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--:-- Noel King: Have you ever wanted to freeze time to preserve life?
--:-- Anna North: For the past 12 or so years, the option of freezing eggs has been popular for women who may want kids but don't want them right now.
--:-- Noel King: If the perennial question is, can women have it all, could the answer be egg freezing?
--:-- Anna North: Some companies even started to offer to pay for the procedure, on average about $11,000 per cycle, as a perk of employment.
--:-- Noel King: With the great resignation and full swing, it's become hard for companies to hang on to their people. And so now we're seeing egg freezing, IVF, and others emerging as a whole new category of benefits up for grabs.
--:-- Anna North: And now, a dozen years on, we're getting the data on how well this process has been working for women and for families, and those outcomes are coming up on Today Explained.
--:-- Noel King: Anyone in any department can focus on the work that matters most. I've never met an AI agent. Learn how ServiceNow puts AI to work for people at servicenow.com.
--:-- Noel King: Having a night out with your friends is awesome. Dealing with hangovers sucks. Meet Senorita, the THC-infused margarita that lets you skip the booze but keep the vibe.
--:-- Anna North: Made with real fruit, organic agave, and Himalayan pink salt, every sip is like a mini getaway. No fillers, no hangovers, just full flavor and a better buzz.
--:-- Noel King: Find your flavor at senoritadrinks.com. Use code VOX20 for 20% off. Must be 21 and over. This product may cause intoxication. This product has not been evaluated or approved by the FDA. This product may contain up to 0.3% THC.
--:-- Noel King: Call your cable provider and kindly demand that today's plane is added to your lineup. Call and subscribe today.
--:-- Anna North: My name's Anna North. I'm a senior correspondent for Vox.com, where I cover American family life, child care, education, and a whole lot of other things.
--:-- Noel King: You recently wrote a piece for Vox about women freezing their eggs. And you noted in this piece that women sometimes talk about freezing their eggs as kind of an insurance policy against time.
--:-- Anna North: You know, I freeze now and then I fertilize when it's convenient. Is it working the way we seem to think it is working?
--:-- Noel King: We now have more data than ever about the effectiveness of egg freezing. And while it is working for some people and, you know, some people go and have a great experience, it has failed to live up to some of its early hype.
--:-- Anna North: I think at the beginning, you know, it was thought this is going to usher in this new era of gender equality. Tech giants Facebook and Apple confirming they will pay for female employees to freeze their eggs, telling ABC News.
--:-- Noel King: We want to empower women at Apple to do the best work of their lives. It seemed sort of careless of me not to take advantage of the fact that I can't stop myself from aging.
--:-- Anna North: I can't fall in love overnight, but I am able to stop the aging of my eggs. It's going to free people to pursue careers in a really different way.
--:-- Noel King: But now there are a lot of concerns with some experts saying this procedure really just serves as another way for companies to make money from stoking women's anxieties.
--:-- Anna North: What was the promise? Like, if you could boil it down to a few words, when women were sold on freezing their eggs, what were they told?
--:-- Noel King: Around 2014, when this procedure was really becoming more mainstream, there was a thought that it would be as big as the birth control pill in terms of how much it would change people's lives.
--:-- Anna North: And then there's this really famous 2014 Bloomberg Business Week cover story that used the phrase, freeze your eggs, free your career. Imagine a world in which life isn't dictated by a biological clock.
--:-- Noel King: If a 25-year-old banks her eggs and 35 is up for a huge promotion, she can go for it wholeheartedly without worrying about missing out on having a baby.
--:-- Anna North: So there was this idea it's going to upend gender roles, it's going to upend the way that women might be discriminated against in the workplace.
--:-- Noel King: Indeed, if you look at the dominant marriage strategy in 1980, it was for men to delay their parenthood and then marry and impregnate younger women. Now in the 2010s, we actually have a more gender equitable strategy where both partners can invest in themselves and delay.
--:-- Anna North: It's going to change everything almost the way that birth control changed everything in the 1940s.
--:-- Noel King: The first successful births from frozen eggs were actually all the way back in 1986, a pair of twins born in Australia.
--:-- Anna North: That turned out to be kind of difficult to replicate for a long time. So egg freezing doesn't really take off until the 1990s, starting at a clinic in Italy.
