Future of Fertility Dr. Brian Levine: Audio automatically transcribed by Sonix

Future of Fertility Dr. Brian Levine: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Abby Mercado:
Hi, I'm Abby Mercado, an IVF mom, former VC investor, and CEO of Rescripted. Welcome to The Future of Fertility, a podcast dedicated to shining a light on the entrepreneurs and innovators who are changing the face of family building. With billions in funding over the past few years, we'll introduce you to the people, the ideas, and the businesses that are changing the fertility industry and in turn, millions of people's lives. The future of fertility is bright. Now let's get into it!

Abby Mercado:
Dr. Brian Levine is the founder of Nodal, a company on a mission to disrupt the surrogacy industry by focusing on transparency and access as tools to drive down the astronomical costs. The company is building a platform and community based on education, advocacy and support, with a goal of connecting intended parents and gestational carriers that share similar values. As a well-loved physician, board certified in both reproductive endocrinology and fertility and obstetrics and gynecology. Dr. Levine has seen the problems Nodal is solving firsthand many, many times over. Dr. Levine and I met early on in my own journey as a fertility entrepreneur, where he listened intently to the problems I was dreaming to solve. As the founding partner of CCRM New York and its practice director, Dr. Levine has always been an entrepreneur, too. I'm so glad he's now joined our ranks as a tech entrepreneur as well. Thanks so much for joining us today, Dr. Levine, it's so good to see you and catch up!

Brian Levine:
Well, thank you, Abby. I'm super excited to be here, and Dr. Levine is totally fine for the interest, but let's just go by Brian.

Abby Mercado:
Okay, cool. Like, what's, like, one of your, your parents friends from, like, early on in your lives, and they asked you to call them by their first names, and you're like, what? But, okay, Brian, fine, fine. I'll do that, here we go.

Brian Levine:
Perfect.

Abby Mercado:
So, Brian, first of all, congrats. Super, super pumped to chat with you about Nodal. For the listeners who might not know about the well-loved Dr. Brian Levine, tell us a little bit about yourself, lind of from soup to nuts, and please end on one fun fact that few people know about you.

Brian Levine:
Sure. So I think the, it's funny, whenever I hear my intro, the first thing that stands out to me is the doctor. And I think that's what I spent my life doing, it's actually a pretty easy decision. In high school, you want to be a doctor, you study to do well in the SATs and you go to college and you're pre-med and med school and residency and fellowship and it's just like it's a very structured plan. And then, of course, for me, I took a hard right and did kind of like a 90-degree turn from the normal place that people typically go to. And instead of just joining a practice that was established, I helped start CCRM New York, which is amazing practice. And so being a doctor is definitely one of the things that defines me. But I think being a dad is probably the thing that I love being called the most. Having two little girls at home, Isabel, who's five and starting kindergarten next week, and Addison, who is one and changed a little over one and a half, is really I think, it helps motivate me to kind of keep pushing. It helps me understand why I need to work so hard every day and what I need to do every day. And then, of course, I have this whole other second life out here where I've started now as a tech entrepreneur and a founder, and it's my two girls that kind of motivated me to do this because I feel like people who want to dream of having a family or growing a family should not have to dream, they should be able to do it. And so here I am with these three titles of dad, doctor, founder, but none of them probably describe the fact that I am an early morning reader and coffee drinker. So outside of like all these other things, I think the reason I've been successful and as a physician and also as a dad who still has breakfast every morning with our kids and as someone who's been able to start and grow a company is that I wake up every day at 4:30, doesn't matter what day of the week it is, I don't use any electronics and I just read, I read papers, I read newspapers, I read journals, and I'm really, really picky about my coffee. And so I love my Nespresso machine, I like my certain blends, so every morning starts with a good cup of coffee and probably a journal.

Abby Mercado:
It's an amazing fun fact. I have so many follow-up questions. So what time do you go to bed?

Brian Levine:
I go to bed every night at 11 p.m..

Abby Mercado:
What? So you're one of those crazy people who just doesn't need sleep. When did that start, med school?

