Best-Selling Author Warns ‘You Might Not Want to Buy’ His Book

Patrick Rothfuss Gage Skidmore/Flickr

Patrick Rothfuss is the author of the mega-bestselling novels The Name of the Wind and The Wise Man’s Fear, and is currently hard at work on The Doors of Stone, the final volume in his epic fantasy trilogy The Kingkiller Chronicle. His latest book, The Slow Regard of Silent Things, is a novella set in the same world. This new book is enough of a departure that Rothfuss took the unusual step of writing an author’s introduction that begins, “You might not want to buy this book.” That may cost him some sales, but will hopefully result in fewer disappointed readers.

“If only five percent of my readers end up reading this and hating it, that’s still kind of a lot of readers,” Rothfuss says in Episode 122 of the Geek’s Guide to the Galaxy podcast. “I’ve got upwards of half a million here in the US alone, and pissing off five percent of those is kind of a lot of people.”

The Slow Regard of Silent Things delves into the mind of Auri, a quirky, mysterious character from the earlier books. Rothfuss warns that the story is likely to be confusing for new readers, like starting a movie in the middle. The book also lacks many of the qualities readers might expect from his writing, such as vivid action scenes or witty banter. In the afterword Rothfuss recounts how the story grew in its own peculiar way despite his best efforts to force it into a more conventional shape.

“This story is about who Auri is and what she’s like,” he says. “The people that are curious about Auri, and about this piece of my world, that’s who this story is for.”

Since Auri is such a peculiar character with such an unusual worldview, it took a great deal of time and energy to maintain her voice for the length of an entire book. Spending a lot of time on each project is something Rothfuss is known for. He did 80 drafts of The Slow Regard of Silent Things, and solicited feedback from about 50 beta readers. And he reports that most of them have liked it a lot, despite his fears to the contrary.

“Am I obsessive? Yes I’m absolutely obsessive,” he says. “It’s entirely possible that I am not a well person. I’m fully willing to admit that.”

Listen to our complete interview with Patrick Rothfuss in Episode 122 of the Geek’s Guide to the Galaxy podcast (above), and check out some highlights from the discussion below.

Patrick Rothfuss on Tunnel Bob:

“Auri started from stories my father would tell me about a guy that he knew called Tunnel Bob. He lives in Madison, Wisconsin, and he’s just a little different from the rest of us, and he is constantly getting arrested for being in the steam tunnels underneath the university, you know, the access tunnels that every big city has. My dad used to run engineering for one of the hospitals down there, and so he had to learn how to deal with Tunnel Bob, like everyone in the city, because he gets into your tunnels. What do you do? And so my dad actually solved the problem by saying Tunnel Bob could volunteer there three hours a week, but the rest of the time he couldn’t be in there. And it worked like a charm. Suddenly they didn’t have to worry about him wandering around when he wasn’t allowed, because he would do anything to protect these three precious hours where he was officially sanctioned to be in their tunnels. … ‘So what do you do down there in the tunnels?’ my dad would ask, and he’d say, ‘Well, the first hour I walks around a bit, and the second hour I cleans up some, and the third hour, well, that’s just for me.’”

Patrick Rothfuss on childhood:

“I was a very good boy. I was not terribly rebellious. I was not terribly wild. I liked to stay at home and read books. I lived out in the country, and the only neighbor within any sort of walking distance was my grandpa, who lived up the hill. And then he moved out of that house and some other people moved in, and there was a kid who was exactly my age, and he kept coming to my house. He would come to my house and he’d knock on the door, and he’d say, ‘Do you want to do something?’ Because he came from a suburb where there were a ton of kids, and they were always playing and doing things together. And he’d come and he’d knock on my door, and I’d look at him like, ‘What the hell are you doing here?’ because I’d never had anyone of my own age to play with before. And he’s like, ‘Let’s do something,’ and I’m thinking, ‘I am doing something. I’m reading a book, and you are interrupting me. Go away.’”

