The latest trend in assisted reproduction is egg-freezing parties, sales events often described as the “new Tupperware parties.” In the I Love Lucy era, Tupperware parties were a marketing breakthrough that made Tupperware plastic storage containers wildly successful. Hosting parties offered women a way to earn money at a time when Rosie the Riveter was being shoved back into the kitchen. Their friends and neighbors, attracted by the games, food, and company, attended as a respite from the tedium of housewifery. And the partygoers bought. Today, an estimated 90 percent of American homes contain a least one piece of Tupperware. As the Danish band Aqua has told us, “Life in plastic, it’s fantastic.”
The analogy to Tupperware parties is catchy, especially when the hostess herself makes the comparison. But it is also flawed. The storage on sale at 21st-century egg-freezing parties is not nifty products in an array of designer colors, but a complicated set of medical procedures to harvest eggs, culminating in annual fees to keep the microscopic results on high-tech ice. Egg harvesting and storage are sold as fertility insurance for “clock tickers.” These parties are thrown to persuade those who do not want to become mothers now to save gametes for an unknown, but anticipated, future time, when they may face age-related infertility. Unlike Tupperware, fertility insurance is not useful in 90 percent of American homes, or even to 90 percent of women who wish, some day, to bear children. While the odds vary by technique used, the American Society for Reproductive Medicine warns that even for women under age 38, the chances that any one frozen egg will result in a baby are 2-12 percent, and the odds diminish for older women.
Further, unlike Tupperware, egg freezing is a luxury service, with price tags running $15,000 or more (not including the price of later attempts to use the eggs via in vitro fertilization). While Tupperware parties offered inexpensive fun in postwar suburbia, as many commentators have pointed out, egg-freezing parties are promoting pricey lottery tickets, with possible health risks to purchasing women and any resulting baby.
Measured by target market and cost, the business model of egg freezing is much more like that of early commercial sperm banks than of the Tupperware company. As the value and meaning of egg freezing spark public debate in yet another round of our persistent struggle to reconcile the categories of “working woman” and “mother,” it is worth remembering the first sperm bank boom and its eventual collapse. Today’s latest and greatest family planning service for women is a business model that has been tried before, but in the 20th century, gamete storage was a service marketed to men.
The first sperm bank boom took a long time to get started. In the winter of 1953, Dr. Raymond Bunge was waiting impatiently in Iowa to learn the outcome of three pregnancies. The women had been inseminated with semen that had been frozen, stored briefly, and then thawed. Their babies would prove that cryopreservation of human sperm was possible. In the 1950s, during the heyday of the Tupperware party, IVF remained a distant dream. But artificial insemination using freshly collected sperm was an established treatment, used to help women with infertile partners bear children. Bunge and his colleagues at the university fertility clinic knew that in animal husbandry, frozen semen had increased the usefulness of artificial insemination. They hoped for similar success in humans, success that would allow them to treat more infertile couples. Bunge and the young zoology student Jerome Sherman, who developed the technique for freezing and thawing human sperm, immediately saw the potential for “sperm banks”—inventories of frozen sperm that would allow all would-be parents, infertile or not, to choose the genetic father of their child. Bunge wrote a letter to his mother in Michigan, joking that soon human sperm would be available in the freezers of her local A&P supermarket. Nobel Prize winner Hermann Muller, a professor at Indiana University, had been writing about this method of improving humankind for decades. Muller’s ideas would provide the inspiration for the so-called “genius bank,” a unique early sperm bank that opened in the late 1970s.
The first frozen sperm babies arrived safely. But the doctors quickly realized that while it was possible to use frozen sperm, artificial insemination was much more successful using fresh semen. Within a year, the pioneering Iowa group had largely given up using frozen semen. The Iowa clinic, and a few other university and private clinics, maintained a few vials of frozen sperm for unusual situations. In the 1960s, Bunge occasionally shipped vials to doctors wanting to use donor insemination in communities so small that recruiting an anonymous donor was nearly impossible. Sherman, who became a professor at the University of Arkansas for Medical Sciences, was once able to provide frozen sperm from a black donor for a black couple living where their local doctor could offer fresh sperm only from European American men.
Despite these occasional uses, Sherman, whose careerlong devotion to supporting and improving the techniques and institutions of sperm cryopreservation would earn him the title “father of sperm banking,” had to admit in the medical journal Fertility and Sterility in 1973 that there was virtually no clinical demand for frozen semen.
Sperm freezing for its first 20 years was a technology without a market, much like egg freezing has been since the first report of a pregnancy from a frozen egg in 1986. Egg-freezing parties are designed to create consumer demand in the face of medical discouragement. While the American Society for Reproductive Medicine recently declared that egg freezing is no longer “experimental,” it also reiterated that it does not endorse egg storage as a way of deferring child-bearing. Although fertilization rates for frozen-thawed eggs, especially from younger women, have been improving with new freezing, fresh eggs work better in IVF, just as fresh semen works better for artificial insemination.