Brian Levine:
So I always blame that medical school ruined my sleep and I was convinced for a super long time that it was unhealthy. And then I invested in this thing called a whoop band, which is actually on my wrist right now, who actually follow all my biometrics and I follow it. And I actually have found that I learned how when to stop eating and when to go to bed, and how I actually can kind of hack my own health to get restful sleep in five and a half hours. It's been, probably a work in progress over the last 42 years of my life of trying to be more efficient during the day. But yet my wife hates it, like my family can't stand it because I'm always awake first, I want to tell them about the weather and I want to tell everyone like, you know, it's looking bad outside, you need to pick new clothes. But yes, I am a painful early riser.

Abby Mercado:
Wow. A super early riser. That's, you know, also your, you're a physician, so we should all probably believe this. I don't think Arianna Huffington would like this very much, but that's okay, she can talk to you. I guess you guys are both based in New York. So, Arianna, you're listening, go, go find Brian. So tell us how and this is actually a question I think I've always wanted to ask you. What was it about the, the fertility industry infrastructure, as you graduated from fellowship, that made you want to do your own thing and not join a huge practice?

Brian Levine:
Yeah. So when I was in residency, I had an unbelievable experience at Columbia. So I did my med school at NYU, and that's where I've met great people like Dr. Sarah Barton, who's also an NYU graduate out in Denver. But when I was in residency at Columbia, it was a very busy practice at the time. And what I realized was that the practice was so busy that the doctors are just exhausted. It was like, it was draining on them. And yes, they were smiling and happy, but they were tired. And then when I walked to do my training at Cornell, I was like, oh my gosh, I'm at like the mecca of training, it's supposed to be incredible, and I realized it was just work harder, work faster. And what happened was I had this aha moment very early in my fellowship training where I said, I don't want to be just another cog, I just don't want to be another person who just turns and burns and walks in a room and says to a patient, I'm so sorry you're having a miscarriage or congratulations, you're pregnant. And both of those conversations to end with go talk to a nurse. And so I decided that the only way to do that was to focus on the patient experience and the only way that I'd be able to focus on patient experience, I truly felt was by starting my own practice, which is what I did. And of course, if you want to start a practice, you have to make sure that you have something behind you. So that's why I partnered with CCRM to have, you know, what I view is one of the most powerful laboratories possible.

Abby Mercado:
Got it. That's an amazing story. And I think that and what, what you've done, I think so many REIs, is kind of look, look at you and say, wow, this is really cool. You know, because essentially able to kind of define his own path, which is great, and to focus so much on the patient and to be just so acutely aware of, of the patient experience is sometimes unique in this industry, which is an amazing thing that I really like about you. So thank you, from past infertility patient so.

Brian Levine:
Well, thank you. I think as I've gotten older, I've realized that we're all really fragile and people have different breaking points and you don't know where someone's breaking point is, but if you just treat a patient the way you'd want your mother or sister or wife or daughter to be treated like they'll never get in trouble. And so by starting my own practice and bringing on some amazing partners, that's what we did, right? We kind of just focus on the patient experience because we know the science is behind us and it's been a winning formula since 2015.

Abby Mercado:
Awesome, awesome. So we'd love to, well, also ... Where were you, like, born and raised? Like, where are you from?

Brian Levine:
So I'm as New Yorkers it comes, I grew up on Long Island. I've never had another driver's license from another state my entire life. Grew up in Long Island, went to Cornell for undergrad. I actually started a PhD at NYU, initially in molecular biology genetics and hated it and I dropped out after a year. And then on the second day of med school, I heard a lecture about the genetic testing of embryos, I was like, oh my god, this is what I'll do the rest of my life. So that's why I became a fertility doctor and literally did residency, fellowship in New York City as well. And I raised my family in New York City and I'm like a through and through believer that New York bagels are the only bagels in the world.

Abby Mercado:
It's the water, right?

Brian Levine:
It's the water. It's, it's why our pizza's the best, our bagels are the best, it's why our marathons are the best, it's all about the water.

Abby Mercado:
There you go. What is your favorite thing to read in the morning at 4:30 a.m.?

Brian Levine:
So I have a rule, I read for pleasure three days a week and I read for work four days a week. So my favorite thing to read is either The Economist or Harper's, because it is so far out of what I do every day that I feel like I'm getting smarter or I'm just getting more relevant when I go out to dinner with my friends because I know what they're talking about. But yeah, those are definitely my favorite things. And if you want one other really crazy fun fact about me, my wife and I made the very conscious decision in the end of August that we're going to learn what this Game of Thrones thing is all about. And so we started watching Game of Thrones and we've actually gotten it down that we can watch half a season in pretty much one night.

