A Legacy Built on Care
By the time Dr. David Smotrich jokes that he’s merely “an accessory” to his fashion-loving wife, you already understand something essential about him: he’s the kind of man who can casually understate a legacy. It’s a legacy that quietly changed thousands of lives.
For more than three decades, the founder of La Jolla IVF has helped bring children into the world for couples who were often told “no” by everyone else. Long before rainbow logos became corporate seasonal branding, before LGBTQIA+ family-building rights became headline political debates, and before surrogacy became normalized in celebrity culture, Smotrich was already in the trenches — building families and enduring backlash for believing something radical at the time: everyone deserves the chance to become a parent.
Today, with patients from more than 104 countries around the world and an estimate of over 10,000 children born through his practice, Smotrich stands as one of the most influential fertility specialists in the world. But ask him what matters most, and the answer isn’t prestige, technology, or even statistics.
“It’s personalized care,” he says simply. “One thing you can’t teach is care.”
And that philosophy may be the real secret behind the empire he built in sunny La Jolla.
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Seeing Humanity Beyond Labels
Born and raised in Los Angeles, Smotrich came of age during an era when LGBTQIA+ representation in American culture was, at best, painfully limited and, at worst, openly hostile.
“The gay community was always depicted on film as unusual,” he recalls. “Lots of negative types of roles on TV.”
But life has a way of educating people faster than ideology ever can.
While training in reproductive medicine at George Washington University and the NIH in the early ’90s, Smotrich found himself immersed in a social circle that included many same-sex couples through his wife, an aerobics instructor with a vibrant community of friends. What struck him wasn’t difference — it was familiarity.
“Rather than liking women as I did, they liked men,” he says with a shrug. “Everything else was pretty much the same. Interested in education, interested in health, interested in happy lifestyles and safe environments.”
It was a revelation grounded not in politics but in humanity.
That perspective would eventually lead to one of the most groundbreaking moments in modern fertility medicine.
Dr. David Smotrich and his son, Ariel Smotrich, during a humanitarian mission in Luweero, Uganda, where they helped support the construction of a community hospital while providing care and guidance to local patients and families.
The Case That Changed Modern Parenthood
In 1997, Smotrich became one of the first physicians ever to help a male same-sex couple have a child through egg donation and surrogacy — resulting in the first California birth certificate listing two fathers.
Today, that may sound almost unremarkable in progressive circles. In the late ’90s, it was seismic.
“That case required attorneys involved,” he explains. “There was a chain of custody. Who does the child belong to? Genetics, all those kinds of things.”
What followed was legal scrutiny, professional criticism, and outright hostility. “They wanted to take my medical license away,” he says matter-of-factly.
At the time, many colleagues questioned his ethics. Hospitals worried about controversy.
Fertility medicine itself remained deeply conservative. Smotrich remembers physicians asking him, “Do you know what you’re doing? Why are you doing this?”
His answer was simple.
“My frame of reference is that every parent has the right to have children.”
That conviction helped make legal changes across California and eventually the country. Today, countless same-sex couples can build families through IVF and surrogacy. A big part of that is because one doctor in San Diego decided compassion mattered more than convention.
Since that first case, Smotrich has worked with several thousand male couples from around the world.
And yes — he still keeps in touch with that very first family.
“The child is in her late twenties now,” he says, smiling.
When IVF Was Still Experimental
There’s something poetic about that timeline. The children once considered impossible are now adults themselves.
But Smotrich’s story isn’t simply about LGBTQIA+ rights. It’s also about the evolution of fertility medicine itself — a field he entered when IVF was still considered experimental.
He traces the beginning of his fascination back to medical school in Tel Aviv in 1988. During an OB-GYN rotation, he met a woman pregnant with IVF twins after seven years of infertility.
“She was so excited to share that with me,” he remembers. “I fell in love with that area of medicine because in my mind, there’s no greater thing than to have a family blessed with children.”
At the time, IVF success rates hovered around a discouraging 10 to 14 percent. Today, some cases at La Jolla IVF approach 65 percent success with single embryo transfer — a staggering leap forward driven by advances in genetics, laboratory science, and embryo screening.
Yet despite all the cutting-edge technology inside his clinic — including the highly advanced RI Witness tracking system safeguarding every embryo in the lab — Smotrich remains deeply resistant to reducing fertility medicine to numbers.
“I don’t count like that,” he says when asked about the thousands of babies born through his practice.
Every patient, he insists, is an individual story.
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Taking the Cases Others Won’t
That mindset has become increasingly rare in a medical landscape often dominated by metrics and marketing. While some clinics refuse “poor prognosis” patients in order to preserve pristine published success rates, La Jolla IVF has built a reputation for taking the difficult cases others turn away.
Older patients. LGBTQIA+ couples. Veterans. International families. Patients with years of failed cycles elsewhere.
Smotrich welcomes them all.
“We don’t refuse patients based on age or past history,” he says.
That inclusivity extends far beyond fertility buzzwords. During the early years of his practice, Smotrich says he actively vetted staff members to ensure they were genuinely comfortable working with LGBTQIA+ families.
“Back in the old days, it was not commonplace,” he says. “I needed to make sure they had no issues with my desire to help the community have children.”
It’s difficult to overstate how quietly revolutionary that was at the time.