Like Harvard Business School grad Christy Jones, founder of Extend Fertility, an early egg-storage business, entrepreneurial doctors and investors in the early 1970s saw a market opportunity in gamete cryopreservation even in the face of medical pessimism. Rather than strive for a supermarket-like array of frozen sperm for would-be parents, the type of sperm bank envisioned by Hermann Muller, they saw money to be made by persuading men to bank their fertility today in case they decided to become fathers in the future. In 1971, when Genetic Laboratories opened in St. Paul, Minnesota, as a for-profit semen storage facility, it charged men $50 to make a “deposit,” and then an annual storage fee for the preservation of the specimens. The target customers were not men deferring parenthood while pursuing a career and fearing an age-related fertility decline, but rather the burgeoning numbers of men choosing to have vasectomies.
While the numbers are uncertain, in the late 1960s, the number of men undergoing surgical sterilization increased dramatically—as much as sevenfold between 1969 and 1971. Sperm banks offered their storage service as “insurance” for these men, in case they changed their minds. With divorce rates increasing, the implication was that should they later find themselves married to different, younger women, they might wish to father more children. Men with banked sperm could participate in the dating market knowing that they could grant a potential mate’s wish for motherhood. Genetic Laboratories was so confident in its business model that it rapidly opened four more branches. A competitor, Idant Corp., which began in New York, soon announced that it planned to expand to 20 cities and then move overseas.
By 1976, though, both companies were closing branches. Failing to recognize the potential of the Tupperware party model to boost sales, the banks relied on urologists performing vasectomies to tell patients about their services. Urologists, though, knew that fresh semen was better than frozen when it came to artificial insemination, and they began to see disgruntled sperm bank customers returning to their offices seeking vasectomy reversals when their thawed sperm failed to impregnate their new wives. A prominent medical journal published an article in 1979 titled “Frozen Sperm—A Poor Form of Fertility Insurance.” One reason that 21st-century sperm banks are so picky when selecting semen donors is that sperm differs in its reaction to the trauma of freezing and thawing. Semen from about two-thirds of men, even if fertile by all other measures, does not contain sufficient concentrations of viable sperm after cryopreservation for successful insemination.
In the 20th century, it was men who were being asked to pay out of pocket for “insurance” that they might never need. And it was men finding that if they did try to use that insurance to become a parent, the outcomes were often disappointing. With neither burgeoning clinical nor consumer demand for male gamete storage, this business model was a bust.
Yet sperm banks are highly profitable businesses today. What happened? In the late 1980s, clinical demand for frozen sperm surged. When doctors came to understand that HIV was present in human semen, fresh semen became life-threatening. As HIV testing became possible, doctors also understood that it took significant time after initial infection for the virus to become detectable. A donor could test negative, but his semen could be infectious. Only by taking a semen sample from a man who tested negative for HIV, storing it for six months, and then retesting that same supplier to make sure that he remained HIV negative could doctors be sure that the semen was safe to use. Within a few years, doctors who had been using fresh semen for 80 percent of artificial inseminations switched to using only banked semen.
Today’s sperm banks thus provide frozen sperm in response to a robust demand for frozen, medically screened sperm, as banked sperm replaced fresh sperm for those seeking to create a child with donor gametes. It remains possible to store one’s own semen. Some sperm banks offer special pricing to service members planning for deployment, as well as programs for men planning vasectomies or undergoing cancer treatment, an option chosen by Lance Armstrong. But the banks focus on purchasing sperm from those men whose sperm is biologically best suited to withstand freeze-thawing. They are in the business of collecting, screening, and providing donor gametes. While Tupperware parties provided a long-lasting boost to that brand of high-end plasticware, the free wine and shrimp at today’s egg-freezing parties may prove to be only sufficient to create a short-term boom before the egg bank, too, reorients its business from those willing to gamble on a possible future effort to conceive to those seeking children today via donor gametes. Fresh is better than frozen, but frozen donor eggs from a woman in her 20s may offer a better chance at pregnancy via IVF to a woman in her 40s than her own fresh eggs. Eggs frozen for only a few months, to allow several would-be mothers to split cost and bounty of one donor egg harvesting cycle, might offer a better chance at pregnancy than eggs frozen six years or more by a woman now seeking to become pregnant in her 40s or beyond.
There is a second alternative. As data accumulate regarding the increased risk of abnormality to children born from the sperm of older men, gamete storage may become newly attractive to men as well, opening the door to sales events that mingle microbrew tasting and pretzels with information about the latest techniques of sperm cryopreservation. Who knows? If gamete storage becomes popular enough, there might even be a market opportunity for Tupperware, which has remained successful by continually updating its product line to meet America’s storage needs.
