Eggsurance

Why is egg freezing the most hotly discussed health benefit in Silicon Valley? Cristen and Caroline put the science and success rates of oocyte cryopreservation, or egg freezing, under the microscope to determine whether it really is the great workplace equalizer for women.

Learn more about your ad-choices at https://www.iheartpodcastnetwork.com

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:03):
Welcome to stuff mom never told you. From how supports
dot com. Hello, and welcome to the podcast. I'm Kristen
and I'm Caroline, and today we're going to talk about
side crying reservation. Egg freezing. Okay, Yeah, you just take

(00:23):
your eggs and you put them in a little ice tray,
you run some water under it that you put it
in the freezer. Yep, and then yeah, you've got eggs
to go. Just don't get it mixed up with your
regular ice cube trays. Yeah, please, that could be That
could be bad, f y. That's not how egg freezing
works at all. Well, the reason why we're talking about

(00:44):
it is because a little while back now in October,
news broke that's starting in January, Facebook had begun offering
up to twenty thousand dollars of egg freezing benefits for
employees under its lifetime surge to see reimbursement benefit. And
it's starting in Apple will begin offering the same deal.

(01:07):
And just f y, I JP Morgan and City Group
have already had this benefit. Why that hadn't made headlines?
I don't know. UM, and Google will likely follow suit soon. Um.
But for whatever reason, this Facebook related news, perhaps because
of the Facebook connection to Cheryl Sandberg and leaning in
and all of that. It generated so much conversation and

(01:34):
a social media freak out. Essentially, Yeah, there are all
sorts of voices that emerged on all sides of this
argument over whether this benefit for women would really truly
help them advance in the workplace, especially considering it's price tag,
which is is nothing to sneeze at. But speaking of
Cheryl Sandberg and Lenan, Jessica Bennett, who does a lot

(01:56):
of work with the Lenin Foundation, wrote in Time, Maga
seen that this whole egg freezing deal would be the
great equalizer, and she said that it's a potential solution
to the so called myth of opting out, essentially arguing
that by allowing women to freeze their eggs and having
it covered because it is super expensive, you're letting them

(02:21):
choose when to have children and allowing them to choose
to work harder, longer, and have kids when they're supposedly
ready now. Not surprisingly, when it comes to pretty much
anything dealing with women choosing whether and when to have children,
it attracts a lot of controversy. Have a lot of

(02:42):
people saying that's selfish, that's preposterous. This is technology gone
too far. So they are all of these voices also
being tossed in, lots of accusations of women just wanting
to freeze away their eggs so that they can have
casual dating lives and then become mothers on their own
when they want to. What world that is? I really
don't know. UM. So that was sort of all the

(03:03):
background noise to it. But when it comes to its
impact on women's workplace life, on the opposite side of um,
Jessica Bennett talking about it being a great equalizer, we
have Harriet Mentor, for instance at the Guardians saying that
it's really just another sign of tech companies in particular
being out of touch with what women really need. And

(03:24):
also this is a new demand for women to give
themselves fully to their jobs. And that was a question
raised in my mind as well in terms of I
saw the news and I was like, Oh, how progressive,
and also oh wait are they what does? What is
the mess the ultimate message that it's sending. I have
a feeling the message was let's offer the richest benefits

(03:48):
possible to attract the like strongest female employees we can possible.
But of course when it comes again to women choice
and child bearing, there's a lot of projection. Yeah, it's
it's interesting to look at all of those different voices, um,
because I think I think I fall somewhere in in

(04:10):
the middle of those two of those two ladies as
far as what they think it means. But um, we
have to talk about the science of egg freezing and
what it even is, because contrary to the top of
the podcast, it is not popping your eggs in your
own freezer at home next year stoffers or link cuisine. True,
I have I don't think there are any hacks on

(04:31):
the internet for how to retrieve your own eggs from
your ovaries. Although one day, ladies, perhaps one day um
in nineteen fifty three, the first human birth from thought
sperm happened, and in so it's taken a while, the
first birth from a frozen oo site or egg happened.
And so that's also something to keep in mind, kind

(04:54):
of in the back of your head as you listen
to all of this, is that sperm preservation and freezing
has been happening for a long time with far less
fanfare and consternation than egg freezing. But also the technology
of freezing egg successfully and then following those eggs and
using them to successfully um to then successfully implant, which

