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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, again, everyone. Now, a deep dive into egg freezing. A thoroughly-researched piece in Vox explores what its headline deems the failed promise of egg freezing. It's also the headline, The Failed Promise of Egg Freezing. Once hailed as a means for women to take control of their fertility and usher in a new era, I should say, of gender parity, the reality has proven more complicated.

The piece in Vox comes to us from senior correspondent Anna North. She writes that though many patients express a sense of relief after making the decision to freeze their eggs, for many years, there wasn't enough data because not enough people had undergone the procedure to know how well it was working out in the long run. Now, however, Anna writes, "A new picture is emerging."

In one important study conducted in 2022 at the NYU Langone Fertility Center, the chance of a live birth from frozen eggs was just 39%, so way under half. What's more, Anna writes, "Far from ushering in a new era of gender equality, some experts say the procedure serves as another way for companies to make money from stoking women's anxieties." Let's hear more now from Anna North, senior correspondent at Vox. Hi, Anna. Welcome to WNYC. Glad you could join us.

Anna North: Hi. Thanks so much for having me.

Brian Lehrer: Listeners, we'll invite your calls with your stories right away, 212-433-WNYC. Help Anna North report this story or share your experiences of egg freezing. Was it successful? Did it give you a sense of control over your life or career? Was it a stoking of anxieties as I referred to a minute ago that some experts say that led you to do it in the first place? 212-433-WNYC, 212-433-9692, call or text. Anna, let's go back to the beginning of the era. When did egg-freezing technology come in and what were the initial promises and expectations?

Anna North: The first successful births that we know of from frozen eggs were actually twins born all the way back in 1986. Things didn't really take off until the '90s, and then not even really, really until 2012, which is when the American Society for Reproductive Medicine says this is no longer an experimental technology. It's saying that, for a long time, egg freezing was something that was used primarily for folks who are about to undergo chemo or who had other health issues that were going to impact their fertility.

Beginning in 2012, it becomes more and more common for people to freeze their eggs, simply because this isn't a good time for them to have children or to try to protect their fertility down the line. It becomes a real blockbuster treatment. I think one of the most famous examples is a 2014 Bloomberg Businessweek cover story that had this really splashy cover line. It said, "Freeze your eggs, free your career." It's going to usher in this incredible time for women in particular who can pause their biological clocks.

Brian Lehrer: This statistic that I cited 38%, 39% of egg freezing is actually resulting in a pregnancy. Is that a lot? Is that a little? How do we understand that number in context and what it means?

Anna North: It's a great question. Every doctor, every reproductive endocrinologist, every expert I talked to, including folks who their career is, in some cases, helping people freeze eggs, they said it's so important to know that freezing your eggs is not a guarantee. It can work. 39%, it's not zero. Those numbers go up if the person is younger when they freeze their eggs.

If someone is 30 and goes to freeze eggs, they're going to have a better chance of having a baby later on than certainly someone who's 40 and does it. The numbers also go up the more eggs the person freezes. If you get a lot, then that's basically more chances. That 39% figure, I think people can look at that and reasonably say, "Oh, this is a chance, but it's by no means a certainty."

Brian Lehrer: Your article says egg freezing has not "materially changed women's lives as initially promised." Can you expand on that and discuss the gap between the hype and the reality?

Anna North: Absolutely. I think there was this thought at the beginning in 2012, 2014 that this is really going to be like the birth control pill. It's going to change things for women in terms of how they manage their reproductive lives in all these ways and that it's going to, for example, allow them to take time to climb the corporate ladder. People are going to freeze their eggs at a certain point, then they're going to work. Then at a time of their choosing, they'll be able to take that time and have a child. That's not really how people have used egg freezing. It turns out a number of sociologists and other experts have talked to a lot of folks who have frozen their eggs.

In most cases, these are people who haven't found the partner that they want to have children with. They're freezing eggs in the hopes that, one day, they might meet that person. It's not necessarily someone saying, "I'm going to really throw myself into work, and then when I'm 40 and I'm ready, I'm going to have a child." It's more people who are frustrated saying, "I'm dating. I'm not meeting that right person. This egg freezing is going to be an insurance policy." There's almost a sense of like, "What has been freed here?" Career doesn't, to some degree, enter into it.

Brian Lehrer: Let's hear somebody's story. Sarah in Oakland, California, you're on WNYC. Hi, Sarah.

Sarah: Hi, Brian. Long-time listener, first-time caller. I'm almost a 40-year-old woman. I froze my eggs just as your reporter said for an insurance policy at 37 before I met my husband. Then we went ahead. We had 11 eggs, which wasn't a lot. Obviously, I knew that. Essentially, when I went to thaw them and create the embryos, at least five of them disintegrated immediately, and then the rest of them disintegrated upon insemination. They said that this was an unusually high attrition rate or whatever, but it just felt like my dreams were flushing away, and the insurance policy was flushing away. I was still paying for those eggs. I still owe $1,500 for those eggs that are now gone.