--:-- Noel King: So the Italian government was about to pass a law restricting the use of frozen embryos. So that's when the egg is fertilized with sperm and starts to grow.
--:-- Anna North: Restricting the use of frozen embryos on the grounds that they constituted human life. And so freezing the eggs instead became a way to get around this law and still treat patients with infertility.
--:-- Noel King: Then we fast forward a little bit. In the early 2000s, the procedure starts to spread more to the United States, around the world.
--:-- Anna North: Probably when this comes into its own, it will be more liberating to women than the oral contraceptives were back in the 1960s.
--:-- Noel King: A lot of people who were freezing their eggs had a medical condition that really made it necessary in some ways to preserve fertility.
--:-- Anna North: So, for example, people who were about to undergo chemotherapy for cancer, which might impact their fertility.
--:-- Noel King: It starts to really get a lot of mainstream interest in 2012 when the American Society for Reproductive Medicine announced it should no longer be considered experimental.
--:-- Anna North: It said babies born from frozen eggs are as healthy as those from fresh eggs. But the committee said the procedure should be limited in its use.
--:-- Noel King: In 2012, what really changed is people starting to freeze their eggs more because they weren't in a position to have children right then.
--:-- Anna North: They didn't necessarily have a medical condition, but they hadn't met the right partner. There were career concerns.
--:-- Noel King: I thought it would be really nice if I could make it so that I had a baby when my life was ready instead of just because my body is ready.
--:-- Anna North: So there was this big change in the way that egg freezing was used.
--:-- Noel King: How does this process actually work?
--:-- Anna North: The procedure starts with 10 to 14 days of hormone injections often two or three per day to kind of stimulate the ovaries to produce more eggs than normal.
--:-- Noel King: Typically, in a cycle, the body is producing like one, maybe two eggs. But in order to harvest eggs for egg freezing, you want the ovaries to make a bunch more.
--:-- Anna North: So you're taking these medications. You're either injecting them yourself. If you have a partner, you can get the partner to do it. You can get a friend to do it. But it's needles, right?
--:-- Noel King: And then you're typically going to a clinic two to three times a week for ultrasounds, blood work. You're monitoring the whole process.
--:-- Anna North: Finally, when the eggs are the right size, the doctor says you're ready. You take another injection, a trigger shot, that's designed to kind of complete that maturation process.
--:-- Noel King: About 36 hours after that trigger shot, and this has to be timed really well, you'll go in.
--:-- Anna North: A doctor will extract the eggs using a needle that actually threads up through the vagina into the ovary.
--:-- Noel King: And, you know, it's not a super risky procedure, but there's a small risk. There can be complications. You can experience blood clots. You can have something called an ovarian torsion, which is as bad as it sounds.
--:-- Anna North: But if everything goes well, if you're under 38, you might get between 10 and 20 eggs. And then they put the eggs on liquid nitrogen. They put them on ice, and you basically store them away until at some point maybe you want to use them.
--:-- Noel King: Okay, so you just walked us through what it's like to do that process one time. What would that one time cost?
--:-- Anna North: It's a lot of money, usually five figures. Wow. Between $10,000 and $15,000 a cycle. One patient I talked to, she froze her eggs in 2022, so pretty recently, cost her about $14,000.
--:-- Noel King: And that included some storage fees. Now, storage fees are going up. They can be about $800 a year or more.
--:-- Anna North: So you do that initial, you know, 10K-ish round, right? But you're still paying in the hundreds every year to keep those eggs and make sure they're safe for when you might want to use them.
--:-- Noel King: One of the big promises, as you've laid out, is that freezing your eggs allows you time to do things at your own pace. Is that true?
--:-- Anna North: How long do a woman's eggs actually remain viable once they've been frozen?
--:-- Noel King: The freezing process has gotten better over time. But eggs contain a lot of water. So they're a little harder to freeze than some other tissues in the human body, including actually fertilized embryos.
--:-- Anna North: So there's going to be some potentially that are lost when you thaw them. It's not a perfect process.
--:-- Noel King: It's also the case that, you know, your own body, you can't necessarily support a pregnancy forever.
--:-- Anna North: So, you know, at a certain point, if you're looking at after 45, things like this, it might be harder and harder to be pregnant.
--:-- Noel King: It's less about how long the eggs last once they're frozen and more about how old were you when you froze them and how good quality were they when they were frozen and how many were they.