Abby Mercado:
So efficient.

Brian Levine:
We are like really into this right now, we like get the kids to bed, we like watch four episodes or like almost half a season. We watch four episodes, then we eat dinner during it, it's amazing. So we're like totally all in on Game of Thrones. We're trying to get through all eight seasons right now.

Abby Mercado:
It's, I think I'm like smiling so hard because it's like my all-time favorite show as it is many other people's all-time favorite show. So.

Brian Levine:
It's incredible.

Abby Mercado:
I hope you continue to enjoy it and finish it all. So.

Brian Levine:
Thank you.

Abby Mercado:
Well, so let's talk a little bit about Nodal. First of all, what is Nodal, tell, tell us about that.

Brian Levine:
Well, let's do this. Let's talk a lot about Nodal.

Abby Mercado:
Yeah!

Brian Levine:
Because I'll tell you, I'm really proud a lot of my achievements and things to date, but this one is super exciting and I'm so jazzed. The, the real issue is that last summer I had this moment where I just couldn't keep having the same continuous conversation with patients where I kept saying, we're about to have a terrible conversation, and people would look at me and they'd be like, why are we about to have a terrible conversation? Because we're going to talk about surrogacy, we're going to talk about a broken system, we're going to talk about a system where you're going to hurry up and you're going to wait. And as someone who's very passionate and I like to help people, obviously, because I think that's, there's a sense of altruism in all of healthcare, no matter if you're a doctor or just someone who's a tech person. I really was feeling uncomfortable in discussing surrogacy with intended parents, it literally was getting under my skin. You also have to remember that surrogacy just became legal in New York State in 2021. So these were new conversations for me, right? Prior to that, we had to send our embryos to other clinics to be used. But the problem is that when I started prefacing every conversation, was that we're going to have a terrible talk, people used to look at me and they'd be like, that just rolled off your tongue. And I'm like, yeah, because that is the current state of it, it's expensive, it's opaque. I'm going to walk you through it, and I want to tell you the truth of how it all works. But end of the day, you're going to be stuck waiting through these murky waters, and I can't tell you if or when is going to work, and that was tough. And so either I can be part of the problem and just keep having that terrible conversation or it can be part of the solution and just put my money where my mouth is and start a company.

Abby Mercado:
So tell us a little bit, tell us more about the problem set and all the hoops and let's say, let's call it a New York patient before 2021 are, a new, a set of New York intended parents like, walk us through everything that they had to do to find a surrogate to ultimately see a live birth.

Brian Levine:
You know, for any patient that I had from anywhere in the country, whenever we want to talk to them about surrogacy, because either it's someone who can't be pregnant because they're a man or maybe the woman had a prior diagnosis of cancer or someone who can't get pregnant, right? They've had failed transfers or someone who shouldn't be pregnant because they've had a complication of prior pregnancy. Whenever we had those conversations, we always say the first thing you need to do is have an embryo to put it somewhere. So of course you take them through the IVF pathway and you make embryos, but once the embryos are sitting in the cryo and they're frozen and they're just waiting to be transferred somewhere, we would then start by saying to them, we need to find you an actual surrogate, and the best way to start that is to call an agency. And of course, in healthcare, you can't just give one name, right? You have to give them a list of people to do and you would guide them. Then you'd say, you can call some agencies and hopefully you can navigate these waters and you can talk to some people. And this is what I typically heard from patients, I called the big three and the big three all told me it was going to cost between 150 and 250, and I don't even know what that money is going to go for. But they said, if I don't pay now, it's just going to be wasting time and I'm going to have to spend no matter what. So who do I give this money to? And I was like, flabbergasted, right? Like, you know, me and my staff will go to the ends of the earth to help someone save a dollar per unit on their drugs that they're taking for their fertility care. And now all of a sudden, I kept hearing that these agencies were saying, you can prepay and a retainer fee and you can hold us and whatnot. And typically what would happen is that the patient would sign up with an agency because they were either fearmongered or they got scared or nervous or they had fear of missing out if they didn't pay soon enough, and they would then just basically hurry up and wait and they would wait until the agency would call them with a potential surrogate to match with. Behind the scenes what the agencies are doing for those really high costs is that they're acquiring potential surrogates through legion organizations or other different ways, those surrogates are getting their medical records reviewed, those medical records are being reviewed and processed, and then ultimately they're making sure the person is sound, either by doing background checks or psychological evaluations or on site visits or whatnot, to make sure it's a good fit for the potential intended parents. But pretty much it was like, pay us money and wait.

