Should You Freeze Your Eggs?
The egg-freezing boom might just be selling a fantasy of control to women.
Nine years ago, when she was 28, TLC's Dare to Wear host, Tai Beauchamp, called off her engagement after realizing that her then-partner wasn't the right match after all. She spent the next few years dating, but when she hit 35, she started to feel anxious about her biological clock, so she decided to freeze her eggs. After shelling out an initial $15,000 and paying an annual storage sum of $1,200, she now has 10 eggs stowed away in a freezer. "It's comforting to know I have my eggs on ice," she says. "It's the ultimate insurance policy. You can have all these plans for how you think your life will work out, but in reality, you actually have very little control. Having your eggs frozen is one place you can control. It's really given me peace of mind."
After Apple and Facebook announced in October 2014 that they would cover the costs of egg freezing for female employees, interest in the technology ramped up. Now, fertility clinics are wooing potential clients with free seminars and charts that trace the inexorable decline of a woman's eggs. Companies outside Silicon Valley are examining how they approach fertility coverage, while women are scouring their insurance plans and investigating storage options. Many of them will need the help: egg freezing is expensive, costing anywhere between $10,000 and $15,000 for women whose employers do not offer insurance coverage. It's also politically dicey, raising the issue of whether women should be prioritizing career over childbearing in their most fertile years, and whether high-powered companies might subconsciously be pressuring women to subvert their personal lives. There's also no guarantee it will work. According to one of the few large-scale studies conducted, published in 2013 in Fertility and Sterility, the odds of getting pregnant with frozen eggs—even for women still only in their mid-30s—are only about one in five.
And at a philosophical level, the entire business of egg freezing borders on a trap. Because what it's really selling is a hedge against regret: a way for women like Beauchamp to avoid waking up one morning with the sudden realization that they've forgotten to have a baby.
Not that babies are for everyone. Thirty-four-year-old Nina,* a Manhattan lawyer, is torn. She likes the idea of babies and understands the extent to which reproduction is the only means of preserving one's family and, in a way, oneself. But the mundane reality of raising one is not particularly attractive to her—at least not now. Still, like many women, she worries that her current lack of interest might cause her dismay in the future, and she lingers over the fact that so many of her friends seem to hit a point in their lives, usually around the age of 38, she says, where they grab on to relationships that are "focused solely on the necessity of having a kid." even her friends who never wanted to become mothers, Nina recalls, suddenly seemed to hear the "call of the body" and turn their once-casual dating habits into a checklist of qualities. If a guy has enough check marks, she says with a laugh, it quickly becomes: "Great, let's get married and have a baby." Nina is worried she'll feel that way in a few years, so egg freezing is an intriguing prospect, not so much because it promises something she wants (a baby), but because it will protect her from something she doesn't want: to confront the possibility that she's waited too long. And so Nina is still on the fence, trying to decide what to do.
Natalia,* a 29-year-old literary agent in London, has a similar concern, even though she's young and engaged. "What if I have a really great job opportunity?" she wonders. "What if I keep traveling like I do now, spending less than half my time each month in any given city?" Her mother already voted for intervention, urging Natalia that "if you don't get married before 30, you need to freeze your eggs." So she did it quickly and did it big, with what she describes as the "rolls-royce version": 18 safely preserved eggs for $22,000. Looking back, Natalia says that it was "not at all a rational thinking process." She didn't carefully weigh her options (getting pregnant now or in a few years; freezing embryos with her fiancé) or even undergo testing that could have revealed the overall health of her available eggs. She didn't discuss the procedure at any great length with her fiancé. She simply signed on. Now, she says, "I don't worry about having a child anymore." She's just getting on with her life.
Once upon a time, people married (nearly always), had sex, and had kids. Any woman of a certain age who was left without a partner, or with a partner but without a child, was generally labeled as unlucky. In the late 19th century, though, a handful of doctors began to suspect that some apparently infertile wives (at the time, a couple's infertility was always presumed to be caused by the woman) might be "cured" through the transmission of another man's sperm. When these procedures proved successful, clinics in the united States moved slowly and quietly toward more commercial forms of insemination, eventually selling the sperm of so-called donors to couples and single women alike. By the early 1980s, artificial insemination had become a relatively large business, and clinics had mastered the art of freezing sperm as well, cooling it to minus 196 degrees and then storing it in tanks of liquid nitrogen. In vitro fertilization was the next step on the reproductive road, allowing couples to mix eggs and sperm outside the woman's body. While IVF was initially conceived as a way to treat women who suffered from blocked fallopian tubes, it quickly became employed for a much wider array of circumstances and conditions. Couples who carry genetic mutations, for example, can use IVF to create multiple embryos and screen for the healthiest; women whose eggs have grown too old can purchase other women's eggs to fertilize and implant; and couples unprepared to become parents right now—maybe she's about to undergo chemotherapy, maybe one partner is stationed overseas—can create embryos and freeze them for later use. The technology for embryo freezing is nearly the same as that for sperm: a chemical treatment to protect the delicate material, freezing, and then deep storage in liquid nitrogen.
