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March 17, 2008

Should You Freeze Your Eggs?

Trying to beat her biological clock, Sarah Elizabeth Richards turns to extreme science.

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"You've got to think about these things!" my mother pleaded. The problem was that I couldn't stop, and over the past year, the chatter in my head had become unbearable. "These things" were the fact that I was 36, did not have children, and had no immediate plans to produce them. And I was exasperated and exhausted with the message that if I didn't hurry up and get knocked up, I was going to be Very, Very Sorry. The worst part was that I was starting to believe it.

I was pretty sure I wanted kids. I just didn't want them right now. For about a year, I'd been dating a great guy who showered me with affection and stocked my favorite wine, but he was in no rush to have kids either. I wanted more time to discover who we were as a couple — to fantasize about trips to Thailand and Armenia, work from Miami in February, linger at dinner, and loaf on Sundays. I'd spent years looking for him, and I didn't want to share him with anyone yet.

I knew it would be gratifying to make and raise little beings that had his Cheshire-cat smile, but I didn't feel that soul-strangling emptiness that made my girlfriends lose it while gazing into the windows of Tartine et Chocolat. I'd worked hard to create a life full of kooky friends, volunteer committees, softball games, and tasting menus. As Johnson & Johnson reminds us, "Having a baby changes everything." Well, I liked "everything" the way it was. I didn't need a baby to complete me.

But there was The Biological Clock — a worn metaphor but spot-on accurate, because sometimes it ticks so loudly it makes us stay up all night feverishly Googling "fertility options." We panic that somehow we are going to miss what we didn't even know we were missing: the chance to photograph fat-cheeked toddlers in floppy sun hats on the beach, watch them smear birthday cake all over a high chair, or nauseate strangers with clapping songs. We used to have decades. Now, we're down to a few years. Without even realizing it, we have become Clock Tickers. I have seen this pressure push people into lackluster marriages or fret their lovely, confident selves into frenzied, fearful heaps. The Clock is freaking the bejesus out of us. That is why I found myself sitting in an overly air-conditioned conference room in a New York City office building on a Wednesday night with about 30 pretty, well-dressed women of a certain age to hear a presentation about egg freezing. No one, including me, was chatty. Dr. Alan Copperman, director of infertility at Mount Sinai Medical Center, droned on about what we already knew: The quality of a woman's eggs significantly declines after 35, plummets after 40, and is generally toast by 45. He traced the familiar downward slope on a graph, then pointed to an intersecting flat line. That was the uterus, which apparently functions the same if we are 25 or 65. Imagine, he challenged us, being able to stop our eggs from maturing through a revolutionary new freezing process. We could have them thawed, fertilized, and implanted in our own ageless uteruses — whenever we wanted!

Hands flew up. We pressed him for answers: Did it work? How much did it cost?

We learned that Copperman was representing Extend Fertility, an egg-freezing company that is partnered with seven fertility treatment clinics nationwide. To do it, he explained, you stimulate your ovaries to crank out about a dozen eggs by injecting yourself with hormones for 10 days or so. After a 10-minute surgery to retrieve them, the eggs are dehydrated, filled with an "antifreeze" (to prevent ice crystals), slowly frozen to minus 196 degrees Celsius, and transported to a liquid nitrogen tank outside Boston. But empowerment doesn't come cheap: The whole shebang costs anywhere from $13,000 to $17,000, plus an annual storage fee of $450.

I remembered reading about egg freezing when Extend Fertility opened in the summer of 2004. Back then, a handful of fertility clinics cautiously offered the procedure to cancer patients worried that chemotherapy would damage their eggs. But Extend was one of the first to unabashedly market "elective fertility preservation" to Clock Tickers. (The website trumpets "Fertility. Freedom. Finally.") It's not clear how many of the country's 400 or so fertility clinics have expanded their clientele, but it's clear that a number of them are tapping into this new market. Founder Christy Jones, who froze her own eggs two years ago at age 34, said that about 60 percent of the 200 women across the country who had frozen with Extend had done it for age-related reasons. So far, no one had come back to use them.

I also remembered that early success rates were depressing: A woman had less than a 20 percent chance per in vitro fertilization (IVF) cycle of getting pregnant using a frozen egg — and that was if it survived the freezing and thawing process in the first place.

Now, a few years later, Copperman delivered the big bang we were all waiting for. Thanks to the refinement and export of a slow-freezing process by Italian scientists, results had improved dramatically. He announced that five of six women had successfully become pregnant using their eggs frozen at his clinic — RMA of New York — and IVF New Jersey; so far, seven healthy babies (including two sets of twins) had been born. That seemed even more miraculous when you looked at how many eggs it takes to make just a few embryos: For the two women from the New Jersey clinic, a total of 48 eggs were frozen; 38 survived freezing and thawing (85 percent), 33 were fertilized, and five of the 12 embryos were successfully implanted.

I knew these samples were small, but I felt relief wash over me, and I wanted to shout at these strangers: "Did you hear that? It's all going to be OK." On the way home, my eyes started to water. For once, it didn't matter that I'd frittered away my 20s with a man I loved but did not want to marry. Science would save me.


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