Medical Examiner

Should You Freeze Your Eggs?

An egg freezing party is not a great place to find answers to this or other questions.

Illustration by Mark Alan Stamaty.

Illustration by Mark Alan Stamaty

The cocktail party at the trendy Crosby Street Hotel in SoHo could have been a networking event for a hip New York investment bank or publishing house—a swarm of young women in their late 20s and 30s, mostly in business attire. But the attendees weren’t thinking about their careers. They were thinking about their ovaries. The event was hosted by a company called EggBanxx, and the women had come to drink free wine and learn about egg freezing, something their hosts were promoting as a way to stop the biological clock so they can have their babies later, whenever they damn well please.

Despite the positive vibe, egg freezing doesn’t necessarily stop the biological clock, not when the average age of egg freezing in the United States is 37.4. By that time, the eggs being frozen have already suffered a lot of the chromosomal breakage and genetic replication errors that make later childbearing iffy to begin with. Yet if the women at the cocktail party had their suspicions, they weren’t being addressed at the information session that followed. After all, EggBanxx had billed the event as an evening of “The Three F’s: Fun, Fertility, and Freezing”—no F’s left over for “Failure Rates.”

Since the mid-September event, company “patient advocates” have aggressively emailed the women who attended, offering special financing plans and a $500 discount for signing up by the end of the month. “Hoping to help you chill and have no regrets!” went a typical follow-up email. “The future you will thank you!”

The “no regrets” part of that promise is debatable. According to the American Society for Reproductive Medicine, even freezing eggs relatively early—younger than age 38—is a long shot; the chance that one frozen egg will lead to an eventual baby is a dismal 2–12 percent.

“It was kind of disturbing how they were plying women with alcohol and trying to sell them what was basically a product,” Tanya Selvaratnam, author of The Big Lie: Motherhood, Feminism, and the Reality of the Biological Clock, told me a week after the event, which she attended without letting on how skeptical she was of the whole affair. “They were preying on women’s insecurities, kind of like the plastic surgery business.”

Egg freezing technology originated in the late 1980s as a fertility insurance policy for young women with cancer, giving them the option of preserving eggs that would almost certainly be destroyed by chemotherapy. Used this way, Selvaratnam said, egg freezing can be “an incredible gift … a miracle,” avoiding the piling-on of unwanted childlessness onto the original anguish of a cancer diagnosis.

But in the past several years, since the advent of a better technique for flash-freezing eggs known as vitrification, the proportion of procedures done on thirty- and fortysomethings hoping to extend their reproductive options has increased. It’s hard to know exactly what that proportion is, though two-thirds of fertility clinics in the United States that performed egg freezing reported in a 2009 survey that they offered it as an “elective” procedure to delay childbearing.

Standing against the wall at the EggBanxx party was a soft-spoken lawyer, age 32, who thought it was a little strange to turn the event into some kind of mixer, given that all she wanted was some information. “I’m leaning toward doing this,” she told me. “But I’m not sure who I would even be doing it for—myself? Some unknown man of the future? I just want to find out what my options are.”

At last the dance music stopped thumping, and the lawyer and dozens of other young and youngish women moved into the next room for the panel discussion. Tall boxes of free popcorn were handed out at the door, and the ladies moved into a swank auditorium, the Crosby Street Hotel’s “screening room,” with purple walls and plush orange seating.

The four women on stage were all slim, stylish, and long-legged, all projecting the same upbeat mood that had been pumped up at the open bar. It was hard to ignore the feeling that they were about to offer makeup and fashion tips, rather than the cold hard facts about ovarian stimulation, egg retrieval, the zona pellucida, and intracytoplasmic sperm injection.

“We are only trying to educate and empower women; that’s why I’m up here,” said Leahjane Lavin, moderator of the panel. Lavin, the sales and marketing manager of EggBanxx, froze her eggs earlier this year at age 34; her Twitter handle is @FreezeHer_LJ. “I’m not here to sell you anything, but to have you meet these amazing doctors and help you find your truth, help you own it.”

The truth seemed so uncomplicated. Janelle Luk, a reproductive endocrinologist at Neway Fertility (one of several fertility centers affiliated with EggBanxx), for instance, breezily described egg freezing as “part of technology that exists to help us all, just like the iPad, just like Skype.”