Patrick Rothfuss on Acquisitions, Inc.:

“I told my publisher, ‘Yeah, I’m going to go play D&D with the Penny Arcade guys,’ and she’s like, ‘You should probably stay at home and work on your book.’ And I said, ‘No, no, no. You don’t understand. I’m going to go play D&D on stage in front of two thousand people, and another twenty thousand are going to watch it live streaming, and then another couple hundred thousand are going to watch it online, after the fact. And she was just flabbergasted by that, in the same way that those of us who aren’t into sports just can’t understand why anyone would go to a football game. But it’s a little more understandable if, instead of ‘role-playing’ or ‘D&D,’ you say, ‘I’m going to watch a group of incredibly quick-witted, articulate, funny people engage in interactive, improvisational storytelling for two hours.’ And then suddenly you realize that what it really is is Whose Line Is It Anyway? with a strong narrative thread. … And as a bonus we get dragons and sword fights too.”

Patrick Rothfuss on Infocom games:

“They called it ‘interactive fiction,’ and it was absolutely interactive fiction. You read the text, and you took actions, and your actions influenced the games. And one of these games, Zork III , I played with my friend Chad, in like the sixth grade. We started in sixth grade and we played that game for two years before we solved it. … It was pre-internet. It was vastly pre-internet. We had no answers and no way to get them. … When I talk to the brilliant people in my generation — people doing things, telling stories, making things, they played Infocom games. Neil Gaiman played Infocom games, Terry Pratchett played Infocom games, Felicia Day played Infocom games, and they were all frustrated, and they all spent months trying to get the frickin’ Babel Fish in Hitchhiker’s Guide to the Galaxy . And now it’s virtually impossible to write a game that successfully provides challenge and frustration, and that’s a shame. We are going to lose something that makes scientists, that makes doers, that makes hard-minded, witty, clever people, and I worry that those people aren’t being made these days.”

How Car Recalls Work

The 2004 Honda Accord, shown here during a crash test performed by the Insurance Institute for Highway Safety, is among the cars involved in the Takata airbag recall. Insurance Institute for Highway Safety

Editor’s Note: This is an updated version of a story we published on June 11, 2014, in the midst of General Motors’ recall of nearly 30 million cars.

There are more than seven million vehicles on US roads today equipped with airbags, made by the Takata Corporation, that may have faulty propellants, and have the potential to fire shrapnel into passengers when they inflate. Those cars, including models from Toyota, Honda, Mazda, BMW, Nissan, Mitsubishi, Subaru, Chrysler, Ford, and General Motors, are being recalled.

This is a particularly terrifying problem: It makes a tool designed to save lives into one that’s masterful at taking them instead. The problem has been linked to at least two deaths in the US, according to The New York Times . A House committee has promised an investigation, and politicians have criticized the NHTSA’s decision to focus action first on regions with high humidity, which seems to make the defect more likely.

Recalls like this one—and the massive General Motors recall of nearly 30 million cars earlier this year—are marked by deadly crashes, furious consumers, and publicity-seeking politicians. But the reality is, most recalls don’t stem from accidents and are settled pretty easily.

Cars have thousands of parts and things go wrong all the time—this month alone, the National Highway Traffic Safety Administration (NHTSA) has announced dozens of recalls, most of them quite minor. There are rules in place to put things right. Here’s how that process works.

Drivers who find something wrong with their car can report it to NHSTA, whose technical experts take a look. If the agency receives enough reports (there’s no fixed number) about a particular problem, it takes action. That involves ordering the automaker to fix the problem safely, effectively, and for free.

Most recalls are spearheaded by automakers, which discover problems via customers, dealers, lawsuits, and their own inspections. Those defects don’t always affect safety. Sometimes a car just isn’t quite up to code for federal regulations or the automaker’s quality standards.

When an automaker initiates a recall, it’s required to notify NHTSA and file a public report airing all the dirty details, including how it discovered the problem, who is affected, and how it plans to fix things. That last bit usually means notifying customers and asking them bring their cars to dealerships for a free repair.