Abby Mercado:
And like all of that, I mean, I'm, I'm flabbergasted by those numbers, and I've been in the industry for a few years now. That's, I mean, holy moly. And I think I knew it, knew those numbers, but it's just a really, really stark reminder what like, what is actually, like what, what if, what of that costs is like cheese on top. Like, like what should this actually cost people?

Brian Levine:
Great question. So I'll rephrase your question with, which is what any individual would ask if it was a business outside of a business of being born, right? But the question you're really asking is what are the margins that these agencies are taking?

Abby Mercado:
Yeah, sure.

Brian Levine:
And the answer is it's unclear. What we do know is that the compensation to the surrogate or the woman who's going to carry the pregnancy has run anywhere from 40 to 45,000 dollars over the last five years. So even though the cost of surrogacy was about 75k 5 years ago, and now, like I said to you, it's pacing know, call it 125-150 to 250, the compensation to the woman doing the heavy lifting really hasn't changed. So there are legal fees involved in there, there is insurance that's involved in there, there's her medical care, there's money for her lost wages. And then there's this really unclear, big, opaque agency fee. And it might be the money being held in escrow at a certain rate, it might be the money that's going to be handed to the potential surrogate at the end. But there's a lot of agency fees that are just unclear.

Abby Mercado:
Yeah, interesting.

Brian Levine:
So in this big opaque mess of what we're calling agency fees is unclear of actually what is going to the agency and what is actually necessary and what is the tees or the fluff on top. What I do know is that having kids is really expensive. And what I do know is that every dollar that you can reallocate to your children is huge. And I know that every dollar that you could potentially reallocate to that woman who's taking the incredible risk to carry your most precious thing ever, your future family, probably is a better way to spend your money than to be directing it towards an agency. Now, when I would talk to agencies being like, hey, why is this cost so much money? Like, why is my patient getting charged a match fee? And the woman you send to us to potentially evaluate it wasn't really a good fit. So we have to get another one now, but they're being charged again for a rematch? Like what is this match that you're doing? And every agency pretty much said to me, that's their secret sauce, like they can find a match better. So as someone who doesn't like to sit idle and likes to actually fix problems, I said, let's fix the match and welcome to Nodal.

Abby Mercado:
Yeah. So we've heard about the problem that Nodal is solving. We've heard how expensive this problem is. How big is this problem? Like how many people need surrogacy? How, will this market grow? Tell us tell us a little bit about that.

Brian Levine:
Yeah. So, you know, it's, it's interesting because to start a business means you have to go through fundraising. And to do fundraising means you have to talk to investors or to people who are naive to fertility, right? So I pretty much had to become a subject matter expert very quickly beyond just the clinical side, but really the business of surrogacy, to understand it, to help be able to articulate the problem at hand and the solution that we're trying to propose. What we know today and this is again, going by the domestically published data from the Center for Disease Control is, right, because the CDC is the one who tracked all the pregnancies, we know that there are approximately 5000 babies born through surrogacy on an annual basis. To me, that seems incredibly low for a country of 380 million people.

Abby Mercado:
Yes, it does, incredibly low.

Brian Levine:
It doesn't make sense, incredibly low, and it doesn't make sense to have such a low number. Well, what we know from the the society versus the reproductive technology or SART, the gestational surrogacy rate's approximate 50% to 55%, so probably around 10,000 embryo transfers a year for surrogacy with the most recent data that we have, which is 2019. So if we think that the market is flooded right now with either supply, meaning type of surrogates, or flooded with tons of interest, meaning tend to parents, do you mean to say there's only really 5000 people who, or 5000 intended parents out there who desire a kid through surrogacy? Absolutely not. What we know is that when we start talking to agencies and you ask them of all the phone calls you receive, how many people actually get to go through the process, they'll tell you confidently it's around 8%.

Abby Mercado:
Wow, okay, wow.

