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In this video, we explore the industry and medical world of egg freezing. From speaking with professionals, to following one woman's journey to freezing her eggs, we are looking to uncover what these new procedures actually mean for women.

This video was originally published on Broadly and is being repurposed by Refinery29.

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Transcript
00:00There's been a lot of buzz about egg freezing being a kind of insurance policy for women
00:04looking to delay motherhood, especially with trendsetting companies like Apple and Facebook
00:08offering to pay for the procedure through their employees' benefits packages.
00:12But what do we really know about this procedure?
00:15Well, we know it's expensive, and we know it's kind of invasive, but does it work?
00:21Is it worth it?
00:23Is it dangerous?
00:24Is this just a scam where people are preying on women's insecurities about dying alone?
00:30It's important that we know that because if the perennial question is, can women have
00:35it all, could the answer be egg freezing?
00:46Given today's social and professional climates, more and more women are delaying pregnancy.
00:52I guess I think maybe I'd be like in my mid-30s.
00:55As a young woman, I'm thinking more about what I want to do professionally than I am
01:00about family and stuff like that.
01:01How old are you, Gabby?
01:0221.
01:04Are you really?
01:05Nope.
01:06I'm 20.
01:08Do you ever think about having babies or starting a family?
01:12I'm mostly thinking about trying not to have a kid.
01:16Yeah.
01:17I need to live out my life, and I want to be in a comfortable spot financially.
01:23Fifty-five years ago, birth control pills gave women control over their own bodies, enabling
01:28them to chart their own reproductive destinies, to delay pregnancy until the time was right.
01:34According to a recent study by the CDC, first births to women 35 and older have increased
01:39nearly ninefold in the past four decades.
01:42As women, we spend so much time in our teens and 20s trying to prevent pregnancy because
01:47that's considered the responsible thing to do.
01:49But that also makes it easier to forget our own biology, that our most fertile years are
01:54between the ages of 19 to 26.
01:57Now, many women are looking to assisted reproductive technology to help them beat their biological
02:02clocks, or at least to press the snooze button and buy a little more time.
02:08For the segment of women who say, I want to pursue a career, then egg freezing in particular
02:15provides them a tremendous option that women of my generation, and certainly the generations
02:20before me, just did not have.
02:22I think egg freezing is a tremendous advance, perhaps one of, if not the most tremendous
02:26advance in women's reproductive health in the last 50 years.
02:30Up until about 15 years ago, eggs were frozen using a slow freeze method, which was generally
02:35ineffective.
02:36But, in 2000, the process was significantly improved by a new technology called vitrification.
02:42And in 2012, the American Society for Reproductive Technology lifted the experimental label
02:48on vitrification, making the procedure widely available for women looking to delay motherhood.
02:53Life today is younger women postponing childbearing, advancing careers, advancing education, advancing
03:01their families doing whatever they want to do.
03:02And all of that requires postponing childbirth.
03:04It's really a great, great insurance policy.
03:07And while many people see egg freezing as an empowering advance for women, others are not
03:13so sure.
03:14It's not an insurance policy, that's for sure.
03:17You might be one of the lucky people, but you're more likely to undergo a lot of discomfort,
03:23some risk, and a lot of expense, and then have heartbreak, because you don't have a child.
03:30And you thought maybe you were going to get one out of those frozen eggs.
03:33The marketing right now is suggesting that this is a hassle-free, easy, liberating thing
03:38that all young women should consider.
03:41The idea that we would market this to everybody, I find that deeply unnerving.
03:45There is this whole new market niche, which is healthy young women who aren't infertile.
03:51And, of course, any business is going to jump to get a whole new demographic as customers.
03:58Hi!
03:59I'm Tracy.
04:00Nice to meet you.
04:01So, why did you decide to freeze your eggs?
04:03You know, that's a really good question.
04:05I'm young, and I have a great career.
04:07How old are you?
04:07I'm 28.
04:08Yeah.
04:08And I'm in digital ad sales.
04:10And so there isn't this immediate urgency to freeze my eggs in most people's opinions,
04:15but for me, freezing my eggs allows me to fulfill my dreams on my own timeline, without
04:20depending on a man or my biological clock.