Because federal guidelines change slowly and old people still own cars, automakers must send those notifications as letters—in the mail!—to the registered owners of affected automobiles, then follow up with a postcard every three months for a year and a half to remind them to take care of the issue. The automaker can also send notifications through its cars’ OnStar vehicle diagnostics system and via a monthly “state-of-the-car” email that customers can choose to receive. If things are bad, dealerships and customer service folks may call owners to push them to come in for repairs.

Problem is, those letters are easily and often ignored, or may never reach the current owner—especially if the car’s changed hands multiple times since it was first sold. And that’s what worries the NHTSA in this case. “Responding to these recalls, whether old or new, is essential to personal safety,” says NHTSA deputy administrator David Friedman. “And it will help aid our ongoing investigation into Takata airbags.”

If you’re worried in the meantime, you can see the list of affected vehicles here, or be proactive and see if you need to get your car to the dealer car here.

Best-Selling Author Warns ‘You Might Not Want to Buy’ His Book

Patrick Rothfuss Gage Skidmore/Flickr

Patrick Rothfuss is the author of the mega-bestselling novels The Name of the Wind and The Wise Man’s Fear, and is currently hard at work on The Doors of Stone, the final volume in his epic fantasy trilogy The Kingkiller Chronicle. His latest book, The Slow Regard of Silent Things, is a novella set in the same world. This new book is enough of a departure that Rothfuss took the unusual step of writing an author’s introduction that begins, “You might not want to buy this book.” That may cost him some sales, but will hopefully result in fewer disappointed readers.

“If only five percent of my readers end up reading this and hating it, that’s still kind of a lot of readers,” Rothfuss says in Episode 122 of the Geek’s Guide to the Galaxy podcast. “I’ve got upwards of half a million here in the US alone, and pissing off five percent of those is kind of a lot of people.”

The Slow Regard of Silent Things delves into the mind of Auri, a quirky, mysterious character from the earlier books. Rothfuss warns that the story is likely to be confusing for new readers, like starting a movie in the middle. The book also lacks many of the qualities readers might expect from his writing, such as vivid action scenes or witty banter. In the afterword Rothfuss recounts how the story grew in its own peculiar way despite his best efforts to force it into a more conventional shape.

“This story is about who Auri is and what she’s like,” he says. “The people that are curious about Auri, and about this piece of my world, that’s who this story is for.”

Since Auri is such a peculiar character with such an unusual worldview, it took a great deal of time and energy to maintain her voice for the length of an entire book. Spending a lot of time on each project is something Rothfuss is known for. He did 80 drafts of The Slow Regard of Silent Things, and solicited feedback from about 50 beta readers. And he reports that most of them have liked it a lot, despite his fears to the contrary.

“Am I obsessive? Yes I’m absolutely obsessive,” he says. “It’s entirely possible that I am not a well person. I’m fully willing to admit that.”

Listen to our complete interview with Patrick Rothfuss in Episode 122 of the Geek’s Guide to the Galaxy podcast (above), and check out some highlights from the discussion below.

Patrick Rothfuss on Tunnel Bob:

“Auri started from stories my father would tell me about a guy that he knew called Tunnel Bob. He lives in Madison, Wisconsin, and he’s just a little different from the rest of us, and he is constantly getting arrested for being in the steam tunnels underneath the university, you know, the access tunnels that every big city has. My dad used to run engineering for one of the hospitals down there, and so he had to learn how to deal with Tunnel Bob, like everyone in the city, because he gets into your tunnels. What do you do? And so my dad actually solved the problem by saying Tunnel Bob could volunteer there three hours a week, but the rest of the time he couldn’t be in there. And it worked like a charm. Suddenly they didn’t have to worry about him wandering around when he wasn’t allowed, because he would do anything to protect these three precious hours where he was officially sanctioned to be in their tunnels. … ‘So what do you do down there in the tunnels?’ my dad would ask, and he’d say, ‘Well, the first hour I walks around a bit, and the second hour I cleans up some, and the third hour, well, that’s just for me.’”

