It's okay to not freeze your eggs

Sep 13, 2022

Young women face a lot of pressure to freeze their eggs. Some arguments against.

Earlier this year, I sat on a panel in a university seminar. Towards the end of the session, egg freezing came up. My two fellow panellists, one a fertility lawyer, the other a fertility counsellor, both got behind it. They thought it was a great advance. They encouraged the young women in the class to consider it.

I disagreed. I encouraged them to be skeptical.

I have been watching with both interest and alarm as egg freezing has moved from the sidelines to the mainstream. From "freezing parties" and "free fertility checkups" to workplace benefits and Twitter confessions by academics who are opting for it, young women are feeling pressured to follow suit.

If freezing eggs and using them later were simple, I would be more enthusiastic. But I'd still be sounding a note of caution. As I will try to set out below, eggs are only one part of the issue. The other parts may in fact be more important.

But egg freezing is not simple. And using frozen eggs is not either. In fact, it sets the egg freezer up for an expensive, medicalized conception. It also sets her up for some very complicated decision making.

I have no doubt that for some women, egg freezing will prove to be a good decision. But I worry that for the majority, it will be a misstep, and for a few, a tragedy.

I predict that in 30 years' time we will look back on this as one of the biggest boondoggles of our generation. We will talk about how we duped our young women, took their money in return for false hope, channelled them toward ruinous choices and left many of them not just in debt, but childless. All the while, we failed to resolve the real issues behind why many women who want children don't feel they're able to have them.

If you are in your twenties or early thirties and have no medical reasons to freeze your eggs, the item below is for you.

8 minute read

It's okay to not freeze your eggs

You are a young woman who is still making her way in the world. You are hopeful, but still not sure how things are going to turn out. You are pretty sure you want children, but also pretty sure you don't want them right now. You hope for a life partner, but haven't found the person yet. You expect that your earnings will improve as you climb the ladder, but in truth, you can't be sure; and you're not rich. Should you freeze your eggs?

It will give you more choices, you're told. It will take the pressure off. It's like an insurance policy. It will empower you to live your best life. It's a way to have your children when you decide — to have them when the time is right. To enjoy what you have now and to get what you want later. Should you freeze your eggs?

You might be wondering — will you regret it if you don't? Should you do it just to be on the safe side? Should you freeze your eggs?

There are several things that should give you pause. The first is that egg freezing is not medically benign — it carries risks. Another is that it's not financially neutral — it's pricey. But even more concerning is its psychological impact — the way it makes you feel more secure and confident about your prospects of becoming a parent, while possibly making those prospects even worse. Because ultimately egg freezing kicks all the hard decisions down the road into a far-off future. But they will still be hard, or even harder, when you find yourself inhabiting that future.

I'm here to tell you that it's okay to not freeze your eggs.

Let's start with the medical. Egg freezing may well make your journey to parenthood harder than it needs to be. You are in your twenties or early thirties, with no evidence of illness, but if you opt for egg freezing, you are undergoing a prophylactic medical intervention.

Sure, retrieving the eggs is a fairly straightforward outpatient procedure. But it's one that involves taking hormonal drugs for a few weeks in advance (to boost the number of ripe eggs you produce that month), there could be some short-term side-effects, like moodiness, severe bloating and discomfort (or even ovarian hyperstimulation syndrome, which is more serious), and there could be adverse consequences down the road (nobody knows all that much yet, but there is reason to be at least curious about the long-term effects of the elevated estrogen and the multiple punctures of the ovary).

Once removed from your body, the eggs will be frozen and stored in a cryoprotectant. (There are unanswered questions about the effects of that too — on the egg, and the person who results from that egg.)

In the best-case scenario, you conceive effortlessly and you never need these frozen eggs. It was all for nothing — a security blanket. (To date, few people have gone back for their eggs. Were they successful on their own? Did they give up? We don't know.)

All you would need to do then is decide what to do with your unused stash (which might turn out to be harder than you think).

However, if in the future you decide to use those frozen eggs, you must commit to a medicalized conception. That means having the eggs thawed in a lab. It means providing the sperm through a clinic. It means using the fertilization technique known as ICSI — where the sperm is injected into the egg (because the outer shell of the egg gets hard during the freezing) — even though ICSI has been associated with increased health complications in the child.

