Today, Explained - The quest for the perfect baby

Episode Date: October 18, 2026

Men and women are trying to maximize their reproductive health due to anxieties around declining fertility trends. But are we taking “embryomaxxing” too far? This episode was produced by Miles Bryan, edited by Avishay Artsy, fact-checked by Melissa Hirsch, engineered by David Tatasciore, and hosted by Jonquilyn Hill. A surrogate mother undergoes an ultrasound scan at the Beta Fertility Clinic, where her pregnancy is being monitored, in Tbilisi in Georgia. Photo by Marie Audinet / Hans Lucas / AFP via Getty Images. If you have a question, give us a call at 1-800-618-8545 or email [e-mail] to Explain It to Me ad-free by becoming a Vox Member: vox.com/members. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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your belt if it's just going to break when you do. Get the good stuff in store at Marshalls today. Dipping your testicles in icy water. I want to ultimately have 10, 11, 12 children if I can. Use a suite of fertility technologies to basically make the perfect human. Ariel Dom is a journalist who writes a lot about men's health. And recently, she talked to some guys for a story in GQ about infertility. One of these men, he was about 30. He told me that he was told by the doctor he probably wouldn't ever be able to have children. He told me it was Valentine's Day and it was just, you know, like the room was in so much.

emotion and he started crying. And like so many of the men I spoke to in my research into this topic, he said or he thought to himself. What does it mean to be a man if you can't reproduce? Because I do think that in the same way, I guess for women, fertility can also be attached to their sense of gender identity. I think the same thing can happen for men as well. And this guy basically set himself a three-month window. He was going to try everything he possibly could to maximize his fertility. And it sounded like it was really took over a lot of his life. Like he'd sit watching TV with ice on his balls. He, I presume over his trousers, he would sleep naked. He would wear loose underwear. He didn't keep his phone in his pocket. He stopped

drinking or drunk a lot less. I will say with a lot of these things that he was trying, you know, there's varying degrees of scientific evidence. that these things could be helpful, but in his case, it was successful. His wife received a positive pregnancy test. That man isn't alone. Baby making has now entered the optimization era. I'm John Glenn Hill, and this week on Explaining to me from Vox, we're fertility maxing. Spur maxing essentially is the pursuit of more sperm and healthier sperm.

So as a man that's trying to take my sperm count from literally zero to 30 million, these are the most important things that I've added to my grocery list. Here are three things I'm taking for my sperm health. I put my balls into ice cold water for three minutes every single day to enhance my fertility. Now, sperm health is quite a good marker, scientists think, for overall health. So there's some obvious things that you can do to improve your overall health, like drinking less and smoking less and, getting into good shape, which is believed to correlate to good sperm health. But what I was seeing

is more obscure ways of maximizing your sperm health online. So I went deep into Reddit threads, different creators posting on TikTok, quite strange ways that you can maximize your sperm health. So things like dipping your testicles in icy water. Your sack is outside your body because it needs to be a lower temperature than the rest of your body. Eating raw garlic. I do it every single day, raw garlic. Taking a lot of supplements with names I hadn't heard of before. Looking for a simple addition to his daily wellness routine?

Meet conception for him. But what's really interesting on what I found out in the process of my reporting is when I started off, this felt quite, I guess a lot of it felt quite silly to me. And I was surprised. Yeah, I can see how on first blush it's like you're dipping your balls in ice water. It felt like a symptom of the maxims and culture and this obsession with optimization. It felt very Jimbrough vibe. But the more I delved into this subject, the more that I learned how serious the topic it was. In about half of heterosexual couples are experiencing infertility. There's a male factor involved. Yet doctors often don't know how to diagnose male infatility. And I think there's also a cultural factor as well and that I think it's more normalized. for women to talk about their anxieties around their biological clock or fertility generally. I don't think it's the same for men.

Something else I'm reporting on right now is sperm racing. Oh. Everything big always starts small. Ladies and gentlemen, this is the world's smallest sport. Live in San Francisco. It's a new sport which launched in California last year, basically what it sounds like men competing, how fast their sperm can move under a microscope. Julius closed that gap.