Patrick Rothfuss on childhood:

“I was a very good boy. I was not terribly rebellious. I was not terribly wild. I liked to stay at home and read books. I lived out in the country, and the only neighbor within any sort of walking distance was my grandpa, who lived up the hill. And then he moved out of that house and some other people moved in, and there was a kid who was exactly my age, and he kept coming to my house. He would come to my house and he’d knock on the door, and he’d say, ‘Do you want to do something?’ Because he came from a suburb where there were a ton of kids, and they were always playing and doing things together. And he’d come and he’d knock on my door, and I’d look at him like, ‘What the hell are you doing here?’ because I’d never had anyone of my own age to play with before. And he’s like, ‘Let’s do something,’ and I’m thinking, ‘I am doing something. I’m reading a book, and you are interrupting me. Go away.’”

Patrick Rothfuss on Acquisitions, Inc.:

“I told my publisher, ‘Yeah, I’m going to go play D&D with the Penny Arcade guys,’ and she’s like, ‘You should probably stay at home and work on your book.’ And I said, ‘No, no, no. You don’t understand. I’m going to go play D&D on stage in front of two thousand people, and another twenty thousand are going to watch it live streaming, and then another couple hundred thousand are going to watch it online, after the fact. And she was just flabbergasted by that, in the same way that those of us who aren’t into sports just can’t understand why anyone would go to a football game. But it’s a little more understandable if, instead of ‘role-playing’ or ‘D&D,’ you say, ‘I’m going to watch a group of incredibly quick-witted, articulate, funny people engage in interactive, improvisational storytelling for two hours.’ And then suddenly you realize that what it really is is Whose Line Is It Anyway? with a strong narrative thread. … And as a bonus we get dragons and sword fights too.”

Patrick Rothfuss on Infocom games:

“They called it ‘interactive fiction,’ and it was absolutely interactive fiction. You read the text, and you took actions, and your actions influenced the games. And one of these games, Zork III , I played with my friend Chad, in like the sixth grade. We started in sixth grade and we played that game for two years before we solved it. … It was pre-internet. It was vastly pre-internet. We had no answers and no way to get them. … When I talk to the brilliant people in my generation — people doing things, telling stories, making things, they played Infocom games. Neil Gaiman played Infocom games, Terry Pratchett played Infocom games, Felicia Day played Infocom games, and they were all frustrated, and they all spent months trying to get the frickin’ Babel Fish in Hitchhiker’s Guide to the Galaxy . And now it’s virtually impossible to write a game that successfully provides challenge and frustration, and that’s a shame. We are going to lose something that makes scientists, that makes doers, that makes hard-minded, witty, clever people, and I worry that those people aren’t being made these days.”

How Car Recalls Work

The 2004 Honda Accord, shown here during a crash test performed by the Insurance Institute for Highway Safety, is among the cars involved in the Takata airbag recall. Insurance Institute for Highway Safety

Editor’s Note: This is an updated version of a story we published on June 11, 2014, in the midst of General Motors’ recall of nearly 30 million cars.

There are more than seven million vehicles on US roads today equipped with airbags, made by the Takata Corporation, that may have faulty propellants, and have the potential to fire shrapnel into passengers when they inflate. Those cars, including models from Toyota, Honda, Mazda, BMW, Nissan, Mitsubishi, Subaru, Chrysler, Ford, and General Motors, are being recalled.

This is a particularly terrifying problem: It makes a tool designed to save lives into one that’s masterful at taking them instead. The problem has been linked to at least two deaths in the US, according to The New York Times . A House committee has promised an investigation, and politicians have criticized the NHTSA’s decision to focus action first on regions with high humidity, which seems to make the defect more likely.

Recalls like this one—and the massive General Motors recall of nearly 30 million cars earlier this year—are marked by deadly crashes, furious consumers, and publicity-seeking politicians. But the reality is, most recalls don’t stem from accidents and are settled pretty easily.

Cars have thousands of parts and things go wrong all the time—this month alone, the National Highway Traffic Safety Administration (NHTSA) has announced dozens of recalls, most of them quite minor. There are rules in place to put things right. Here’s how that process works.

