When Your Dreams of Motherhood Are Destroyed

Inside a small closet under the stairs in Rachel Mehl’s impeccably decorated two-story home in Pittsburgh sits a steel-gray garbage bag knotted at the top to conceal an infant bouncy chair that features pastel drawings and bits of well-known nursery rhymes: “Humpty Dumpty,”“Little Boy Blue,” “Hickory Dickory Dock.” Mehl bought the chair back in 2003, when her sister-in-law was pregnant; she purchased one for her niece and an extra for the child she herself hoped to have one day. “I remember my niece sitting in her chair and loving it,” says Mehl, 40. “And I thought, My baby is going to love that too.”

The chair has been with her through many life-changing events: five jobs, three boyfriends, three homes in two cities, and one cancer diagnosis. In 2016, days after her 38th birthday, Mehl learned she had an aggressive form of breast cancer, and her doctors warned chemotherapy would likely destroy her ovaries, rendering her infertile. They gave her the option of delaying treatment—jeopardizing her survival—in order to freeze her eggs, thus preserving the chance to have a biological child in the future. For Mehl, it wasn’t even a question. “Many people know what they want to be when they grow up. Truly, my only ambition was to be a mom; it’s the only certainty I’ve ever had,” she says. “I would work jobs, but it was all just waiting until I found the guy, settled down, and had kids. I felt like that’s when my life, my dreams, would actually begin.”

Mehl was referred to a fertility center run by University Hospitals (UH), an affiliate hospital of Case Western Reserve University, in Cleveland, known regionally for its fertility expertise. For three weeks, she injected herself with hormones—paid for by the Livestrong Foundation’s Fertility Program, which helps cancer patients cover fertility preservation; the remaining cost was covered by a donor-funded grant program at UH—all the while wondering what impact her decision would have. “Even though I consciously chose to delay treatment, it was constantly on my mind: Is the tumor growing inside of me? How quickly? At the end of these three weeks, is the cancer going to be everywhere?” Mehl says. “It was terrifying.” In the end, she felt the risk and fear had been worth it when she found out her doctor was able to retrieve 19 eggs. “I felt empowered,” continues Mehl, who works as an operations management consultant for small businesses.“When you are diagnosed with cancer, you lose control of everything. Your doctors tell you what to do, and you’re just sort of on this train. Freezing my eggs felt like I was taking back control of something—I had a decision in this—and I could potentially still retain that future I wanted.”

After the retrieval, Mehl went through four rounds of chemotherapy, daily bouts of radiation, and a lumpectomy. By the end of the year, she was told there was “no evidence of disease” left in her body. Her type of cancer has a high rate of recurrence, and doctors advised waiting to get pregnant for five years, so she tried to get on with her life, knowing her 38-year-old frozen eggs could be used to impregnate her well into her 40s.

Or so she thought.

In March 2018, four months after learning her cancer had returned, while she was undergoing chemotherapy for a second time, Mehl received a letter in the mail from UH informing her that there had been “an unexpected temperature fluctuation” in a tank where frozen eggs and embryos (fertilized eggs) were stored at the fertility center and directing her to call a dedicated phone line for more information. “I felt like the wind got knocked out of me when it set in what they were saying,” Mehl recalls. “I had just had such a string of bad luck, so even though they left room that maybe my eggs weren’t affected, I just knew.”

Her gut was right. Mehl soon learned she was one of 950 patients whose genetic material was destroyed when the temperature inside the storage tank rose more than 150 degrees. In a letter dated March 26, UH wrote, “We are heartbroken to tell you that it’s unlikely any [of the more than 4,000 eggs and embryos affected] are viable,” meaning absent a medical miracle, Mehl will never be able to give birth to a biological child. “It’s hard enough not to know if I have a future, and then to try and reformulate what that might look like after a lifetime of assuming it would be having a family—I don’t even know where to begin,” Mehl says, tears brimming in her big green eyes. “When you put your trust in people and practices and institutions and they fail you, what are you left with?”

At first, Mehl wasn’t mad; cancer has given her an understanding of the bad, uncontrollable parts of life. “I knew this was going to have a massive impact, and I felt for the UH employees who might lose their jobs,” she says. “I felt compassion for them.” But the more Mehl learned about what occurred at the fertility center—the careless way her precious genetic material was handled, and how the industry as a whole lacks government oversight and regulation—her furor bubbled. “I am very, very angry now,” she says. “I just don’t know how there could be such disregard for eggs and embryos. It’s unfathomable.”

