I’m thrilled to sit down with Dr. Sherman Silber, a true pioneer in fertility medicine. Dr. Silber has been at the forefront of groundbreaking advances like mini-IVF, ovarian tissue transplantation, and in vitro maturation (IVM) of eggs. His work has transformed what’s possible for patients around the world, and I’ve admired his contributions since my earliest days in medicine. Together, we dive into the latest innovations and what they mean for anyone thinking about their fertility journey, planning for the future, or exploring new options.
In our conversation, we explore the science and future of reproductive medicine, from the practicalities of mini-IVF and IVM to the exciting potential of creating eggs and sperm from skin cells. We discuss the implications of these advances for patients with PCOS, those considering fertility preservation, and the evolving landscape of genetic testing and embryo selection. Dr. Silber shares his insights on ovarian transplantation, the ethics and emotions around egg donation, and what the next decade might hold for fertility treatment.
In this episode, we cover:
- The differences between traditional IVF and in vitro maturation (IVM), and why IVM could be a game-changer
- How mini-IVF protocols can improve egg quality and reduce medication side effects
- The science and future potential of creating eggs and sperm from skin cells
- Ovarian tissue freezing and transplantation as options for fertility preservation and delaying menopause
- The unique challenges and solutions for patients with PCOS
- The controversies and future of genetic testing and embryo selection (PGT-A and PGTP)
- The emotional and practical realities of egg donation, and why it can be a positive choice
Resources:
- Dr. Sherman Silber’s website
- Dr. Silber on Instagram @silberinfertility
- Join Dr. Aimee’s IVF Class at The Egg Whisperer School
- Learn About Dr. Aimee’s Fertility Essentials
Full Transcript:
Dr. Aimee: Hi, everyone. Welcome back to The Egg Whisperer Show. I’m Dr. Aimee. Today, I am so excited to be joined by a true pioneer in the world of fertility medicine, Dr. Sherman Silber. Today’s focus is on Breaking Fertility Barriers: Mini-IVF, IVM, and the Future of Reproduction.
Dr. Silber is world-renowned for his groundbreaking work in infertility and reproductive biology. He has helped develop techniques like mini-IVF, ovarian tissue transplantation, and in vitro maturation of eggs. I know that’s a lot of words there, but we’re going to break it down today. These innovations have changed what’s possible for so many patients around the world. I have been following Dr. Silber since I was a medical student. We’re going to talk about some of these exciting advances and what they mean for you if you’re thinking about your fertility journey, planning for the future, or exploring new options.
Let’s jump in. Dr. Silber, welcome.
Dr. Sherman Silber: Thank you very much, Dr. Aimee. I do appreciate this opportunity to be with you.
Dr. Aimee: Thank you. Let’s start with something many patients may not be familiar with, in vitro maturation, also known as IVM. Can you explain what IVM is and how it’s different from traditional IVF?
Dr. Sherman Silber: With traditional IVF, of course, we stimulate the woman with hormones in order to get more follicles, because you don’t want to just get one egg and go through multiple cycles because the majority of human eggs aren’t going to be a baby. We like to get multiple eggs, maybe 10 or 15 eggs, more if possible, so that she only has to go through one cycle to get embryos that will result in a baby. You give hormones for that. Actually, what we’ve found is you don’t have to do that with all cases.
We discovered that with our ovary freezing for cancer patients, that we can dissect that ovary and find these immature eggs that haven’t been stimulated and subjected to hormonal stimulation, so they’re no good in their present form. You can even retrieve them with a tiny needle, for cases of patients with PCOS particularly, then we can mature them in vitro. In other words, we can take these immature eggs that we call GVs and we can actually mature them into what we call M2 oocytes that we normally get when we stimulate a woman and retrieve her eggs for IVF, so we don’t need hormonal stimulation.
In fact, when we take out an ovary and freeze it for a cancer patient to preserve her fertility, we can preserve not only ovary tissue, we can freeze these eggs that are ready for IVF without any hormonal stimulation whatsoever.
