Lauren Makler first came across the process of traditional egg donation at the age of 28. She had been diagnosed with a rare disease, multicystic peritoneal mesothelioma, which caused non-cancerous masses to grow in her abdomen. Multiple surgeries were required to remove them.

Since her medical team couldn’t guarantee that her reproductive organs wouldn’t be affected by the surgeries, Makler, then dating her now-husband, Jake, began researching fertility options, including egg donation.

She found herself uncomfortable with the process of looking for donors through private clinics and hospitals. It was “icky,” she said, and paying an unknown woman for genetic material “felt transactional.” In addition, Makler, who is Jewish, wanted eggs from a Jewish donor, which can be hard to find.

That was five years ago. Today, through their one-year-old startup, Cofertility, Makler and co-founders Halle Tecco and Arielle Spiegel are reshaping both egg donation and freezing throughout the United States to help those who want to start a family right away as well as women looking to preserve their fertility.

Like other egg donation agencies, Cofertility matches donors with potential parents. But what makes it distinct is its donate-and-freeze Split exchange program, which makes egg freezing accessible to more women and the donation process more open and less transactional. By using Split, women who qualify can harvest and store their eggs at Cofertility-affiliated sites for up to 10 years—for free—if they donate half their eggs to potential parents enrolled in Cofertility’s Family by Co program.

Makler, who lives in Los Angeles, was fortunate. Her sister volunteered her own eggs—“which gave me peace of mind” going into the surgeries, she said. Even luckier, she became pregnant without interventions and gave birth to a daughter. Nevertheless, the experience of looking for eggs stayed with her.

“Egg donation is an essential part of how LGBTQ families are built,” said Makler, Cofertility’s CEO. “And it’s a huge part of the process for other people as well,” including women whose fertility has been impacted by cancer treatments or who have diminished ovarian reserves due to age or health conditions.

Egg donation and freezing is an expanding business. It’s hard to estimate the number of babies born through egg donation since the technology was introduced in 1983, but nearly 9,500 babies were born from egg donors in the United States alone in 2019, the most recent year for which statistics are available, according to a report from the Society for Reproductive Technology. Most clinics charge over $40,000 for one cycle of donor eggs; donors receive a percentage of that fee, on average $10,000, depending on the clinic.

Over the past decade, egg freezing—preserving oocytes to use at a later date—has become increasingly popular as “women are starting families later than ever,” Makler said. Indeed, a study on trends in elective oocyte freezing published in 2021 in the journal Fertility and Sterility showed a 39 percent increase in egg retrievals compared to prepandemic levels.

Leah, a Jewish medical student who did not want to share her last name, is a donor in Cofertility’s Split program. Focused on finishing her degree, the 31-year-old said she is currently more interested in helping others start their family than in having children herself. 

In Split, prospective parents pay for all the medical costs associated with egg retrieval and receive half the eggs retrieved from their matched donors; the other half are frozen to be used by the donor at a later time.

Split appeals to her, Leah explained, in part because she does not like negotiating for money.

“The exchange feels more in the spirit of what I’m doing,” she said, while allowing her the time to wait until after her schooling to decide if she wants children. Cofertility “gives me the space to be comfortable with where my priorities are now.”

Split has 120 donors, with over 1,000 on the waiting list. “We’re excited about the traction we’ve had so far,” said Tecco. “We hope that Cofertility can lead the way for the entire industry to become more transparent and ethical.” (In January, another American company, Oma Fertility, started a similar egg donor/freezing exchange.)

It was Tecco who approached Makler over a year ago about creating an egg donation agency that would be, as Cofertility’s website calls it, “human centered.” Makler had recently left her job at Uber, where she helped to found Uber Health, a service that enables health care organizations to arrange rides to and from medical offices.

Tecco, an entrepreneur in digital and women’s health, and Makler teamed up with Arielle Spiegel, who had originally founded Cofertility as a fertility educational and support platform and community. (Both Tecco and Spiegel have experienced fertility problems.) The three then re-launched Cofertility and debuted the Split program. The Los Angeles-based company also offers fee-based egg freezing through its Keep program.

Unlike most other donor databases, Split is not anonymous. The program features options that it calls a “disclosed relationship,” where a matched donor and future parents exchange contact information and communicate directly, as well as an “undisclosed relationship,” where they communicate using the Cofertility platform.

Split also opens egg freezing to those who find the cost of freezing prohibitive. The average age for egg freezing in the United States is 37, though studies suggest that women who freeze their eggs before 35 have a better chance of a successful later pregnancy.

“The best time is usually when you can least afford it,” Makler said. A single cycle—the process of stimulating and monitoring egg production, removal and freezing—can cost $10,000 and up. Women who are in school or at the start of their careers may find that unaffordable.

Compared to most donor databases, Cofertility’s donors “are more accomplished, more mature in terms of how they view being an egg donor,” said Stephanie Levich, founder of Family Match Consulting, a leading donor and surrogate consulting company with access to 100 databases. About 61 percent of Cofertility donors are pursuing a graduate degree. They are also typically a little older than those in other databases, which usually accept eggs only from women 29 and younger.

“They’re not doing it to earn compensation for school,” Levich said, “but to generally help a family and preserve their own future family.”

While Cofertility doesn’t specifically target a Jewish demographic, 20 percent of its donors are Jewish. This is another distinction as “finding Jewish donors”—indeed, any minority—“is definitely challenging,” said Dr. Meir Olcha, an obstetrician and gynecologist who heads the Sama Fertility Clinic and is affiliated with Morgan Fertility and Reproductive Medicine, both in New Jersey.

The uniqueness of its donor database was part of what drew Sammy Kanter and Zvi Zobin to Cofertility. The couple married last May and were interested in starting a family right away. They searched other databases before going to Cofertility, which they heard about through their Jewish congregation, Ikar, in Los Angeles.

The couple recently matched with a Jewish donor on the platform (who declined to be interviewed). “Zvi and I are both very passionate about our Judaism—I’m going to be a rabbi in May,” said Kanter, 36, who is the rabbinical intern at Ikar. Zobin is Ikar’s director of membership and community giving. “We both come from Ashkenazi Jewish families, and we were interested in an egg donor that looked like she could be in our family, would have that similar Jewish vibe.”

He said that they were also drawn to the idea of a less transactional process of matching with an egg donor, one that “was more of a partnership.”

The donors at Cofertility, said Kanter, “were thoughtful about why they wanted to go through the process and what it meant to give their eggs to someone.”

And, he added, “we both found that moving.” 

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Amy Klein is the author of The Trying Game: Get Through Fertility Treatment and Get Pregnant Without Losing Your Mind.