04:23So how did the whole procedure go?
04:26The first part, first 14 days, you're taking hormones.
04:28I started off with my hormone estrogen rate at 61, and it got up to 1,900.
04:33Wow.
04:34So by the end of those two weeks, you legitimately feel crazy.
04:37So after those two weeks, I went in for my surgery, which is a fairly simple procedure,
04:43and I noticed that my belly was really swollen.
04:45I looked a couple months pregnant.
04:47So I was nervous about it, and when I asked the doctor, she just handed me a one-sheeter,
04:52and at the title, it was ovarian hyperstimulation syndrome.
04:57Ovarian hyperstimulation syndrome is a condition that can result as a reaction to the hormones
05:01used in stimulating egg production.
05:03Serious cases of the condition only affect about 3% of patients, but in its worst instances,
05:08it can actually cause ovarian torsions, a separate and very threatening complication
05:14in which an ovary turns over on itself.
05:16It was the kind of debilitating pain where you just feel paralyzed, and I started dry heaving,
05:21and I made it just a few steps into my apartment before I blacked out.
05:25And when I came to, I was on the couch and on the floor, covered in a cold sweat, and
05:29I was shivering.
05:30Like, I just had no idea what happened to me.
05:33I couldn't even reach for the Percocet bottle, and so I ended up getting rushed to the ER,
05:38and upon arrival, they diagnosed me with ovarian torsions.
05:42So you gotta understand, your ovaries usually are the size of walnuts,
05:46but mine ended up the size of grapefruits because of your ovarian hyperstimulation syndrome.
05:51It's hard to even relive that moment.
05:56I went through a lot, and I would still do it all over again.
06:00You would?
06:00Yeah, yeah.
06:02Egg freezing is more than just an insurance policy.
06:05It's really setting myself up for any life I want, whether that includes a man or not.
06:15Not everyone Vicki's age is in the financial position to freeze their eggs.
06:19Ironically, the women who can typically afford it aren't the best candidates.
06:22They tend to be in their mid to late 30s after they've established their careers,
06:26but by then, their fertility has already dropped off significantly.
06:32This morning, I'm gonna go for my first ultrasound visit with Dr. Sahakian,
06:37and he's a fertility specialist.
06:40He specializes in freezing eggs.
06:42I'll be 38 in June.
06:44You know, I'm unmarried.
06:46I'm in a strong relationship, and I love him very much.
06:49But that said, it does raise some very sensitive subjects about our relationship,
06:57and about family planning, and about timing.
06:59At some point, I had to ask,
07:02am I doing this for myself so that I have options when I'm ready?
07:07Or are we doing this together as family planning?
07:12Women's fertility in the natural way, the natural arc it has,
07:16the idea that that's somehow a problem that women have to fix,
07:19I find that a deeply disturbing way of understanding women's bodies.
07:23Josephine Johnston is the director of research and research scholar at the Hastings Center,
07:28a bioethics research institute based in New York.
07:31Why are women finding themselves in their 30s, or late 30s, mid 30s,
07:35and feeling like they don't have an opportunity to reproduce,
07:39or they can't do it on the timetable they want?
07:41Those people may want to use this technology, and I certainly wouldn't stop them.
07:45But I would want us to also ask the question about how it is that this is happening.
07:49Why are women in this position?
07:51As the social implications of egg freezing were becoming more apparent,
07:54we decided to familiarize ourselves with the science behind it.
07:58We are in sunny California.
08:00It's way different from the snow in New York.
08:04It's so much better.
08:05And we're driving to Encino to talk to Dr. Jeffrey Steinberg.
08:09He's an endocrinologist and the director of the Fertility Institutes.
08:13So hopefully talking to a medical doctor will give us some insight into what's involved
08:17and what actually happens to your body physically.
08:23Can you describe the egg freezing process?
08:25Sure.
08:26The egg freezing process begins with the woman coming in for a consultation,
08:29where we go through her general health, her general fertility status,
08:32and what she expects out of the entire procedure.
08:35After that, we begin her on fertility drugs.
08:37The drugs are given by injection, and the women are taught to do that at home.
08:41They'll take the injections for four or five days and come back to the office.