Dr. Aimee: That’s incredible. I feel like so many eggs are discarded and wasted in this country every single day because other clinics are not giving eggs a chance that could potentially be used for IVM.
Dr. Sherman Silber: That’s exactly right. We have a motto; “give every egg a chance.” The IVM is remarkably good. We’ve based our approach on experimental work that we did with the Japanese with Dr. Hayashi making eggs in mice, but it works in humans, too, and taking skin cells from the mouse mother’s tail and converting them into stem cells and transforming the stem cells into eggs. That’s very complicated, but we learned from that the simplicity of IVM.
IVM is very simple. If any clinic wanted to take our recipe, anybody could do it, it’s not technically difficult to do.
Dr. Aimee: That’s wonderful that you’re also willing to share. I love what you said, “give every egg a chance.”
Dr. Sherman Silber: Give every egg a chance, yes.
Dr. Aimee: My clinic’s slogan is no egg left behind, but I actually like yours better. Give every egg a chance.
You mentioned the tail of the mouse in what you just said. People are probably wondering what you’re talking about. I think that takes us to our next topic that I would love to dive into with you. Is there hope from skin cells? What I’m talking about is this exciting idea in fertility science, and so many of my patients in the Bay Area ask me about that, and this in vitro oogenesis, which is the possibility of making eggs or even sperm from skin cells. It sounds like science fiction. Can you tell us, how close are we really to being able to do this and what does this mean for patients?
Dr. Sherman Silber: I work very closely with the Japanese scientists and also with Amander Clark at UCLA in Los Angeles, and the leader in England is Dr. Surani, who trained Dr. Hayashi. Dr. Surani is retired, so it’s mostly coming from Dr. Hayashi in Japan. I can tell you what he is embarking on and why it will work. He believes in five years we’ll be able to do this in a human, totally successful in the mouse. However, it will take another five years of regulatory review before we can really be okay by the regulatory agencies to do this in humans. But, we’ll be able to do it in humans, probably in five years.
We already are able in the human to make what we call PGCs from skin cells. Skin cells to stem cells, that’s easy to do in humans, everybody is doing that. Then turning the stem cells into PGCs, primordial germ cells, which means you’re sort of halfway there making the eggs. We can make PGCs very successfully because we know exactly what genes and transcripts to incubate the stem cells in. The next step requires fetal ovarian somatic cells or granulosa cells. A layman may not know what I’m talking about, but the cells that normally support the egg in the ovary. In order to convert these PGCs into competent oocytes that will make a baby, you need fetal versions of these cells, not adult versions. In the mouse, we can make these fetal versions of these cells, just with different transcripts. We have baby mice that just have come purely from nothing but stem cells, baby mice coming from mothers who have no ovaries.
We have PGCs now on many women who are over 50 who are out of eggs, and these are young PGCs, they’re fetal PGCs. When we convert them into oocytes in five years, they’ll be very young eggs. I make this outrageous statement that in about 10 or 15 years when the regulatory review is completed, a 38-year-old woman would be better off having a skin biopsy than an egg retrieval.
Dr. Aimee: Early in my career, I would say, and still say that I look forward to the day that no woman will ever have to go through egg freezing, no woman will ever have to use an egg donor, or even a sperm donor. This could completely revolutionize how we do IVF and what we offer patients. It will be extraordinary. I hope that I can see that day. I’ve been saying that. I used to say I’ll never see that day, but it sounds like we will.
Dr. Sherman Silber: I think we will. You mentioned sperm donor. In men without sperm, it is the same thing. We have PGCs from azoospermic men coming from their skin biopsy. It’s the same type of process to turn those PGCs in the male into sperm.
Dr. Aimee: Do you see the US government supporting these kinds of technologies, or do you think I should set up a clinic in Honduras to help patients with this? I’m totally serious. I have these thoughts in the middle of the night and I start going to ChatGPT asking where is the best place to set up a clinic overseas to offer patients experimental therapies. Do you think fertility clinics will be able to do this?
Dr. Sherman Silber: It won’t be right away. In the early days of IVF, which was 1979, we didn’t have widespread use of IVF until about eight years later. In other words, fertility doctors in 1984 were struggling. It took a while into the late-1980s before IVF became popular, so it was almost ten years later. It will be the same with this.