Mehl and two other women who lost egg sin Cleveland, Danelle Yerkey, 38, and Sarah Deer, 31—fellow cancer survivors who met through a Facebook group for Pittsburgh women with the disease—banded together, with representation from famed civil rights attorney Gloria Allred and others, to file lawsuits. “Part of the beauty of being a woman is that you get to choose if you’re going to be a mom. That choice was taken away from me,”says Deer, a middle school English teacher who planned to use the eggs to get pregnant with her husband in 2020, when she hopes to have been cancer-free for five years. “Those eggs were our plan B, a security blanket after cancer. To lose them, that was the last piece of me: my old life, the me that I knew before cancer, before my new reality set in.” Deer and the others are suing UH for gross negligence and breach of contract, among other charges.“The dreams they had to become biological parents were shattered. It’s devastating; it’s catastrophic. I think anyone who has any feelings at all would want to help them, as I did,” Allred says. “There has to be accountability here. Saying you’re sorry is not enough.”

Mehl, Yerkey, and Deer want far more than an apology: They want change, reform, regulation—something to prevent other women from having to suffer through what they’ve experienced. And that’s key because what happened to them likely occurs at fertility clinics far more often than the public is aware. In fact, the very same weekend as the incident in Cleveland, a fertility clinic in San Francisco announced that it, too, had experienced a tank failure, compromising thousands of eggs and embryos and impacting more than 400 individuals and families. Further, though mass incidents are rare, lawyers interviewed for this story say they have represented dozens of women nationwide whose eggs or embryos were negligently destroyed at fertility clinics. “This is not the first time. We are aware of other incidents where eggs and embryos have been lost all over the country, from California to Ohio to Texas and in between,” says Adam Wolf, a partner at the San Francisco–based law firm Peiffer Wolf Carr & Kane. “Individuals and couples need to investigate seriously the fertility centers in which they put so much trust. These are not just storage centers where you store art or your tricycle; it should be vitally important that they abide by the highest standards of care and act in the most ethical way possible.”

Forty years ago thIs July, Louise Joy Brown, the first so-called test-tube baby, the product of the first successful in vitro fertilization (IVF), was born in England. Two years later, in 1980, the first IVF clinic opened in the U.S., ushering in a new era of assisted reproductive technology. The milestones kept coming: In 1983, the first pregnancy using a donated egg was reported; the following year, a baby was born using a frozen embryo; 1986 saw the first pregnancy using a cryopreserved egg. Between 1987 and 2015, more than eight million babies worldwide had been born with assisted reproductive technology, more than one million in the U.S. alone.

In 2012, the American Society of Reproductive Medicine said egg freezing had demonstrated such success that it should no longer be considered experimental (even though the chance of a frozen egg becoming a baby ranges from 4.5 to 12 percent). The number of women freezing eggs has increased sharply in recent years, from 475 women in 2009 to 6,207 in 2015, according to the latest data available from the Society for Assisted Reproductive Technology (SART). In that same time frame, the number of IVF cycles increased by nearly 60 percent, from 146,244 at 441 clinics in 2009 to 231,936 at 464 clinics in 2015, according to SART. Women pay upward of $15,000 to hormonally stimulate and retrieve their eggs—most often out of pocket, as most health insurers do not cover the procedure—plus an additional fee to store them, which ranges from $300 to $1,000 a year.

One clinic capitalizing on the growing and lucrative industry is UH Fertility Center, which opened in 2011 under the direction of Dr. James Goldfarb, a pioneer in the field. Earlier in his career, Goldfarb established the IVF program at Cleveland’s Mt. Sinai Medical Center that resulted in Ohio’s first IVF birth in 1983 and the world’s first IVF birth using a surrogate in 1986. A 2010 Cleveland Plain Dealer story said Goldfarb “has built a reputation for being able to build up, or turn around, fertility programs,” and Goldfarb himself touted “the most updated laboratory facilities” and state-of-the-art incubators.

This March, that state-of-the-art equipment failed spectacularly. According to news reports, sometime between August and November 2017, a stuck valve caused the autofill function on a storage tank in the embryology lab at UH to malfunction, meaning it was no longer automatically filling with liquid nitrogen, which keeps eggs and embryos at the optimal temperature of –196 degrees Celsius (about –320 degrees Fahrenheit).

UH contacted the tank’s manufacturer, Michigan-based Custom BioGenic Systems (CBS), about the problem. In a statement emailed to Marie Claire in response to requests for an interview, CBS says it provided instructions to UH on the maintenance needed to use the autofill function and, in the meantime, told lab workers to manually fill the malfunctioning tank by connecting it by hose to a reservoir containing liquid nitrogen.