08:44We do a scan.
08:45We count the eggs growing in the ovaries, and we continue on with the medication for another few days.
08:51After about ten days' worth of fertility injections, the eggs are going to be full-size and ready to release.
08:56And through the vagina with ultrasound, we're able to perform an extraction of the eggs.
09:00It takes 20 to 30 minutes.
09:02We have the eggs out.
09:04The woman goes home an hour later and basically recovers.
09:06Very short recovery.
09:08One or two days.
09:09After we've got the eggs in the laboratory, they're assessed for their maturity.
09:13In order to see how this actually works, Dr. Steinberg invited us on a tour of his fertility lab.
09:18I'm in a little danger of, like, crazy camel toe.
09:23I mean, you're a gynecologist, right?
09:26Yeah.
09:30So what do you do in here?
09:32In here, the scientists will receive the fluid coming from the ovary that I extract.
09:36And floating that tube of fluid is a microscopic particle that's the human egg.
09:41So they'll put that fluid under the microscope, and they'll actually identify the egg.
09:44Okay.
09:45So this is a human egg just extracted from the ovary.
09:48That's what it looks like.
09:50And this is a typical egg retrieval.
09:51This is what we have after about 20 or 30 minutes with the patient.
09:57Incubators, this is where the eggs rest before they're ready to be frozen.
10:02So they're kept in a very controlled environment.
10:05And this environment is made to duplicate the inside of the woman's body.
10:09So this is, like, just like inside my vagina?
10:12Yeah.
10:12Inside your fallopian tubes.
10:14Okay.
10:15The eggs are then vitrified, which is a flash freeze process that causes the ice to form
10:20so quickly that crystals don't get a chance to develop.
10:23They're then placed into long-term cryopreservation for as long as the lady likes.
10:29This is Lola and Ben I've got in here.
10:31Oh, my God.
10:31This one's face.
10:35We were just talking about that.
10:36He always shows his teeth.
10:38It's expensive.
10:40Altogether, it'll be between $10,000 and $15,000.
10:44For this portion of it?
10:46Just the freezing eggs.
10:46Okay.
10:47But it would be nice if there was, like, this checklist that says,
10:50okay, keep in mind storage costs.
10:54Keep in mind genetic testing of embryos.
10:57Keep in mind IVF.
10:58These are all of the anticipated costs down the line.
11:01If Amy does decide to use her frozen eggs to conceive a child,
11:05the $10,000 to $15,000 she's paying for her procedure will eventually be compounded
11:10to upwards of $40,000 when all is said and done.
11:18How are you?
11:19I'm great, thanks.
11:20Okay, so you started your period yesterday.
11:21Yes.
11:22All right.
11:22So now this is, like, the most important test I can do is to look at your ovaries,
11:27and I'll show you the follicles that contain the eggs that gives me how many eggs I can get from
11:31you.
11:32So go ahead and put your feet up in the syrup.
11:35Okay.
11:36So as the probe goes in, it's not exactly comfortable.
11:40I know it's not comfortable.
11:41This is your right ovary.
11:43These black circles are eggs, okay?
11:47Oh, wow.
11:47So I have to count them, right?
11:49So one, two, three, four, five.
11:54Now this is the left ovary.
11:55So on this side, I can see about six.
11:58Actually, seven.
12:00So you can sit up.
12:02Okay.
12:02So these two together, the 12 follicles together are called an entral follicle count.
12:11You want that number to be over eight.
12:13So at your age, this is actually perfect numbers.
12:17Well then, we're done here, right?
12:19We're done.
12:20Thanks.
12:21Bye-bye.
12:24You know, yes, I have friends and they all have babies and husbands and full lives.
12:29And it's a beautiful thing and something that I've always wanted for myself.
12:32And then you look back and you're like, how did I, what was I doing?
12:38And I mean, I know what I was doing and it comes down to timing and personal choices.
12:44You know, I moved for a job and I came back and, you know, five years in one relationship
12:49with someone who didn't want kids and four years in another relationship.
12:53And, you know, you make these choices and life moves on, but that's nine years of being
12:58in relationships right there.
12:59that's where the time goes, you know?
13:02And so admitting that you want this for yourself.
