Fresh or frozen? It sounds like a logistics question. It's not.

Richard gets asked this constantly, and the answer almost always depends on something the clinic never asked first: what do you actually want your family to look like?

In this episode Richard and Julio work through one of the most misunderstood decisions in an IVF or surrogacy journey. Why frozen embryos became the clinical default. What the attrition math actually looks like from egg to euploid embryo. Why egg freezing is not the insurance policy most people think it is. What a good clinic asks you before it tells you anything. And what it means when it doesn't.

Richard has helped over 500 families navigate fertility journeys. For him it's statistics. For you it's binary. This episode is the gap between those two things, made legible.

Not medical advice. Richard says that himself.

CHAPTERS

00:00 Why this question came up this morning02:51 What actually happens when you freeze an egg05:49 Why frozen embryos became the default08:42 Two sperm sources, two kids: what the math looks like11:32 What egg banks are and how a "lot of eight" works14:24 The red flag your clinic might be showing you right now17:16 Why egg freezing is not a guarantee, even in your twenties20:10 You are binary. I'm a statistic.

KEYWORDS

IVF fresh vs frozen, donor eggs frozen embryos, egg freezing success rate, embryo banking explained, PGTA testing embryos, IVF surrogacy logistics, two dads IVF, LGBTQ family building, egg donor cycle, euploid embryo, vitrification IVF, IVF clinic red flags, intended parents guide, fresh donor egg cycle, frozen egg bank

Before you sit down with your doctor and they start talking about genetic testing, there is a conversation that should happen first. Richard has it with hundreds of patients every year. This is that conversation.

Richard Westoby works with intended parents every day before they see their doctor. Pre-implantation genetic testing is one of the first things that comes up and also one of the things people feel least prepared for when the appointment actually happens.

In this episode Julio and Richard walk through what PGT actually is, the different types, what each one looks for, what it costs, and how to think about whether it makes sense for your journey. Including why Richard did not do it himself when he had his kids, why nothing is ever one hundred percent even after testing, and what the new generation of polygenic testing means for families making these decisions today.

This is not medical advice. This is the conversation that helps you walk into the medical advice ready.

IVF, PGT, pre-implantation genetic testing, embryo testing, surrogacy, gay dads, intended parents, egg donation, fertility, IVF costs, embryo screening, sex selection, genetic testing IVF, surrogacy journey, LGBTQ family, IVF explained, fertility podcast, gay parents, family building, IVF add-ons

Chapters

00:00 Introduction to PGTs

02:27 Understanding PGT Types

05:37 The Role of PGT in IVF

09:05 Ethical Considerations of Gender Selection

11:42 Exploring PGT-M and PGT-SR

16:01 The Future of PGT: PGTP

22:54 The Emotional Impact of PGT Testing

SPOTIFY DESCRIPTION

You've done the research. You've read the blogs. But there's a specific moment in the IVF journey that almost every gay man gets blindsided by and it's not the one you think.

Dr. Michael Gornaccia of New England Fertility Institute has spent over 30 years helping LGBTQ families build through surrogacy, egg donation, and IVF. In this episode, he walks through the real timeline, the part of the process that costs the most time, what the 2am anxiety is actually about, and why one in-person visit to Connecticut might be the only thing standing between you and your embryos.

If you're building your family from abroad, EU, UK, Asia, this one's for you.

CHAPTERS

00:00 Introduction: who is Dr. G?01:03 The first thing your doctor needs to know before anything else03:18 HIV-positive fathers: the Beacon Institute process explained06:25 The male screening visit: what happens and why you cannot skip it09:29 Egg donation: clinic bank vs. private agency, real difference in timing13:01 When both partners want to use their genetics17:21 Second cycles: not uncommon, not the end20:25 The 2am anxiety moment everyone experiences and nobody warns you about22:18 What surprises patients most and why internet stats will gaslight you26:18 LGBTQ families vs. heterosexual couples: the grief nobody talks about30:06 HIV-positive dads: what to know if you are scared to ask31:04 Adoption as a valid path: patient autonomy in practice31:50 Final advice: the one thing to do when you are up at midnight

New England Fertility Institute: https://www.nefertility.com/Instagram: https://www.instagram.com/nefertility/Men Having Babies: menhavingbabies.orgBeacon Institute (HIV sperm processing)

"The biggest time factor in this whole journey isn't the medical process. It's finding a surrogate." Dr. Michael Gornaccia, New England Fertility Institute

"A lot of LGBTQ patients tell me: I never thought when I was growing up that I'd be able to have a family. That grief is real, even when everything is going well." Dr. Michael Gornaccia, New England Fertility Institute

"The two-and-a-half week wait while we test the embryos. That's when everyone panics. Every single patient. And it's completely normal." Dr. Michael Gornaccia, New England Fertility Institute

"In IVF, women go through hormones and medication. Men go through paperwork and waiting." Julio, IVF Daddies