Why the Egg Freezing Industry Is Booming

Why the Egg Freezing Industry Is Booming

  • Post category:Health

Spring Fertility, a clinic in Midtown Manhattan, looks like the place where the main characters on “Broad City” would have wound up if the millennial sitcom had done an episode about egg freezing. The waiting room has books by America’s youth poet laureate Amanda Gorman and its Instagram poet laureate Rupi Kaur. The kitchen is stocked with Spindrift. A conference room also serves as a venue for “shots nights,” less raucous than they sound, where patients inject themselves with fertility drugs communally, with encouragement from staff.

Spring’s medical director in New York, Catha Fischer, dressed in a loose blouse and a low ponytail, beamed as she showed me the phlebotomy stations and operating room, where patients are anesthetized so that a doctor can puncture their ovaries with a needle and suck out eggs for freezing. The room, Dr. Fischer noted, “looks like a Grey’s Anatomy O.R.”

There is always a market for products, from skin care to weight loss, promising to ease the angst of womanhood. Efforts to slow down the reproductive clock are no different. The business of egg extraction is thriving, among the privileged group of people who can access it.

Across Spring’s clinics nationwide, the number of egg freezing cycles undertaken last year jumped 37 percent from the year before. That surge is visible at fertility clinics around the country, according to data from the Society for Assisted Reproductive Technology. The prototypical patient also seems to be getting younger, doctors say, a change coinciding with a steady uptick in corporate benefit packages that cover fertility preservation. In 2015 just 5 percent of large employers covered egg freezing; in 2023, nearly one in five did.

Some medical technologies spread slowly, but the embrace of fertility preservation has grown at a remarkable rate. In 2015 there were about 7,600 egg freezing cycles recorded nationwide, and by 2022, that number hit 29,803, a nearly 300 percent increase.

An egg freezing cycle starts when a woman injects herself once or twice a day with hormones (see: “shots nights”) that stimulate the production of multiple eggs and ends about two weeks later when a physician extracts those eggs with a needle. Some patients go through multiple cycles in the hopes of getting more eggs, which are then preserved in liquid nitrogen tanks, a mad science experiment enabling deferred motherhood.

Egg freezing has been around since the 1980s, but for decades it was primarily used by cancer patients before undergoing treatment that might damage their fertility. The American Society for Reproductive Medicine lifted the treatment’s experimental label in 2012. In the decade that followed, the vast majority of people who froze their eggs fell into one defined demographic, painted vividly in anthropologist Marcia Inhorn’s book “Motherhood on Ice”: women in their late 30s who hadn’t settled down with romantic partners and wanted to preserve the option of becoming a mother. Ms. Inhorn called egg freezing a solution to the “mating gap,” the lack of eligible male partners for educated women.

But in recent years the motivations offered for freezing eggs have gotten more varied. There are those who see it as a way to spend their early 30s focused on career, untethering professional timelines from reproductive ones. There are those who have seen friends freeze their eggs and figure they may as well do the same.

Others see egg freezing as something ineffably empowering, all the more so following the Supreme Court’s Dobbs v. Jackson decision, which has led to states around the country curbing access to reproductive health care; in vitro fertilization has recently become a legal and religious target too. And some view elective fertility treatments simply as a way to exert control over the uncontrollable: their aging bodies. All of these rationales are made more possible with corporate benefits.

“I just had a consult, before I met you, where the patient is young, she’s 30,” Dr. Fischer told me as we toured the Spring clinic. “I said, ‘What has you considering this?’ and she said ‘Frankly because I have the benefit and it would be silly not to.’”

When my employer, The New York Times, expanded its coverage to a lifetime cap of $50,000 for fertility treatments on company-sponsored plans earlier this year, I decided, at age 29, to freeze my eggs. My roommate had frozen her eggs because she was on a short-term professional fellowship that covered it. Another close friend described the process of giving herself hormone injections as an arduous but exhilarating experience in which every day she marveled at her body’s capacity to nurture future life.

After years of absorbing the reasons my generation dreads motherhood — the costs, the bodily toll, the disappearance of friendships, the looming climate and social disasters — freezing my eggs felt like a gift of ridiculously unmitigated optimism. It was a way to invest in the possibility, however far-off, of becoming a mom, not as a negation of all the cultural doom and gloom surrounding it, but as an antidote. After I froze my eggs, two other good friends decided to do the same; I made one a playlist for injections, “Eggselent Beats.”

Mine is the first generation with access to a technology that promises to slow, a little bit, the biological clock, and, for those lucky enough, bosses who will foot the bill. That brings with it a magical thinking that we’re already accustomed to: for every difficulty we saw our parents grapple with, there’s an app for that.

But as I spoke with more friends and experts, I wondered whether the hype over egg freezing, in a backhand way, affirmed the seeming impossibility of balancing parenthood and work.