Could be about a 10 second victory for the Aussie, and that is going to be the case. I spoke to one contestant who was eating loads of oysters, which was apparently good for sperm health. Do you want better sperm, my friends? Eat oysters. So oysters are high in zinc. Oysters contain a lot of zinc,

and there is evidence that could be good for sperm health. In general, I think the things you can do to make, maximize your sperm health do correlate to just good health. But the majority of these things, it seems like, is just being healthy. But then there's more dubious things online. And there's also, I guess, a lot of money to be made by, you know, snake called salesmen suggesting that you can do all these obscure things to maximize your sperm counts, which maybe aren't at all scientifically backed. So Ashwaganda for males is amazing. You carry your cell phone in your pocket for men. It reduces your sperm count by 7.

It's radiation. What are sperm counts looking like right now? Like, is this common? Research does indicate that sperm count is falling worldwide. Sperm counts across the world have plummeted. From 1973 to 2011, both sperm concentration and overall sperm count declined more than 50%. Some scientists don't agree that there has been a big decline. in sperm counts. Other researchers indicated that sperm quality has declined, but I think there is a

big body of research indicating that sperm counts are declining. Do we know why? No. From what I understand, there's a lot of competing theories, so things like microplastics, obesity, smoking. As far as I know, a scientist hasn't been able to definitively say it's because of this one fact. Yeah, I imagine it can just be so confusing when you don't know what's causing this. A lot of times in medicine and science, men are kind of held up as, okay, everything is tested on men. Medicine is made for men, but there is this huge gap on this really important part of life. Totally. I think that's such a good point. I mean, as someone who writes about the gender health gap a lot, that's absolutely true. There's so many cases where it's women's health, where there's been so much

less research and funding, and it's interesting that in this incidence it is the male side of things that's less funded. Does this mean, I don't know, it's easy to sort of turn your nose up at maxing, but is sperm maxing actually a good thing? I mean, as I've said, I think women really do grow up talking about so many of the more quote unquote private parts of our body, whether it mental health or sex or fertility. And I think so many men I spoke to said that they felt ashamed or embarrassed or they felt like less of a man when they found out that their sperm count wasn't as high as they thought it was or they had other fertility issues.

I think it's good that there now is increasingly a space for men to talk about these feelings even if it is on Reddit where there's a lot of misinformation. I think the narrative that, you know, having less sperm counts in the same way that people are talking about testosterone makes you less masculine. I think we need to be wary of those narratives. But in general, I think optimizing your health is a good thing. Fertility maxing isn't just for men. Up next, the women on a quest to preserve as many eggs as possible. Support for the show comes from Framer, but don't expect your photo to come back in a

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My name is Amy, Dr. Marcus. I am a health and science reporter for the information. Egg freezing is no longer a foreign concept to most people. But Amy wrote about a group of women, taking it to an entire, different level. Her story starts with a group chat called to make an omelette. It's a group chat of women, a lot of them based in Silicon Valley, and that's where the group chat got started. When I was doing the reporting, it was over 90 women, and I'm sure there's more. And these are women that are trying to freeze a lot of eggs, not the 10 or 15 eggs that

a lot of IVF doctors will tell you you need to give yourself a good shot at a base. baby, but hundreds of eggs, more than 100, you know, sometimes more than 200 eggs. The women in this group, they're talking not only about trying to collect a lot of eggs, but also how best to do it. They're reading scientific papers about egg freezing and fertility treatments. They're sharing strategies about what sort of drug regimens work best for maximizing the number of eggs that you could retrieve in one round and how many eggs you could freeze and swapping tips about doctors who are open to discussing these techniques with them and clinics where it may be less costly to do multiple rounds of egg freezing.