Brian Levine:
So what we know is that it's around 8% of met-need today. Or if you want to look at it, how I'm looking at this problem, 92% of the people who pick up the phone and call an agency don't actually get to achieve their goal, which is to start or grow a family that doesn't even include all the members of the LGBTQI community, all the individuals who might have great fertility benefits that don't include surrogacy, all the individuals out there who potentially have had the diagnosis of cancer and can't be pregnant again, who've never even explored this option. So we believe it's a huge untapped area right now.

Abby Mercado:
Thank you for breaking those numbers down for me, I am super convinced. So how is Nodal fixing this? Tell us about Nodal. What does Nodal do?

Brian Levine:
Yeah. So first of all, the word Nodal comes from three different places. The reason is called Nodal is because we're connecting a bunch of nodes of information. What we're doing is we're connecting different nodes, right? The first node is the potential gestational carrier or the surrogate. The other node is her medical records, her background history. Then the node is her profile, and then we're connecting her to potentially an intended parent, to address the problem of reducing the cost of surrogacy, right? Like, how do we address that problem where surrogacy is price prohibitive if we're focusing completely on the match today. So we're not an agency, and in fact, I don't want to be an agency. And in fact, in New York State, a doctor can't own an agency. So we're not.

Abby Mercado:
Yeah.

Brian Levine:
But what we are is a matching platform. What we're actually doing is helping intended parents meet gestational carriers or surrogates, in what I would say is an equitable fashion. Now, what we're doing really is giving surrogates and gestational carriers a voice. What I mean by that is that we allow them to come onto the platform and we use some targeted advertising and educational programs and resources and friend of friends, referrals and things like that. But we let a gestational carrier surrogate onboard herself so that she can build her own profile. In that profile, she says what she hopes to have. Either a single embryo transfer, an open surrogate relationship, or closed, where she actually wants to know the intended parent to have a relationship or not. Maybe she wants to fly or not fly or driving distance from the intended parents. But we try to do is to really help her have her voice to what she's hoping for. Maybe she also wants to receive, instead of 40 to 45000 dollars of compensation, 50 or 55,000 dollars compensation. So we ask her upfront about what are her wishes and what are her wants. Ultimately, all that information is gathered through our, our program coordinator, who has a prior surrogate herself three times within an agency as well. And we help that gestational carrier build a profile. We also then have a huge list of intended parents. And so we allow the intended parents to build their own profile as well. What are they looking for? Maybe they're looking for someone who's within driving distance of them. Maybe they're looking for someone who's willing to take or accept a two embryo transfer or one embryo transfer, and there's maybe a budget, and what people are hoping to do. And what we're really trying to do is our bumble and the matching profiles that happen out there, is we let the surrogate see three profiles of intended parents. The surrogate makes the first move, and that's what makes us so different here. What we're doing is we're charging the intended parents a monthly fee to be on the platform, and each gestational carrier surrogate is given three profiles to view. What happens is that by allowing the surrogate to pick who she wants to work with for the first time in the history of surrogacy, we are empowering this woman that she made the decision of who she wants to be with. Empowering this scenario and putting them together, I think, is incredibly heartwarming for the intended parents to know they were picked, so that this woman who wants to carry their potential pregnancy chose them. More importantly is that for the surrogate for the first time, she feels like she has a voice. She has the ability to really say who she wants to work with. She's not just being traded through an agency. She's not just being assigned through an agency. And oh, by the way, imagine our profile, on, our platform is 6000 dollars, not 50, not 60, which is what the agencies say it costs for a solid match? 6000 dollars. So hopefully, if someone, an intended parent can match with a surrogate for 6,000 dollars, they can put that money to where it matters, back maybe towards more compensation for the surrogate or back towards covering the legal fees or the administrative costs, but the other issues that pop up along the way.

Abby Mercado:
So we've talked a little bit about what a, an intended parent might look like, what a set of intended parents might look like, tell us a little bit about a surrogate. What kind of, what kind of people are surrogates?