By late February of this year, the reservoir had run dry, so lab workers began pouring liquid nitrogen directly into the top of the freezer tank, even though, as CBS notes, that directly contradicts the product manual’s instructions. The last time the tank was topped off was Friday, March 2. UH told the Plain Dealer that at the time of the incident it was planning to move the materials stored in the malfunctioning freezer to a replacement tank within “a day or so;” UH has not said why it didn’t use the replacement tank, which was delivered on November 2, 2017, sooner. (CBS says the extra tank was available to UH as of August 15, 2017, but UH did not finalize arrangements for its delivery until October 27.)

According to a survey prepared as part of the Ohio Department of Health investigation, on Saturday, March 3, an unnamed lab worker checked the temperature on the malfunctioning tank and noted it was appropriate at about 1:20 p.m., before he or she left for the day. The temperature inside the tank began to rise just 40 minutes later. The lab was not staffed Saturday night, so when a local alarm sounded on the tank at 5:06 p.m., alerting anyone within earshot that the temperature had risen to –156 degrees Celsius, no one heard it.

The local alarm should have triggered an external remote alarm that phones lab technicians at home, but the alarm had been turned off. UH says it is investigating why the remote alarm was deactivated. Had it been in use, a lab worker would likely have been able to get to the tank and potentially fix the problem before its contents were damaged.

At 7:20 a.m. on Sunday, March 4, when the first employee set foot in the embryology lab, the local alarm was still blaring. By that point, the temperature inside the freezer had risen to –32 degrees Celsius, effectively destroying everything inside. “We understand the sorrow of those impacted by the loss of their eggs and embryos,” UH said in a statement emailed to MC. (UH declined to be interviewed.) “We continue to support our patients with their clinical care, including emotional support. We do not yet fully understand why the temperature fluctuation occurred in the storage tank and will not be able to make a further determination until we have appropriate approvals from the court to conduct testing. In the interim, however, we are continuing our review to help our industry improve the care for patients.”

UH says they have stopped using the malfunctioning tank and that it has purchased four new storage tanks, hired additional embryologists, nurses, and support staff, and instituted new policies and procedures for checks, preventative maintenance, and remote alarm monitoring. It is also offering affected patients refunds of storage fees paid to date ($400 per year), free storage for seven years, and a free “in vitro package tailored to their individual clinic needs” at UH or another clinic if the woman elects to go through the retrieval process again. “When we learn more, University Hospitals intends to share our learnings with other fertility clinics,” the statement concluded. “We want to help ensure the highest standards of patient care for those who seek our services.”

But in court filings, UH has denied liability and said, the “plaintiffs were fully advised of the material risks, benefits, and alternatives available for the treatment, and thereafter voluntarily assumed and consented to those risks.” The consent form UH requires patients to sign includes lines reading, “I was informed and I understand that no promise or guarantee is made to me concerning a final result, outcome, or cure” and “There is no guarantee that the eggs harvested and frozen will survive, or that they will fertilize and create a baby in the future.”

Lawyers representing the women will argue the forms don’t cover UH’s errors. “While there may be some language that indicates the technology is not perfect, that is not what happened here,” says Stuart Scott of Spangenberg Shibley & Liber LLP, one of the law firms representing Mehl, Yerkey, and Deer. “It doesn’t say that one of the risks that might reduce your chances of having a child is our negligence in storing the eggs and embryos.”

For Danelle Yerkey, one of the three Pittsburgh women suing UH—one of 61 lawsuits filed against the hospital as of July 13—the course correction comes too late. Four years ago, when she was diagnosed with stage III breast cancer at age 34, her doctors urged her to proceed with chemotherapy right away—warning her in not so many words that if she didn’t, she may not be around to have kids one day. “And I’m like, ‘You don’t understand; not having children is not an option,’” Yerkey says. “I took all the chances—I didn’t even care if it killed me—because I didn’t want that life after cancer of being barren.” She woke up in the hospital after the procedure with the number 33 scrawled on her hand to represent the number of eggs retrieved; ultimately, 24 of her eggs were deemed viable and placed in a tank at UH for safekeeping.

Her oncologist then proceeded with treatment, giving Yerkey a drug known to have disastrous effects on fertility. “I thought, Well, I’ll be okay because I have my eggs, so let’s save my life. I have 24 viable eggs; that will be my future,” she says. “They were my light at the end of the tunnel.”