Wow, that is a lot of eggs. And for people who aren't familiar, I mean, the egg freezing process, it is difficult on the body. It is not an easy situation. Egg retrieval is the culmination of an arduous process, nearly two weeks of daily self-administered hormone injections, sometimes several a day. It's a huge needle. Why are these women trying to collect so many when their doctors may say, hey, you need 15, 20 at most? Yeah, I mean, the reasons vary. First of all, just to start with why anyone, you know, freezes eggs. A lot of the women I interviewed, they were freezing eggs because they hadn't met the partner that they wanted to have a child with. Maybe they were getting older.

and they were wary that when they did want to get pregnant, their eggs wouldn't be viable anymore. But some of the people who were, you know, trying to freeze a lot of eggs, they're interested in using advanced technologies that would allow them to kind of rank embryos to try to assess what qualities they'd like to ideally have in a future baby.

A lot of women in this group chat live in Silicon Valley. Is there a certain type of woman who, is the typical egg maxer? I think it's very hard to describe because the trend itself is new and not so widespread yet. It's just getting started. But I think when you're in a place like Silicon Valley or probably a lot of other big cities where people go because they're trying to start their career or they're getting a lot of education, the women that I was encountering, you know, they were starting businesses or they

were pursuing higher education, you know, and so they were thinking about egg freezing as a tool also to preserve their options for fertility so they could make decisions at whatever age they were at whatever stage of life they were to try to bring a child into the world. My name is Simone Collins. I have done a total of seven rounds of egg retrieval, retrieving a total of 112 mature eggs. I've done a total of eight frozen embryo transfers that has resulted in five live births, though I want to ultimately have 10, 11, 12 children if I can. But the world record for C-sections is 11, so I may not make it that far. Simone Collins is kind of an it girl in pronatalist spaces.

It's a movement concerned about falling birth rates. She and her husband, Mike, want Americans to have a lot more babies. I'm in the Make an Omelet chat. It's an amazing place where a lot of women are coming in just to share what they're going through and trade notes. One of the big issues in the fertility space is a complete lack of transparency. You don't know what other people are paying. You don't know what med protocols they're getting. You don't know if their doctors are telling you.

So when you're going through this process on your own as a woman, you're flying blind and you don't know if what you're going through is normal or not normal. And this space has been such an amazing place for people to be able to gain some perspective, some solace, some comfort in understanding, hey, this is not normal. You should go talk to someone. Hey, no, you need to stand up for yourself. Here are some options. It's one of the best threads groups I've ever been in, ever. The most painful part of the egg retrieval process for me was the price of the medication.

It is so expensive in some cases. Most people, including myself, are doing this all out of pocket. pocket. There's not insurance coverage for this. No one can afford that. So the only time I actually cried in the fertility office was when I discovered that an entire vial of medicine, I think it was like maybe $2,000 worth of medicine or it was some insane amount I wasn't going to use, but it was going to expire. It was refrigerated. I couldn't actually use it myself and I couldn't return it. So I just broke down crying like all this money and I wasn't even going to use it. I ultimately went on read it and I gave it to someone. There's this whole like black market of people giving,

you know, unused meds to each other, which is not safe or recommended, right? But it's the, the ends to which people have been driven by all this. A big driving factor that is going to drive more people to do this in the future is the fact that now we have more women in their 40s having kids than teenagers. So we're just, there's more of a demand for IVF. And the reason I did this is I can't have kids without IVF. We're going to have more people in that position. So in that way, it is somewhat of an inevitability. However, many people just don't want to do IVF. And don't have the money for it.

So I think there is a cap on how much of a trend this is ultimately going to become. Amy, I wonder, how does the medical establishment feel about egg maxing? There are concerns of potential health consequences that increase as you do more and more rounds of egg freezing. again because of the hormones and the potential that you might over-stimulate a woman's body, and that might have health consequences for her. And then more than that, there's concerns among many fertility doctors about trying to assess and rank embryos based on different qualities. There are IVF clinics that if you tell them, hey, we'd like to test our embryos,

and we'd like to test them for not just for health, traits, but we'd like to try to assess which ones we think are more likely to have higher intelligence and then, you know, choose embryos based on that. Not all IVF clinics are supportive of women who want to use the technology to do that. That technology is letting us have more and more control over how our babies will turn out. But just because we can, does that mean we should? That's coming up. Support for the short day comes from Grow Therapy. One of the biggest barriers to entry for a person to begin therapy is cost. But therapy is too expensive.