I think eventually every clinic will be able to do it. Frankly, the genes and the transcripts that we use to do these conversions to stem cells and to eggs, you can purchase all of them, they’re all for sale, they’re commercially available, so you can make the media.
Dr. Aimee: I want to talk about another topic that you’ve really pioneered. You made mini-IVF an option for patients. I would love for you to talk about mini-IVF, how you came up with it, how it works, and why it might be a better option for some patients.
Dr. Sherman Silber: I think it’s a better option for all patients. I’ll explain. It came out of our work with ovary transplantation in humans and with the in vitro production of eggs in the mice. The way it works is we discovered that all of your eggs in your ovary are always exposed to pituitary hormones, the stimulatory hormones, but in modest amounts. That’s all that’s necessary to mature the egg and make it a good egg.
The way it works is that almost all of your eggs are in a resting phase in the outer membrane or cortex, the outer shell of the ovary, and they’re recruited, on average, 30 a day from this resting phase. They go through four and a half months of genetic development that is not sensitive to hormones. It’s like the far side of the moon, we really don’t know. Now we’re finding out what’s happening, we need to, but it’s four and a half months of this strange process where the eggs are getting ready to be sensitive to hormones. Four and a half months later, they emerge from that phase and they enter the ovulatory menstrual cycle.
We discovered that less than seven days of exposure to the pituitary hormone and the eggs will never mature, no matter what you do. More than 12 days of exposure to these pituitary hormones and those eggs will probably degenerate, they won’t be very good. There’s a sweet spot of seven to 12 days of exposure to pituitary hormones that prepare them for becoming fertile and mature. Once we knew that, we realized that you want to synchronize when you stimulate to when eggs are first emerging from this resting phase.
It’s very simple. We put them on birth control pills for a minimum of 18 days. You could do it with some other method, like an antagonist, but what you want to do is just clean out all of those eggs that have had some exposure already to pituitary hormones so that when you stimulate, all you’re getting are eggs that on the same day you started the stimulation started becoming sensitive to the hormones. What we’ve found is you don’t really need much. You don’t need very much of the stimulation like FSH. All you want to do is create follicles so you can retrieve the eggs.
I’ll make an extreme statement. The only reason for a follicle is to make it easy for us to stick a needle in and get an egg. A very low dose will get the same number of eggs with a low dose of stimulation FSH as we would get with a high dose. We’ve known for decades, from work out of Europe and Holland, that high doses of the hormone will actually create a higher incidence of genetic abnormalities that we call aneuploidy. A high dose of FSH, frankly, is going to ruin most of the eggs.
Three things. Suppress first with birth control pills so that you can synchronize the stimulation. The second thing is a low dose of FSH, like 150 IU every other day. The third thing is you need LH for egg quality.
That’s important. We’ve found with the in vitro work in the mouse that I was telling you about, if you don’t have some LH, it’s very inefficient. How do you get LH? We can’t give it exogenously, because it has a one-hour half-life. Nobody makes it, we can’t buy it. We give them that 70-year-old drug, Clomid, in a low dose. You don’t want a high dose of Clomid. Just 50 milligrams, that’s it. That will give you the slight LH boost that you need for egg quality.
That’s very simple. Those are the three basic principles of this protocol. It’s a very low stimulation dose. Drug companies hate that because they want you to use a higher dose. The low dose will give you a better quality egg.
Dr. Aimee: What do you consider a high dose? I have patients that come to me for second opinion consults, like I’m sure you get all the time, and they ask, “Do you think that I was on too much stimulation and that’s why my embryos were abnormal?” How would you define high doses?
Dr. Sherman Silber: It’s not exactly a red line, but for example, couples that have low ovarian reserve or particularly difficult cases are put on 450 IU a day. Actually, 150 IU every other day would be ideal. You could do 75 a day, but you just reduce the number of shots by doing it every other day because FSH has a longer half-life. Anytime you get up to 300 or 450, you’re harming a lot of the eggs. Not all of the eggs, but you are reducing the number of eggs that are fertile.