Brian Lehrer: Does it leave you with advice for other women one way or another?

Sarah: Yes, I was just like the reporter said where I hadn't met him yet, so I didn't know. I would say, do it when you're younger. If you're going to freeze them, freeze them while you're younger. I just really encourage companies to also provide plans and benefits that help women to do that because it is a major issue now. We don't know what we're going to do and we want to start a family. I wish I would have thought about it sooner.

Brian Lehrer: Sarah, thank you so much for sharing that. I think that could really help people. Do you have any other anecdotes from your reporting, Anna, that you might want to use one as an example.

Anna North: Sure. I talked to someone named Mimi Fox. She's talked a lot about her experience. She froze her eggs, actually, a long time ago when it was still newer and was very excited to be able to make this happen for herself. It was very expensive. It took her about a year to save up the money, but she felt like, "Okay, it's a real weight off my mind." A lot of patients describe this, this feeling of, "Okay, I've done this thing for myself. It's a real relief," then she met someone. She went back to hopefully try to use those frozen eggs.

Actually, there was a mistake or an accident in the packing of the vials for transit and the eggs were essentially destroyed. They were unusable. All that money that she'd spent, all the injections, the things that she'd put her body through, which were not insignificant, she had nothing to show for it. She did end up having children later on through IVF. She was able to have the family that she had hoped for and planned for, but that was a lot more money out of pocket. The insurance policy that she thought that she signed up for, it didn't materialize.

Brian Lehrer: It's interesting that you mention IVF because IVF seems so under attack now by the anti-abortion rights movement. People are rallying around IVF. Maybe some listeners are thinking, "Wait. Why right now when all kinds of reproductive options are under attack? Why come out with an article bashing egg freezing?"

Anna North: I definitely thought about this as I was writing the story, which I've been working on for a while. As I started to wrap it up, we, of course, heard the news out of Alabama. Even before that, actually, when I spoke with experts about this, they would say, "With all the concerns that we might have about the cost or about whether people are receiving the upfront information they need about this procedure, we certainly don't want it to be banned. We don't want people to have fewer reproductive choices in this country."

Even before what we learned out of Alabama, obviously, this has been a time of curtailment of reproductive choices. That's not what even, I think, the starkest critics of egg freezing that I spoke to want to see. Instead, primarily, what they'd like to see is just better disclosure and better regulation around what people are told so that if they're going to pay $10,000, $12,000, plus hundreds of dollars a year in storage fees, they have a better idea of what they're getting.

Brian Lehrer: 212-433-WNYC. Elizabeth in Brooklyn, you're on WNYC. Hi, Elizabeth.

Elizabeth: Hi, I'd like to ask what the comparison is between the natural way of conceiving babies and the frozen eggs because as I understand it, my mom told me when I was young that one-third of naturally-occurring pregnancies don't get beyond the first few months or weeks. Is that true? We got to compare life to not life, I think.

Brian Lehrer: That's a really great question. Do you know that stat? I know I've heard things like that. If only 38% of the frozen eggs turn into viable babies when they try to use them for pregnancy, if that's a similar number to those that result in early miscarriage, then maybe it's not so bad.

Anna North: Yes, absolutely. We know that the rates of miscarriage very early in pregnancy are quite high. I think though that the 39%, the way to think about that is that someone in this study, that patient freezes their eggs. If I'm interpreting it correctly, then at the end of the study, their individual chance of having a baby is around 39%. It's not like each individual egg has a 39% chance of becoming a child, more that the patient might have a 39% chance of having a child through this procedure.

The way that something that was really illuminating that the study author helped me understand is that these numbers are in line with IVF success rates. For example, if you freeze your eggs at 35, then you would basically have the same chance later on when you go to use those eggs. You'd have the same chance of having a baby that you would if you were to undergo IVF at 35.

The thing about freezing your eggs that's positive is if you have those frozen eggs at 35 than you're 40, you maintain the chance of a live birth of a 35-year-old. You're a little bit putting a pause on that clock, but you're still looking at those numbers. It's still IVF numbers. It's not like you have the chance of becoming pregnant that you would as a 20-year-old trying to conceive naturally.

It's complicated to understand because we're throwing so many numbers around and there's all these different ages. I think that's why it's extra, extra important that doctors or companies or whoever is offering the service is really sitting down with people and saying like, "These are your chances. These are your numbers. This is what you can expect," because, otherwise, it can be mind-boggling.

Brian Lehrer: Erin in Brooklyn, you're on WNYC. Hi, Erin.

