On her morning PATH-train commute more than a decade ago, Jankhna Masina, now 44, noticed an ad for egg freezing.
In her early 30s at the time, Masina, who is Indian-American, had been feeling societal and cultural pressure from her family to find a husband and have children. “It didn’t matter that I was climbing up the ladder in my career in finance,” she recalls. “It didn’t matter that I had purchased a condo in Jersey City by myself.”
Masina knew she wanted to have a child someday, but rejected the idea of settling for anything less than achieving career success and meeting the right partner. “All my friends were getting married and having kids. I wasn’t,” Masina says. “And I refused to get married just to have kids.”
Surrounded by other commuters on the crowded train, Masina searched on her phone for more information about egg freezing, which at the time was classified as an experimental procedure. The procedure involves surgically removing a woman’s eggs and preserving them in liquid nitrogen to eventually be used for in vitro fertilization (IVF). The goal is to give women a chance to have their own biological children in the future.
“I had a gut feeling once I found out about it,” says Masina. “I knew I wanted to have that option to be a mother one day. But at the same time, I knew I didn’t want to be a single mother. That was my choice.” She soon found a nearby fertility clinic that offered the service. To finance the procedure, which would cost as much as $12,000 and was not covered by her health insurance, she skipped the solo vacations she had been taking, and put the money toward freezing her eggs instead.
After enduring a challenging series of tests and hormonal medicines administered through self-injection, the retrieval day finally came. When Masina woke up after the surgery and learned they had only extracted one viable egg to freeze, she was devastated. Her doctor, who advised at least four more eggs be harvested, recommended another round, which would heighten the chances of a successful live birth. But Masina declined. “I put that one egg in a basket and locked it,” she says. Whether that egg would one day result in a child was unknown.
Oocyte cryopreservation, the technical term for egg freezing, was developed in the 1990s, years after the first IVF baby was born in 1978. All IVF births result from eggs fertilized in a laboratory. The resulting embryo is then implanted in the woman’s uterus or frozen for future use.
But freezing eggs was long considered highly risky. Each egg is a single cell and far more fragile than a 100-celled embryo. In its early days, egg freezing was largely reserved for those with serious medical conditions or women who needed sudden cancer treatment.
When Masina embarked on her egg-freezing journey, she was one of a small group of women electing to do so. In 2009, the first year the Society of Assisted Reproductive Technology (SART) started collecting data on egg freezing, only 475 women nationwide went through the procedure. Then, in 2012, the American Society for Reproductive Medicine removed the experimental label from the procedure, which had achieved higher rates of egg survival through new methodology. That broadened the appeal of egg freezing. Since then, the number of women opting for the procedure has steadily increased. According to the most recent SART data, 13,275 women froze their eggs in 2018, up from 9,607 in 2017 and 8,825 in 2016.
As the millennial generation continues to delay traditional milestones like marriage, home ownership and parenthood, egg freezing has established itself as an appealing—and viable—option for younger women who want to be proactive about future motherhood.
Unlike men, who produce new sperm cells throughout their lives, women are born with their lifetime supply of eggs, around 2 million. That number drops month by month with each menstrual period. Over time, the quality and quantity of a woman’s remaining eggs decline, with a dramatic drop after age 35. When the ovaries stop releasing eggs, menopause is triggered.
Egg freezing offers women the option to hit the pause button. “It allows you the luxury of being able to prioritize both your career and your family, and not settle for a partner who isn’t necessarily your best match, or try to force yourself into childbearing at a time that’s not right,” says Dr. Marcy Maguire, a reproductive endocrinologist at Reproductive Medicine Associates (RMA), one of more than 15 fertility centers in New Jersey, most of which have on-site egg and embryo storage. “It’s hugely beneficial to women’s equality.”
In the last few years, a crop of fertility startups with names like Kindbody and Extend Fertility (both based in New York) has given egg freezing something of a makeover. Marketing the procedure as essential self-care for the everyday woman, these companies reach young women through targeted ads on Instagram and Facebook, as well as at chic pop-up events and happy-hour informational sessions—at least, they did in pre-pandemic times.
The marketing push has brought more attention to egg freezing. But the recent boom can more likely be attributed to improved overall success of eggs surviving the freezing process. “It is a more reliable treatment now than it was 10 years ago,” says Maguire. Back then, egg freezing was done using a technique called slow freezing, during which the egg was cooled very slowly—in some cases, too slowly. The longer the egg-freezing process takes, the more likely it is that ice crystals will form in the egg cell, damaging its structures and making its survival impossible.
In the early 2000s, fertility doctors started using a process called vitrification, during which eggs are flash-frozen so that ice crystals never form. This changed the egg-freezing game, increasing egg survival rates to 90 percent or more, up from 60 percent with slow freezing.