Dr. Aimee: I agree with that. I see that, too. Patients have a follicle count of five or less, and they’re pumped with these high doses of medications for absolutely no reason. It doesn’t make any sense to me.
Dr. Sherman Silber: It doesn’t increase the number of eggs. It just ruins the eggs.
Dr. Aimee: Exactly. You emphasize with mini-IVF that you’re focusing on the quality, not just the number. Why is it that fewer eggs can sometimes mean better chances of success?
Dr. Sherman Silber: We don’t mind getting a lot of eggs. The point is you don’t want to get a lot of eggs by stimulating with a high dose of hormones. There can be women with very good high ovarian reserve, you give a little Clomid at 50 milligrams and 75 of FSH, and you might get 15 or 20 eggs if they have a high ovarian reserve. That’s just fine. I’d love to get more eggs, but not because they’ve had too high a dose.
Dr. Aimee: I want to talk a little bit about ovarian transplantation because you’re a pioneer in this, too. I’m going to throw out a scenario to you. Do you see a time when a woman in her thirties who hasn’t started her family goes and has a laparoscopy to freeze her ovary for later transplantation? Do you think that would ever be a thing?
Dr. Sherman Silber: Ovary freezing is a really good method of fertility preservation. It’s the only method that I would recommend for cancer patients. I still recommend it even for women who just want to preserve their fertility for later. I can explain why. However, if they’re not a cancer patient who is about to undergo sterilizing chemo, who are about to be sterilized by their cancer treatment, they really aren’t excited about going through surgery and removing an ovary. There’s no reason to be afraid of that because studies from Japan have shown that if you take an ovary out of a woman with two normal ovaries, you’re just adjusting menopause by only one year. Instead of the average age of 51, the average age in a population of women who have had unilateral removal of an ovary would be 50. And you’re definitely not making her less fertile.
I think it’s a perfectly good idea to remove an ovary and freeze it for a woman that wants to preserve her fertility. Instead of getting maybe 10 or 15 eggs, you’re going to get 100,000 eggs.
I don’t know if it’s ever going to be popular. Egg freezing is nonsurgical. You go through hormones and you go through multiple cycles and it’s miserable, but taking out an ovary sounds too formidable. For cancer patients, it’s not formidable. They know they’re going to lose everything, let’s take out an ovary. We leave the other ovary in, and the reason is we want to in the future transplant the ovary tissue back to the other ovary because it’s perfectly positioned for the fallopian tube to pick up the egg. What we’re aiming for is spontaneous pregnancy rather than an IVF pregnancy when we do an ovary transplant.
Recently, we’ve started in the last several years doing ovary allotransplant. That means not just a woman’s own ovary and not just an identical twin, but a sister, a cousin, or even someone unrelated. The immunosuppressive methods we’re using now are so safe that we’re happy to do this immunosuppression even for non-life-saving procedures because it’s very safe.
Dr. Aimee: My mind is blown. You’re talking about basically an organ transplantation, but the ovary, you’re not your own donor.
Dr. Sherman Silber: For many religions, egg donation is not allowed. They feel it’s someone having someone else’s baby and they don’t like it. Many people just don’t like the idea of it. A perfectly good option is to transplant an ovary, because then she’s ovulating inside of her own body. No one is fooling anybody, it’s not her DNA, but it really doesn’t matter because she’s making the egg herself, it’s being made within her body. The religions are happy with it that would be against egg freezing. Many patients prefer that idea.
Dr. Aimee: This is so exciting. How long can frozen ovarian tissue last once it’s transplanted back?
Dr. Sherman Silber: That’s a good question. We’re only going to transplant back about one-fourth of the tissue at a time. We’re going to freeze the other three-quarters. We might have frozen it all and we only will transplant about one-quarter of the tissue at a time. That will last about 10 to 12 years. We’ve discovered that follicle recruitment is strictly pressure mediated. The higher pressure of tissue in the ovarian cortex is what keeps those follicles at rest. I’ll actually talk about that when we talk about you and I living long enough to see this happen. That’s an aside that’s interesting.