Erin: Hi. I was somebody who went through 12 miscarriages and then, at 39, ended up freezing embryos. I was informed by my doctor at the time that the chances of success with an embryo is significantly higher than an egg. I've even had friends who have loosely dated somebody, known them as a friend, and asked to go ahead and make embryos with them to increase their chances of having a baby knowing how poor the rate is for just freezing eggs. I am constantly advocating to friends who go through this to consider trying to

find a way to make an embryo over an egg. At 39, I'm 45 now and I had two babies from my one egg retrieval that made embryos. That's worked for me.

Brian Lehrer: Really interesting. Anna, first time you heard something like that? I'll bet not.

Anna North: No. Congratulations first of all on your children, but no-

Erin: Thank you.

Anna North: -it's absolutely true that doctors will also and experts will also tell you that embryos, it can be a safer bet than freezing eggs. There's a couple of reasons for that. One is that embryos just freeze a little better. Eggs have really high water content, embryos much less so. Then also fertility clinics do types of screening and testing on embryos that it's not possible to do on eggs or wouldn't make sense to do on eggs. In some cases, that can give people a better idea of whether the embryo is likely to lead to a successful pregnancy.

If you have four embryos, three embryos, your doctors can work with you to give you, I think, a better idea of what you might end up with than if you had a number of eggs. This is absolutely something more patients are considering. Anecdotally, I've heard that more doctors are talking to patients about it. It even showed up on the show Succession, where I believe it's the character Shiv says that she heard that embryos freeze better or last longer than eggs. It's something that's entered pop culture as well.

Brian Lehrer: Listeners, if you're just joining us, we're talking to Anna North, senior correspondent for Vox, where she covers American family life, work, and education, talking about her story, The Failed Promise of Egg Freezing. We can take some more phone calls and texts. The texts are really coming in. 212-433-WNYC. About half of them are asking the same question, which we will get to in a minute, but let me read you this one, Anna.

Listener writes, "I froze 35 eggs, the result of four stimulation and retrieval cycles in my late 30s. This eventually resulted in two genetically normal embryos, neither of which implanted on transfer to my uterus, $70,000 down the drain." Then the listener writes, "If I was a man, that might have gone into a 401(k), not to mention the unspeakable devastation and grief. For the industry to call it fertility preservation is really a misnomer that gives women false hope. In Europe, they seem to use the term 'social freezing,' which at least does not make a false promise." What are you thinking listening to that?

Anna North: First of all, thank you for sharing that experience. It can be so devastating to go through this process. I think something that folks talk about that's really important to acknowledge is just the emotional toll. People face that emotional toll in all different ways of trying to build a family, but there is this really intense emotional toll of going through these medical procedures, hoping it's going to work, wondering if it's going to work. Then when it doesn't work, that disappointment and devastation. That is so real.

I think too that something that the listener brings up is the way in which we see these numbers fall off. A patient can get a large number of eggs and feel really good, then only a few of them fertilize. Then are those embryos genetically normal according to the tests and then to those implant? There are just so many stations of inexactitude and ways that things can go wrong. Of course, that's true when you're trying to conceive without assistive reproductive technology as well, but the difference is it doesn't cost as much money.

Brian Lehrer: Another story from Samantha in Queens. You're on WNYC. Hi, Samantha.

Samantha: Hi, Brian. I'm long-time listener. Thank you for taking my call. My story is probably typical-ish. In 2015, I was 37. I froze my eggs after my doctor really highly recommending. My, again, relationship wasn't finding the person to have a child with and only got nine eggs. Six of which were viable. No one sat me down at that time really to have a conversation to say, "Hey, you probably need to deal with this immediately because that's not a lot to get in one retrieval." That conversation didn't happen. At the time, I actually had health insurance that covered retrievals.

I just went on my merry way and then started trying at 42. I think I had one embryo and it did not take. It took another eight years to have a child using an egg donor. It was a really hard, long, very expensive journey of a lot of loss. It's very frustrating to have these unrealistic expectations, I think. I'm sure some of it is what I maybe assumed, but I just find that the education, I learned so much along the way, and mostly from support from other people going through the same journey versus the actual providers.

Brian Lehrer: Any advice after your experience to women considering egg freezing?

Samantha: Yes, I think it's really important to go to really educate ourselves and even joining support groups where you're going to actually meet other people with real stories, not just those outlier success stories that give you so much hope, which are important. It's important to have the hope and to have the support and be able to really feel like encouraged to advocate for oneself. Often, we just think doctors. They'll tell us if there's something we should know. That's not necessarily the case often. I think really connecting to other people on this journey can be really helpful.

Brian Lehrer: Samantha, thank you for connecting to other people considering the journey. Rachel in Brooklyn, you're on WNYC. Hi, Rachel. Rachel in Brooklyn, you there?