It means having your embryo cultivated in a dish in a lab, in some culture medium (whose full ingredient list is not made public and full influence not entirely known). It means using drugs to prepare your uterus for pregnancy and then having a medical doctor transfer an embryo into your body. It means taking drugs to sustain the pregnancy until it's viable.

It's not a horror show — it's just assisted reproduction. But that's a lot of medical intervention for a person without infertility.

And of course, you're going to have foot the bill for all that. There's the $8000 or so for the retrieval and freezing, plus another $4000 or so for the drugs. (Costs vary.) That's quite a financial commitment for a young person starting out.

Then there's the $300 to $500 a year just to store them. If you wait ten years, that could be $5000. Wait 20 and it could set you back ten grand. What else could that money have been spent on? (Or will you just carry it as debt?)

And that's not the end of it. Don't forget, if you want to actually use the eggs, they'll have to be professionally thawed. You'll have to pay for that. You'll have to pay for the ICSI, too, and the early embryonic growth in the lab and the transfer into your uterus and the drugs to sustain pregnancy. It adds up. And you might have to do each of these steps two or three times, and pay for them two or three times, to get one live birth. (You might be encouraged to do multiple freezings too, doubling or tripling that initial cost.)

And even after all that, you might not get a live birth. Numbers aren't that reliable because we haven't been doing elective egg freezing for very long, but success rates aren't stupendously high.

You might realize in the midst of all these calculations that egg freezing is not at all like insurance, but more like gambling: insurance is a sure thing, but live birth after egg freezing is anything but.

And what will you have had to forego for this gamble? Travel? A degree? Fun? Solvency? And you are not even infertile. You are perfectly healthy.

And if you are not infertile and you are perfectly healthy, then you probably have about a 90 per cent chance at age 30 of conceiving without medical help. At age 35, it's likely still around 75 per cent. Even at 40, it's more than half. Waiting till 45 feels like throwing away a gift.

Yet that's the essence of freezing your eggs: trading in today's high chances for tomorrow's uncertain promises.

We talk a lot these days about high rates of infertility — and it is important that we do — but we too often gloss over the fact that a good deal of that infertility is societally-induced. Many women are pushed into infertility by a way of life that insists the only time to build a career is during her last fertile years and the only way to raise a family is by yourself on your own dime.

The egg freezing option is very much part of that lifestyle narrative. You haven't advanced far enough in your career yet to take time to build a family, it tells you. You don't have enough money to raise a child yet. (But start a tab with us...) There will be time to find a partner later. Don't worry. Don't think about that now.

But you should think about that now. You should be allowed to think about that now.

Freezing your eggs promises to open up options, but what are the new options you will pursue? To work more and work harder? To put your relationship to one side? To indulge yourself? Will it get you closer to what you want? Maybe. Or maybe not.

Do you know what you want? Have you thought about what you want? Is delaying parenthood what you want? Or is it what you feel you need to do?

It is okay to not freeze your eggs. It's okay to defy societal norms. It's okay to pursue parenthood earlier, even if everyone says you'll take a hit for it.

Because the truth is, every parent takes a hit for parenthood. There is no ideal time to have a child. No matter when it happens, it will interfere with the life you are living. Almost everyone underestimates the magnitude of its impact. No matter when you have kids, it will be an earthquake in your life.

Pregnancy and birth are unpredictable. The depth of love you will feel for your child is unimaginable. The amount of care and work you will be called upon to provide is unfathomable. It will be disruptive. But it's supposed to be disruptive.

You don't feel ready now, and maybe you are not. But it's important to keep in mind that you may never feel ready. At some point, if you want to have kids, you have to overcome that.

I am just going to put it out there that, although it feels like it from where you are now, it may not be an easier decision to make in the distant future. It will just be a different decision, with different tradeoffs. Your body will be older, pregnancy will be riskier, your own parents will be more frail and less able to help out. You still may not have a partner. Your workload may be even heavier. So, the decision may not be easier. It may in fact be harder.

The people who are offering you elective egg freezing are, first and foremost, salespeople. Don't lose sight of that. They want you to buy their product. They want you to believe that you need it.

Their central pitch is that delaying your decision for as long as you want will make it easier. But it won't. It will be hard no matter what.

HeyReprotech

It's okay to not freeze your eggs

Young women face a lot of pressure to freeze their eggs. Some arguments against.

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