Brian Levine:
I think the ideal surrogate is courageous and strong and kind and caring and helpful. When you talk to people who go through surrogacy and you talk to the actual women who are brave enough to do this, it's not for the money. It's actually really, really interesting. Money is not the motivator for the gross majority of people who want to be a surrogate. It's actually the sense of wanting to help others and loving being pregnant. My wife hated being pregnant. She's like, I love the kids, I hate the experience, of course we did it, but she's like, I'm good. ... To other people, I think the opportunity to help a family start or grow when you love being pregnant, I think it's like a great match. And the truth is the ideal surrogate is someone who's willing to help, it's the person that you'd want to sit next to on an airplane. She doesn't have to be your best friend, she's just the person that you trust with your most precious next step for your family. I think another way to describe the ideal surrogate is someone from a stable home. You have to remember that every surrogate is a mom, and this is really important to us is that we recognize that you can't be a surrogate unless you already have kids and you already are a mom. And so what we're trying to do and we hope to continue to do is to show these courageous women the respect that they deserve and show their families the respect that they deserve. So we're not lowballing them on compensation. We're not trying to get to squeeze an extra embryo in there for just a couple extra thousand dollars. No, we're trying to do the opposite. We're actually trying to say let's be as transparent as possible because you have a responsibility now to the kids that you have at home and to the kid that you're going to potentially help someone else have along the way, and we respect that relationship so much.

Abby Mercado:
I love it. It's I mean, it makes all the sense in the world. And I don't know, it's just going back to like you guys are truly the bumble to the tender, right? Like, you're having the other, the other person makes the decision, you know, the other person swipe in whatever direction, and that makes makes all the difference.

Brian Levine:
Yeah. I think, you know, as a physician, we prescribe a lot of medication, we prescribe a lot of treatments, but I think the most successful doctors out there are the ones who partner with their patients where the doctor who feels the winds with the patients and the doctor's there for the losses. And that's part of my DNA and that's part of my ethos and that's part of this company. So how do we ensure buy in from day one? Is we let the person doing the heavy lifting make the heaviest decision.

Abby Mercado:
So tell us a little bit about how, how is this different from founding a clinic? Founding Nodal, like how, what was different about your experience as an entrepreneur? Kind of switching gears a little bit. After we're, after we're now all obsessed with the Nodal and just so fascinated by the surrogacy market.

Brian Levine:
So, a couple of things. One is starting a clinic is lots of structure and regulations. Starting a clinic is having a great lab partner like I did along the way and having incredible partners to work with, which I do every day. Starting a company is about realizing you're gonna expose to to risks that you don't know, right? Like this company was started with savings that my wife and I had planned for potentially a second home. And we felt like it was so important to us to say, like, we're going to delay that, we're going to delay that gratification for our family, for our nuclear specific family, to help other people have families. And so I put my money where my mouth is, and I put six figures into this from day one. From there, it was having a mission, and it was finding people. And the mission is simple because it is what we've been talking about this whole time. It's about being transparent and honest and open and respectful, and then it's about hiring good people. And of course, I think the most the most important thing I've learned from the clinic is you don't micromanage anyone, you empower people to make decisions and you empower people to make mistakes, and the person in charge is really just the storyteller, you know, they have to be able to tell the story and keep the lights on. And so I really respected that role of myself, and so I started with some incredible hires, and now we have a team of 15 people. And as I grew this company and as I went through the fundraising, I was, you know, back in February, I was hoping to be able to raise 1.5 million dollars over a couple of months, we'd end up, we actually raise 1.5 million dollars over three days.

Abby Mercado:
Wow.

Brian Levine:
And when I saw that the interest was so high and that people were really jazzed about being part of a solution and not just another problem out there, forget the financial gains that they were potentially seeing, but just seeing the opportunity to not sit idle and to not just say it's okay, that's how it is, but to say, how do we fix it? And Brian and his team are going to do it, well, then we end up raising close to 5 million dollars in the end over 21 days from some incredible investors, from diverse backgrounds. And so I think the skill set of running a company is the same skill set as running patients and running a clinic. It's about being organized and it's about treating people with respect, it's about keeping the lights on.

Abby Mercado:
Yeah, yeah. And it's, for sure, and I just want to, I think it's so interesting to know, like, we know that you're solving a problem that has been expensive, but you're literally solving a problem where there, there just has not been access, like you are truly opening up a market. So it doesn't, it doesn't surprise me that you were massively oversubscribed on your, your capital raising. So tell us a little bit about how you kind of forged that, your team and how that team has come to be, like what does everybody do? Like, you know, you have this very busy day job also. I know, obviously you don't sleep very much, we already know that, but what is the team dynamic like? Who are these people? What are they doing?

