round, I did get some cards too. There was like a special, I think it was like an Etsy fertility card company where it says, I'm sorry for everything I said to you while I was going through fertility treatments or something like that. Anyway, no, there's definitely a lot to be done. And there is a lot of money to be made if it's done right. Do you think it's more difficult to raise money for women's health issues than it would be for gender neutral health issues, female focused startups? On the VC funding, I come from a different seat, mostly because the PR firm I built, we worked with a lot of venture capital funds, but we were primarily focused in fintech.

22:34It wasn't until the last two years of the company that we started to see this shift. And there was so much more capital flowing into healthcare, flowing into femtech. And from my perspective, it made sense to transfer into this industry. I really believe that like you need to be able to spot waves and know when to get off. And so Bevel was always focused in fintech and crypto. And then we just started to see the doors open here on the funding specifically for women health care companies. Even this year, women's rights are certainly top of mind on the ballot. And so I think that it's not just our issue.

23:13It's everyone's issue. And so I think communicating to VCs in the way that they would understand that, hey, listen, the U.S. growth rate and birth rate is the lowest it has ever been. And third world countries are outpacing our growth rates faster than ever. That's a conversation that anyone can digest because it'll have huge economic impacts. And so it's not just a woman's issue. I think it's an issue for everyone. Like a population issue, for sure. It's a population issue. Yeah, we're not having enough babies. Yeah, definitely a lot more questions than answers. I do see tech helping in some personalized medicine as well, because everyone's fertility picture is different.

23:57You, Jessica, for example, had egg yolk sac cancer. First of all, can you share what that is for any listeners who might not know? I think most people don't know because one in 4 billion people get egg yolk sac tumors. And when I had it, there wasn't a cure, but an egg yolk sac tumor, it reached stage four and I was treated at Strong Memorial Hospital in Rochester. And one of the graduates, a new graduate from medical school, Dr. Kourounis, he actually was able to find a cure and treat it very aggressively through chemotherapy. But my fertility was always like from a very young age. I was two and a half years old and then I was in the hospital for two years.

24:41Because I had chemo and because I had radiation, they were like, you're probably not going to be able to have kids. That's actually not true, but it's certainly when someone says that to you and then your parents are always talking about it, it's just something that carries on with you over the years. You're on a mission. I'm on a mission. Yes. Well, thank you for doing that. And do you think that technology can also help with the success in going back to get the frozen eggs? I do think that there's a lot of rhetoric that this is a complete insurance policy. And oftentimes it's not foolproof. You can go back and there could be a thousand issues of thawing and the partner that you chose not working.

25:29Can you talk a little bit more about how some of these startups are phrasing the chances of success? Yeah. So, I mean, on that, to your point, there's even more issues than just the thawing. There's issues of climate change. And let's say you have your ex-person in a brownstone on the Upper East Side, or you have them in a storage facility and then the power goes out or there's a flood or there's so many different things. And I think there's been a lot of advances in terms of some people are suggesting store your eggs in multiple places. So diversify where your eggs are stored. There are some women who are going to Europe to get this done just because it's much more affordable there.

26:14But I think here, to your point, I do fundamentally believe it comes back to education. And if you freeze your eggs earlier, the quality of the eggs will be much better. So right now the average age women are freezing their eggs is 35. You should freeze your eggs at 25 and you shouldn't wait. And so the quality decreases basically every single year. And so that is what is affecting not just the thawing, but when you have the eggs, your success of actually creating embryos. Yeah, I think one of the most popular modern love articles of the New York Times is don't put all your frozen eggs in one basket.