Freezing Your Eggs Is Complicated, Expensive, And Might Not End With A Baby

Kate Durkin froze her eggs for the same reasons so many women freeze their eggs: she found herself single and about to turn 35. Her friends were having kids and she knew she wanted a family someday, too. So Durkin saved the money, found a clinic in New York where she lives, and started the hormone injection process. She was surprised at how hands-off the treatment was, with none of the medical staff giving her a sense of how her body was responding or whether her results were good or bad. She assumed the eight eggs she froze were sufficient. “I felt good,” she said. “I thought that meant eight babies.”

Fast forward three years and Durkin, fresh off a break up, decided it was time to use those eggs with donor sperm. When the nurse called to give her the results of her egg fertilization, Durkin says she glossed over the fact that six — six — of her eight eggs didn’t survive the thaw. Of the remaining two, just one had fertilized. Genetic testing revealed that embryo was mosaic, meaning it had both normal and abnormal cells.

“I was devastated. I couldn’t believe it,” said Durkin, now 40. She recalls sobbing, wondering how any of this could happen. “I spent a lot of money on this,” she told me. “I thought I was doing all the right things.”

Planned oocyte cryopreservation, as egg freezing is medically known, is rising sharply in the U.S. Researchers from Yale projected some 76,000 egg freezing cycles would take place in 2018, up from 8,800 cycles in 2016, the most recent data available from the Society for Assisted Reproductive Technology. Once the domain of women in their mid to late 30s, egg freezing is now increasingly common among those in their early 30s and even 20s.

The popularity is thanks in no small part to a new crop of clinics meant to destigmatize the egg freezing and make it more accessible. New York-based Kindbody, which refers to itself as a “women’s health and fertility platform,” has been called the “SoulCycle of fertility” and has plans for a nationwide chain of clinics. It offered a New Year’s pricing special on fertility consultations and assessments, and has hosted pop-up fertility testing in many places, including the Hamptons last summer. Trellis, which just opened in New York and bills itself an “egg freezing fertility studio,” promises on its website an “Insta-worthy studio, with phone chargers, a juice bar and a modern workspace.” On its website, Chicago-based Ova clinic has a video testimonial of a former Bachelorette star alongside Whitney Bischoff Angel, a Bachelor winner and an egg-freezing nurse specialist at Ova. “Freezing your eggs is such an empowering choice because you are taking control of your life,” Bischoff Angel says.

These clinics garnered a slew of media coverage highlighting the potential upsides: a chance to stop your biological clocks, focus on your careers and date freely. Egg freezing is often referred to as an “insurance policy.”

But it’s not, not exactly— and not for everyone. Lost in the headlines and soundbites of the new, public conversation are the significant uncertainties in potential outcomes, as well as a candid explanation of the toll on the women who undergo the procedure, both physically and financially.

“It’s a very complex and nuanced discussion,” said Dr. Paula Brady, a reproductive endocrinologist at Columbia University Fertility Center. It’s important to talk about expectations “and how much of an insurance policy it really is.”

All of the aforementioned new clinics say they make it very clear in the initial meetings with potential patients what egg freezing entails and what the risks are. Trellis’s website features a lengthy FAQ on the procedures, costs, and side effects. “We want to make sure there is transparency across the process,” says Jennifer Huang, Trellis’s chief marketing officer. At Ova, Bischoff Angel says she explains the details during all of her initial, complimentary consultations. “We don’t want to patients to think it’s 100% a guarantee for having a baby,” she said.

Still, a lot of the press and marketing around egg freezing can leave many women, such as Durkin, with a false sense of security. Here, we unpack some of the most common myths surrounding the procedure.

For as casual as some of the news reports make egg freezing sound, it’s important to remember that it’s a major, costly medical undertaking. Egg freezing is essentially the first half of in-vitro fertilization (and if you decide to use those eggs in the future, you’ll need to do the second half). Patients inject themselves with hormones to stimulate their ovaries for up to two weeks, with frequent appointments to monitor their progress, and then undergo an egg retrieval under anesthesia. For a single round, egg freezing costs start around $5,000 — many of the women I spoke to spent twice that. Patients must then pay to store their eggs, which annually can range from $300 to more than $1,000. If they want to inseminate those eggs to create embryos, and transfer them in hopes of pregnancy, that’s several more thousands of dollars.

“The first night I was standing in my kitchen with all the stuff” — the needles, syringes, and medication — “spread out on the table, totally terrified of doing it,” said Emily Cotton who lives in Boston and froze her eggs last year at the age of 34. While Cotton felt okay during the injections, after her egg retrieval she was diagnosed with ovarian hyperstimulation syndrome (OHSS). She was in pain for the next two weeks, and unable to fly for six. Cotton says she is glad she froze her eggs, but wishes more people would talk openly about it. “You are subjecting your body to a lot with an unknown outcome and a pretty good expense,” she said.

The most common misconception among new patients is that each egg represents a future baby. “I have 10 eggs, I have 10 babies on ice,” is what Dr. Jaime M. Knopman, a reproductive endocrinologist and director of fertility preservation at CCRM New York hears. “That is not the case, not at all.”