Brian Levine:
So it's 15 incredible people that I would love to sit next to on an airplane on the longest flight around the world. They're diverse and they're different. Some people who come to mind are Taliya, and Taliya as our chief of staff, and she was our first hire. Taliya comes from a health care background, knew nothing about surrogacy whatsoever, and spent months learning about it, calling clinics, calling agencies, meeting people, really became an industry expert from a background of just coming from the health care finance world. And Kyle, who is our CTO, comes from a health insurance world and he too had to learn everything in anything about how what's the tech behind this. Now, what's crazy is the current tech that's being used today by agencies is like deceptive marketing. Like, hey, would you like to make 40,000 dollars while working from home? Or like, have you ever thought about making 45,000 dollars from the comfort of your couch? Or would you like to be able to take care of your kids and be able to fund their college in the future? Like weird marketing ads, lead gen organizations, infiltrating Facebook groups. So it's pretty easy for Kyle to recognize that the tech sucked. But of course, what the real tech is that, Nodal is doing, is that we screened people's medical records very quickly. We can screen most people in minutes, not months, because we have really cool technology to pull back their previous medical history and their prescription plans and things like that. But if you have tech ... great marketing, and so the person who I'm also super proud of is Meredith. Meredith joined our team after coming from Maven and Birchbox and Virgin Sports and Hey Mamma and I had to convince Meredith to join our team because she's like, look, Brian, I adore you as a friend, but I'm not doing another startup, I've done this a bunch of times, it's exhausting. And we know each other because I've been an advisor for Maven since inception in 2014 and she was like, I really don't want to do this. And I said, well, Meredith, you're the only person I know who can jump on a program like this with a mission that's so pure, that's so focused on fixing a real broken system, and you can do it with grace. And she was so annoyed, which is for the best.

Abby Mercado:
I mean, you always want to annoy your employees, right?

Brian Levine:
And I adore her, I adore her. And, you know, she jumped on and jumped in with two feet. And she's been able to build out an incredible marketing team. And then there's another person, Carly. So Carly is our general counsel. And Carly's a lawyer by training, and Carly has worked in the public legal world for a very long time, but she's also endured over 20 embryo transfers herself. She's also gone through multiple surrogates, she's also gone through egg donor, she's also had her embryos lost in a tank failure. She's literally experienced it all and she's experienced the happy side, and she has an incredible child from surrogacy. And she has an incredible child on her own when she least expected it and had the unexpected pregnancy that people talk about, the miracle, so she's literally experienced it all. And by the way, on the side, she was helping people navigate the real choppy waters of surrogacy as a lawyer and just helping people for minimal compensation, like at night, after putting your kids to bed. And when I found out about this incredible Tribeca mom, I was like, she must be on our team. And I picked up the phone and I called her and I said, I don't know you, but I'm in awe of you. You've experienced it, you've done it, and you do it every day. We need you. And that's kind of been the way that the team has been built, is that we haven't hired for a role, we've just hired people. And we have 15 great individuals who are incredible, and when we have our team dinners at night, that's when the work of Nodal really gets done for me. And we have a team dinners at night, I can tell you they go way too late because we all love being around each other. Now, what I'll also tell you about this team is that they're incredibly efficient. We recognize today that the reason that we are really building and fixing a problem, despite all the financial turmoil that we're experiencing, despite the downturn of the markets and all the weird stuff that we're going through today is because we are so focused on keeping our budget tight. And so we are cost constraining whatever possible, and we're really being cognizant of like, how do we not waste our investors money, but how do we look at our investors money as a real precious resource that we know needs to go far and we need to make them proud, and so that's what we've been doing. And I think,here we are nine months later, we have an incredible team that's kicking ass. We have close to 30 surrogates live on our platform today, which is huge because the average agency in America does around 25 matches a year.

Abby Mercado:
Really? Oh, that's such a hidden stat, gets depressed under the rug.

Brian Levine:
Yeah. So on day one we crush them. We have over 1000 intended parents who have already reached out to us with interest about our platform and we're throttling them because the truth is we don't want to be another pollution, we want to be a solution. And so what we're trying to do is we're saying, look, we'll bring you on the platform as supply increases, as we have more potential surrogates for you, we'll do that. We don't want you to just join a platform and pay us a monthly rate just to wait, because that's what the current system is today, and we're trying to fix that. And the truth is, are our next two opportunities that we're focusing on in the surrogacy world today, still focus on the match, are incredible, and I can't wait to tell you about those on the next time we do a podcast.