In March, Yerkey called UH after her mom heard about the incident on television. She collapsed on the floor of her kitchen in the two-bedroom townhouse she shares with three rescue pugs upon hearing the news. “I screamed so loud, the neighbor probably thought I was dying. I cried all that weekend. I wanted to die. And I’ve been in mourning for the two months since then,” Yerkey says. “I felt like I lost a child that day.”

The fact that UH knew the storage tank was problematic and did not do more to safeguard its contents is what bothers Yerkey most.“Cancer is no one’s fault—you can’t help if you get it—but this could have been prevented. This was someone’s fault. This was someone’s carelessness. That makes it harder to swallow,”she says. “Those eggs were worth more than gold. If someone offered me a million dollars for an egg, I would say no.” And, Yerkey adds, had the eggs been made of gold, they may have been treated more securely. “If there were that many golden eggs in a vault, they’d be guarded. There would be alarms around the clock,” she says. “That’s how our eggs should have been treated.” Now she wants to ensure no other woman has to feel her pain. “Our main goal is legislation to prevent this from happening again,” she says.“We want everything to be changed: the protocol, the safety measures, the regulation.”

The laws Yerkey and the other women desperately hope for are unlikely. The federal government takes a hands-off approach to assisted reproductive technology. In 1988, Congress passed the Clinical Laboratory Improvement Amendments, requiring all labs that perform tests on humans to be accredited and to adhere to quality standards. But embryology labs were excluded and, thus, fertility clinics can choose to be accredited or not. (Most do; according to the Society for Assisted Reproductive Technology, of the 464 surveyed for its 2015 report, 92 percent were accredited.)

An amendment passed in 1995 prohibiting the Department of Health and Human Services from funding the creation or destruction of human embryos for research purposes further explains why there hasn’t been more federal involvement. “With government funding comes government oversight. If the government isn’t contributing to this work, it doesn’t really have a foothold to say, ‘This is how you should do it,’” says Dov Fox, professor and faculty director of the Center for HealthLaw Policy and Bioethics at the University of San Diego School of Law. “The position that Congress reached then, and really hasn’t budged from since, is that it’s going to stay out of the way.” It’s “extremely rare” for the government to take such a hands-off approach, Fox adds. “In every other area of medical research, the government plays a big part. How research is conducted, what kinds of certification or training practitioners need—all of that is fair game for every other area of medicine except this one.”

The main form of federal oversight comes from the Food and Drug Administration (FDA), which regulates all drugs and medical devices used in assisted reproductive technology, as it does in every field of medicine; the agency also mandates donated eggs and sperm be tested for communicable diseases. But it does not control how clinics maintain storage tanks because they don’t fall under the FDA’s jurisdiction since they are not marketed to patients.

When it comes to reproductive legislation, the U.S. is an outlier. “If you step almost anywhere else in the world, assisted reproduction is far more heavily regulated,” says Rene Almeling, a sociologist at Yale University and author of Sex Cells: The Medical Market for Eggs and Sperm. The United Kingdom, for example, has a government agency, the Human Fertilisation and Embryology Authority, dedicated to regulating the industry.

There are positives to the lack of oversight. The U.S. does not restrict who can use reproductive technology to make a baby, while in France, for example, only heterosexual couples can access donor sperm, forcing lesbians and single women to go elsewhere. “Historically, when governments get involved in telling people who can reproduce, how, and with whom, it does not end well,” says Almeling, citing the eugenics movement in the U.S., which for some 70 years sought to eliminate supposed negative genetic traits through forced sterilization of poor, uneducated, and minority populations.

Neither major political party is expected to push for more regulation. Democrats aren’t likely to touch fertility because of how close the issue is to the abortion debate. “Any attempt to regulate reproductive technology almost inevitably leads to difficult questions relating to abortion,” says I. Glenn Cohen, director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. “As a result, people have been shy, including those on the left who might be interested in pushing regulation in this area, because once they do so, there’s a real possibility it ends up resulting in restricting women’s reproductive rights.” Republicans similarly aren’t inclined to wade in because the whole idea of assisted reproductive technology (ART) makes them uncomfortable and regulating it is seen as tantamount to condoning it. “A significant number of conservatives find ART troubling or immoral,” Fox says. “They view the creation of life inside a lab as playing God and think if you regulate this stuff, you implicitly approve of the underlying practice that you disapprove of.”

