Choosing to freeze your eggs is choosing to be a fertility patient, with all that entails. It’s a physically and emotionally brutal process.
As a woman who (a) believes in reproductive choice and (b) needed assisted reproductive technologies to conceive, I should like egg freezing as an idea that attempts to preserve both choice and fertility. But it’s precisely those reasons that make me squeamish by the recent discussion surrounding Apple and Facebook.
For the uninitiated, let’s talk for a moment about how the technology works. To put it simply, the process of retrieving and freezing eggs involves the exact same procedures as IVF; in this case, eggs are saved for later use instead of being immediately fertilized and transferred to the uterus as embryos.
Unlike TV renditions on shows like Private Practice, it’s a method that takes weeks, if not months, of careful preparation. First, a woman’s body is hormonally “suppressed” or shut down in order to achieve a maximum number of eggs later on. Then she starts up on hormones, generally injected medications given once or twice daily, in order to produce more follicles (which hopefully contain eggs) than she would on a “normal” menstrual cycle (ideally 10 or more). Follicular development is gauged by blood tests and sonograms every other day or even daily. And then, after approximately two weeks, the eggs are retrieved one at a time by a long needle that pierces the vagina and travels up to the ovaries (under general anesthesia).
Let me say it bluntly: Choosing to freeze your eggs is choosing to be a fertility patient, with all that entails. It’s a physically and emotionally brutal process.
And although companies like Facebook and Apple have said they’d cover the financial costs up to $20,000, that doesn’t get you very far in the world of IVF. Medication cost alone can easily run into the thousands. Blood tests and sonograms total about $400-500 each appointment. Then there’s the cycle management fee to the doctor’s office and the cost of egg retrieval, including the payment to an anesthesiologist, annual storage fees, and, eventually, embryo transfer. All told, on average, an IVF cycle runs $10,000-$15,000 or more nationally. An annual fee for egg storage is going to run $300-500 or so, a cost that could quickly get up into the thousands over the period of years. And most women who attempt to freeze their eggs need to do more than one cycle, in order to maximize their chances. (One of the most vocal proponents of egg freezing, Sarah Elizabeth Richards, opens her infamous WSJ piece saying she has 70 eggs in storage; her first retrieval resulted in only nine. You can do the math.)
These are just the financial costs. Through all this process, this young woman is probably missing a substantial amount of work in order to accommodate all these doctor’s visits. And the risks of undergoing ovarian stimulation and egg retrieval should not be dismissed. They run the gamut of the more banal headaches and bloating to the very real concern of ovarian hyperstimulation, which can result in serious illness, hospitalization, and even death.
If that’s not enough to dissuade a young woman against freezing her eggs, she should go sit in a fertility clinic waiting room and talk to teary patients and do hardcore research about success rates. Even using donor eggs—from fertile women generally under 30—the national average for singleton live birth from “fresh” (not frozen) cycles is only 35%. That’s not a whole lot of backup plan.
This is the point when I have to say, despite my apparent negativity, as a long-term fertility patient and survivor of pregnancy loss, I do not begrudge any woman the right to have a biological child, if that’s what she wants. Egg freezing is an incredible technology that allows cancer patients to preserve their fertility while undergoing treatment, and, more recently, has allowed fertility patients with certain diagnoses, including genetic abnormalities and premature ovarian failure, to become mothers from donated eggs, in a way that is much cheaper and easier than “fresh” donor egg cycles. Recent improvements in freezing methods are only now making egg banks possible, while we’ve had sperm banks for a very long time.
But as other critics have said, egg freezing—even when supported by the workplace—is not a systemic answer to a larger systemic problem, which is a culture that makes it difficult for women to succeed in their careers and have a family; that is, a lack of structural support that make it difficult for women to “have it all,” as Anne-Marie Slaughter talks about.
Egg freezing is a new spin on an old, problematic answer feminists call “sequencing,” which in essence means job, then partner, then baby, then back to work—in this case, it just prolongs the first part of the sequence so the “career clock” and the “biological clock” don’t conflict. It does nothing to help the large numbers of women who don’t have such financial privilege, or such biological privilege, who actually need to negotiate the complex world of work, partnership, and family. If anything, it makes the problem disappear behind a screen of privilege and so-called “choice.”
As proponents tell it, it seems like a feminist utopia when, in actuality, it’s a choice that upholds patriarchal-capitalist gender norms, narratives, and assumptions, the most significant of which is a woman should want to have a baby, with her own eggs, with a heterosexual partner…after she’s well-established in a lucrative career.
Instead of making an argument for individual women to put their reproductive lives on ice, can we talk instead about programs like subsidized childcare, workable parental leave policies, support for breastfeeding mothers, and mandatory insurance coverage for all forms of fertility treatment (and not only for married women)—in short, the social policies that would help women in a range of situations make real choices about how and when to have children?
Assisted reproductive technologies are, when they work, amazing; they gave me two children I wouldn’t have otherwise. But I really can’t imagine anyone who doesn’t have an infertility diagnosis willingly choosing to be a fertility patient.
Robin Silbergleid is the author of the memoir Texas Girl, about becoming a single mother by choice in her twenties, and two chapbooks of poetry, Pas de Deux: Prose and Other Poems and Frida Kahlo, My Sister. Her collection of poems The Baby Book is forthcoming in 2015 from CavanKerry Press. She lives in East Lansing, Michigan, where she directs the Creative Writing Program at Michigan State University, and raises her two children. You can find her on Twitter @RSilbergleid and robinsilbergleid.com.