Drivers who find something wrong with their car can report it to NHSTA, whose technical experts take a look. If the agency receives enough reports (there’s no fixed number) about a particular problem, it takes action. That involves ordering the automaker to fix the problem safely, effectively, and for free.

Most recalls are spearheaded by automakers, which discover problems via customers, dealers, lawsuits, and their own inspections. Those defects don’t always affect safety. Sometimes a car just isn’t quite up to code for federal regulations or the automaker’s quality standards.

When an automaker initiates a recall, it’s required to notify NHTSA and file a public report airing all the dirty details, including how it discovered the problem, who is affected, and how it plans to fix things. That last bit usually means notifying customers and asking them bring their cars to dealerships for a free repair.

Because federal guidelines change slowly and old people still own cars, automakers must send those notifications as letters—in the mail!—to the registered owners of affected automobiles, then follow up with a postcard every three months for a year and a half to remind them to take care of the issue. The automaker can also send notifications through its cars’ OnStar vehicle diagnostics system and via a monthly “state-of-the-car” email that customers can choose to receive. If things are bad, dealerships and customer service folks may call owners to push them to come in for repairs.

Problem is, those letters are easily and often ignored, or may never reach the current owner—especially if the car’s changed hands multiple times since it was first sold. And that’s what worries the NHTSA in this case. “Responding to these recalls, whether old or new, is essential to personal safety,” says NHTSA deputy administrator David Friedman. “And it will help aid our ongoing investigation into Takata airbags.”

If you’re worried in the meantime, you can see the list of affected vehicles here, or be proactive and see if you need to get your car to the dealer car here.

Game|Life Podcast: Papers, Please Developer’s Stunning New Adventure

Lucas Pope

WIRED’s own Angry Nerd Chris Baker returns to the Game|Life podcast this week! He’s downloaded the demo version of Return of the Obra Dinn , the next game from Papers, Please creator Lucas Pope, and he wants to tell Peter Rubin and me all about it.

Also on the menu: My early impressions of Sunset Overdrive for Xbox One (look for the review next week), and some discussion of the rising prices of classic videogames—news from last weekend’s Portland Retro Gaming Expo and some interesting thoughts from a well-known Japanese retro game retailer.

Game|Life’s podcast is posted on Fridays, is available on iTunes, can be downloaded directly and is embedded below.

[dewplayer: "http://ift.tt/1D91kRL"]

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Stephen Hawking Joins Facebook, Urges Fans to ‘Be Curious’

Professor Stephen Hawking on Sept 19, 2013. Rex Features via AP Images

Stephen Hawking is exploring yet another bizarre and fascinating part of our universe that stretches the very idea of reality: Facebook.

On Friday, Hawking posted his first Facebook status update. “I have always wondered what makes the universe exist. Time and space may forever be a mystery, but that has not stopped my pursuit,” the renowned British physicist wrote Friday morning. “Our connections to one another have grown infinitely and now that I have the chance, I’m eager to share this journey with you. Be curious, I know I will forever be.”

Hawking’s page has been live since the beginning of October, but this is the first we’ve heard from—dare we say?—Facebook’s smartest new member. And though Hawking, who has ALS, may have missed the frenzy of the Ice Bucket Challenge, he didn’t miss the opportunity to post his own Ice Bucket Challenge video, which he filmed earlier this year, on his page. “Because I had pneumonia last year, it would not be wise for me to have a bucket of cold water poured over me,” he said, through his speech-generating device. “But my children, Robert, Lucy, and Tim gallantly volunteered to take the challenge for me.”

So far, Hawking’s page has garnered more than 900,000 likes, but that number is likely to exponentially grow when a biopic about Hawking’s life called The Theory of Everything premieres in the coming weeks. Starring Eddie Redmayne, it’s based on a book by Hawking’s first wife, Jane, called “Travelling to Infinity: My Life with Stephen.”

Hawking doesn’t strike us as the type to join Facebook just to cash in on the buzz surrounding the movie, though. He generates a substantial amount of buzz on his own. Hawking fans from Pakistan to Canada flooded his page with welcome messages and notes about what an inspiration the 72-year-old scientist is.

