The problem with the egg-freezing boom

Brenna Carney was 26 when she started seeing videos circulating on TikTok of women her age freezing their eggs. She began to panic. Was this something she should be thinking about? The Texas native was single at the time and had always wanted children. "When I was 18, I thought I'd be married by 24, with my first kid by 26," Carney told me. "That definitely did not happen."

She started researching and found numerous articles preaching the advantages of freezing eggs before age 35 for higher viability in the future. "I felt the biological clock ticking," she said.

Egg freezing offered a plan B. She wouldn't have to worry about her fertility declining or rushing into a relationship with someone — she would have viable eggs to use whenever she found the right partner or decided the time was right. So in 2022, at the age of 27, she discussed it with her primary-care physician and was referred to a fertility clinic. "I put a lot of thought into it, but I will say I was kind of just freaking out a little bit," she said.

Carney is one of many young people who feel like they're running out of time. Ever since the American Society for Reproductive Medicine lifted the "experimental" tag from egg freezing in 2012, more people have decided to freeze their eggs. Between 2012 and 2020, procedures surged by 400% in the US, according to the Society for Assisted Reproductive Technology. Initially, ASRM recommended egg freezing only for women undergoing medical treatments that affected their fertility, but in 2021, thanks to improved technology, ASRM acknowledged "delaying childbearing" as a valid reason for the procedure. And in 2022, women were given the option to store their eggs for up to 55 years, a significant increase from the previous 10-year limit. For the first time, egg freezing was an option for younger women worried about their reproductive future.

Since then, clinics have used platforms like TikTok and Instagram to entice an increasingly young base of women with the message that they're running out of time — the earlier you freeze your eggs, the better, they warn. From 2021 to 2022, the most recent year for which data is available, US egg-freezing procedures jumped another 20%, to nearly 30,000. Younger and younger women are posting online about freezing their eggs — and getting paid by clinics to do it. But the messaging often ignores a few key realities: Egg freezing is expensive, the chances of success vary significantly, and the idea that earlier is always better isn't clearly supported by research.

"Egg freezing is a really valuable and important technology," Zeynep Gurtin, a sociologist and lecturer at the Institute for Women's Health at University College London, told me. However, she said it's not a blanket positive. "What we're starting to see with egg freezing now is the overexploitation of egg freezing as a technology that's marketed as being potentially useful to all women who should use it as some kind of backup plan," Gurtin said. "That's absolutely not what this technology is designed for or is right for."

The first step in Carney's egg-freezing journey was to go on birth control — something she had never done before. "That week, I was a raging bitch," she said. The pill sent her emotions spiraling in every direction. Then, Carney had to self-inject daily hormone shots for 10 days to coax her ovaries to mature as many eggs as possible. Finally, the doctor could remove her eggs.

During a typical egg-retrieval procedure, a doctor guides a needle attached to a catheter through the vaginal wall and draws out the eggs using light suction while the patient is under anesthesia. The harvested eggs are immediately preserved in a cryogenic freezer in liquid nitrogen, where they stay until they're needed for in vitro fertilization. The whole procedure takes less than 20 minutes — but recovering from the anesthesia might take several hours.

The more eggs the doctor can retrieve, the better the chance one will result in a successful pregnancy down the road. In a 2022 study, women who froze their eggs before the age of 38 had a 70% chance of having a baby if they thawed 20 or more eggs. But if they thawed fewer than 10 eggs, the success rate plunged to 36%.

Women under 38 typically get 10 to 20 eggs per retrieval, but of the eggs that are frozen, not all will survive the thawing process. Even fewer will be successfully fertilized, fewer still will become embryos, and even fewer will result in a live birth. At each stage of the process, there's a chance that something goes wrong. "Even in the best-case scenario, your success rate is never going to be higher than the average IVF cycle, which is around 30%," Gurtin said.

Carney's retrieval resulted in only nine eggs. "I thought that I would get a lot more because I was 27 and very healthy," she told me. "Some women get, like, 25 to 30." She felt frustrated and discouraged. "I just did all that and now I only have nine?" she recalled thinking at the time. Most women undergo the entire process multiple times to retrieve more eggs and increase their chances of success. But that also comes with a cost — and Carney doesn't plan to do another round.

Egg retrieval typically runs you $8,000 per procedure, plus $2,000 to $5,000 for the hormone shots. Each year you store your eggs, you also have to pay a fee ranging from $400 to $800. And when you decide to use your eggs, it costs $3,000 to $5,000 for the frozen-embryo transfer. Insurance coverage for these procedures is rare, with exceptions in situations such as when a cancer patient's fertility is endangered by chemotherapy. Some employers do offer assistance — Meta and Apple, for instance, cover up to $20,000 for egg freezing, and since 2016, active-duty women in the US military can have the procedure covered — but everyone else is on their own.

To pay for her procedure, Carney took out a $6,000 loan. Her insurance covered a couple of doctor visits, and her mother helped out with an extra $2,000 to $3,000 for the hormone treatments. Carney now pays $200 each month to pay off the loan, and when we last spoke, she had just paid her annual $600 fee to keep the eggs frozen. She plans to keep paying until she turns 36; if she hasn't used them by then, she'll have them destroyed to avoid paying more fees. Nine years of storage would bring her total cost to nearly $14,500, not including interest on the loan.

