The Egg Freezing Boom: Empowerment, Expense, and the Illusion of Control

Egg Freezing has skyrocketed in popularity in the past decade as more and more people are opting to defer parenthood until later in life. Once an experimental fertility preservation technique for women going through treatments and other medical conditions that affected fertility, Egg Freezing has evolved into a proactive option for modern family planning. It is hailed as a ground-breaking procedure allowing women to pursue personal and professional ambitions by alleviating societal pressures to rush parenthood. Despite its mainstream status and the revolutionary advances in the field of reproductive medicine, preserving one’s eggs remains a gamble. It is an arduous, expensive, and unpredictable process that can often lead to a false sense of control.

What is Egg Freezing?

Oocyte cryopreservation (OC), also referred to as “social” egg freezing or “elective” egg freezing”, is a process in which “a woman’s eggs (oocytes) are extracted, frozen, and stored as a method to preserve reproductive potential in women of reproductive age,” according to UCLA Health. The first human pregnancy achieved from a previously cryopreserved oocyte resulted in the birth of twins in 1986. In the decades since, “OC has become increasingly utilized as an option for future biologic children in patients facing gonadotoxic therapies, such as for the treatment of cancer,” as described by Eric Han and David B. Seifer. In 2012, the American Society of Reproductive Medicine (ASRM) removed the “experimental” designation from Egg Freezing and as a result, planned OC “is growing in popularity as a means to circumvent age-related fertility decline.”

Increased Demand for Egg Freezing

In 2009, 482 healthy women froze their eggs in the United States. By 2022, that number had soared to 22,967: a 4665% increase. According to WIN data, the demand for Egg Freezing services increased 194% from 2020 to 2023 alone. The number of Egg Freezing cycles performed each year rose from around 7,600 in 2015 to 29,803 in 2022, a 292% increase. Additionally, there are over a million frozen eggs and embryos stored across the US today, as stated by TMRW Life Sciences (TMRW), a fertility technology company.

Source: WinFertility, Elle, American Society for Reproductive Medicine

A driving factor for this increase in demand is women choosing to delay motherhood. This trend is illustrated in the new Census data: the median age at which women give birth has shifted from age 27 in 1990 to age 30 in 2019, the highest on record. Birth rates have declined for women in their 20s and jumped for women in their late 30s and early 40s.

A WIN survey revealed that 79% of women who became mothers at 35 or older said they would make the same choice again, despite fertility challenges. The top reasons women delay motherhood were as follows: relationship status (53%), lifestyle (45%), finances (44%) and career goals (36%). Anna North, a senior correspondent for Vox, notes that many people felt a sense of relief after making the decision to freeze their eggs. They viewed it as a way to take back control of their lives after a frantic race against the clock to find a partner. Women who cited finances as a reason might not want to pay the “motherhood penalty,” writes Eva Epker of Forbes. They choose to become mothers only after they have already established themselves professionally and financially.

The Cost of Egg Freezing

Egg Freezing is expensive. The cost of a single cycle is about $10,000 to $15,000. This typically covers an initial consultation, medications, tests and monitoring, anesthesia fees, and the retrieval process. “The number of eggs collected varies from woman to woman, and, for many, the only way to get a sufficient number to make success likely is to have more than one cycle”, opined Dr. Timothy Hickman, Medical Director and Co-Founder of CCRM Fertility in Houston. This can raise the cost to $30,000 to $40,000.

Once the eggs are retrieved, they are frozen using liquid nitrogen and stored in a lab until they are ready to be used. The storage of frozen eggs can cost up to $1,000 a year, depending on the fertility center used. It costs another $5,000 to $7,000 to thaw and fertilize the eggs, grow embryos in the lab for a few days, then transfer them to the woman’s uterus, a method commonly known as in vitro fertilization (IVF). Many women test the embryos for chromosomal anomalies as well, which costs another $3,000.