The chance that a single egg will result in a live birth for a woman under the age of 38 is just two to 12 percent, according to the American Society for Reproductive Medicine. That’s because a lot needs to happen before an egg can become a baby: the egg must be retrieved, deemed mature, and able to be frozen; then it must stay frozen and survive the thaw. Eggs are incredibly sensitive, more so than embryos or sperm, to water and ice damage, Knopman says.

From there, the egg needs to be fertilized with sperm and the resulting embryos must grow to a point where they’re suitable for transfer back into the woman’s uterus. Even then, it’s far from a guarantee. Live birth rates vary by age, embryo quality and clinic, but with women under the age of 35 it hovers around 40%, according to the Society of Assisted Reproductive Technologies. And it goes down to the low single digits with patients over the age of 42.

Egg freezing is a numbers game. The more eggs you have, the better your chances. And, for many women, that means doing more than one round. Take Valerie Libby, an OBGYN who now lives in Cleveland. Faced with a demanding career, and armed with the knowledge that her mom went through early menopause, Libby decided to freeze her eggs in the hopes of improving her chances of having three kids someday. The first two rounds, when she was 29 and 30, banked her 12 eggs. “Twelve, 30-year-old eggs would probably get me one kid, maybe two,” she said. So Libby decided to do it again, at age 33, retrieving 20 eggs, of which 15 were able to be frozen. With 27 eggs on ice, “I feel comfortable,” Libby said.

But doing multiple rounds comes at a cost — literally, it’s expensive. Libby, who’s in speciality training for reproductive endocrinology, got a discount on the procedure and her parents helped cover her costs. Her mom flew in from Atlanta for each of her retrievals, to drive her home and help her recuperate. “They really want grandchildren,” Libby said.

Not all fertility clinics are created equal. The major advantage this new crop of clinics offers is a focus on egg freezing, often with cost savings, and with what many say is an improved patient experience. Victoria Reitano, the founder of 6boro Social, a digital marketing agency, froze her eggs last year when she was 29. She chose to do it with Extend Fertility, a New York-based egg-freezing practice that launched in 2016. “I didn’t want to go into an IVF clinic,” she said. “I didn’t want to be around couples preparing for a happy moment where I’m here like, ‘Am I going to be 40 having these babies alone?’”

However, doctors that I spoke to at long-established full-service fertility clinics expressed doubts about newer egg-freezing facilities, not because of the quality of the doctors, but the experience of the labs. Recent freezing failures, in Cleveland and San Francisco, with potentially thousands of lost eggs and embryos, have brought to light the potential shortcomings of some labs. It’s the labs that handle the fragile eggs, ensure they stay frozen, and then fertilize them if a patient decides to use them.

Patients should ask for statistics not just on egg retrieving and freezing, but also thawing and fertilization, says Dr. Brady from Columbia: “You want a place that can care for those eggs through the whole process and whatever the future may hold.”

Dr. Joshua U. Klein, chief clinical officer and a reproductive endocrinologist at Extend Fertility, says the team of doctors and technicians at the practice have extensive experience in the field. Klein also said that the practice’s new space allowed for the latest equipment, compared to other clinics that may be a decade or more old. “We have more modern, up-to-date and cutting-edge stuff in the lab than pretty much any other lab in New York City,” Klein said.

Some other new, egg-freezing clinics also have relationships with long-established labs. Trellis is a division of IntegraMed Fertility, a network of fertility clinics with 103 locations that has been operating for more than three decades. Ova was created by a Parent Laboratory, which handles more than 2,000 IVF cases each year. “Patients don’t really think about how important the lab is,” says Ova’s Bischoff Angel. “That’s where all the magic happens.”

There is no research that suggests freezing an egg for a year or 10 years is any different, says Dr. Knopman of CCRM. But that doesn’t mean egg freezing earlier in life is without complications, both financially and logistically. The longer a patient stores her eggs, the more she’ll have to pay in storage fees. Say you freeze them at 27 but don’t get around to using them until you are 37, that could be another $10,000 in costs. If you decide to use those eggs, you must pay more to fertilize and transfer the resulting embryos, costing another several thousands dollars.

Also, a lot of life can happen between freezing your eggs and using them. What if your job transfers you across the country, or around the world? You can make arrangements to travel back to your eggs, which is likely not cheap, or have your eggs shipped to you, but that comes with its own risks.

Dara Mersky froze her eggs in Dallas and shortly after moved up to New York for a new job. Her doctor in Texas offered to help her find a place to store her eggs closer to her. Mersky, who is 36, declined. “I want them to stay put,” she said, adding that she was so pleased with her doctor that she couldn’t imagine doing it with anyone else. “I would fly back to do [a transfer] with her.”

Above all else, doctors say, women considering freezing their eggs need to understand that it does not ensure a baby in the future. Along with problems that could arise with the eggs, there are many other causes of infertility — male factor, for example, as well as women’s issues such as endometriosis and polycystic ovary syndrome — that could hinder plans to get pregnant.

Dr. Fahimeh Sasan, who spent more than a decade at Mount Sinai before becoming a founding physician at Kindbody, makes it clear the possible outcomes when she talks with patients. “This can improve your chances of having your own biological child,” she said, but cautioned: “We’re not selling a guarantee and no one should be.”