While freezing eggs doesn't guarantee children, it's also not clear whether doing the procedure in your 20s gives you a significant advantage for a successful pregnancy. Most studies compare women in their early 30s with those in their late 30s and early 40s. In those studies, women under 35 tended to have better outcomes than those who froze their eggs at 40 or later. But that doesn't mean earlier is always better. Other studies have found that there isn't much added benefit to freezing eggs earlier than 30. One 2015 paper looked at the optimal time to freeze eggs among women 25 to 40. It found that freezing your eggs before your 30s didn't generally improve your chances of having a live birth over trying naturally. While egg freezing has the highest chance of success when done before 35, the researchers found the age at which freezing your eggs made the most sense in terms of both viability and cost-effectiveness was 37.

"I generally recommend women who are considering freezing their eggs do so before the age of 35 if they can," Dr. Geeta Nargund, the medical director of the fertility center ABC IVF, told me. "If there is no medical reason to freeze your eggs in your 20s, I would advise that you would be in a better position to make an informed decision in your early 30s instead, while the chances of success of treatment remain good."

There's also the chance that someone never uses their frozen eggs. In fact, very few women do — only 16% of women who froze their eggs at one London hospital between January 2016 and March 2022 came back to use them, a 2023 study found. It's another reason earlier isn't always better: In your 20s, you still have a lot of runway. The right partner might be around the next corner, and when it comes to conceiving naturally, time is on your side. More women are having children into their late 30s, and if someone reaches that point and still doesn't see kids in their immediate future, there's still time to explore options.

"A 27-year-old doesn't need to feel like she's left behind or left out because she's not freezing her eggs," Gurtin said. "The reality is, most women, let alone women in their 20s, are not freezing their eggs, don't need to freeze their eggs, and don't need to think about freezing their eggs."

Fertility clinics have an obvious business case for trying to convince as many people as possible that egg freezing is something they should do. In a 2020 study, Emily Tiemann, then a regulatory-policy manager at the Human Fertilisation and Embryology Authority in the UK, dug into the marketing strategies of egg-freezing companies. First, she noticed a significant lack of comprehensive information on egg-freezing sites. Second, she was struck by the language used, which seemed to target young women at a particular stage in their lives. Phrases such as "you haven't found the right partner," "you're waiting for Mr. Right," and "you want to take control of your life" were common, she told me, adding: "The kinds of messages that you wouldn't necessarily think would be on a clinical site that offers medical treatment."

Since then, marketing toward younger women has amped up. Kindbody, a venture-backed egg-freezing company that launched its first "boutique" clinic in New York City in 2018, traveled nationwide in 2020 with an Instagram-friendly van providing complimentary hormone tests to check fertility and marketing its services. Another well-known fertility studio, Trellis Health, calls itself "the Equinox of egg freezing," a nod to the $385-a-month luxury gym chain popular among millennials.

Several companies have partnered with social-media stars to leverage their reach. Alex Stewart, an influencer who was 35 at the time, was offered a significant discount by the fertility-preservation program Ova to share her experience with her Instagram and podcast audiences. Similarly, Serena Kerrigan, a 28-year-old content creator, decided to freeze her eggs with Spring Fertility in New York after it approached her for a paid Instagram collaboration. Other companies have targeted women in their 20s, with blog and social-media posts that tout "having children on YOUR time" and say, "Don't feel you have to rush into a relationship this year."

When Carney began exploring fertility services, she couldn't ignore the targeted ads that followed her everywhere, recalling ones featuring the popular reality-TV star Lala Kent. Carney also documented her own journey on TikTok.

Since most women who use their eggs are in their late 30s, clinics make money on the prolonged storage times. "The earlier, the more expensive," as Tiemann put it. In 2022, fertility-tech startups raised $855 million, according to PitchBook — a significant jump from the $306 million raised in 2017. And in fiscal year 2023, Kindbody grew its revenue by 50% to about $180 million.

Yoojin Jang, now 32, said she regretted freezing her eggs at 30 in a video posted on her YouTube channel. The procedure affected her body, she said, causing muscle loss and fat gain. It also influenced her dating life. "Before going on a first date, I would think to myself, 'Is this guy worth the 23 hormone injections that I just had?'" she said, adding: "My standards became ridiculous." She said she wished she had waited until she was 35 and seen where she was in life. In a 2018 survey by researchers at the University of California, San Francisco, one in six women who'd had their eggs frozen reported feeling significant regret.

Carney has mixed feelings about her procedure. Whether she meets someone in the next few years and gets pregnant naturally or gets a sperm donor to inseminate her eggs down the line, she can't predict the future. In that sense, she doesn't regret her decision to give herself a fighting chance at becoming a mother. But knowing everything she knows now, she wonders about her timing: "I would still do it. I would just wait a little bit longer."

Eve Upton-Clark is a features writer covering culture and society.

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