--:-- Anna North: You know, if you only froze four, then you've got to hope that one of those fertilizes. It's just, it's a numbers game.
--:-- Noel King: Okay. So we have an expensive process and typically things do, things like this do get cheaper over time.
--:-- Anna North: They go from being like a super rare thing to more common. This has become a huge growth industry.
--:-- Noel King: Can you talk us through the process of it being very rare to it being highly available to anybody who has those five figures?
--:-- Anna North: So in 2012, after the American Society of Reproductive Medicine says this is no longer experimental, from there we kind of get this explosion in media coverage.
--:-- Noel King: And so now we're seeing egg freezing. A national medical group decided that freezing eggs is showing a lot of promise.
--:-- Anna North: And then we're also seeing these new companies spring up specifically to offer and market egg freezing.
--:-- Noel King: Kind Body is reinventing the women's health care experience for the modern woman. Extend Fertility, which was launched in 2016, offered Instagram influencers reduced rates in exchange for posting about egg freezing.
--:-- Anna North: There was a quote unquote fertility studio called Trellis that opened in the Flatiron in Manhattan in 2018. Called itself the equinox of egg freezing.
--:-- Noel King: The startup Kind Body, which was also launched in 2018, had parties with drinks and scented candles.
--:-- Anna North: The women invited to this party all have something in common. They're successful in their careers with no immediate plans to have children, but they know their eggs will never be as healthy as they are now.
--:-- Noel King: It feels like there's a lot of pressure to find the right person and the clock is sticking and you don't want to be rushing that.
--:-- Anna North: A lot of these companies would have kind of a distinctly like millennial 2010s ethos and these taglines like plan your path or it's really about like empowerment and women's empowerment.
--:-- Noel King: And there was a girl boss vibe, I think, to this era. It's just about hanging out and realizing that you're not alone.
--:-- Anna North: There are a lot of women out there just like you.
--:-- Noel King: Who are you targeting specifically?
--:-- Anna North: Anyone with a question about whether egg freezing is for them.
--:-- Noel King: And we do get this real skyrocketing popularity. So the figure that I've seen is about 2,500 people were freezing their eggs in 2012.
--:-- Anna North: And by 2020, that was 13,000.
--:-- Noel King: Vox's Anna North, she'll be back along with writer Maymay Fox, who is among the thousands of women who were told that freezing eggs was a way to buy them more time.
--:-- Noel King: Support for Today Explained comes from Built Rewards. These days, it seems like everybody has a rewards program. You swipe your card and you get one cent on the hundred dollars.
--:-- Anna North: But with your rent, frequently, you just pay month after month. You never get anything from it other than that roof over your head.
--:-- Noel King: Not anymore, says Built Rewards. Built Rewards says it lets you earn points on your rent.
--:-- Anna North: By paying rent through Built, they say you can earn flexible points that can be redeemed toward hundreds of hotels and airlines, perhaps a future rent payment, your next Lyft ride, and so much more.
--:-- Noel King: Your home isn't just where you sleep. It's your community. And Built wants you to go out and do things in the community.
--:-- Anna North: You can eat at your favorite local restaurants, then earn more points. You can get VIP treatment at certain fitness studios.
--:-- Noel King: You can enjoy exclusive experiences just for Built members every month.
--:-- Anna North: When you're ready to travel, they say Built points can be converted to miles or hotel points all around the world.
--:-- Noel King: You can earn points on rent and around your neighborhood wherever you call home by joining Built.com slash Explained.
--:-- Noel King: This is Today Explained. I've always wanted to have children my entire life. And I love being around kids.
--:-- Maymay Fox: I desperately want to have my own, but I have gone through a divorce when I was in my early 30s that left me single at this stage of my life.
--:-- Noel King: I was ghostwriting a book for Sarah Brokaw, and we went into the office of a fertility doctor, Dr. Jamie Griffo at NYU, to interview him about fertility issues.
--:-- Maymay Fox: And at this point I'm 37 years old and I'm in excellent health so I'm just thinking that I'm not going to have any trouble getting pregnant if and when I finally meet the love of my life.
--:-- Noel King: So we go into the office and he sits us down at a table and he shows us a chart.
--:-- Maymay Fox: This is a graph that illustrates the rate of infertility of women after the age of 35.
--:-- Noel King: And it isn't a gradual decline in fertility, as I had imagined. It is an exponential curve.