(05:20):
would then lead to hopefully a successful pregnancy, has been
a lot more recent in coming because it's the largest
cell in the body, and it's surrounded by a bunch
of liquid that tends to crystallize during freezing. And when
that liquid crystallizes, it breaks down the cell structure. And
obviously if that starts happening, it's not going to be

(05:40):
very it's not gonna have good outcomes, right, And so
in two thousand and four we get a scientist in
Japan who developed the process of vitrification or flash freezing,
which has thus paved the way for more viable egg
freezing today. And that's when you see a lot more
women going to their doctor to ask about the possibility

(06:02):
of not just preserving eggs in case of health problems
or or things like that, but to actually look into
elective egg freezing because they just want to delay childbirth. Yeah,
an elective egg freezing is a really new conversation because
up until the past few years, it was really only
cancer patients facing chemotherapy induced infertility or other medical conditions

(06:26):
that would adversely affect fertility, who were the most common
egg freezing patients. A lot of the conversation was simply
directed to them, but now with the trification, the focus
is shifted to the elective egg freezing and elective use
now in order to delay childbirth was the reason sided

(06:47):
by sixty four percent of respondence in a two thousand
ten study, and it was followed by egg freezing to
then be used for in vitua fertilization and then for
medical reasons at a distant second. So elective use has
shot up in popularity totally. Yeah, And so how does
it work? Do they Can you just go into the

(07:08):
doctor one day and elect to have this done or
is their lead up? Oh? Boy, is their lead up.
You basically have to have somewhere between two and four
weeks of self administered hormone injections plus birth control, which
basically kind of shuts off your natural hormones, followed by
ten to fourteen days of more hormone injections to stimulate
mature egg production, and then these ripe and ready eggs

(07:31):
are removed by an ultrasound guided needle and are immediately
frozen at a temperature of negative one dred and ninety
six degrees celsius or negative three degrees fahrenheit, and they
can be stored by some estimates up to ten years.
Then thought then usually injected with a sperm, which is
called intra cytoplasmic sperm injection. And then hopefully that union

(07:57):
of the thought o site and sperm will develop into
an embryo which will then be implanted into a uterus,
which will then hopefully lead to a successful pregnancy. Now
that's a lot of steps to get to hopefully baby
in your arms. Um. So the question then is viability.

(08:20):
What is the success rate? Well, the exciting thing that
has led up to this sparking interest around the elective
use of egg freezing is that vitrification in particular has
very much increased the success rate of falling viable eggs.
So when you hear about plus success rates when it

(08:41):
comes to egg freezing, that is not my friends, that
is not frozen egg too. Baby in your arms success rate.
That is success rate of following viable eggs, which is
you know, hailed as a success marker for vitrification. But
when it comes to using it for in the hopes

(09:04):
of getting pregnant, one day as that being your go
to in the case of, Okay, you got a job
at Facebook, awesome, you want to really get in there,
or just delay childbirth for whatever reason. Choose your choice.
I don't care you get your eggs frozen. It doesn't
necessarily mean that you will be able to plan out
that you won't necessarily be able to plan out becoming

(09:25):
a mother, right exactly. And a major sticking point in
elective egg freezing was the fact that it was classified
as an experimental procedure by the American Society for Reproductive Medicine.
A lot of their studies were like, yeah, um, the
slow freezing method of egg freezing is okay, and people

(09:46):
do it, and a lot of cancer patients do it.
People who are about to undergo chemotherapy do it. Um.
But this whole vitrification thing, it's experimental, and so insurance
companies of course follow suit and they're not going to
cover it. But in any twelve the American Society for
Reproductive Medicine took vitrification off of its experimental list, which

(10:06):
opened the door for a lot of women to then
seek it out as an option for them in their lives. However,
in their report, on this when they took it off
of the Experimentalist. The American Society for Reproductive Medicine talks
about how data on the safety, efficacy, cost effectiveness, and
emotional risks of elective egg freezing are insufficient to recommend

(10:30):
elective egg freezing for women, and they said making this
technology for the purpose of just deferring childbirth may give
women false hope and encourage women to delay childbearing. So basically,
the A s r M is saying to women, don't
put all your eggs in one basket. Pun pun. We

