Podcast Summary:

How To Fail With Elizabeth Day
Episode: On Fertility and Finding Your Family… with Rebecca Coxon
Date: March 9, 2026
Host: Elizabeth Day
Guest: Rebecca Coxon

Episode Overview

This emotionally resonant episode departs from the podcast’s usual three-failure format for a candid, wide-ranging conversation about fertility, donor conception, endometriosis, and redefining the meaning of family. Elizabeth Day is joined by award-winning documentary maker and author Rebecca Coxon, whose book Inconceivable traces her journey from a shocking DNA discovery to personal fertility struggles and ultimately new understanding and compassion towards herself and others. Together, they share their deeply personal experiences, challenge societal assumptions, and underscore the power of sharing one’s story.

Key Discussion Points & Insights

1. Discovery of Donor Conception and Identity

• Rebecca’s DNA Test Revelation
  • Rebecca recounts logging onto 23andMe for a routine check and encountering a new result: a half-sister on her paternal side, which didn’t make sense based on what she’d been told about her family (03:10).
  • Initial response from her mother was shock and denial, attributing it possibly to her (adopted) father’s side, but Rebecca soon realized this "family secret" could only be explained by sperm donation. This led to an emotional family confrontation and the truth came out.

    “Most of the time it’s not a wrong DNA result, it’s a family secret.” — Rebecca (04:17)

2. Living with Endometriosis

• Rebecca shares her drive to describe endometriosis in relatable, visceral terms, going beyond textbook medical descriptions (05:58):

  “I talk about it feeling like a cactus through my colon and the steel plumbing of my pelvis... It's more like living with bone aching flu that can affect you on so many levels... And that's not even discussing the infertility, which has its own grief.” — Rebecca

• She highlights how endometriosis is underfunded and misunderstood, resulting in a “half sickness” that is often invisible but impacts all aspects of life.

3. Choosing to Donate Eggs: Ethics, Motivation, and the Experience

• Rebecca was already researching the ethics of fertility and the U.S. donor market when she learned she was donor conceived (08:34).
• The pandemic, her own uncertain fertility, and losing work prompted her, at age 30, to donate eggs in the UK:

  “I know people who are struggling with infertility…I’m just flushing these eggs down the toilet. I may as well…there is a shortage of egg donors in some parts of the UK. I’m going to sign up as an egg donor.” — Rebecca (09:18)

• She describes the process as straightforward and deeply rewarding, underscored by a heartfelt letter from her recipient.

4. Experiencing and Navigating Egg Donation from Multiple Sides

• Elizabeth shares her own (unsuccessful) journey through egg donation in LA, navigating a system that commodifies genetic material and ‘swiping’ through donor profiles (11:14).

  “You realize what stupid little things you think are important…all of that went out the window as it was harder to find a donor.” — Elizabeth

5. Dating & the Gendered Realities of Fertility Pressure

• Rebecca describes her difficult experiences dating men in their 30s who had never considered fertility timelines. She details a long relationship with “James,” who delayed trying for children, only to pull out days before IVF retrieval, devastatingly ending their relationship and her anticipated support system (14:34).

  “I felt like I was running on a treadmill, double the speed of everyone else…my endometriosis was getting worse. I was told that my ovarian reserve was low — I had the eggs of a 40 year old in my early 30s.” — Rebecca
  “Any whiff of desperation or wanting a family scares people off.” — Rebecca

• Elizabeth reflects on the privilege men often hold in these scenarios:

  “Some of the men that I dated had this privilege of being able to say, 'I’m not ready'—but part of that privilege was their firm belief that they would meet someone who would open up the gift of their ovaries and their womb to them at the notional point that they might suddenly feel ready. Now that is an entitlement.” — Elizabeth (18:23)

6. Meeting the Donor: Complex Gratitude and Distance

• Rebecca describes finally making contact with her donor — “Rodney” (a pseudonym) — over video call (21:25). She expresses complex feelings:

  “It’s felt like somebody trespassing and putting a stake in the ground that says father. But I will describe him as the donor. He’s not my father, he’s not my dad.” — Rebecca
  “It’s a really complicated relationship because there’s no manual for how you interact with your sperm donor…he didn’t change any of our nappies, he didn’t have anything to do with our upbringing. He’s just a random person really.” — Rebecca

• She discusses being grateful for his donation but wanting to keep an emotional distance.

7. Fertility Struggles in Social Contexts

• Rebecca shares the pain of watching friends achieve milestones she longed for, quoting her own writing:

  “Every milestone in their lives feels like a splinter in mine.” — Rebecca (25:02)

• She describes a friend's analogy: infertility is like ordering in a restaurant and watching everyone else’s meal arrive before yours (25:45).