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It's growth therapy.com slash explained. Growth therapy.com slash explained. Availability and coverage vary by state and insurance plan. Support for the show comes from bombus. Cozy season is upon us, which means it's time to talk about socks. No more ankle cleavage, you freaks. The sweatpants are on. The socks are pulled all the way up and your feet are snuggled in your slippers.

Oh. And if you're on the hunt for some comfy new staples, you can check out Bombus. Since fall weather can be fickle, Bombus makes socks that can handle it all. Marino wool blend pairs for keeping your toes warm, sweat-wicking sport socks for fall race training and dressy styles for any fall weddings. I love a fall wedding. Have I been to one? Not sure. Then there's the Bombus Compression Sock Collection. They make specialized designs for every moment of travel. errands, workout, and recovery. Compression socks can save your life. Think about that. You can head over to bombus.com slash explain and use the code explain for 20% off your first purchase at B-O-M-B-A-S dot com slash explain. Code Explain to check out. This is explaining to me. I'm J. Q. I'm Kristen V. Brown. I'm a health and science journalist. And I am writing a book right now called The Immortal Womb, the centuries-long quest to control the female body.

hack human reproduction. So I think a lot about human reproduction. I mean, I think that what we're seeing right now is that people will do anything they can to have the healthiest baby possible. And one of the ways they're doing that right now is through a technology called PGTP, which stands for pre-implantation genetic testing for polygenic risk. New software from a company called nucleus genomics is giving IVF patients the ability to screen and rank embryos with unprecedented precision. You can explore your future child's health, appearance, and even their well-being. And one of my favorite features, you can even name your embryos and leave notes on the ones you like. You know, if you go through IVF very often in this country, they'll have you do

a basic genetic screening where they are looking at, you know, does this embryo have all the right chromosomes and all the right places? And that can detect things like Down syndrome, right? So this screening takes that up a notch and it uses that same pre-implantation genetic testing to look for the risk, the likelihood of complex genetic conditions, the really common stuff like heart disease like diabetes in order to, quote, let people have the healthiest baby. What else are these tests screening for? What can they screen for? I think that what's motivating most people is the health aspect, but a lot of these companies marketing these tests are saying they can also look for height. They can look at eye color. Some of them are promising IQ. Today, what Orkid offers

is super baby version zero, which is getting to live alive, hopefully, at radically lower odds for a disease. Tell us about your company, Heresite. We wanted to build the best polygenic predictors in the world, and that includes IQ. What is intelligence, even? Like, how do you even define intelligence, let alone how do you define the genetics of intelligence? Alzheimer's disease, longevity, right? Which embryo is going to live the longest life? So these scores have the guise of being predictive.

You look at the score and you say, oh, okay, this embryo is. is going to be way less likely to have the heart disease my father died from. But they're not predictive. It's a likelihood. And it's not clear right now how useful or accurate they will wind up being. We're going to have to wait for babies to be born with this technology and then grow up and see if they get heart disease to even know really if it's doing what it promises. So that's decades away. Do we know how many people are doing this, how widespread is it? So I think it's a very small number of people at this point.

But I think that we're seeing more and more companies in the space, and we're seeing more and more support from fertility doctors. But I want to, you know, emphasize that most mainstream medical societies are against this, but I think we're seeing support growing. And I think that a lot of people in the fertility space are already envisioned. a future where this does become more mainstream because the idea is just so appealing, even if the technology has flaws. What about embryo editing?

