Egg freezing: what is it and will your insurance cover it?

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Egg freezing: what is it and will your insurance cover it?

Updated April 8, 2019: I am 28 and childless. While most of my childhood friends have children and are fantastic mothers, most of my college and city friends do not — choosing careers, travel and partying over toddlers, playdates and finger paint. It’s not to say we never want children — more than ever I see myself eventually having a family — it’s that we don’t want children right now. We want to enjoy our partners, rockin’ bods, careers, sex lives and open schedules before we have children.

While I know those things are possible with children, I choose to enjoy them child-free. For as long as I can, I want to lean in at work and climb the corporate ladder, even though I’m underpaid. For as long as I can, I want to jet off to an island for the week and not worry about calling a babysitter. And for as long as I can, I want to have it all, whatever having it all even means anymore.

But am I running out of time? Are my career, travel and partying plans lessening my chances of having a family? If I want to have children one day, should I freeze my eggs? I’ve thought about this more recently as my 30th birthday looms. Although I don’t want a family now, the longer I wait, the harder it will be to conceive. Everything in my life seems to point toward motherhood: In the past few months, I’ve moved to the suburbs, I’ve become more obsessed with my dog, and I like Crate and Barrel A LOT. But if I continue to wait to start a family, will I lessen my chances of a natural conception?

While men produce new, viable sperm throughout their lives (and never seem to age or wrinkle in general), women are born with every single egg they will ever have the rest of their lives. A woman’s eggs age before birth and die at menopause. Although it’s important to never be pressured into having a family prematurely, it is vital to know that the longer you wait, the fewer eggs and chances you have to conceive. Because of that, some women who are not ready to have children now are freezing their eggs to have children later.

What is egg freezing?

Egg freezing is when women take hormones to produce multiple eggs then have those eggs removed from their ovaries and sent to a lab where they’re frozen and stored until women want to use them to have a baby. Sounds like sci-fi, right? It’s actually a quick, painless procedure that the American Society for Reproductive Medicine has deemed safe and effective. But while they have lifted the experimental label from egg freezing, they still have not endorsed "social freezing" (the industry term for freezing your eggs to delay motherhood) because they fear women will overestimate the benefits of it and have unrealistic expectations of what it will do for them. (Read our guide to the financial tasks to tackle when you're ready to start a family.)

Why do women freeze their eggs?

Women freeze their eggs for a myriad of reasons.

  • They currently don’t have a partner and worry about carrying a child when they do. As women age, so too do their risks of miscarriage, pregnancy hardships, and birth defects.

  • It takes the pressure off dating; if women want a family eventually, freezing their eggs allows them to be more in control of their dating lives and focus on Mr. Right instead of Mr. Right Now Baby Maker.

  • They’re choosing to further their educations and careers before furthering their families.

  • They have cancer or have history of cancer in their families. Not only can cancer make a woman infertile, it can also wreak havoc on her ovaries and cause premature menopause.

When should women freeze their eggs?

Women should freeze their eggs in their 20s and 30s. Since younger eggs freeze better and have a better a chance of surviving the process, the earlier women freeze them, the better chance the eggs have of becoming inseminated. The longer women wait, the less chance they have of a successful retrieval: women in their early 30s can expect a 50% chance that their eggs will be able to make a baby while women 36 to 38 have a 35% chance. If you’re 39 or older, your chances align with in vitro fertilization (IVF) success, teetering around 15% to 20% chance per attempt.

And what about quality? Since I’m pushing 30, are my eggs cracked and ugly?

"An embryologist can observe egg maturity in the lab, but the best assessment of egg quality must await fertilization," says Dr. Philip E. Chenette from the Pacific Fertlity Center of San Francisco. While the best predictor of egg quality is age, a doctor cannot assess the egg quality until after it has been fertilized.

How does the egg freezing process work?