(10:50):
can make puns, right, we can make some ocite crime
preservation puns. That's right. And the reason we're getting into
this level of detail and maybe offering these and in
caveats is not to throw this new and exciting technology
under the bus, but also to kind of highlight the
fact that there was all of this controversy surrounding something

(11:13):
that clearly a lot of people reacting to it didn't
even understand the details of um. So let's get more
in to those details. Let's talk about the age factor,
because obviously, when it comes to delaying childbirth, a lot
of a lot of the women that are profiled in
articles about it, are in their early mid thirties even

(11:34):
late thirties wanting to delay childbearing until their forties. And
we did a whole podcast on age and fertility, the
whole biological clock thing, and we talked about how egg
quality does deteriorate with age, especially after age thirty eight.

(11:55):
So when it comes to the prime time for getting
your eggs frozen, doctors recomm and freezing by the early thirties.
I mean, if you can freeze your eggs in your
early twenties, doctors are like, absolutely freeze those primo eggs.
But that doesn't happen as much because if you are
thinking about having a kid at that time, chances are

(12:16):
you might just have a kid at that time. Well,
speaking more about the age factor, the average age of
women who are freezing their eggs for non cancer related
reasons is a little over age thirty seven. Um. But
a story in Life Science they used an online fertility
calculator and found that a woman who freezes fifteen eggs

(12:39):
at age thirty two has about a twenty eight percent
chance of becoming pregnant by using them, although that chance
actually might be a high estimate. Yeah, the real world
success rates are limited. And there still have been very
few berths from thought eggs. So keep in mind that

(12:59):
the research catching up to this technology, and a lot
of this research to on live births from uh O
cite cryo preservation are from women who have had fertility issues. So,
as the A s r M mentioned, it will be
interesting to see how these numbers would compare to women

(13:20):
who are doing more elective um egg freezing. But we'll
talk about what we know right now in terms of
success rates when we come right back from a quick break.
So on the upside, and one of the reasons why
in two thousand twelve, the American Society for Reproductive Medicine

(13:42):
or the a s r M took vitrification Office experimental
list is because the research conducted so far suggests that
I V f intro in vitro fratilization success rates are
comparable for both frozen and fresh eggs, with no additional

(14:02):
risk of congenital abnormalities, but the implantation and pregnancy rates
aren't a statistically sure bet. But the A s r
M did point out, for instance, that eggs from European
downers under aged thirty resulted in pregnancy rates ranging from
thirty six to sixty one percent, so more reason for

(14:23):
starting younger. I guess possibly um because there was a
two thousand thirteen study from the A s r M
which is a meta analysis of the age specific probability
of live birth with mature oocite cryo preservation, which is
probably one of the most comprehensive studies we have on
this subject to date, and it found quote, for example,

(14:45):
the probability of live birth for a thirty year old
woman who has two to six eggs thought is twenty
four point four to twenty four point one percent. With vitrification.
When it comes to the slow for using process, the
probability of live birth drops too, between nine and ten percent.

(15:06):
And in this meta analysis they determined age forty four
to be the upper age limit to even offer vitrification
implantation of in other words, having the thought eggs implanted
into your well, the thought eggs then injected with sperm,
then having that embryo implanted into your uterus. Although again

(15:30):
this is still such preliminary data because a lot of
it has been based on infertil patients, so the picture
could change if you look at fertile patients freezing specifically
to delay childbirth not because of outside health reasons. Well,
so we just threw a lot of science and a
lot of numbers at you. But let's get back to

(15:51):
that point that we brought up at the top of
the podcast, where uh, certain writers have addressed the issue
of what this will mean for women in the world place.
Will it be the great equalizer that for instance, Jessica
Bennett thinks it will be um And it plays into
a lot of the conversations that Kristen and I've had
on the podcast as far as the idea just the

(16:12):
idea of women having it all. That's right because almost
as soon as vitrification was taken off of its experimental
status in two thousand twelve, all of these trend stories
popped up on women in their mid to late thirties
freezing their eggs. And only as far back as two
thousand and twelve, it was clear in the tone of