13:05Here I go.
13:11And why are you tearing up now?
13:13Um, it's admitting to yourself that it's so important to you.
13:17Mm-hmm.
13:18You know, and it, it makes you vulnerable.
13:22It makes you vulnerable in your relationships.
13:24Mm-hmm.
13:25Because you have to be honest about what you want.
13:29And there is a sense of urgency.
13:30There is a sense of timing about this and you can't turn back.
13:35And so admitting to yourself that this is pretty much the highest priority for you.
13:44And I really just want to make it happen, you know?
13:49Amy isn't alone in how she feels.
13:51Many women are feeling the need to secure their eggs for the future.
13:54And ever since the procedure's experimental label has been lifted,
13:58fertility clinics have started to offer egg freezing as an elective procedure.
14:02For-profit, third-party brokers have also sprung up,
14:05serving as a go-between, connecting women with fertility doctors.
14:10EggBanks is one of the largest egg freezing brokers in the world
14:12and also happens to be how Amy found her fertility doctor.
14:16We're going to go speak with Gina Bartesi, the CEO of EggBanks,
14:20which is a company that sells egg freezing to women
14:24through these egg freezing parties.
14:29Can you tell me about EggBanks? What is EggBanks?
14:31Yeah. EggBanks is a national network of 185 reproductive endocrinologists,
14:37or fertility doctors, that specialize in egg freezing.
14:39We've been called kind of the Uber for the fertility industry.
14:43In Uber's case, they pay the drivers, and in our case, we pay the fertility doctors.
14:47Patients can purchase egg freezing cycles directly online.
14:51We have negotiated exclusive pricing with 185 fertility doctors in the country.
14:56We're really about a mission of empowerment and giving women options and choices.
15:01Can you tell me about the egg freezing parties?
15:04Yeah, so the average age at our EggBanks cocktail parties are 33.
15:08We started them as egg freezing events.
15:11We wanted to get like-minded professional women in an intimate, fun setting.
15:16Our goal is to help them become educated that the science has improved significantly over the last couple of years,
15:22and then to just give it to them in a transparent, easy-to-access way.
15:27EggBanks is a pretty incredible and a new entity.
15:31It's the first network of fertility doctors specializing in egg freezing,
15:36and we offer exclusive savings for women because it's not expensive.
15:40The commercialization of egg freezing is an area that's, again, new,
15:45because egg freezing is new, and it's controversial.
15:48And I'm not 100% in favor of it at this point.
15:51I think one of the most important things is a young woman who makes a reproductive decision
15:55is being fully advised and informed of everything that's going on.
15:58What do you think about the brokers who facilitate egg freezing, like egg banks?
16:03Mm-hmm.
16:04I think they're out there marketing their wares, and they're trying to make money on that as a business does.
16:11They're trying to persuade women by making them fearful that they're not going to be able to have children naturally.
16:18It's a hard sell.
16:20If you're almost 40, I think all these doctors are going to say,
16:23OK, you need to talk to an egg bank, somebody in the back, and figure out how you're going to
16:28preserve your fertility today.
16:29But Mark, Mark, what do you need to tell them?
16:30The way it's being discussed and marketed is liberating and empowering,
16:35because those are words that really are meaningful to us,
16:38that we've struggled for a long time to be able to be liberated and empowered,
16:43and it's an ongoing struggle for women to be those things.
16:45And then that language is used back at us in a technology like this to sell services that cost tens
16:53of thousands of dollars.
16:54Is it really liberating? Is it really empowering?
16:56You know, maybe it is, but do ask yourself that question.
16:59I think don't take it on faith that if they say it's liberating and empowering,
17:03it really is liberating and empowering.
17:05What would be liberating and empowering would be for women to be able to feel that they really did have
17:10a choice
17:10about whether they have child now or later, that it was a real choice,
17:13as opposed to feeling like you're backed into a corner.
17:19In addition to the questionable marketing strategies used by egg-freezing brokers,
17:24critics take issue with the success rates they advertise,
17:27and it's hard not to think that they're capitalizing on a phenomenon that's as modern as the women it affects,
17:33FOMO, fear of missing out.