  “Your meal finally arrives, but then the waiter drops it on the floor.…It’s not an equal playing field.”

8. Speaking the Unspoken: Anger, Shame, and Writing

• Both women discuss how expressing anger and discomfort in their writing enabled catharsis and helped break shame and silence:

  “Women have been so conditioned to exist in shame and silence and to deny their right to anger or confusion or pain or sadness. And actually, it’s the discomfort that we need to lean into.” — Elizabeth (27:22)

9. Bioethics: Sperm Donor Overreach

• The episode details the Netflix documentary The Man With a Thousand Kids, about a donor who fathered around 1,000 children and was legally barred from donating (28:46).

  “The documentary said this was the first case of a man's bodily autonomy being restricted. I just paused the TV and I was like, what? There isn't a day that goes by that women's bodily autonomy is not restricted.…I just thought it was absolutely bonkers." — Rebecca

10. Endings, Acceptance, and New Beginnings

• Elizabeth shares her acceptance of not having a biological child after years of treatment and miscarriage. She emphasizes diverse paths to family and fulfillment (30:45).
• Rebecca then reveals, in a How To Fail exclusive, that after finishing her book (which concluded before a “happy ending”), she unexpectedly found herself pregnant with her new partner, Ollie:

  “The book ends with… I'm still on the shoreline waiting for my time, standing alongside people who are struggling.…And so I took a pregnancy test like I always do, and it had a double line. It was the first positive pregnancy test I'd ever seen. And it was the same week I handed in my book, my book about infertility.” — Rebecca (32:37)

• She expresses immense gratitude, acknowledges the ongoing complexity, and underscores that the legacy of infertility never fully leaves you, even with a positive outcome.

Notable Quotes & Memorable Moments

• On Family Secrets:

  “Most of the time it’s not a wrong DNA result, it’s a family secret.” — Rebecca (04:17)

• On Living with Endometriosis:

  “It takes a lot from you. We’re not taking it seriously enough and it’s really underfunded still. We don’t really know what causes it. But it is affecting hundreds of millions of women and girls in the world…” — Rebecca (05:58-06:44)

• On Donor Relationships:

  “Him coming into my life has felt a bit like somebody trespassing and putting a stake in the ground that says father. But he…is not my father, he’s not my dad.” — Rebecca (21:25)

• On Navigating Uncomfortable Emotions:

  “The anxiety is the necessity, because women have been so conditioned to exist in shame and silence and to deny their right to anger or confusion or pain or sadness. And actually, it’s the discomfort that we need to lean into.” — Elizabeth (27:22)

• On Unexpected Endings:

  “At the end of every month, I always do a pregnancy test because I don’t want to get my period at work and just be thrown by it… And so I took a pregnancy test like I always do, and it had a double line. And it was the first positive pregnancy test I’d ever seen. And it was the same week I handed in my book, my book about infertility.” — Rebecca (33:01)

Timestamps for Important Segments

• 03:10–05:28 — Rebecca’s DNA discovery and confronting her family
• 05:58–07:59 — Honest depiction of endometriosis
• 08:34–11:14 — Deciding to donate eggs; motivations and experience
• 11:14–14:34 — Elizabeth’s story: being an egg recipient in the US
• 14:34–18:23 — Dating, gendered fertility anxieties, and breakup with “James”
• 21:25–25:02 — Contact with donor “Rodney,” managing the emotional aftermath
• 25:45–27:22 — Metaphor for infertility: the restaurant analogy
• 27:22–28:46 — Expressing anger and rejecting shame
• 28:46–30:45 — Ethics: The “1,000 Children” sperm donor controversy
• 30:45–33:01 — Elizabeth on acceptance and family without children
• 33:01–36:00 — Rebecca’s unexpected pregnancy and reflection on family
• 36:00–37:01 — Final gratitude, praise for the book, and wrap-up

Tone & Language

The episode has a warm, confessional, and at times cathartically humorous tone. Both Elizabeth and Rebecca speak with raw honesty about complex emotions—shame, anger, grief, envy, hope—while maintaining a compassionate and encouraging spirit. The language is open, relatable, and refrains from euphemism, giving voice to experiences often left unspoken.

Final Thoughts

This episode offers a rare, unvarnished look at the reality of fertility struggles, donor conception, and the modern reevaluation of what makes a family. Through humor, pain, and wisdom, both women help to destigmatize these experiences, offering hope and community to listeners in similar positions. Inconceivable, Rebecca Coxon’s book, is championed by Elizabeth Day as a guide and comfort to all those navigating these uncertain waters.

Recommended Listening For:

• Anyone facing or touched by infertility
• Those curious about donor conception and modern family
• Listeners seeking honest discussion about the realities of women’s health
• Anyone ready to reflect on the meaning of belonging and the courage it takes to shape one’s own story