But first, let me just point out that this tissue pressure is reduced when you transplant a piece of tissue. You have a massive over-recruitment of eggs, so you lose a lot of eggs in the process of ovary tissue transplantation. There might be something like 25,000 eggs in that one-quarter of the ovary that you’re transplanting, and you’re losing a lot of them. But it doesn’t matter because as the number of eggs goes down, the rate of follicle recruitment goes down. That’s why you can take out one ovary and the woman doesn’t have menopause any earlier, except maybe one year earlier. As that ovarian reserve goes down, the rate of recruitment goes down, and it keeps the ovary going.
You don’t want to do IVF with these pieces of ovary tissue because you’re only going to get one or two eggs. The woman will be ovulating an egg every month for the next 12 years, so you want her to be able to get pregnant naturally. That’s why we want to put that tissue back where the ovary that has been killed by chemotherapy is located, so the fallopian tube has no problem picking up the egg.
I just have to mention this aside. When there’s high pressure in that outer cortex, those resting oocytes, the resting eggs, and the nuclei are rotating. In low pressure, the nuclei are not rotating. It’s a pressure gradient from the outside of the ovary to the inside. At that point where the nuclei stop rotating, that’s where they go on and develop and they’re either ovulated four and a half months later or they die. Ovarian longevity is related to that tissue pressure that causes nuclear rotation.
That is true in all of your stem cells in your body. I recommend exercise for longevity. If you’re lucky enough not to get some terrible cancer that might kill you, the way to delay your aging process is a lot of exercise because it creates tissue pressure, myogenic tension, causing your stem cell nuclei to rotate.
Dr. Aimee: I know this sounds silly, but what about a weighted blanket? You’re talking about pressure. If you slept with a weighted blanket, especially over your pelvis, would that help?
Dr. Sherman Silber: I never thought about that. It depends on how that pressure is transmitted inside. I will say this. When the woman is pregnant, the ovary goes to sleep, there’s no follicle recruitment. That’s been shown with the AMH studies. Women just keep on having more babies, often. The increased abdominal pressure of pregnancy prevents follicle recruitment because the entire ovary is subjected to pressure and all of the eggs’ nuclei are rotating.
Dr. Aimee: That’s so interesting. Very interesting. I want to talk a little bit about PCOS and then bring in some of the concepts that we’ve talked about today. Fertility treatment can be really scary for women who have PCOS. There’s always concern about a very scary condition called severe OHSS. How can IVM or mini-IVF make this process safer and less stressful for them?
Dr. Sherman Silber: First, we have to understand what PCOS is. So many physicians are so confused about it, calling it the metabolic syndrome and there’s so much controversy about it. It’s really simple. These are women who are born with too many eggs. That excessive number of eggs or follicles inhibits the pituitary gland’s release of FSH when they have a cycle, so they don’t recruit a dominant follicle, or they recruit it inadequately. It’s not this adequate huge increase in FSH at the time of menstruation. The PCOS is just caused by having too many eggs.
It can be aggravated, for sure by obesity. The fat cells absorb estrogen and release estrogen, and those fat cells thereby can also inhibit pituitary’s release of FSH, which should go way up at the time of menstruation, so wouldn’t recruit a dominant follicle. If women who are obese lose weight, we may very well see them go from irregular cycles to more regular cycles, and they may even get pregnant spontaneously. But that isn’t really the root cause.
The root cause is having been born with an excessive number of eggs. The proof of that pudding actually is that their cycles are all messed up and irregular until they’re in their mid-forties, and then they become regular. That’s because you lose eggs as you get older. In your mid-forties, the egg quality is down and they’re less fertile, but on the other hand, you ovulate them in your mid-forties, even with PCOS.
Dr. Aimee: Thank you for that great explanation. You’ve been studying how eggs develop inside the ovary for years. What’s something new you’ve learned that gives you insight into how we can better preserve fertility or improve IVF results?
