In the summer of 2020, Shara Seigel faced more than just heartbreak when she broke up. Living in New York City, single at 35 and at the height of the COVID-19 pandemic, Seigel worried whether ending her relationship would also mean losing her chance at motherhood.
“It was still the height of the pandemic, and it was hard to meet new people so quickly,” she said. “Even if I did meet someone, I didn’t want to rush or feel pressured into trying to conceive just because of my age.”
Then Seigel saw something on Instagram. An influencer she followed had documented her experience freezing her eggs. As Seigel browsed posts revealing the egg freezing process, something that had once seemed daunting and unattainable began to feel within reach. “I felt like it was buying myself time and giving myself a backup plan,” she said.
Less than a month later, Seigel began her first round of egg freezing. In December 2020, she repeated the process to improve her chances of obtaining viable eggs. Although she hasn’t yet achieved fertilization and implantation, Siegel says she now feels more relaxed about her fertility. “I have a lot of peace of mind.”
Many fertility clinics have seen a surge in interest in egg freezing during the pandemic. Some data suggest that in the US, egg freezing has increased by 39% compared to pre-pandemic levels, and in the UK, inquiries in the summer of 2020 were up 50% compared to the previous year.
For women who have found the pandemic disrupted their family-building timelines, or couples who have decided to postpone childbearing due to economic uncertainty, preserving fertility can be a lifeline. However, this isn’t without nuance: assisted conception comes with its challenges and isn’t guaranteed. As more and more people participate, it could change some women’s perspectives on living independently and planning their families.
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A Privileged Position
Oocyte freezing, commonly known as egg cryopreservation, was developed in the 1980s to help women with serious medical conditions requiring treatment improve their chances of fertility after treatment.
The procedure involves collecting a woman’s eggs, freezing them, and then thawing them for use in fertility treatment. In recent years, egg preservation has evolved from a medical necessity to an elective treatment, with women now having the option to freeze their eggs to improve their chances of having children later in life.
Bat-Sheva Maslow, a reproductive endocrinologist who has performed over 2,000 egg freezing procedures, says egg freezing offers women who currently cannot afford to have children a chance to become mothers later, as their natural fertility may decline.
Siegel, a single, college-educated woman in her 30s who works for a knowledge-based company, is in many ways a typical example of someone in need. A 2021 study showed that women who undergo elective egg freezing are typically single, between 36 and 40 years old, white, highly educated, and employed.
Many of these individuals are well-off. “Unfortunately, egg freezing isn’t cheap,” says Elizabeth King, a certified fertility coach in Los Angeles who helps women overcome infertility, miscarriage, and conceive. The average cost of self-funded egg freezing in the UK is £7,000 to £8,000 (US$8,520 to $9,740), compared to $10,000 to $20,000 in the US, making the procedure generally accessible only to high-income individuals or those working in specific industries.
Some of these women work for companies that offer egg freezing as an employment benefit. These employees are overwhelmingly high-ranking, white-collar workers, often in the tech industry. “A significant number of startups and tech companies offer egg freezing as a benefit to attract younger generations, encouraging them to work harder rather than start families,” King says. “This means that, generally speaking, most women freezing their eggs fall into higher-income brackets.”
However, King says the number of people exploring egg freezing has broadened. With the global cost of living crisis, a sharp increase in job changes, and concerns about the lasting impact of the pandemic, she has observed that people in long-term relationships are delaying pregnancy. Through her practice, she has also noticed an increasing number of women in their 30s and early 40s seeking guidance on egg freezing, with the number of Black and Latina women also increasing in recent years.
The growing interest in egg freezing comes amid a growing trend toward older motherhood and technology-assisted pregnancy. In the UK, the average age of first-time mothers has been increasing since the 1970s, now reaching a historic peak of 30.7; in the US, the number of women giving birth over the age of 40 has reached a record high.
The reasons are complex. Increased access to effective contraception, along with improvements in education and labor market participation, have given women more opportunities and choices. On the other hand, poor family policies, such as a lack of state-funded childcare, increasingly unaffordable housing, and growing economic uncertainty, mean that many women feel unable to have children, even when they are ready to become mothers.
“Procrastinating”
Within this broader trend, experts say there are several reasons why the pandemic has sparked a surge in interest in egg freezing.
According to an April 2022 Pew Research Center study, three-quarters of American daters say dating has become more difficult than ever during the pandemic, and many, including Siegel, have heightened concerns about finding a partner.
The flexibility of remote work has also made the logistical situation easier for some women. Siegel says this shift means she can accommodate the multiple appointments required for a successful egg retrieval within a more flexible work schedule, making preserving fertility a realistic prospect for the first time.