“Everything is a numbers game,” says fertility specialist Dr. Alan Martinez of the Reproductive Science Center of New Jersey. Generally, the earlier a woman freezes her eggs and the more she freezes, the better chances of a future live birth. But it’s not a complete insurance policy.
“The ideal time to freeze eggs, biologically, is in your 20s,” says Dr. Stephen Sawin, medical director at the South Jersey Fertility Center. “However, when counseling somebody, you have to balance that against whether they’re ever going to get used. With somebody who’s 24 or 25, there’s a very high likelihood that they’re never going to use those eggs, because they’re going to end up in the right relationship and get pregnant on their own without ever having to worry about it.” In practice, most doctors agree, the best time for a woman to freeze her eggs is around ages 30–35.
“I feel strongly that we don’t push someone into doing something just because the technology exists,” says Martinez. Instead, he empowers his patients through education, encouraging them to make their own decisions once he’s given them all the facts about their own fertility.
Egg-freezing success rates vary based on the number of eggs a woman chooses to freeze and the age she was when they were retrieved. According to a 2017 study, women under 35 who freeze 10–20 eggs have between a 70 and 90 percent chance of at least one live birth later on. Those numbers drop dramatically for women over 35, who are recommended to freeze twice as many eggs for similar results.
Many women pondering egg freezing are hyperaware of the numbers. Thirty-eight-year-old Shivani (whose name has been changed to protect her privacy) pored over every egg-freezing statistic she could find before ultimately deciding to go through with the procedure. The Jersey City resident had toyed with the idea of freezing her eggs before, when she was 29, but says “the science was still catching up,” and so she put the idea on hold. Shivani, whose background in is technology, says she doesn’t even buy the latest iPhone when new models are released. “I always wait and let them figure out all the kinks and bugs,” she says. “I followed the same kind of thought process when it came to egg freezing.”
By the time she turned 36, she was reading about vitrification and its improved success rates and decided to take the plunge. Still single and back in school working on her MBA, Shivani knew that motherhood wasn’t yet within reach, though her drive to have a child was strong. “If somebody had asked me, ‘What do you want to do?’ I would have immediately said, ‘I want to be a mom.’”
Shivani, whose company covered the egg-freezing costs, underwent her first retrieval in March 2019, which resulted in 12 viable eggs. Not satisfied with that number, she went back for another round in June and now has a total of 29 eggs stored for a later date.
Those 29 eggs don’t necessarily equal 29 babies. Compared to embryos, “an egg that’s frozen still has a lot of work to do,” says Sawin. “That egg has to survive the thaw. It has to be fertilized with a sperm, which not every egg is capable of doing. And then the fertilized egg has to grow for five days in the laboratory into an embryo.”
Explains Martinez: “The medical technology has advanced so much, and we’ve become adept at doing this now. But there’s no guarantee.”
Egg freezing is not for everyone. The cost alone is a financial burden to many. One retrieval process can cost anywhere from $8,000 to $12,000, plus annual storage fees. Add the cost of thawing and fertilizing the egg and transferring the embryo via IVF, and the total price climbs closer to $20,000—but a live birth isn’t assured.
While big tech companies like Amazon, Facebook and Google have started covering the cost of egg freezing for their employees, most companies do not include it in insurance packages. In New Jersey, companies that employ more than 50 people must cover the diagnosis and treatment of infertility, including up to four rounds of egg retrievals for IVF. “But someone who’s single and wants to do elective egg freezing is, by definition, not infertile,” says Sawin. “They haven’t been trying and not having success.”
The steep price tag excludes many millennial women, the generation who would currently benefit from egg freezing the most. “One of the biggest limiting factors, of course, is the cost for a lot of people,” says Sawin. “Many people are just starting their careers and don’t have $8,000–$10,000 lying around to do a cycle. So what ends up happening is the grandparent-to-be is the one funding it.”
But many women who have already invested in egg freezing say it’s been worth it.
For Shivani, who’s now navigating dating during a pandemic, it’s one less thing she has to worry about. “What I’m focused on now is meeting someone,” she says. “I have the eggs in the freezer, and if it happens naturally, great, but I’m glad I have that option.”
Several years after freezing her single egg, Masina met Mark, the man she would go on to marry. The couple, who now live in Branchburg, tried to conceive naturally, but it resulted in a miscarriage. Masina was diagnosed with endometriosis, a disorder that causes pain and scarring, and makes it difficult to get pregnant. To increase their chances, the couple decided to embark on the egg retrieval process again. By then, Masina was in her early 40s, and the procedure yielded no eggs.
So she turned to the single egg she had frozen more than a decade earlier. It first had to survive thawing. Then it had be fertilized and transferred to her uterus. The chances of it resulting in a successful pregnancy were slim—around 15 percent.
But it took. Their son, Matteo, whose name means “gift of God,” turned three last August.
“Science gave me the option to have a child when I was ready,” says Masina. “It just happened to be later in life for me.”Click here to leave a comment