Covering the Cost of Egg Freezing

The cost of Egg Freezing is usually not covered by health insurance as many insurers view it as an elective procedure. According to an article by Tanya Benedicto Klich, “many women are finding themselves in precarious financial positions” to freeze their eggs, even going into debt to finance fertility treatments. The article mentions Angela Rastegar, a former director at Circle Surrogacy, part of one of the largest fertility and surrogacy companies, who saw various instances of similar circumstances. Rastegar recalled a woman selling her engagement ring, many others liquidating their 401(k)s, women in their twenties signing up for sizable loans before they had even purchased a car or a home, and some even selling shares in businesses they owned to cover the cost of fertility treatments.

Klich points out this “affordability gap” has given birth to a booming industry of fertility financing. Many clinics leave women with no other option than to get unsecured loans with high interest rates, while others “offer in-house financing options with partnering lenders and financial institutions that specialize in fertility financing available on the spot.” There are also clinics that provide more of an empathetic, as well as transparent approach. They prioritize educating patients about the financial aspect of their care so that there are no surprise costs.

A silver lining when it comes to assuaging some of the financial burden is that more and more companies across industries are offering fertility benefits to their employees in order to compete for and retain top talent. Fertility benefits plans range widely and can include coverage for infertility treatments, egg and sperm freezing, adoption, surrogacy, and more. In fact, the nation’s largest employer, the federal government now offers plans that cover several fertility services, including up to $25,000 annually for IVF procedures and up to three artificial insemination cycles each year. This growing commitment from both the US government and companies is further underscored by the Centers for Disease Control and Prevention's recent analysis on fertility trends from 1990 to 2023. The US birthrate is now well below replacement level, at 1.62 births per woman. It is crucial to move this closer to 2.1, the rate needed to maintain a stable population and avoid a future population imbalance in which fewer working-age individuals are left to support a larger elderly population.

The New York Times’ Emma Goldberg highlights that “the prototypical patient” also seems to be getting younger, a change that is concurring with a steady boost in corporate benefit packages that cover fertility preservation. For example, a survey by Southern California-based HRC Fertility showed that 62.7% of Gen Z women reported fertility/pregnancy benefits play a crucial role for them when selecting a new position. Gen Z women now make up 20.5% of the workforce.

Financials aside, Egg Freezing is an emotional and physically demanding endeavor, especially for people undergoing the procedure for medical reasons or for same sex couples who rely on it for family planning, remarks Klich. The gimmicky language around Egg Freezing can give the illusion of it being an easy “one-and-done” procedure, downplaying serious emotional, physical, and financial complexities.

Efficacy of Egg Freezing

Egg Freezing is heavily marketed as an insurance policy, when in reality, it is more of a lottery. The largest US study of elective fertility preservation outcomes to date, led by NYU Langone Fertility Center, found that the overall chance of a live birth from frozen eggs was 39%. The average age when women froze eggs was 38.8 and on average, they waited four years to thaw and fertilize their eggs. However, for women who froze their eggs when they were younger than 38, the live birth rate was 51%. Nonetheless, experts maintain that the notion that large numbers of people in their 20s should freeze their eggs as a measure against future infertility is “misguided.” People in their 20s and early 30s have time and are able to conceive without assistance.

Reliable data reporting outcomes is scarce, in part because very few women return to use their eggs after Egg Freezing. Currently, all published data for usage rate show that the average return rate worldwide is only around 12%. Natalie Lampert explains that many people also find the procedure does not work as they had hoped because not all eggs survive the thawing process, and women typically do not freeze enough eggs or do so at a young age.

It is imperative to note that the US fertility industry, projected to reach $8.7 billion by 2033, is not overseen by a “cohesive regulatory agency” when it comes to the “fertility centers and the treatments they provide." This lack of oversight allows companies to use sales pitches that overpromise the efficacy of fertility treatments like Egg Freezing. This sentiment is echoed by Dr. Jody Madeira, JD, PhD at Indiana University Bloomington and author of Taking Baby Steps: How Patients and Fertility Clinics Collaborate in Conception. She says instead of liberating women from their biological clocks, sales pitches about Egg Freezing have just become another way to put pressure on them.

The growing fashionability and accessibility of Egg Freezing have presented women with an additional option to consider when planning their futures. However, it should not be treated as a guaranteed path to parenthood that justifies the financial risks it comes with. Beyond the procedure itself, the broader industry surrounding Egg Freezing deserves careful scrutiny and each step should be meticulously planned out and reviewed with both medical and financial professionals.