17:36Critics would say that you're selling women on a narrative,
17:40but not really being upfront about the potential lack of efficacy.
17:47Yeah, so we're actually not selling women on anything.
17:49They're more savvy consumers than that.
17:51They've done their homework.
17:52They know that there's not a guarantee with any kind of reproductive science or opportunity.
17:58I mean, you said consumers, but aren't they really patients?
18:01Yeah, they are. That's right. Consumers, patients, same thing, yeah.
18:05So what are the statistics of getting a live birth from freezing your eggs?
18:10And I'll tell you, the biggest thing right now is it's hard to get statistics from egg-freezing,
18:15and the reason is because there's a relatively new technology that's being used to freeze eggs,
18:20and that technology is called vitrification that says we're going to freeze eggs when you're younger,
18:24and then when you're older, you're 38 or older, you're 35 and older,
18:27you can use those frozen eggs to conceive a healthy live birth down the road.
18:33So that's the data that exists.
18:35Those success rates are anywhere from 50 to 65 percent.
18:38That's 50 to 65 percent per lot of six embryos.
18:42The stats that companies like egg banks point to aren't necessarily inaccurate,
18:46but there is definitely a difference in the way that a business out to make money frames them
18:50compared to how they're presented in scientific studies.
18:54Okay, so one way to think about it is for each frozen egg,
18:58what's the chance that that egg will, down the line, turn into a live baby?
19:04And the professional organization of fertility clinics called SART,
19:09they put that rate at 2 to 12 percent for each egg for all ages of women combined.
19:16And the meta-analysis data, they're looking at 75, 6, 7 percent failure rate for women age 30,
19:26close to 90 percent failure rate for women age 40.
19:29Do you think that the women who elect to do this are aware of the failure rates?
19:36If they're getting their information from the fertility clinics
19:39or from the brokers that have sprung up to facilitate egg freezing,
19:45they're not going to know this.
19:47In addition to these relatively low success rates,
19:50the sample sizes are incredibly small.
19:52To date, only about 2,000 babies have been born from frozen eggs worldwide.
19:57If more women were made aware of this information,
19:59it's difficult to imagine many would spend their money on such a costly procedure.
20:04Time to pick up the meds.
20:09I think in part because the fertility industry has developed in the public sector,
20:13it's not covered by most health insurance in this country,
20:16and people are paying out of pocket.
20:18It's a lucrative business,
20:21and nobody has an interest in finding out what the long-term effects are.
20:28We've got a big bag over here.
20:30So it involves taking a couple of weeks of injections of powerful hormonal drugs
20:36to first shut down your ovaries and then hyper-stimulate them.
20:40The hormonal drugs that are used are quite powerful,
20:43and many are used off-label,
20:46so they were never originally developed or approved by the FDA
20:49for the purpose of egg retrieval.
20:53And it's really disturbing that after egg retrieval has been going on for a couple of decades,
21:00there's really inadequate data and evidence about the level of its safety or risks.
21:06So that's a really important thing for women to know about and to think about.
21:13They upped my dosage.
21:15It's actually twice as much as we discussed in the appointment.
21:18And they said because my follicle count was somewhat low,
21:22he counted 12 follicles at the last appointment.
21:25So they want me to do double the amount.
21:29I'm supposed to do this to my dosage,
21:33which is 375, 2, 3, 75.
21:46This is what I learned by watching those movies.
21:49You're supposed to get the bubbles out.
21:55Well, so they said do it about an inch below your belly button or to the side.
22:01And I have a couple more shots to go, so I'll just pick a spot, I guess.
22:08I'm scared. I'm actually really effing scared. I hate this.
22:13Effing...
22:14Okay, I'm supposed to hear clicking.
22:25That's one.
22:27I did it to 375.
22:29I think I did it right.
22:32Moving down the line.
22:33It all depends on what you want to expose your body to
22:36because you're taking, you know, 10 to 12 days of hormone injections.
22:41Sure.
22:41So, you know, it's a commitment and you have to do what's right for your situation.
22:47It's in there.
22:54So we're here at Dr. Sahakian's office and Amy is being prepped for her procedure right now.
22:59She just got an IV and some pre-op antibiotics.