--:-- Maymay Fox: So with each passing month after the age of 35, your chances of conceiving a child are exponentially less.
--:-- Noel King: And I'm able to ask Dr. Griffo. What about me? I'm in perfect health. I do yoga. I eat well. I've never been a smoker.
--:-- Maymay Fox: This isn't true for me, right?
--:-- Noel King: And he's just like, no, that has nothing to do with it. These eggs have been in your body since you were born.
--:-- Maymay Fox: And this is a degradation that happens to every woman as a result of age.
--:-- Noel King: I am shocked and devastated.
--:-- Maymay Fox: And my eyes are widened. And we're talking to him about what are your options.
--:-- Noel King: And one of the options at this time was still considered an experimental procedure, freezing your eggs.
--:-- Maymay Fox: I wanted to have children with a partner, but I was single and I didn't have a partner. So I was like, gosh, I better freeze my eggs.
--:-- Noel King: There was starting to be a lot of chatter in the media and there were women throwing egg freezing parties and it was very much seen as your insurance policy.
--:-- Maymay Fox: Why wouldn't you do this? Why wouldn't you go get insurance if you have a choice? If you have, you know, if medically you're able to do it and financially you're able to do it, why wouldn't you?
--:-- Noel King: So I scrounged up $10,000, it's a lot of money for me at the time, and I went through the process of freezing my eggs.
--:-- Maymay Fox: And it was very successful, I was told. I had 18 frozen eggs. It was a terrific number for my age.
--:-- Noel King: They all looked healthy. I had really great hormone numbers, and everything looked strong.
--:-- Maymay Fox: So I had my insurance policy. That piece of it was really important to me that psychologically at that point, I relaxed a little bit about the ticking clock.
--:-- Noel King: And I was able to go back to dating with more confidence and more calm and more presence to just like, let's enjoy this process instead of being in a blind panic about, oh my God, I have to meet a guy so I can get married and have kids.
--:-- Maymay Fox: Shortly thereafter, I went to Costa Rica to learn to surf and to write. And I met the love of my life, my husband, Kiran Ramchandran.
--:-- Noel King: And it still took us a few years to get together. We were both involved in sort of on-again, off-again relationships.
--:-- Maymay Fox: And eventually, three years later, I moved down to LA and we decided to get married and immediately start trying to have kids because I was rapidly approaching my 40th birthday and he was a little bit older at 42.
--:-- Noel King: We got pregnant. We were thrilled over the moon and then I miscarried, which was devastating.
--:-- Maymay Fox: And at that point, we went in to see the fertility doctor in LA and he said, look, why don't you use those frozen eggs? This is the perfect opportunity.
--:-- Noel King: And I thought, that's a great idea. Let's do it.
--:-- Maymay Fox: So we arranged for them to be shipped from Stanford facility in San Francisco down to LA.
--:-- Noel King: And the morning that my eggs arrived in Los Angeles was the worst day of my life.
--:-- Maymay Fox: I get a call from the fertility doctor and he says, I have bad news. Are you sitting down? All your eggs were destroyed in shipping.
--:-- Noel King: And as you might imagine, my first reaction was just confusion. I asked a million questions.
--:-- Maymay Fox: Why what happened he said well it looks like they were mispacked it was like what what are you talking about he said do you want to come in and see
--:-- Noel King: And I said absolutely
--:-- Maymay Fox: So Kiran and I drove to the doctor office in LA and he showed us these vials where the tops had not been appropriately sealed.
--:-- Noel King: It had not been packaged. So if you can imagine taking eggs that you buy from the store and instead of them being carefully packaged in cartons that protect them during shipping, they're just kind of all tossed into one bin together.
--:-- Maymay Fox: I was so heartbroken. I mean, I really cried and felt angry at the universe and had to do a lot of work to get past it.
--:-- Noel King: One of my decisions actually was to file a lawsuit against Stanford for medical negligence.
--:-- Maymay Fox: And we actually did file a lawsuit and it went to court and the judge threw it out because he said it was an experimental procedure.
--:-- Noel King: No one told me there was any risk involved in shipping.
--:-- Maymay Fox: And that would have been so easily solved. I mean, I was in L.A. and I could have easily flown up to San Francisco and had the procedure done entirely there if I had been told that there was a risk in shipping, which I was not.