Abby Mercado:
Yes, can't wait. So it seems like all flower, like flowers and butterflies. Like what are some of Nodal's challenges?

Brian Levine:
I think one of the biggest challenges right now is the financial times that we're in. People keep talking about the terrible layoffs and people losing their jobs. No one's talking about the fact that people are losing their benefits, people are losing their fertility benefits and their opportunity to start or grow their family. And if you work at one of these big tech companies that might have incredible insurance and incredible opportunities, you might have just actually made your cost of having a child outside of the realm of possibilities for you and your partner or you by yourself. And so, of course, because we're completely dependent upon people having embryos that they can use, there's definitely a role here for the Nodal helping people, but they need to have embryos first, and that's one of the challenge is. The other one is we're the new kid on the block, right? Ask me who our competitors are, I'll tell you today, the answer is none. We're not competing with anyone, we're actually collaborative. If you want to match on the platform and then go off to an agency, mazel tov, go do it. Like you can use whoever you want to then do the next step of your journey. You want to do a lawyer? You want to do um, independent journey, you want to use an agency? However you want to do it, that's your prerogative. We're just trying to help you reduce the cost of what everyone says is the most expensive bottleneck today. But of course, the challenge is trust. And so we've spent a lot of time on marketing and planning and how do we actually make sure that our story is out there and that we're open and we're honest with people? And lastly, I think our biggest challenge is people. We need to keep reaching out to these incredible women, these incredible, honest, altruistic, brave women who want to be surrogates. And of course, we're completely based on supply. And so we figured out how to get the cost of acquisition of a potential lead down significantly. The average agency in America today says it cost nearly 10,000 dollars to find a viable surrogate. Well, we already have that cost down to close to 1000 dollars. So we've already reduced that cost out by 90%. And so as we keep figuring out what we're doing, by doing what we're doing, we're learning the challenges. But yeah, I think, you know, I think really just trust and awareness, which is why we're doing this podcast today, and the financial times are quite the two biggest things for us.

Abby Mercado:
Last question. There's so much more that I want to talk to you about, but this, unfortunately, we're running out of time. So we ask us to every guest because it's so important. So as somebody who is well-renown in the field of fertility and is now a tech entrepreneur, what is the one thing you would rescript about the fertility industry besides maybe besides surrogacy? Because that's easy.

Brian Levine:
So if I could rescript one thing about the fertility industry, it would be that it's okay not to win every time. I think we've become so competitive as a society, every retrieval has to be a certain number of eggs, it has to be better than your friend, every IVF cycle has to be more embryos than your friend, every IVF cycle feels like it needs to have normal chromosomal and normal embryos, every transfer needs to be a perfect outcome. And I think if we were just more honest with each other and we talked about our losses and we mourned our losses and we talked about the fact that not everything we do is perfect, but as long as you're surrounded by people who matter, that's what matters most. As long as we talk to people about our fertility struggles, I think the industry would be better for it. So I hope that resolve and ASRM, which do an incredible job of advocating for patients, which is great, continue to do that, but I hope people listen to your podcasts and I hope people understand that these conversations are really tough, but they're important because you never know who you're going to sit with at your dinner table next. And maybe she or he is suffering in silence and they have no one to talk to and they don't realize what someone else has been through. So if I could rescript it, I'd say stop being silent.

Abby Mercado:
Thank you for that. Well, so this has been awesome. Thank you so much. Where can people find you? Where can they learn more about Nodal?

Brian Levine:
Yeah. So Nodal.com, N O D A L.com. You can find us, and then on Instagram and Facebook and Twitter, it's NodalHealth. You can email me Brian@nodal.com and I'm sure we'll have links when this podcast goes live as well. But this has been so awesome and I can't believe we've been chatting for an hour already, because I feel like we just started. So.

Abby Mercado:
No, I know, same.

Brian Levine:
Thank you. Thank you for taking the time.

Abby Mercado:
Thank you, Brian. I'll talk to you soon.

Abby Mercado:
Thank you for tuning in to the Future Of Fertility. We hope you'll leave here feeling empowered about all of the exciting innovations taking place in the fertility space. If you liked today's episode, don't forget to click subscribe, and be sure to check out Dear (In)fertility, our popular podcast/advice column where we chat with experts about all things fertility and fertility and pregnancy loss. To learn more and to join our free Fertility Support Community, head to Rescripted.com.

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