In one day, Hawking also achieved the ultimate status symbol on Facebook today—a Like from Mark Zuckerberg, himself. Not bad for a newbie.

The Sobering Facts About Egg Freezing That Nobody’s Talking About

IVF treatment sperm being injected into human egg. Science Photo Library – ZEPHYR/Getty Images

A self-proclaimed geek friend once described Silicon Valley as a place where instead of going to the movies to watch a film, everyone takes a seat in the theater and turns around to look at the projector. The Valley is home to cross-disciplinary teams of scientists, engineers, doctors and inventors who wake up every day wondering how they’re going to master the impossible. When they have a prototype they find an equally enterprising storyteller to help them package and translate the benefits. Great things have been invented as a result.

This is also a place that falls in love with outsized expectations and dreams of what could be—sometimes to the detriment of early adopters. This could not be truer than in the area of reproductive medicine. It has been 36 years since the birth of the first in vitro fertilization (IVF) baby. We’ve since been led to believe that science has mastered Mother Nature. This is not true. I know. I am a former patient of three clinics in the Bay area, all of which were happy to sell me services as long as I could pay the bill. I had multiple fresh and frozen embryo transfers. Instead of taking home a baby, I came away with tremendous heartache. And my experience is not unique. Around the world, there are an estimated 1.5 million IVF procedures each year, and 1.2 million fail.

Pamela Mahoney Tsigdinos

Pamela Mahoney Tsigdinos works in the venture capital and tech sectors. She is also the author of the award-winning book, Silent Sorority. Her work has been featured in The New York Times and Huffington Post.

The very latest whizzy reproductive ‘product’ being marketed and wrapped into lucrative employee benefit packages at companies like Apple and Facebook is egg freezing. Lost in all the cheerleading about empowerment and liberating women from their biological clocks is a more buzz-killing, underreported set of facts, which women and families would benefit tremendously in understanding. The American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine (ASRM) do not endorse the use of egg freezing to defer childbearing. The ASRM’s decision to lift the ‘experimental’ label from this still young procedure in 2012 only applied to medically indicated needs, such as women with cancer.

Moreover, there is no long-term data tracking the health risks of women who inject hormones and undergo egg retrieval, and no one knows how much of the chemicals used in the freezing process are absorbed by eggs, and whether they are toxic to cell development. Furthermore, even with the new flash freezing process, the most comprehensive data available reveals a 77 percent failure rate of frozen eggs resulting in a live birth in women aged 30, and a 91 percent failure rate in women aged 40.

The Numbers and Risk Profile

Egg freezing is invasive and it comes with serious short- and long-term physical and mental health risks.

To secure any eggs you must first submit to a demanding series of rigorously scheduled blood tests, hormone injections, and ultrasounds conducted over several weeks prior to the actual egg retrievals. During a typical natural cycle, your body will release one egg a month. During the egg freezing process you will inject yourself with a cocktail of powerful hormones—many prescribed off-label – that hyper stimulate your ovaries to produce eggs.

Depending on your age and reproductive health you may only generate a few eggs or you might produce two dozen. (As many as one-third of women who undergo ovarian stimulation suffer from a condition known as ovarian hyperstimulation syndrome (OHSS), which in extreme cases, can be life threatening.)

After nine to 13 days of self-injection, usually twice daily, you will submit to the risks of sedation while a doctor collects the eggs by punching a series of holes into your ovaries and applying suction. If you have exceptional egg quality and produce six eggs in one cycle, there will probably be one reasonable attempt at pregnancy. To increase the odds of sufficient viable eggs to fertilize, egg freezing businesses advise at least two cycles. Assuming unlimited financial resources or a generous benefit package you may endure multiple cycles. With each round of powerful hormones and punctured ovaries the risk of complications and long term health consequences increase. Once flash frozen, your eggs are stored indefinitely for an annual fee ranging from $500 to $1,000.

Fast forward many months or even years into the future. You now attempt to get pregnant with your frozen eggs. Hopefully you have sufficient savings, or are still employed by Facebook or Apple, because you must now undergo at least one, but probably multiple rounds of invasive and life-altering in vitro fertilization (IVF) procedures.

