Egg-freezing gives women more options, so thanks Apple and Facebook.

In Defense of Egg-Freezing Benefits

In Defense of Egg-Freezing Benefits

The XX Factor
What Women Really Think
Oct. 16 2014 8:52 AM

In Defense of Egg-Freezing Benefits

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Options.

Photo by LEX VAN LIESHOUT/AFP/Getty Images

Earlier this week, Apple announced that it would join Facebook in offering benefits that cover egg-freezing for female employees who are not ready to bear children, but want to have some eggs in the freezer before their fertility starts to decline. That decision has gotten a lot of backlash, with many expressing concern that offering women a way to defer child-bearing is tantamount to hanging a sign that says “moms need not apply,” others lamenting women’s waning commitment to incubating the next generation, and yet others wondering if egg freezing perks just distract from more important benefits, like paid family leave and flexible work schedules.  

Boy, do I wish these egg-freezing benefits were on the table alongside better parental leave, friendlier lactation policies, and free universal daycare. But I don’t think the egg-freezing coverage has to be instead of family friendly policies, and I also don’t think egg-freezing has become necessary because of women’s career trajectories or their sexual tendencies or their persistent desire for equal pay and civil rights. Egg-freezing is simply a need, one of many, that women may have.

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I’m a maternal fetal medicine specialist, and so I field lots of questions from women, both in my professional and personal life, about egg freezing. Patients, but also friends, cousins, colleagues and neighbors will turn some age (36? 38? 40? everyone’s panic button is different), and I’ll get a call or an email about where to get this “done,” and what the experience might be like. How much will it cost? Will it work? How will it feel? I get these questions from women who span the gamut in terms of race, ethnic background, and cultural expectations.

But here’s one way in which these women are the same: They’re usually single. And that makes sense, right? Because if these women were partnered, but still wanted to delay child-bearing, they would probably pursue IVF with their eggs and their partner’s sperm, and freeze the resulting embryos. IVF and embryo cryopreservation is an older, more refined, and arguably more successful technology, although as egg-freezing becomes more sophisticated, it is reportedly beginning to approach the same success rates. (I’m focusing this discussion on heterosexual women, for whom the alternative to egg-freezing seems to be an easy fix: making babies the old-fashioned way. This means that I’m excluding a bunch of other wonderful kinds of families here, and not discussing the ways that assisted reproductive technology offers some great options for those people too.) Before you ask: These are women who can’t achieve their goal with a sperm donor. What they want is a baby, yes, but with a willing partner for child rearing and a present father for their child. Sometimes this is called “social infertility.”

Almost by definition and against stereotype, these women who approach me about egg-freezing are prioritizing child-bearing. They are willing to go through an expensive, yes, but also painful and difficult set of procedures in order to make those theoretical, beautiful, children of the future, the ones they so very much want, possible. In my experience, what the vast majority of heterosexual women are missing is not the ability or desire to step away from their careers, or the desire for children, or the understanding that having children at an older age has its challenges—what’s missing is the father.  

When asked about delayed child-bearing in many studies, the two factors that come up again and again are financial stability and the availability of an appropriate partner. We really like to talk about that first factor, and tie reproductive lateness to hard-charging women who have their own career-centered, family-unfriendly priorities. But for a moment, let’s talk about that second factor: the appropriate partner. This is the one that I think creates the egg-freezing push. At some point, while dating, and waiting, and having hearts broken (or yes, breaking hearts), many women want to start working with what they have, and not waiting for the right XY chromosome carrier to come around. They want him to come around, they believe he’ll come around, but they don’t want to lose their chance at healthy, genetically related children while they wait for the father of those children.

Because of the longstanding unfairness of biology, men do not have the same time pressure for reproduction. And because of a second unfairness of biology, freezing sperm is easier, cheaper, less invasive, and exceedingly likely to be successful. But as we continue to discover some of the concerns associated with advanced paternal age (generally, health problems more subtle than those associated with advanced maternal age, but still present), perhaps male sperm preservation should become a job perk as well.

In the meantime, what I see—anecdotally, but overwhelmingly—is single women, aching to start a family, acutely aware of the passage of time. And egg-freezing puts the whole process on ice until they can find a way to have the family they really want, with the partner they really want. In the end, egg-freezing is not about work versus family, and it’s not pro- or anti-motherhood. It is new technology, and it creates options. And options are something every woman wants, and in this case, I think reasonably deserves. If your job supports that, so much the better.

Chavi Eve Karkowsky is a specialist in high-risk pregnancy, also known as maternal-fetal medicine, in New York City. Follow her on Twitter.