(16:34):
a lot of these articles in response to it, that
people were approaching it very cautiously, that it seemed strange
that these women were doing it. There was an air
of desperation about it. For instance, there was this New
York Times trend piece on parents and this is again
two thousand twelve, this piece on parents funding their older

(16:54):
daughters egg freezing in the hopes that one day they
would have grandchildren because she just had and on Mr Wright. Yet. Yeah,
and not only do we have this piece on parents
providing for their daughters to be able to have children
at a later date, hopefully, we also have the trend
stories about women who have shelled out thousands of dollars

(17:18):
to go through this process and ending up having a
more satisfying and relaxed dating life as a result. For instance,
Sarah Elizabeth Richards wrote an op ed in The Wall
Street Journal in which she discussed spending fifty thousand dollars
on the whole egg freezing process and the fact that

(17:38):
it revolutionized her dating life because suddenly she's not so
worried about weighing every man's ability to be a father
and a husband and all this stuff. She can just
date to date and hopefully find love at her own
pace because she knows that she has her eggs banked. Yeah.
And what comes into a lot of these conversations are

(18:01):
mentions of having it all, leaning in owning yourself and
still finding Mr. Wright. And like all of these things,
it's a lot of Times. These stories on it which
profile these um women in their men to late thirties
early forties, are very it's it fits a very particular

(18:22):
mold of this um woman today who um we almost
it's like it's not pity, but it's like this woman
trying to have it all and yet she's sacrificed love
for her career, but now she's found a way to
get it back. And and in that Wall Street Journal piece,

(18:42):
Richard's even tosses in a cheeky reference to leaning in
you know. She says, well, this is this is the
way that we can do it because we can legitimately
plan everything out, and she cites a lot of other
women saying that as soon as they freeze their eggs,
everything ing, all the dominoes seemed to fall right into place.

(19:02):
And then we have a story that features Bridget Adams,
who launches the website egg surance dot com. Bridget was
going through similar things to Richards and to the women
featured in the New York Times piece on egg freezing,
wanting to have children, not finding the right man um
and so she created this online community where women like

(19:25):
her could come together and trade tips and tricks and
advice and basically just communicate to each other about the
whole process. Yeah. And in the Time article featuring her
and other women as well, the lead was she's already
got a copy of Goodnight Moon to read to her
unborn child. And so there is an air of that

(19:48):
with a lot of these profiles in terms of these women.
Look look at these women. They already have they already
have these books booked picked out. Some women already have
names picked out, and now they're freezing their eggs. And
there's so little recognition that of actual science. And I'm
not trying to um criticize these women's approach at all,
it's more the portrayal, right, Yeah, And something that I

(20:11):
was gonna say as far as Richard's leaning in on
her reference and Bridget already having the books for her child, Like,
that's all wonderful and you absolutely should plan. Um. But
I mean, as we've kind of touched on earlier in
this episode, the science and the numbers don't very strongly
back up the assertion that you definitely will have a

(20:33):
baby from this. And so while it is great any
time a woman can have a say over her reproductive
choices in life, that's wonderful and women should have more
choices for everything and be able to choose the lives
in the past that they want. However, a lot of
people in these articles point out like, well, that's great,
you might end up forty two, totally ready to go,

(20:56):
have your eggs thought and create an embryo and be
ready to go, but it's just might not happen too
So there's always the the fear out there that while
you've planned for this so carefully, things don't always go
according to plan. But regardless, fertility clinics offering egg freezing
have been reporting upticks and patients seeking the treatment. Clearly

(21:19):
word has gotten out, but this is an issue again,
which is great, especially for um couples who have been
dealing with infertility or for women wanting to, you know,
take more control over their reproductive cycles. But this question, though,
this ultimate question that that really got me in Caroline
thinking and talking about this, is this question of whether

(21:40):
or not it is this great equalizer, particularly in the workplace,
and when you look at the economics of egg freezing
on top of the science and what we there's still
a lot that we need to know in terms of
viability and success rates. That might change in technology will
probably improve, But when it just simply comes to who

(22:02):
can access this service, it could be a great equalizer,
but for very few women. Yeah, and I mean this
goes back to a lot of the criticisms that we've
heard about lean In, specifically in terms of, like, it's
wonderful advice. It's fantastic advice for career women, women who