More fundamentally, Anisha Patel-Dunn, a psychiatrist and chief medical officer of LifeStance Health, a US behavioral healthcare company, notes that the pandemic has been a time for reflection, prompting many people to seriously reconsider their life choices.
“The pandemic has created existential crises for many, raising questions like, ‘What is the value of my life? Is my work meaningful? Is my partner truly the one for me?'” she says. “Whether you’re trying to achieve your life or career goals first or are reconsidering your romantic partner, all this introspection we’re seeing could be leading people to feel like they’re not ready for children right now.”
King agrees that the uncertainty and instability of the pandemic are major factors in the surge. She says, “People have had a lot of time to isolate and think about their future. Single women are realizing that freezing their eggs is a great opportunity to ‘buy time’ if they haven’t met the right person. Some couples are freezing their embryos to start a family when the world is more stable or financially better.”
These factors were very apparent to Laura Pommer when she chose to freeze her eggs. Pommer, who lives in Texas, and her ex-partner decided to divorce a month before the pandemic began. The 37-year-old Pommer, living alone for the first time, experienced a period of isolation that gave her the opportunity to consider what she wanted from single life.
“I had a lot of time to reflect on what’s important in life,” says Pommer, whose parents helped finance the process. “I used this time to really think about what life experiences are, how I want to live, and how to achieve the future I want. That’s when I knew I wanted children and that I was going to freeze my eggs.”
Clear, practical benefits
The widespread availability of egg freezing technology has clear benefits. However, those seeking it must consider the complexities of the interview process.
Both Pomer and Siegel experienced the initial physical and emotional burden of the egg freezing process. Siegel described the stressful weeks leading up to the procedure, during which patients must inject themselves with a cocktail of medications. She said the inability to exercise during this time affected both her physical and mental health.
Pomer said she struggled for a month with appointments and hormone injections, and recalled how “nerve-wracking” the final injection, which had to be given at midnight a few days before the egg follicles were extracted, was. “A few days later, I went for the egg retrieval. The process went smoothly, but I was uncomfortable for a few days afterward; the hormones definitely took their toll,” she said.
More importantly, there are no guarantees. Some experts worry that the odds of successfully conceiving using frozen eggs may be exaggerated by some clinics and warn that women should not view fertility preservation as a foolproof insurance policy.
In the UK, for example, a study based on 2016 data from the Human Fertilisation and Embryology Authority, a UK government agency, found that 15% of thawed frozen eggs were fertilized and transferred. Of these, 13% resulted in a pregnancy—a total of 22 pregnancies out of 1,204 thawed eggs.
The age of a woman when she freezes her eggs is a factor in success: women under 35 have an 18% chance of conceiving if they freeze five eggs, but this drops to 7% if they are over 35.
Outcomes are influenced by the number of eggs a patient has frozen; to maximize their chances, clinicians often recommend multiple egg freezing cycles (the number of eggs retrieved per cycle varies, averaging 15 for women under 35 and as low as six for women over 42). However, this increases costs, which can be prohibitive for many.
Thus, the high cost of egg freezing and relatively low success rates mean that some women may pay a large sum for a so-called guarantee that only slightly increases their chances of becoming a mother. There are concerns that some clinics may be taking advantage of women who are anxious about fertility by not adequately explaining the realities of a successful pregnancy after egg freezing.
“I think there’s a false sense of security that women who have frozen eggs will have healthy embryos or live births,” says Kim. “I do think clinics should do a better job of explaining the realities of the process, not only from a physical perspective but also from an emotional one.”
“I can let life come to me“
However, based on current trends and anecdotal reports, interest in the procedure remains high even after the pandemic abates, which could change how some people plan and expand their families in the long term.
“Whether, when, how many, and with whom we have children significantly impacts every aspect of our adult lives—where we live, where we work, how we spend and save money, and our physical and mental health,” said Maslow of Reproductive Medicine Associates in New Jersey. “Family planning is part of our life plan.”
Maslow said we may see more mothers in their 30s and early 40s. King also said some women will experience increasing freedom in their work and planning for the future as they increasingly feel they have control over their fertility, something previous generations missed out on.
However, King warned that the procedure is limited to the middle and upper classes, who are more likely to be able to afford the procedure. Of course, another caveat is that not everyone who chooses to freeze their eggs will be successful and have their plan work out as hoped.
In Pomer’s case, this process has allowed her to feel less pressure to find a new partner or advance her career. Now, she can focus on her growing business and, once things have calmed down a bit, her long-term goal is to have a child. “I have the flexibility to choose where I live now and let life happen to me, rather than trying to control a certain outcome,” she says.