Chenette explained the process to me:

The first thing you’ll have to do is generate multiple eggs for retrieval; this phase lasts about 10 days. Your doctor will prescribe fertility medications to stimulate follicle growth and produce multiple eggs, and, using a needle (a very fine needle, but a needle nonetheless), you’ll inject these medications just beneath your skin. To monitor the follicle growth and egg production, you’ll then be observed with ultrasounds and lab tests on a regular basis. Once the follicles are ready for retrieval, you’ll stop taking the fertility medication and switch to an ovulation trigger, a hormone that brings on the final phase of egg maturation. Egg retrieval, which is usually scheduled 36 hours after the ovulation trigger, is when the eggs are removed from your ovaries with a fine needle (there’s that needle again) four hours before the predicted time of ovulation. The retrieval usually takes 10 to 15 minutes while you’re under sedation. The retrieved eggs are then rapidly frozen and preserved until you need them.

After the retrieval, you’re home free. Due to the anesthesia, most clinics require someone to take you home, where you’ll rest for the remainder of the day.

If you want one child, you should only need to do one retrieval, but if you want a large family, then you should do more than one. The average retrieval yields 10 to 13 eggs and each group of six usually produces one reasonable attempt at pregnancy.

Where should a woman freeze her eggs?

Chenette says the best place to go is wherever there’s an expert team with strong experience and success in both egg freezing and pregnancies.

"A board-certified reproductive endocrinologist should be providing your care, and a PhD embryologist with 10 or more years of experience in the lab should be managing the eggs," Chenette said. "A clinic should have excellent education resources and a well organized patient intake and care system."

Is egg freezing safe?

Although the surgical procedures are mostly safe and create babies just as healthy as if they were created the old-fashioned way, there are risks. The hormone shots carry a risk of ovarian hyperstimulation syndrome, which can make some women ill or even prove fatal in extremely rare cases. Fortunately, OHSS occurs in less than 5% of women. Chenette says OHSS occurs more than 20 of follicles are stimulated, and that it’s more common in younger women who have polycystic ovary syndrome or irregular menstrual cycles. The hormones also cause mood swings and bloating.

How much does egg freezing cost?

Since most health insurance companies do not cover egg freezing, expenses must be paid of out of pocket and can cost tens of thousands of dollars. Cancer is the primary reason insurance companies pay up. In a CNN article, Dr. Jeffrey Steinberg said, "... if a woman is diagnosed with cancer or has to undergo surgery, radiation, chemotherapy or some sort of medical procedure that will render her infertile, we can usually get the insurance company to cover the process."
If you don’t have cancer (and hopefully you don’t and never will), here’s the cost breakdown:

  • An anti-Mullerian hormone (AMH) test (which is given in order to determine how many eggs you’re likely to make) costs about $250.

  • Egg collection can range anywhere from $7,000 to $15,000 per attempt.

  • Drugs (like the pre-measured injection of follicle-stimulating hormone FSH) will cost $2,500-$7,000 per attempt.

  • Storage costs will set you back $500 upfront and $250 annually.

  • Thawing and insemination costs $7,500.

And although many facilities have financing programs to help women who can’t afford it, the whole process can cost you around $50,000.

Are there cheaper alternatives?

Some clinics offer package deals to lighten the financial load. The more rounds of egg retrieval you do, the less money you’ll pay.

Another option for women delaying having children is embryo freezing. According to The Huffington Post, women who already have partners (specifically ones they like) should consider it since eggs are delicate, and not all of them will survive the thawing process. Mixing your partner’s sperm with your eggs and making an embryo will increase your odds of success (and cut some costs) if and when you decide to have children.

Do any companies cover egg freezing?

"Costs are covered on a state-by-state basis, and on an insurance-by-insurance basis," says Dr. Chenette. "Consumers need to check their benefits carefully. Since companies such as Google, Yahoo, Apple, Facebook, CitiGroup, JP Morgan Chase and Microsoft are offering an egg freezing benefit, referencing these companies might help women bring this up to their employers."

According to Mercer’s annual survey of employer health benefits, high-tech companies are more likely to cover fertility services compared to other firms — 45% of them cover IVF and 27% cover other reproductive procedures like egg freezing. In companies with 500 or more employees, roughly one-third provide no coverage for any fertility services.

"In our experience, women are relieved that they have the choice and opportunity for fertility preservation," says Chenette. "They are not expressing career pressure to do this, but rather empowerment and relief to have the opportunity to preserve their future reproductive potential. Any benefit companies offer that may appeal to working women and men can be positive depending on the individual and their circumstance."

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Image: Suhyeon Choi