But that doesn’t entirely explain why the government couldn’t impose a set of safety protocols, require annual inspections (currently, accredited clinics are inspected every other year),or codify straightforward reforms such as splitting up genetic material in two or more storage tanks so that a patient’s eggs aren’t literally in one basket. Few clinics take such additional safety measures because they add cost and complicate record keeping. “I’m aware of a handful of clinics storing material from one patient in two tanks, but this is currently not standard practice,” says Catherine Racowsky, director of the assisted reproductive technology lab at Brigham and Women’s Hospital in Boston.

Such legislative changes may come in Ohio, at least. State senator Joe Schiavoni, a Democrat, plans to introduce a bill to regulate fertility clinics that will include “reasonable changes” that won’t be overly “restrictive or burdensome” for clinics, including requiring 24-hour on-site monitoring, storing genetic material in different tanks, and mandating that clinics notify accreditation agencies if cryopreservation is compromised. “It’s just sensible,” Schiavoni says. “We have to do the best we can to prevent something like this from happening again.”

The American Society of Reproductive Medicine (ASRM), an organization dedicated to the advancement of the science and practice of reproductive medicine, advocates against government intervention, promoting the industry’s ability to regulate itself. “The field is best left to professional self-regulation,” says Sean Tipton, ASRM’s chief advocacy, policy, and development officer. “When government starts codifying those kinds of practices, it typically doesn’t understand the clinical science nearly as well as professionals do. You often will codify the technology in place in a rapidly moving field. Governments are slow and unresponsive; that can create some problems.”

But as Cohen cautions, ASRM has an inherent bias. “The industry has done a good job of trumpeting its self-regulation as a reason for regulators not to get involved,” he says. “Critics of ASRM think that it’s too close to the regulated community—basically, it’s made up of the regulators—and some of the decisions being made are driven by the interests of people providing the medicine, not always the patients.”

ASRM issues extensive guidelines to its members and requires that clinics be accredited, but it has no mechanism to discipline those that don’t, other than revoking their memberships. Tipton says the industry does “pretty well” at regulating itself; in a statement issued days after the incidents in Cleveland and SanFrancisco, ASRM said, “Up until last week, the history of cryopreservation had been a steady string of improved performance and reliability.”

But how would we know if that’s true? Fertility clinics are required to report their success rates—the number of cycles started, what materials were used (fresh or frozen eggs, etc.), and resulting live births—to the Centers for Disease Control and Prevention (CDC), but not all do, and there is little consequence for those that fail to report. (All that happens is the CDC puts them on a list of “non-reporting” clinics.) Further, the CDC does not ask clinics to disclose how often tanks malfunction or how many genetic samples have been destroyed, so there’s no way of knowing how often such incidents occur. “I suspect this happens a lot more often than we know, but because of the lack of regulation and transparency, we don’t really know,” says Naomi Cahn, professor at the George Washington University Law School and author of the book Test Tube Families: Why the Fertility Market Needs Legal Regulation. “We need mandatory reporting whenever there are mishaps like this. It’s important that when this happens, we find out more about it, because that’s the only way we’ll be able to better safeguard people and their precious reproductive material.”

As clinicians in Cleveland were dealing with the temperature fluctuation in its storage tank, a remarkably similar incident was playing out nearly 2,500 miles away at Pacific Fertility Center (PFC) in San Francisco. According to a class action lawsuit still pending at press time, on Sunday, March 4, during a routine walk-through at PFC, an embryologist discovered a substantial loss of liquid nitrogen, likely caused by a failure of the tank’s vacuum seal, in a storage tank containing thousands of eggs and embryos. (The clinic has not released the exact number.) PFC hasn’t been able to conclude whether all of the tissue in the tank was destroyed; instead, the more than 400 individuals and families impacted have been told the only way to know if the eggs and embryos are viable is to begin the IVF process and see if they get pregnant or not. In an April 19 email, PFC told patients, “After thawing and transferring some of the embryos, we can report several early pregnancies.”

For Marianne, a PFC patient who requested we omit her last name, the reports of successful pregnancies only set her up to be devastated again. “They let us be more optimistic than they should have,” says Marianne, who had her now-3-year-old son in 2015 using an embryo stored at PFC. When she and her husband returned to PFC this April in the hopes of having a second child, they were told all three of their embryos had been destroyed. “Because my son had come out of that same batch, I felt like I could picture them,” Marianne says, her voice breaking. “We knew two of them were girls and one was a boy.”

Marianne and her husband were lucky; they happened to have two frozen embryos at another clinic. They transferred one of those embryos in April, and at press time, Marianne was in her second trimester. Still, she and her husband are suing PFC, one of at least 15 lawsuits filed against the clinic.