(22:23):
are in a very specific segment of the working population.
But for a lot of women, like say, shift workers, waitresses,
things like that, the lean In advice doesn't apply to
their working lives quite as well. And so it's kind
of the same thing when you have companies like Google
and Facebook offering egg freezing. That's wonderful, but it is

(22:45):
so expensive, and so it's really only open to very
specific segments of the population. Yeah. For instance, that Facebook
benefit covers up to of this, which might sound very
generous and it is very general us. However, that would
have not even covered half of what Sarah Elizabeth Richards,

(23:05):
who wrote that Wall Street Journal apot an entire book
about this um. That would have covered less than half
of the fifty thousand dollars that she spent on it.
Because the cost for a single cycle of egg retrieval
and freezing usually runs between five to eighteen thousand dollars,
not including the cost of hormone injections, which can run

(23:28):
a few grand, and egg storage which is typically five
dollars per month, and the fact that it often requires
more than one cycle to retrieve enough viable eggs, so
at the end of the day, we're talking easily tens
of thousands of dollars. There are some clinics that offer
financial breaks, but it is highly, highly costly, right and

(23:51):
Dr Beth Kennard, who is the director of the Division
of Reproductive indo Chronology and Infertility at the Ohio State
University Wexner Medical Center, points out something else about the price.
She says that the first in vitro fertilization procedure was
done back in nine but it's still not a technology
and a procedure that every woman can afford to do,

(24:13):
and it's been around for a while, and you take
into account how new this vitrification processes, for instance, and
the fact that it is so expensive, and it just
makes sense that the price probably isn't going to come
down a significant amount anytime soon. And speaking more on
in vitro fertilization specifically UM. According to the CDC in twos,
about one point five percent of US bursts we're through

(24:36):
assisted reproductive technology, which includes IVF. So that's still that's
still not a huge number. Yeah, I mean if if
in Rebecca Mead made a great point about this at
The New Yorker saying, fine, well, and good for you
to offer this as part of a comprehensive surrogacy benefit
package to your employees companies, go for it. However, if

(25:00):
we really want to tackle that myth of opting out
the whole motherhood versus career, all of these conversations that
even as a woman who is not a mother, I
think about a lot in terms of is this something?
Can I handle this in my reproductive future? If we
really want to tackle that, it's going to take a
lot more than some egg freezing benefits. Because American women

(25:25):
continue to evase issues such as the fact that we
have limited availability to subsidize care for preschool children. There
is quote the resistance of corporate culture, too flexible or
reduced hours for the parents of young children, an a
lack of federally mandated paid family leave. The US is
far behind so many other countries when it comes to

(25:46):
maternity and paternity leave as well. There there's a lot
going on that egg freezing is not going to fix.
And I think that something as hyperbolic as the Great
Equalizer needs to be accessible to more than just the
very top elite percent of women who are getting jobs

(26:11):
at these top elite companies. Yeah, and I mean it
is great. I mean we've established as you've said this, like,
it is great that these companies are offering it, of course,
but it it just seems like they're trying to fill
in the gaps that they can, um, because we have
I mean, we're in the dark ages in our country
as far as providing these types of benefits to mothers

(26:32):
and families who are looking to have children, take care
of children, but also continue to work and have a
full life that way. Um, I agree totally with Rebecca
me that we have so many, just like society issues
in our country that needs to be examined. It's great
that this egg freezing thing is an option for people.

(26:54):
That's wonderful that anytime you can, like I said, anytime
you can have control every reproductive health. But the criticism
comes in when it's only open to a very certain
segment of people well, and even for that segment of
people that the option might be financially available too, it's
still crucial to understand the science behind it and understand

(27:17):
that there are a lot of steps involved and it
isn't necessarily locking down a guaranteed future, and perhaps so
as the data continues to roll in on the success rates,
particularly for um fertile women, taking advantage of elective vitrification

(27:39):
is maybe taking a step back to and also addressing
the social and cultural factors at work that create so
much panic and freak out over the idea yet again
of women having some potential, say over childbearing. Yeah, I

(27:59):
mean we we haven't even gotten fully into that issue
in this episode, because I feel like that could be
its own episode. But I mean, Christen and I definitely
were talking about the comments that we saw on a
lot of these articles featuring these women who had made
this life choice, and a lot of people again it
was the the old refrain of how selfish. Um. It
was the refrain of you know, you're going against nature

(28:21):
or God, Um, you are breaking up what family should be,
when in reality it's like, okay, first of all, just
lay off these women for making their personal choices. But
but second of all, a lot of these women that
are featured in these stories, they do want a family.
They do want a life partner to raise a child with.