Dr. Sherman Silber: I didn’t completely answer your question about PCOS, but that’s related. Again, mini-IVF is ideal. You don’t want to over-stimulate those ovaries, that leads to hyperstimulation syndrome. I think for women with PCOS, they should do mini-IVF when they want to have a baby and they should be on cyclic hormonal birth control when they don’t want to have a baby, because the irregular cycles are miserable and there is a metabolic syndrome that develops from not ovulating which results in a high testosterone level, which is not great, causing skin problems, hypertrophic endometrium, so higher risk of cancer of the uterus later in life. I think it’s really important to manage PCOS as a women’s health issue, not only as an infertility issue.
I think the best way right now for improving results with IVF and lowering the cost is the mini-IVF protocol that we talked about. Particularly if they are PCOS patients, I would also make sure we trigger maturation with Lupron rather than HCG, because it’s still potentially dangerous. I would plan on freezing all of the embryos, because you don’t want to get pregnant when your ovaries are big, because that could result in hyperstimulation syndrome. I think mini-IVF with Lupron trigger and good reliable embryo freezing is important.
There is a lot of controversy about genetic diagnosis in biopsy of the embryos. It’s still controversial. If a couple is a carrier for a particular genetic disease or mutation, it’s extremely accurate. We were the first ones to do that in the United States for cystic fibrosis in a patient with congenital absence of the rash, and we published it in 1995 in JAMA. It remains very accurate. However, routine screening for what we call aneuploidy and euploidy is just plagued with controversial results. We certainly would think it’s not a bad idea if a woman had just huge numbers of eggs and a number of embryos, but there are going to be embryos you diagnose as abnormal that would have been a baby. I think it’s a problem if there’s only a small number of embryos. You would throw away embryos that would have been a baby, so that’s very controversial. It may improve in the future, so I think embryo biopsy and genetic diagnosis is an area of great research.
What I’m very excited about is the possibility of if a couple has a family history of a particular disease that we know is familial or genetic, whether it’s heart disease or diabetes or high blood pressure, it’s possible now with PGTP to actually get a score on the embryo biopsy so that you have some idea what is the percentage chance that baby is going to have an adult disease that the parents had or the grandparents had when it grows up. You can reduce that risk by embryo biopsy. It needs more research, but I think that’s the most exciting aspect of embryo biopsy.
Dr. Aimee: I think you’re one of the first fertility doctors that came out publicly and have been very cautious about interpretation of PGT-A results. That’s one of the many things that I’ve admired you so much for. I actually tell my patients PGT-A really should be PGT-ambiguous.
Dr. Sherman Silber: That’s perfect. Ambiguous is right.
Dr. Aimee: Because I think if you were to a someone who doesn’t have a background in this field, “What are you screening when you’re doing PGT-A,” a lot of people think that they’re screening for autism and birth defects, they’re baby is going to be perfect and genetically normal, which is not true.
Dr. Sherman Silber: Exactly right. We shouldn’t be calling it genetic testing. All the patients say, “You are going to do genetic testing, are you not?” Then I have to explain the whole thing to them about whether it’s a good idea or a bad idea because it’s not genetic testing.
Dr. Aimee: Right. Let’s talk about the future of fertility treatment. If you look five or ten years into the future, what breakthroughs do you think patients might see when it comes to treatment?
Dr. Sherman Silber: The biggest problem, of course, is older eggs and also azoospermia. I’m very confident that we’ll be able to make sperm and make eggs in the future. As I said, in five years, but with regulatory review, it might be ten or fifteen years away before it’s the common practice.
I certainly think that a 45-year-old woman who has maybe a 10% chance of success would be much better off having a skin biopsy, converting those skin cells into stem cells, those stem cells into eggs, because they will be fetal eggs. You can’t get younger eggs. You don’t need very many of them because they’ll be very fertile eggs that we’ll get from skin cells.
Dr. Aimee: What about for a menopausal woman or someone who is perimenopausal and is just having a miserable time with menopause, is there a role for ovarian transplantation for her? Maybe removing an ovary at 40 and then replacing it in her late-forties, to potentially delay menopause for her as a potential way of increasing longevity?