Egg freezing is more complicated, since eggs have a higher water content than either sperm or embryos, and are thus more likely to develop damaging crystals during the freeze-and-thaw cycle. Over the past few years, researchers have refined a process known as vitrification, which flash-freezes and dehydrates the egg to protect it. As this technology has improved and become more widely available, new firms have rushed into the commercial space, offering egg freezing not only to women who might need such services (like cancer patients), but also to the almost infinitely larger pool who might want them. Extend Fertility, the first commercial egg-freezing firm, launched in 2004, attracts young professional women with the promise of "putting their biological clocks 'on ice.'" For roughly $10,000 plus annual storage fees that can go up to $1,000, women can harvest their eggs while still relatively young, storing them until, as the company's website puts it, they've had the chance to "navigate around [their] personal, professional, or health circumstances." More recent entrants offer an expanded buffet of options: 30 eggs for a flat fee of $18,000, for instance, or "all-inclusive freezing," complete with cycle monitoring, egg retrieval, and one year of storage.
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This is where egg freezing is different from other reproductive technologies, and arguably more problematic. It's not the morality of messing with Mother Nature—we've been doing that since the condom—or even the medical risks involved (mostly, a rare condition called ovarian hyperstimulation syndrome, which causes a woman to produce an abnormal number of eggs and to experience swollen and painful ovaries). It's that all of the other technologies have been used to solve preexisting problems. Artificial insemination, for example, solves the problem of male infertility. IVF solves fallopian-tube problems; donor eggs can substitute for a woman's damaged or too-old ones.
But egg freezing attacks a problem that hasn't yet happened, a problem that very well may never happen at all. Egg freezing is not about combating infertility. It's about avoiding the potential for disappointment. Take a look at how this procedure is being marketed. EggBanxx, which offers discounted freezing packages and low-interest financing ("infertility loans" are another arm of this growing cottage industry), hosts cocktail parties in urban centers like New York and Chicago, offering champagne, cadbury crème eggs, and the not-so-subtle slogan of "Let's chill."
"Maybe you haven't found Mr. right just yet," its website coos reassuringly. "Freezing your eggs now will allow you to tackle conception later." egg freezing, said Gina Bartasi, CEO of EggBanxx parent company FertilityAuthority, in an inter- view with Business Insider, is "an insurance policy. It's about having no regrets." After Apple and Facebook made their egg-freezing announcement, notes Jay Palumbo, vice president of patient care at EggBanxx, calls to the company increased from roughly 10 a week to 10 a day. extend Fertility, mean- while, has been reevaluating its own business model, as CEO and founder Christy Jones explains, expanding from women in their late 30s or early 40s who turned to egg freezing as an "act of desperation" to younger women, who will increase the volume of egg freezing and thus bring prices down.
There's nothing wrong with trying to wrest some small measure of control over the massive uncertainty that is the future. The problem, though, is that egg freezing doesn't really solve that issue—it just delays it. Or as dr. Nieca Goldberg, medical director at NYu Langone's Joan H. Tisch center for Women's Health, explains, "You can put things off, but it doesn't mean there's a better time." With the security of her18 frozen eggs, Natalia may delay having a child the old- fashioned way, reasoning that she has insurance against the inevitable risk of age. If all goes well with this decision, she could wind up regretting having taken the time and money to freeze her eggs. Or she might wait too long, overlooking the frustrating but undeniable fact that it's not only women's eggs that age, but their entire reproductive systems as well.
Which isn't to say that egg freezing makes life any more difficult. It's just that it takes the usual twists and turns of life and scrambles them in a new way. Statistically speaking, most women in their 20s today will eventually become mothers— and most women who freeze their eggs will not become pregnant using those eggs (either because they don't return to try them—the norm thus far, according to Jones—or because the probability of moving from egg to embryo to pregnancy to baby is still so small). And that's without any consideration for the partners who may or may not appear, or the careers that may or may not flourish. To put it more bluntly: Freezing one's eggs doesn't guarantee a baby and partner later in life any more than not freezing one's eggs guarantees a carefree life of professional success. Or as Dr. Mark Sauer, one of the country's leading fertility specialists, told me, "Having children is never convenient. It's a Hollywood myth that there's a perfect time."
So if you're fully comfortable with the physical and financial demands, go ahead and freeze. Or don't: Take the chances that age and love have long imposed upon women. But neither decision is inherently right, or guaranteed to produce a certain outcome. And don't lose the chance to grab whatever matters most at any stage of life, rather than presuming that any insurance policy—be it for eggs or fertility or job safety—can somehow promise what nothing can: perfection.
This article appears in the July issue of Marie Claire, on newsstands June 23 and is a part of a week-long series on fertility. See the rest here.
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