The ins and outs of egg freezing | 60 Minutes Archive
In a Nutshell
Egg freezing lets women preserve fertility by stopping eggs from aging, but success depends heavily on the woman's age when freezing and the number of eggs banked, with 70% of those freezing 20+ eggs before 38 achieving a live birth. The process costs $12,000–$15,000 per cycle plus storage, and even with a good number of frozen eggs, significant attrition occurs during thawing, fertilization, embryo development, and implantation. While increasingly common and offered by many large employers, critics argue it may encourage women to delay childbearing when societal changes like paid leave and affordable childcare would better support earlier parenthood.
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Fertility rates in the United States are near historic lows. One reason is a sharp decline over the last three decades in the number of American women having babies in their 20s. There has been no change in women's biology or the age at which fertility declines. Freezing embryos for in vitro fertilization (IVF) has been possible for decades, but freezing unfertilized eggs was a tougher scientific challenge. Egg freezing was initially used for patients with cancer and other conditions that threatened fertility. Egg freezing for non-medical reasons became an accepted practice 12 years ago, and since then demand has skyrocketed with hundreds of thousands of eggs now frozen.
Egg freezing could offer women the chance to put the biological clock on ice. Kate Sonderger came to a fertility clinic in Midtown Manhattan to undergo a minor surgical procedure to harvest and freeze her eggs. At a different fertility center, Katherine Schneider was another egg freezing patient.
Egg retrieval is the culmination of nearly 2 weeks of daily self-administered hormone injections. The shots induce the ovaries to ripen multiple follicles, the sacks that contain eggs, so that a surgeon can go in with a tiny needle and drain the fluid in those follicles. The fluid is run into an adjacent embryology lab to search for the eggs. After a few hours, the eggs are put onto tiny special straws, then plunged into liquid nitrogen and stored in tanks at -320°F where they will stay possibly for years until their owner is ready to thaw them, add sperm, fertilize, and turn them into embryos.
Dr. Singer states that egg freezing is as revolutionary as the pill was in the 1960s and 1970s. The pill changed everything by giving women the option of choosing who to be with and not to accidentally get pregnant with the wrong guy. Egg freezing took it an extra level, allowing women to delay fertility into their 40s. Women will have kids in their late 40s with their own eggs that were frozen in their 20s and 30s.
A 40-year-old woman froze her eggs when she was 35, doing the first cycle at 34 and the second at 36. Another woman did two cycles last year when she was 34. Yasmin Higgby is 29, works in consulting, and has a serious boyfriend. She froze her eggs to enjoy time with her partner more instead of rushing to have kids. Nam Jacob, 38, a healthcare administrator and strategist, isn't ready yet because she hasn't found the right partner. Egg freezing takes the stress away from dating.
Dr. Lucky Secon of Fertility Clinic RMA of New York explains that women are born with all of the eggs they will ever have and don't make new eggs. The number of eggs decreases over time and the eggs keep aging. Women have a peak number of 6-7 million eggs at 20 weeks as a fetus in their mother's womb. From then on, the number keeps going down and the eggs keep aging. When you freeze an egg, you are stopping it from aging any further. If you remove the egg and freeze it when you're 28, that egg is 28 years old until you thaw it.
Not only does the quantity of women's eggs decrease with age, but their quality also decreases. Even at peak fertility in women's 20s, about 25% of eggs when combined with sperm will create embryos that are chromosomally abnormal. At age 35, that number increases to about 30-35% of embryos being abnormal. At ages 37-38, it's 50%. At age 40, 60-70% of embryos are abnormal. By age 45, 90% are abnormal. There is no data to suggest that you can influence your egg quality through healthy lifestyle choices.
The optimal age to freeze eggs is in your 20s because that's when you're at your lowest possible rate of genetic errors in the embryos that result from those eggs, and you also have a lot more eggs at that age. Kate decided to freeze her eggs at the unusually young age of 22 because she's going to medical school and knows she has a long journey ahead of her with four years of education and four to seven years of training after that.
When Dr. Singer started doing egg freezing in 2012, most of the women were 40, 41, 42. Today, most patients are in their late 20s or early 30s. There used to be a stigma as though freezing eggs meant something hadn't worked out in a patient's life, but not anymore. It became a common thing, almost empowering.
Freezing eggs is expensive. A single cycle, including medication, costs an average of $12,000 to $15,000, plus another $500 to $1,000 each year for storage. Thawing and fertilizing the eggs later costs an additional $10,000. In 2014, Apple and Facebook started offering egg freezing as a covered benefit for their employees. Today, more than a third of the largest corporations in the US, those with 20,000 or more employees, cover egg freezing. Karissa Simick changed jobs three years ago partly because the company offered egg freezing coverage. Her egg freezing cycles were covered, as were Nam's.