--:-- Noel King: That was Maymay Fox. She's a New York Times bestselling author and editor and a contributor to Forbes.
--:-- Noel King: All right. Vox's Anna North is back with us now. So Anna, Maymay was a source in your Vox story about egg freezing. That's how we met her.
--:-- Anna North: Can you tell us how common stories like hers really are?
--:-- Noel King: She's not the only person to have encountered problems with egg transportation or egg storage.
--:-- Anna North: There was a 2022 study that found at least nine storage tank failures over 15 years, affecting 1,800 patients.
--:-- Noel King: And then, you know, those are sort of the technological problems. These are accidents, maybe things that wouldn't be expected.
--:-- Anna North: But egg freezing patients also kind of have to contend with the fact that the human body itself is unpredictable, even with this new technology.
--:-- Noel King: So there's just really a lot of points at which egg freezing can fail.
--:-- Anna North: And a doctor who studies this really walked me through it.
--:-- Noel King: First of all, the ovaries might not produce enough eggs, even with the medications that are supposed to make them do that.
--:-- Anna North: The eggs might not survive the freezing process. When they're thawed, they might not fertilize properly.
--:-- Noel King: And then if they're fertilized, those embryos might not implant properly in the uterus.
--:-- Anna North: So just like with anything around pregnancy and fertility, there's a lot of uncertainties really baked into the process.
--:-- Noel King: Are any of these companies able to tell you, or is any of the data able to tell you, like, how frequently this happens?
--:-- Anna North: So is it possible to say, if you freeze your eggs about half the time, it's not going to result in a viable pregnancy? Do we have numbers like that?
--:-- Noel King: Increasingly, we have data. There's a 2022 study out of NYU that got a lot of attention.
--:-- Anna North: They found that the chance of a live birth from frozen eggs overall was about 39%.
--:-- Noel King: Now, that chance goes up if the person is younger when they freeze eggs.
--:-- Anna North: And it also goes up the more eggs you freeze. So if you freeze a lot, you have a better chance of some of them fertilizing and becoming viable.
--:-- Noel King: But what the study author, Sarah Cascante, told me is there isn't a guarantee of having a baby from egg freezing.
--:-- Anna North: Would you characterize it as a necessary thing to do? Or who would it be necessary for?
--:-- Noel King: I think it's so complicated.
--:-- Anna North: When I talked to doctors, there sort of was a sweet spot of like a person that they might counsel to consider egg freezing.
--:-- Noel King: But, you know, that person is not 22, right? Because someone who's quite young, they have a lot of time to build their life in different ways.
--:-- Anna North: They have a lot of time to conceive without assistance. There's not really a need, even though there are some companies that have marketed to very young people about this.
--:-- Noel King: There's not really a need, a lot of experts told me, for someone who's quite young to go through this whole process that costs thousands of dollars, that involves giving yourself shots, that involves some risk of getting sick, you know, for something that they're probably not going to use.
--:-- Anna North: Even for people who freeze their eggs, they're not typically going back and using them.
--:-- Noel King: Only about 12% of patients worldwide actually go back to use those frozen eggs.
--:-- Anna North: So a lot of times they're conceiving without assistance or they're deciding not to become parents or maybe they're becoming parents through adoption or they're becoming parents through partnering with someone who has children of their own.
--:-- Noel King: You know, it's it's something that I do think a lot of people like to have and people who freeze their eggs typically report kind of a feeling of empowerment and a feeling like their stress levels went down they did something for themselves.
--:-- Anna North: But it's actually not something that people are using biologically for the most part to build their families.
--:-- Noel King: All of that was really a dark, dark period in my life. I will say that the good news is we went on to do several rounds of IVF and on the third round we were successful.
--:-- Maymay Fox: And not only that, but we tried for twins and we succeeded and I now have beautiful, healthy twin boys.
--:-- Noel King: So the story has a happy ending, but it was definitely not what I expected.
--:-- Noel King: That was Maymay Fox. We're all very happy for her.
--:-- Noel King: And you also heard from Vox senior correspondent Anna North.
--:-- Noel King: Victoria Chamberlain produced today's show and Amina El-Sadi edited.
--:-- Noel King: Patrick Boyd engineered facts by Laura Bullard.
--:-- Noel King: I'm Noelle King. It's Today Explained. Thank you.
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