(28:41):
But because of just the way that things are structured
and the way that things have shaken out, you know,
their career has come first, or they just haven't found
the right person. But I heard in a lot of
those stories to the echoes of this to me tired
and outdated and honestly us leading myth of having it all. Yeah,

(29:03):
I think that it's time to get rid of that
goal post because it is a complete mirage. But now
we want to hear from you. I have a feeling
there are a lot of thoughts running through listeners heads
right now, and we want to hear from you on
this issue. What do you think about it? And would
you take advantage of this? Have you taken advantage of this?

(29:25):
If you're a woman who has frozen her eggs, we
absolutely want to hear from you too. Mom Stuff at
how stuffworks dot com is our email address. You can
also tweet us at mom stuff, podcasts and messages on Facebook,
and we've got a couple of messages to share with
you when we come right back from a quick break
and now back to the show. Well, I've got a

(29:46):
Facebook message here from Maddie about our episode on vegetarianism
or being a Pythagorean if you're old school like that,
he writes. My name is Matt from Sydney, Australia. I've
been listening to the podcast for a while now and
thoroughly enjoy it. I only just listened to the vegetarian
episode and had some thoughts. I've been vigo now for

(30:07):
two years. I grew up in a very neat centric
family and circle of friends. I was even an apprentice
butcher for a couple of years. I decided to stop
eating meat, mostly for environmental reasons. I understand the ethical
and health aspect of it too, but it was the
waste resources and farmland that cattle needed that really got
to me. I do have to admit that I'm still
a little overweight, but try to keep it fairly healthy.

(30:29):
It wasn't until I listened to the podcast I realized
the vast majority of my friends who are vegetarian and
are vegan are indeed female. When I first stopped eating meat,
the most grief I got was definitely from my male
meat eating friends. It also is still to have to
be the only person at a very big family at
Christmas who doesn't partake in the two turkeys and two
hands we have every year. But my family is starting

(30:51):
to get used to it. But it's when I go
out with my guy friends that it's the toughest. I
don't know if they're just curious or recognize that I'm
an easy target, but I get a lot of slack
from them, to the point to where I've actually lost
friendships because of it. It's probably for the best, but
it sucks that some people can still be so against
the idea. It confuses me. It confuses me to matt Um.

(31:16):
I have a letter here from Sarah about our Women
in the Art of Dying episode where Kristen and I
interviewed Kate Sweeney Um. Sarah shares a great story. She says,
I don't know if this is necessarily a death ritual,
but my aunt Roxanne, who passed about three years ago
from breast cancer, requested that some of her ashes be
left in Japan, where she was born. I happen to

(31:39):
travel there about a year after her passing, and ended
up taking a small bag of her ashes with me.
I spread them in this beautiful snow covered canyon in
a national park, but it wasn't easy. As I was
pulling her ashes out from my coat pocket, a large
male Japanese macaque monkey jumped out and charged me. I
tried walking away for man, but he kept jumping up

(32:01):
at my hands, grabbing for the crinkly bag that he
thought had food. I ended up having to turn my
back on the greedy monkey to quickly pass the ashes
off to my boyfriend, who then walked one way down
the path while I walked the other way with the
snow monkey following me. The mccaque was eventually distracted by
another group of tourists passing by with the crinkly items,
and I was able to spread my aunt's ashes in peace.

(32:21):
I'm pretty sure she was the one who sent the monkey,
as she always had a mischievous sense of humor. So
thank you so much for your story, Sarah, and I'm
not laughing at you. I'm laughing with you, and thanks
everybody who's written into us. Mom Stuff at house stutworks
dot com is our email address. You can also find
links to all of our social media, as well as
all of our blogs, videos, and podcasts, including this one

(32:44):
with links to our sources so you can follow along
with us at stuff Mom Never Told You dot com
For more on this and thousands of other topics, was
it how Stuff Works dot com.