There has been criticism of companies' motives for offering egg freezing. Some people feel that companies do that to keep women at work so that they won't have a child and leave. However, Karissa Simick doesn't see it that way. When she learned about the benefit, it made her more dedicated and committed to her company. It's a good way to retain top talent.
Tina Rampino, now 46, learned about egg freezing when she went for a routine doctor's visit at age 35. Her gynecologist said to her, "Have kids now. You're running out of time. You can get married whenever you want to get married, but you can't have kids forever." The doctor mentioned egg freezing, and Tina decided to do it. Paying out of pocket, she froze 10 eggs as her backup plan. She did not have a partner at the time.
Lindsay Smithson Stanley also paid out of pocket when she froze her eggs at 35. A few years later, she got engaged to Paul. They want children, but not until they're married and Lindsay finishes her PhD. Dr. Singer recommended thawing her 18 frozen eggs, fertilizing them with Paul's sperm, and then doing genetic testing to assess viability. The results showed that Lindsay and Paul have four chromosomally normal embryos on ice waiting for them.
After the pandemic, still single, Tina decided to become a single mother by choice and selected a sperm donor. She had just turned 40 and knew that motherhood was something she always wanted. The first embryo created from her frozen eggs failed to implant, but a second embryo from her frozen eggs did. She gave birth to a son, Christopher. On the day that she started her egg freezing cycle, she screenshotted a quote that said, "Do something today that your future self will thank you for." Tina later gave birth to a second little boy, Christopher's baby brother Theo, in July from the final embryo from her frozen eggs.
Not every egg freezing story has a happy ending. Evelyn Gosn froze her eggs three times at ages 32, 36, and 38 for a total of 30 eggs, considered a very safe number. When Evelyn and her now-fiancé Edward went to use her 30 frozen eggs, only 19 survived the thaw. Once those 19 eggs were fertilized, only one grew to be an embryo. Genetic testing revealed the embryo was abnormal. Dr. Lucky Secon explains that frozen eggs can never be a guarantee because there is drop off at every step along the way. She calls it an inverted pyramid: you start out with this many eggs, then this many fertilize, this many turn into embryos, this many embryos are actually genetically healthy, and this many embryos actually implant.
Dr. Secon emphasizes that you're taking multiple risks. It's a gamble that you'll actually need these eggs. It's a gamble that it would work. And even if you manage to get pregnant, the older you are, the riskier it is to be pregnant. She believes that society pushes high-achieving women to get so much accomplished before they have children that they run out of time. The optimal time from a biological medical perspective is in your 20s or early 30s, but the socially optimal time is later than that.
Dr. Secon argues that a better solution would be to have policies like paid parental leave, flexible hours, and child care at the workplace to make it easier for women to have babies younger. She believes that elective egg freezing sends women a message that it's okay to delay motherhood, but it will cost thousands of dollars, involves medical risks, there's a good chance it won't work, and if it does work, the pregnancy will be riskier.
A 2022 study from one large fertility center found that 70% of women who froze at least 20 eggs before the age of 38 had a baby. Success rates dropped off considerably the older women were and the fewer eggs they froze. Many women do more than one round of egg freezing to bank more eggs. The number of egg freezing procedures has increased more than six times from 6,000 in 2014 to more than 39,000 in 2023.
Business is booming in the field of fertility, and egg freezing is a big part of it. Companies target women with catchy ads on social media and host fun events like fitness classes and manicures to give women information and draw them in. Dr. Marcel Cedars, a fertility specialist with the University of California, San Francisco and a past president of the American Society for Reproductive Medicine, worries that the emphasis on profits in private equity-backed fertility companies is creating warped incentives. Doctors may be pressured to encourage more cycles to lead to more revenue.
Dr. Cedars also worries about the unfairness when lower-income women and those who don't work for large companies can't afford egg freezing. Vardit Ravitzki agrees that the majority of women who freeze their eggs electively are white and well-resourced, and there's a significant gap in options and reproductive autonomy if you have resources or don't.
Dr. Cedars believes it depends on a woman's age and attitude towards family building. If someone says they're 35 and knows they want children, especially if they want more than one child, then yes, they should absolutely do egg freezing. Dr. Singer thinks egg freezing technology will get better and better, and believes that one day virtually every young woman will do this as it becomes routine, affordable, and covered by insurance.
Dr. Singer believes that egg freezing and IVF is going to be the way the next generation will expand. He thinks that having timed intercourse or unprotected intercourse for reproduction is going to be falling out of favor in the next generation or so. Sex will be for fun and for pleasure, but when couples want to have kids, they're going to be using artificial reproductive techniques. The women interviewed believe that gynecologists should talk about egg freezing when young women come in for visits, and that knowledge is power in this circumstance.
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