Dr. Sherman Silber: The University of Copenhagen in Denmark was the first to suggest that, and it’s 100% right. You can take out an ovary and freeze it, and then when she goes through menopause around age 50, instead of allowing her to go through menopause, you could transplant a piece of that ovary. It will last 10 to 12 years. She doesn’t have to be on hormone replacement, it’s going to be natural.
If she doesn’t want periods, it’s okay, you can put in a Mirena IUD and she won’t have periods. Twelve years later, you can transplant another piece of tissue. You don’t even have to put that tissue near where the ovary would normally be. You can put it in her arm and it will work just as well for hormone replacement. She could make it easily to age 95 or 100 without ever having to take hormone replacement.
Of course, I think it’s important for women not to have to go through menopause. I’m not just talking about hot flashes that will be over in three years, but I’m talking about overall health, bone health, vagina not drying up, and recurrent urinary infections, early-onset Alzheimer’s. For all of those reasons, it’s better for a woman, unless she has a real problem like estrogen sensitive breast cancer, it’s very important for her not to be menopausal.
That may be a more important aspect of ovarian transplantation that you brought up than just preserving fertility. If you put women on just pills and hormone replacement, they often just stop taking it. All you have to do is just slap a little piece of tissue on their forearm, and then for 12 years they don’t have to think about it.
Dr. Aimee: Everyone, you heard it here first. Dr. Silber, I’m going to come to you. I want my ovary removed, I’m 49 years old and I actually still have regular cycles. We’re going to do this experiment together because I want to live until I’m 120 and I also don’t want to go into menopause until I’m 90.
Dr. Sherman Silber: I think that’s right. I agree with you totally.
Dr. Aimee: It has been such a delight talking to you today. Clearly, you’re a pioneer in this field. I’m so honored that you’ve spent this time with me today. I want to know, what’s your biggest hope or message that you’d like to share with patients who are listening to us?
Dr. Sherman Silber: I would maybe divert from what I’ve been saying, and the answer to that is this. There are couples where there’s no sperm, and right now we don’t have a treatment for it. We might not be able to do this for 15 years. There are women with no eggs or their eggs are no good, and they desperately want a baby. That’s more and more common because people are putting off childbearing until they’re older. Their only option is donor eggs, and they’re afraid of donor eggs.
I’m very interested in early childhood development. We’ve been using donor eggs for such cases since 1986, so we’ve watched the families grow and the kids develop and grow up. I’m certain of what I’m about to say, though it might sound controversial.
We can easily match for background of parents with egg donation. What you cannot match for are five attributes that are more important; personality, character, intelligence, emotional stability, and bonding with you as the mother. Those five attributes are definitely not in the DNA, but they appear very early, in the first two or three years of life. They arise just like an accent of a Chinese kid that’s brought up in Brooklyn and has a broken accent. They arise in the first two or three years of life from how they are interacting with their parents or their caregivers.
When these kids grow up, we’ve talked to them. The mother is very proud that the kid just graduated medical school, and I say, “It’s not your DNA,” just to challenge her. She said, “Who cares whose DNA it is? It’s my baby.” In other words, it’s their baby. I would like to dispel the idea that egg donation is spooky and inappropriate.
Dr. Aimee: Thank you for that. I think there’s a lot of shame that patients feel when they even start thinking about it. I always tell patients that the one regret my patients have when they’ve had their egg donor baby is that they didn’t do it sooner.
Dr. Sherman Silber: Exactly right. They wish they had done it sooner. Everybody wants their own DNA, and that’s why we struggle to do that. But if they can’t have their own DNA, then rationally, egg donation would make them happy.
Dr. Aimee: Thank you for that. Dr. Silber, thank you so much for joining me today and sharing your wisdom, experience, and hope with us. Your work has opened the doors for so many families and has been an inspiration to me in my career. I know our listeners will take away a lot of encouragement from this conversation.
To everyone tuning in, thank you for joining us. Don’t forget to subscribe to The Egg Whisperer Show on YouTube and follow the podcast on Apple or Spotify so you never miss an episode. I’ll see you again soon.