The incidents we know about in Cleveland and San Francisco may only scratch the surface of how many eggs and embryos are destroyed at fertility clinics each year. Most are likely one-off cases that take place outside of the limelight. “My guess is that in many of these instances, clinics try to settle and avoid the PR,” says Harvard Law School’s I. Glenn Cohen. “Especially if it’s affecting a small number of people, they try to settle quietly.” The earliest known incident of this kind occurred in 1995, when three couples sued a fertility clinic in Rhode Island, accusing it of losing 15 embryos. More recent headlines include a 2006 mechanical failure in a storage tank at a Florida health center, impacting 60 men who had sperm samples frozen there, and a tank failure in 2012 in Chicago in which sperm and testicular tissue were destroyed. This June, a class-action lawsuit was filed against an Ontario-based clinic where a vacuum-pump failure and temperature rise inside a storage tank destroyed an unknown number of eggs, sperm, and embryos. One impacted patient, Qi Zhang, who is seeking $25 million in damages, told The Toronto Star she had 65 eggs stored at the clinic before the incident.

Adam Wolf, of Peiffer Wolf Carr & Kane in San Francisco, says over the past four years he’s represented more than 100 people whose embryos have been lost. “In every single case we’ve had, it has come down to human error and negligence,” he says. “All were preventable errors, and all are the most momentous of losses.” In one particularly confounding case that was pending at press time, a client of Wolf’s named Natalia, who asked we not use her last name, was told the embryos she and her husband had paid $35,000 to Coastal Fertility Medical Center in Irvine, California to produce and store had simply disappeared, according to her lawsuit. On the day she was supposed to be impregnated, when doctors at another fertility clinic thawed the straws that had been transferred from Coastal that once contained her embryos, they were empty.“It’s been two years and we’re still devastated,” Natalia says. “Those were our babies. We were promised them, we paid for them, and now we’re left with nothing.” (Coastal has denied liability and said in a statement to MC, “We have no control over embryos once they leave our laboratory.”)

If there’s any silver lining to be had, it’s that the incidents in Cleveland and San Francisco may have scared the industry into taking a hard look at its practices. “It really shook a lot of people in the field; it’s every professional’s worst nightmare,” ASRM’s Sean Tipton says. “I’ve talked to embryologists who put somebody in their labs around the clock until they had the chance to review all of their procedures.”

Paul Bachner, past president and spokesperson for the College of American Pathologists (CAP), the organization that accredits roughly 8,000 labs nationwide, including UH and PFC, says both clinics were to be reinspected this summer (the investigations were ongoing at press time). CAP is also in the process of revising the standards accredited clinics are required to adhere to. Bachner said they are especially focused on storage-tank maintenance, temperature monitoring, and the frequency and type of review for alarm systems. UH has said it will no longer store a person’s genetic material all in one tank; PFC has not disclosed what changes it has made. (PFC declined to be interviewed, but sent a statement from spokesperson Alden Romney: “The doctors at [PFC] are fully focused on patient care and helping our patients achieve their family building and fertility preservation goals.”)

It’s impossible to say what impact such efforts will have. After all, UH and PFC were both accredited and ostensibly should already have been heeding CAP’s guidelines. “My reaction was, if they had the protocols in place, they weren’t adhering to them, and if they didn’t have them in place, they should have,” says Brigham and Women’s Catherine Racowsky, who is also ASRM's incoming vice president. “CAP accreditation is incredibly stringent. There are hundreds and hundreds of check-points you have to pass in order to become accredited. It’s all about making sure you’re adhering to every single one of those checkpoints, every single time, every single day. If you bend the rules at all, you can get yourself into very deep trouble.”

None of that does anything to soothe Rachel Mehl. Shortly after she learned about the destruction of her eggs in Cleveland, she posted a letter on Facebook to the biological son or daughter she’ll never have: “You felt so real to me. So close. I’ve been preparing to be your mom since I was a little girl myself. While some dreamed of being doctors or lawyers, I dreamed of kissing boo-boos and letting you eat the cookie batter. I’m sorry I waited too long. I’m sorry I couldn’t save you.”

This article originally appears in the October issue of Marie Claire.

Editors’ note: We use the terms “woman” and “female” in this article to refer to people with internal reproductive organs; however we understand that not everyone with internal reproductive organs identifies as a woman or a female. We use the terms “man” and “male” to refer to people with external reproductive organs; however we understand that not everyone with external reproductive organs identifies as a man or a male.