23:03She's going to get some propofol that is going to put her out like she's sleeping for a little bit.
23:08And the procedure should only take about 15 minutes and then she should have her eggs.
23:19I don't look forward to a world where people undertake risky and strenuous medical procedures
23:26that they have a high chance of not needing.
23:28I think it would be a dystopian future for me
23:31in which that was the way that we dealt with and responded to women's bodies.
23:37I think that it would mean that we had failed on a number of counts to support women and families
23:43and family building.
23:45Are you awake still?
23:48That's how we know you're sleeping when you stop talking.
23:52The day has come to do the procedure to see how many eggs I can get from her today.
23:57So she's in her 30s, so she's not going to have lots of eggs, but I'm glad she's doing this.
24:04So if you look at the screen, you're going to see one nicely here in a second.
24:09That big follicle you see, the big black circle, you see that needle tip, I just went in and it's
24:16going to collapse around my needle tip.
24:18So this is how you do egg retrievals.
24:20It's one by one you go in and aspirate these follicles and hope that there's a good egg in it
24:26that comes up.
24:27And I just basically go one by one and take these eggs.
24:33Are you happy with the amount of eggs that you guys managed to get?
24:37We'll see. We'll see how many. I mean, I wish she has more.
24:40I always wish somebody has more at her age, but I think she did pretty well for her age and
24:46she might still have to do this one more time.
24:48In about 10 minutes, we'll know how many eggs we got from her.
24:54Why shouldn't women try to have it all?
24:56It doesn't seem unreasonable to me that women should want to have a partner and a career that's satisfying and
25:02also a family.
25:03That doesn't seem to me to be asking too much.
25:05The question is, how do we help make that happen?
25:08Progress to me would actually be that women and men in their 20s and 30s were actually well-placed to
25:17have families.
25:18Not that everybody was putting it off later and later and later. I wouldn't see that as progress.
25:23Things have changed so much for women in recent decades, in many ways for the better.
25:29And I think that egg freezing is going backwards in a big way.
25:32It's a hyper-individualized solution to a very broad social problem that we should be tackling with changes in our
25:40social policies and our cultural expectations.
25:42What women need is to really have a culture where they're not going to be punished for taking maternity leave.
25:50And I'd like to see, you know, better quality childcare with childcare workers who are better paid and more highly
25:56valued.
25:57So that we can leave our kids when they're little and not worry about them and be able to afford
26:03it and balance out working and taking care of kids.
26:08Hey, Amy. How are you?
26:10Good. Thank you so much.
26:12You feel good?
26:13Yeah.
26:13Okay. 13 eggs.
26:15Are you serious?
26:17That was so much better than we thought the last time.
26:20Yeah. So, get on TV.
26:25But you still, we'll talk more, but you probably need to do it one more time.
26:29Okay.
26:29And I want 20 and up, so.
26:31Yeah.
26:31So, as far as Amy's age, is this considered a successful retreat?
26:35Yes. Yeah.
26:35Okay.
26:35This is what you expect to get.
26:37Okay.
26:38So, I would say, you know, she did well.
26:41Do you think you're going to do another round of this?
26:44I'm not sure.
26:46But like the doctor said, it's all just about opportunity and peace of mind.
26:53So, every additional egg I can get after this would be even more reassuring to me.
27:00But for now, I'm just happy with where I am.
27:04While both egg freezing proponents and critics agree that women face an uphill battle in society,
27:09there's a split on whether the problems we face can be addressed with what those in support see as a
27:14technological fix.
27:15The big question is whether this is a fix at all.
27:18Is counting on egg freezing as a form of family planning just a different way of putting all your eggs
27:23in one basket?
27:24Meanwhile, many continue to argue that offering this procedure only exacerbates the inequality that women already experience,
27:31putting even more of the burden of fertility back on women's shoulders.
27:35It is good for them.
27:49You can't do that.
27:53I'm fully satisfied with the proof of cancer.
27:54I don't want to work and I don't know what it is.
27:54I don't know what it is.
27:54I don't know who I am.
27:55I'm just hoping to watch myself and I don't know who I am.
27:55You can find my estate.
27:56I mean I'm just going to work for that I don't know why I can like that.
27:56You
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