Marisa Rodriguez-McGill spent her 20s in graduate school programs, then landed her dream job at Lyft. She sensed that she needed to make up for lost professional time. At 33, she used Lyft’s benefits to freeze her eggs. She says she felt a “psychological safety” that allowed her to work late nights and weekends, relieved of that one anxiety.

Less than two years after freezing her eggs, Ms. Rodriguez-McGill got married and almost immediately got pregnant naturally. Now, as a Lyft senior manager, she is juggling major policy initiatives, on safety and artificial intelligence, while parenting a 10-month-old baby.

“It’s not as simple as I had originally made it out to be with that egg freezing journey,” she said.

Like other women who froze their eggs in recent years, she invested time and pushed her body for something that lies between a feminist dream and a Silicon Valley fantasy. Of course egg freezing didn’t make everything snap into place. But it did bring, at least temporarily, a sense of relief and power.

And she is comforted knowing that her eggs from her early 30s are preserved, offering the possibility of waiting a few extra years to have more children. She added, chuckling: “That’s probably the only type of time travel that exists.”

During the tight labor market of 2022, the media company Forbes found itself, like most media and tech companies, in a war for top talent.

Brooke Dunmore, vice president of corporate benefits at the company, was working remotely from her home in Charlotte, N.C., trying to figure out how to keep employees and entice new ones. Just before the pandemic, Forbes had begun promising up to $25,000 for infertility treatment (freezing embryos and then implanting them in the uterus) and fertility preservation (freezing eggs).

But fertility treatments are expensive. A single cycle of I.V.F., medications included, can cost upward of $20,000, and doctors often recommend multiple cycles to increase the chance of success. Egg freezing can cost between $4,500 to $8,000 for medical appointments and another roughly $5,000 for medication, on top of $500 annually for storage. As she fielded emails and Slack messages from employees, Ms. Dunmore found that a top demand was more money for those services.

“We’re always trying to offer competitive benefits across our industry,” Ms. Dunmore said. “This benefit certainly is attractive to potential candidates.”

Ms. Dunmore researched the benefits that competitors offered and worked out a rough annual cost of expanding Forbes’s coverage to a $50,000 lifetime cap for infertility and fertility benefits (a figure she declined to share).

Forbes revealed the expanded policy in 2024, joining a host of other companies chasing female workers by promising to help secure their fertility. Starbucks announced in 2019 that it would increase its lifetime cap for fertility treatments to $25,000, with another $10,000 for fertility medications. Match Group, which owns dating apps like Tinder and Hinge, increased its benefit in the United States to $10,000 from $5,000 in 2022. Amazon last summer expanded to more than 1 million employees its fertility benefits, which are administered through the benefits platform Progyny and include covering what roughly amounts to two cycles of treatment.

In many workplaces, these new benefits came after years of advocacy from women who paid out of pocket to freeze their own eggs. These “egg freezing activists,” as Ms. Inhorn calls them, felt that colleagues coming up behind them shouldn’t have to shoulder the costs alone. (Although workers who move on to new jobs then have to cover the cost of keeping their eggs stored, often more than $500 a year.)

Fertility benefits can be relatively affordable for companies, compared with other corporate perks, because there is a limited number of employees who are of reproductive age and will use them, according to Segal, a benefits consultancy. Large companies tend to be self insured and pay for the cost of each employee’s treatment through the health plan, according to Mercer, another benefits consultancy, while smaller ones are fully insured and pay a fixed fee to cover the cost of treatment for all employees to the insurer. Companies justify the cost as something that improves diversity and female workers’ productivity.

“It’s usually considered reasonable and a value add because it’s supporting retaining women in the work force,” said Julie Campbell, a partner and senior health benefits consultant for Mercer.

When companies don’t cover it, egg freezing is so expensive that the breadth and demographics of people it reaches is extremely limited. And even when companies pay, it entails taking time for frequent doctor’s appointments. One study, which analyzed nearly 30,000 egg extractions between 2012 and 2016, found that just 7 percent of the women who had undergone the process were Black and 4.5 percent were Hispanic.

In certain white collar industries — law, tech — fertility benefits are increasingly viewed as a new standard for corporate health care. “One company in a group of competitors does it, so then they all have to decide if they’re going to follow suit,” Ms. Campbell explained.

As soon as Sarah Edelstein, a 28-year-old senior communications manager at Forbes, read the email from her bosses detailing the new benefits, she decided to freeze her eggs. During a weekly one-on-one meeting with her boss, she explained that her work schedule might be affected for two weeks as she juggled doctors’ appointments.

Ms. Edelstein knows that she wants to become a mother, but she hasn’t met a long-term partner and wants to save money first. She also hopes one day to run a company. When a former boss in the fashion industry stopped working at 31 after giving birth, Ms. Edelstein saw it as something of a cautionary tale about the tensions between work and motherhood. And she saw egg freezing as a way to invest time in her professional ambitions before her personal ones.