Rachel: Oh, hi. This is me. Hi. My name is Rachel. I just wanted to say that I got very deep into this journey of considering getting my eggs frozen after between the ages of 39 and 42. Those are the twilight years of fertility, according to the clinics. For me, I was shocked to learn that because, in my younger years, I didn't realize how fertile you are in your 20s compared to your late 30s. I was deluded into thinking that I had lots of time when I was younger.

Then once I started consulting in my late 30s, I got this message that the chances are very poor. I almost froze them even though I was informed of that by the clinics because I think what you end up-- Well, lots of people end up in probably, is this almost like a gambling mentality where you're like, "Okay, this might be my only chance to have a genetic child, how much is that worth," right? Even if it's a 10% chance, how much is that worth? It's a 5% chance. How much is that worth?

You get into this way of thinking about it because you feel like you have no other options, right? In the end, I actually decided not to freeze them. Because I felt like if I had done that, I would have been deluded even further into thinking that I had still a chance, and that notion being in the back of my mind would affect my relationships with prospective partners, the way that notion had affected my relationship when I was younger.

Brian Lehrer: Rachel, let me read to you a text that's coming in from another listener that's hearing your story, other stories like these, and cringing and get your take. Anna will ask for yours too as the writer of the article. A listener writes, "I hate conversations like these because they take away the hope that so many of us mid-30s women have. Freezing eggs is better than nothing. I find these conversations to play again on our feelings of inadequacy and stress. I'm so grateful to have the option at the very least. Let us have our hope, please." What are you thinking, Rachel, as you hear that from another listener?

Rachel: I definitely felt the same way. I almost froze my eggs at age 42 for that same reason because I just wanted that hope so badly. I just knew that because my main reason was because I wasn't finding a partner, right? I knew that having that in the back of my mind, "Oh, I have more time because I have some frozen eggs in a bank somewhere," I knew that that would affect my sex life and my relationship life. I didn't want that to be playing out anymore. I decided to just face the mortality of my fertility head-on and hope for the best with the surprise pregnancy [chuckles] without help.

Brian Lehrer: Rachel, thank you very much. Anna, that same listener who texted, texted again, "Continued stories like these creates so much fear and take away the little agency we have over our reproductive health currently. Allow us our agency." Your reaction?

Anna North: Yes, absolutely. That's super real. I think that the need to feel some control over a part of our lives that-- and I'm someone who had children in my late 30s. I was 39 with my second kid, so I am familiar with these feelings and with the numbers and the way that doctors will talk to you. I really understand, in truth, the way that egg freezing can provide hope and also provide success for some people. One thing I want to highlight is that people who end up going through egg freezing often feel good about it.

After the procedure, one researcher that I spoke with said that more than 90% of women had something positive to say. I don't want to paint it like it's this completely negative thing for people's lives. I think this listener is hitting on something really important. I think the other thing that I would say here that really came home to me as I was reporting the story was feeling like how much of the cultural weight and the responsibility for reproduction and creating families in the United States still rests on the shoulders really of women.

The people who are lectured to about their fertility, who are expected to be the ones who figure this out about having a family, the ones who have to figure out egg freezing, spend this money to do this stuff, it's so often women. Some of that has to do with the way that human reproduction works. Some of it also has to do with the way that as a culture, I think the United States still just feels like women are in charge of families and are in charge of children. That is a bigger problem and a bigger issue that I don't think technology can really resolve. It's something that we are going to need to have social change for.

Brian Lehrer: Last question. You touched on this briefly, but I said about half the text we were getting asked some version of this question. I'll read the shortest one that came in from Lauren in Atlanta. "Please talk about the cost. It is expensive." The question becomes, is it equally accessible or is this another divider between rich and poor in our society?

Anna North: 100%, it's so expensive. It runs about $10,000 per cycle. There's some wiggle room within that. In some places, it's a little bit less. There's also storage fees. Those run in the hundreds per year and it doesn't end. As long as you want to store, you got to pay. Now, some employers are starting to offer insurance coverage. That's something that I think was touched on in the conversation.

A lot of experts I've talked to said, even though this procedure isn't perfect, it's something that employers should think about covering because that would level the playing field. Right now, the majority of people who are able to freeze their eggs are people with a significant amount of money. They're typically professional women. They are typically white. There's a big racial gap in terms of egg freezing as there isn't a racial gap in fertility treatments more generally for a variety of reasons.

Yes, this is an incredibly expensive procedure. That's one of the reasons I think that we decided to look at it because it's something that people are really investing not just their time, but a lot, a lot of money in. I think for a lot of folks, if this were able to be a bit more accessible and a bit cheaper for the patient, then I think it would take some of the controversy away.

Brian Lehrer: Anna North, senior correspondent for Vox, where she covers American family life, work, and education. Her story, The Failed Promise of Egg Freezing. Thank you so much for sharing it with us.

Anna North: Thank you.

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