Is that something we're seeing? Like, can people go in and change things around? So not right now. An embryo editing is very much illegal in the United States. It is illegal in most countries. How can you be sure? enough that it's safe. But there is growing interest as the technology has gotten better. Most of the support right now for embryo editing is for disease, right? The argument for it is that,

let's say, you have Huntington's disease. Right now, there is something you can do. You can use polygenic screening to select the embryos that don't have the disease. But in I IVF, even if you don't have a terrible disease hiding in your DNA, it's hard to get a lot of embryos, right? So you have these situations where couples have to do rounds and rounds and rounds of IVF to get one or two embryos that aren't carriers for a harmful variant, right? And so the argument for it is let's give these people a better shot. It's illegal in the United States to try to make babies from genetically modified human embryos. But at least two U.S. startups are hoping to change that. For couples going through IVFs, they're typically older and they have less embryos to choose from in the first place.

So I think having more embryos that could be viable, disease-free, is actually super helpful from like an embryo count perspective. Imagine there are people out there who aren't looking into editing simply for, you know, making children more resistant to diseases, but eye color, height, intelligence, etc. So there's actually a name for it. This tech executive called Brian Armstrong, he coined this term, the Gattaca stack after the movie. I'll never understand what possessed my mother to put her faith in God's hands rather than those of her local geneticist. The vision is to use a suite of fertility technology. to basically make the perfect human.

So the first thing they want to use is this technology called in vitro gametogenesis, which is where you take a skin cell and you turn it into an egg and a sperm, and then you make an embryo with it, right? So women don't have to go through rounds of IVF. So the idea is you can get tons and tons and tons of embryos, and then you can use PGTP to then screen for the best ones, and then you can use an artificial womb to incubate and grow them. That could get us to a place where actually more and more people in the world eventually are born with, like, freedom from like these genetic diseases and you blurs the line into enhancement and other benefits.

You know, it's interesting, that idea of like, yeah, we're going to optimize the human race. It brings to mine a certain E word. And that word is eugenics. I'm just like, what are the, what are the ethics here? on one hand, I can understand, like, there are parents who are just like, I just want to have a healthy baby. I want to bring a child into this world. Like, I just want to put my best foot forward with this human that I'm going to bring to Earth. And then on the other hand, it gets real weird. It's getting, it gets a little weird, you know?

Yeah. Yeah, it does, right? And it gets weird fast. And, you know, in some ways, we've already kind of gone down that slippery slope. When you think about that right now, even if you don't go through IVF, we screen against Down syndrome early in pregnancy, right? And Down syndrome is a condition in which, you know, you have a disability, but you can live a full, happy, healthy life, right? And for a long time, parents of kids with Down syndrome have argued that already, you know, selecting and screening against Down syndrome pregnancies is a form of this. In Iceland, Down syndrome is on the verge of being eradicated, and it's due in large part to the widespread use of genetic testing. We're heading into a dangerous world of eugenics, and why should we decide who gets to be born?

As technology gets more advanced, we see that same question applied to more and more conditions, right? I think that one of the things that we don't talk about enough is that, you know, like the genome is complicated. You can't actually just go in there and be like, I want a tall baby with blue eyes and a great laugh, right? I think that becoming a parent is an exercise in giving up control and it's easier for some people than others, right? And so I have so much sympathy and empathy for people who are trying to stack the deck. But I think that there's just so many variables when it comes to human reproduction, that we're never going to be able to fully control the process

as much as we might want to and as peeling as that might sound. That's it for this week. We want your help with an upcoming show about hobbies and how we spend our free time. Tell us about the hobbies you do to relax, and if your hobby has ever gone from fun to just more work, give us a call at 1-800-6-1845-5-45,

or shoot an email, askvox at vox.com. If you like listening to this show, consider becoming a Vox member. It's the best way to support us. Head to Vox.com slash members to learn more. This episode was produced by Miles Bryan.

It was edited by Aveshii Artsy. It was fact-checked by Melissa Hirsch, engineered by David Tattachore. Our executive producer is Miranda Kennedy. And I'm your host, John Glenn Hill. Thank you so much for listening. I'll talk to you soon. Bye.

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