“I certainly have had this idea about getting my career to a certain place before I have a family,” Ms. Edelstein said.

Dr. James Grifo, program director of the NYU Langone Fertility Center, has seen more younger women like Ms. Edelstein coming for the procedure. The average age of his patients, he said, has dropped from 38 around five years ago, to the lower 30s now, a change he applauds. (The age when American women have their first child is on the rise, reaching an average of 27 in 2021, up from 21 in 1972.)

“Women are given the wrong message — oh don’t worry, you’ll have your baby when you’re ready,” Dr. Grifo said. “Nonsense! That’s not true.”

Preserving eggs at a younger age could increase the chance of later successfully putting them to use. A 2022 study on live births from frozen eggs, which Dr. Grifo coauthored, found that the overall success rate of having a baby from a frozen egg was only 39 percent, but it rose to 70 percent for women who were not yet 38 when their eggs were extracted and who were able to thaw 20 or more eggs.

As the benefit spreads, some women see no downside to using it, according to Ms. Edelstein: “Younger women are like, ‘OK yeah, I’m going to do it, check the box.’”

For some women who now view egg freezing as a to-do list item, it also seems natural to tell others about the experience. Daily injections are emotionally taxing, and bringing along Instagram followers can be a comfort. The stream of social media posts, in turn, has demystified the experience, making it all the more popular.

On TikTok, cameras zoom in on women driving 27-gauge needles into the skin just below their belly buttons. On Instagram, women post photos after their egg retrievals, lying in gurneys wearing hospital gowns and flashing a thumbs up. On Reddit’s r/egg freezing, people discuss what to eat during the 10 to 14 days they are injecting hormones (salmon? berries?), and how daylight savings might affect the timing for the trigger shot, the one administered just before retrieval.

The influencer Serena Kerrigan, who describes herself as “the queen of confidence,” shared videos with her hundreds of thousands of TikTok and Instagram followers showing her injection routine — at least once with a liquor shot chaser in Miami: “When you have fertility shots at 8 and the club at 9.” (She got discounts from Spring Fertility in exchange for doing events with and posting about the clinic.)

Ms. Kerrigan, 30, said freezing her eggs was a choice entwined with professional ambition — she wants to make a movie before she has her first child — summed up in her TikTok caption: “Freezing my eggs because it’s time to build my empire.”

Others in the younger egg-freezing demographic echo that sentiment. “It was about having power,” said Ali Bonar, 31, an entrepreneur who froze her eggs so she could stay obsessively focused on the granola butter start-up she runs with her fiancé. “I get to choose — within reason, I know I can’t be an 80-year-old mom — but I get to choose my timeline a little bit more.”

More than a decade since the technology was first put into use, though, some of its early beneficiaries are vocal about the limitations of its effects on their careers.

In 2011, when she was 39, Brigitte Adams froze 11 eggs. She was single and working late nights as a marketing executive. Five years later, she was feeling fed up with dating and being ghosted, and was past ready to have her own children. She decided to thaw the eggs. She found that only one was viable — a not uncommon experience, research shows, particularly for women who are older when they freeze their eggs — and when she implanted it, she lost the pregnancy within four days.

Ms. Adams, who is now 51 and a marketing consultant in Carmel, Calif., had a daughter in 2018 with a donor egg and donor sperm. (“Yes!” her daughter giggled, confirming this, during a fact-checking call.) She has become an outspoken voice on the ways in which egg freezing can be a psychological balm but not always a practical one. “It’s too bad that a technological revolution in assisted reproductive technology is putting off the discussion of how it’s still impossible for women to have it all,” she said.

Joan Williams, a professor at the University of California Law San Francisco who studies women in the workplace, gave a sigh when I asked her to describe the limitations of egg freezing as a feminist technology, as though pulling out the script for a production she’s done way too many times.

“It doesn’t solve the problem, which is that you still define the ideal worker as someone who is always available for work,” she said.

Egg freezing, Ms. Williams added, only works if it’s part of a bigger package of solutions to ease the burden on working parents: ample parental leave, flexible work, company norms ensuring people can log off when tending their children.

The women I talked to tend to describe their egg freezing experiences with layers of emotional and practical ambiguity — because of course the process, while costly, is insufficient as an answer to all the challenges that complicate life for working parents.

“I’m a fan of anything that forces us to look at hard truths and not put off important questions,” said Natalie Lampert, who has written about egg freezing for a decade and whose book, “The Big Freeze,” is coming out in July. “What does my life look like? Where do kids fit in?”

“No technology is a panacea for confronting bigger questions about what we want,” she added. “But not having it is not a solution.”



by NYTimes