Serena Chen, a fertility expert at the St. Barnabas Medical Center in New Jersey, focused on success rates. Let’s say you get “one or two nice-looking embryos” after defrosting, she said—skipping over details such as how likely or unlikely it is for a 37-year-old egg to defrost successfully, or what the odds are of getting a sperm into the egg to fertilize it, given that freezing seems to toughen the egg’s outer shell. Starting with one or two embryos, she said, there’s a “50 to 60 percent take-home baby rate. So if you have 100 women that freeze batches of eggs, 50 of them will get pregnant.” Next she did some rapid-fire, back-of-the-envelope calculations that left at least a few audience members looking puzzled: Let’s say the 50 who don’t get pregnant come back for another cycle, Chen said, and 25 of them get pregnant. And let’s say the final 25 come back for a third cycle, and that’s 12 more pregnancies. “So after three cycles of transfers via IVF,” she concluded, “you end up with an 85 to 90 percent take-home baby rate.” She helpfully pointed out that “EggBanxx offers discounts for multiple cycles.”

But these stats don’t jibe with the most recent peer-reviewed study of success rates after egg freezing. In an article in Fertility and Sterility from August 2013, scientists at New York Medical College, University of California­–Davis, and the Kirikkale University School of Medicine in Turkey did a meta-analysis of more than 2,200 cycles of freezing and thawing, which they analyzed according to the age at which the women froze their eggs. The best odds were for women who had used vitrification (rather than the older slow-freeze method) and who transferred three embryos (rather than just one or two). Still, the statistics were nothing like the number that Chen calculated after three embryo transfers. The probability of a live birth after three cycles was 31.5 percent for women who froze their eggs at age 25, 25.9 percent at age 30, 19.3 percent at age 35, and 14.8 percent at age 40.

About a week after the “Fun, Fertility, and Freezing” evening, I phoned the soft-spoken lawyer I had met at the bar to see what she’d thought of it. She said she had been a little put off by the bluntness of an OB-GYN who came on stage at the end to warn the audience about how time was a-wasting. “It was a little harsh, I thought, to be telling us, ‘You might look young and feel young, but your eggs are old,’ ” she said. She hadn’t yet decided whether she would freeze her eggs, she told me, but she found the doctor’s message a bit alarmist, “like she was trying to scare us into signing up.”

But maybe that alarmism is exactly the point, according to Selvaratnam. The pitch from organizations like EggBanxx, she said, “brings up so many insecurities in women, who have to navigate these issues of motherhood and careers and futures and partnerships. I think women are caught in the crossfire between these techniques and the people who are promoting them.”

Clearly more women are thinking about egg freezing these days. It was even the theme of the two-part season finale of the IFC series Garfunkel and Oates, in which one member of the comedy singing duo endured the ravages of hormone injections, such as mood swings and crazed libido, in hopes of generating enough eggs to harvest and freeze so she could have a baby of her own some day. (The actress, 35-year-old Riki Lindhome, actually went through the process in real life last year).

And maybe having this option is generally a good thing. “I do think the egg freezing will give women more choices,” said Samantha Pfeifer of Cornell’s medical school and New York Presbyterian Hospital. We spoke in early 2013, shortly after the advisory committee she chaired for ASRM lifted the “experimental” label from egg freezing. But in lifting the label—something that companies like EggBanxx frequently mention in their brochures and on their websites—the committee most emphatically did not recommend using the procedure in the way it’s currently being promoted. Egg freezing “for the sole purpose of circumventing reproductive aging in healthy women” could not yet be endorsed, the ASRM committee wrote, because there was still not enough known about the procedure’s “safety, efficacy, cost-effectiveness, and emotional risks” to offer it as a way to stop the biological clock.

The committee continued:

Marketing this technology for the purpose of deferring childbearing may give women false hope and encourage women to delay childbearing. In particular, there is concern regarding the success rates in women in the late reproductive years who may be the most interested in this application. …  Patients who wish to pursue this technology should be carefully counseled about age and clinic-specific success rates of oocyte cryopreservation vs. conceiving on her own and risks, costs, and alternatives to using this approach.

Or, as Pfeifer put it when we spoke by telephone, “The bottom line is: How much of nature can we really bend?”

I left the event with a bag of freebies: a big acid-green coffee mug, a purple ballpoint pen, a thematically appropriate Cadbury cream egg. The gifts were nice, but they weren’t enough to quiet my worries. EggBanxx tries to soothe women’s fears using the language of sisterhood and empowerment—representatives like to say the company is “created by women for women.” But EggBanxx isn’t your BFF, no matter how much free wine you drink. The company is selling you something: hope, anxiety reduction, a break from the idea that you’re hurtling toward physical breakdown. And science suggests that it might be selling you a bill of goods.