You must again inject yourself with hormones, this time to prepare your uterus to welcome a potential embryo. You must open your entire emotional, social and professional schedule to daily blood tests, ultra sounds, vaginal probes and other assorted procedures that experienced women have referred to as “humiliating.” I can attest to this.

If your uterus responds to the hormones, the frozen eggs must then be successfully thawed––-no easy task given low thaw survival rates. An egg’s shell hardens when frozen in liquid nitrogen so to attempt in vitro fertilization sperm must be injected directly into the egg with a needle to fertilize the egg through a technique known as ICSI (Intracytoplasmic Sperm Injection).

Again, if all goes well and at least one viable embryo is created in the laboratory, it is then transferred into your uterus. As with naturally occurring conception, the final outcome is in Mother Nature’s hands––-and she is clearly not incentive driven. The vast majority of procedures fail.

The Emotional Toll and Lack of Oversight

The emotional toll associated with family-building failure can be crushing. The scientific fascination with the latest protocol and the marketing of fertility procedures as a lifestyle enhancer the past few decades has unwittingly led to a disregard for the emotional responses of these medical procedures, which creates a different kind of health concern – one involving mental health. Studies have shown that people coping with fertility failures are as distressed as cancer patients. Many others suffer depression and post-traumatic stress disorder.

These negatives are conveniently overlooked by those selling services. You will not find failure rates or the harmful impacts highlighted in brochures or on clinic websites. In the U.S. this unregulated industry’s nickname is the Wild, Wild West of American medicine.

This lack of oversight has emboldened the more entrepreneurial doctors and service providers and led to mixed messages. While the ASRM’s practice committee advised that “there was still not enough known about the egg freezing procedure’s safety, efficacy, cost-effectiveness, and emotional risks” and cautioned against the widespread use because it may “give women false hope and encourage women to delay childbearing,” the ASRM annual meeting, held this week in Honolulu, included this session: Fertility Preservation Patients: How to Re-engineer your Practice to Accommodate Them. It was conducted not by an M.D., but by someone with an MBA.

When it comes to reproductive medicine it is buyer beware.

This meeting boasted the slogan: “Surfing the Waves of Change in Reproductive Medicine,” with a program cover showing a silhouette of a lone woman surfing big waves. The subliminal message suggesting that reproductive medicine is fun and carefree could not be further from the truth, as my own experience exemplifies. After my IVF trials failed, none of the clinics bothered to follow up to find out how I was doing, not even after the loss of alpha pregnancies. They were too busy selling to the next consumer — complete with collateral boasting pictures of women cradling babies. The unrelenting focus on commercial returns means there are no consumer protections in place for the customers buying these expensive services. When it comes to reproductive medicine it is buyer beware.

There is big money to be made in selling dreams of parenthood. A report by Allied Analytics LLP estimates that the net worth of the IVF market at the end of 2012 was US $9.3 billion, a figure that is estimated to increase to $21.6 billion by 2020.

Commercial clinics have become cash cows. In an article on reproductive technology, a business journalist and former egg donor reported that universities with medical school programs often host reproductive endocrinology departments that make enough money from IVF treatments to fund entire schools within the university. Generally, fertility doctors are among the highest-paid employees at private universities.

Yet if pay for performance (as in live births) were the metric by which they were paid there would be much smaller pools of capital available.

The Bottom Line

Today service providers and clinics cavalierly market egg freezing to fertile women without fully understanding or communicating the risks. Though I am neither for nor against egg freezing as an idea, I believe strongly that women must be fully informed about reproductive medicine before setting their hopes on it. Facebook and Apple and all companies would do well by their employees to hold fertility vendors to the highest possible standards and not inadvertently put worker’s physical and mental health in jeopardy. Unlike smartphones or apps that can be recalled or re-engineered should they fail, egg freezing and IVF are high-risk processes with life changing consequences. And this science, particularly where egg freezing is concerned, is still in its infancy.