Egg freezing popularity increasing among young women to preserve their fertility
Fertility rates in the United States are near historic lows. One reason is a sharp decline over the last three decades in the number of American women having babies in their 20s. And yet there's been no change in women's biology, or the age at which fertility declines. unsolvable problem? Enter egg freezing.
Freezing embryos for in vitro fertilization, IVF, has been possible for decades, but freezing unfertilized eggs was a tougher scientific challenge, used initially for patients with cancer and other conditions that threatened fertility. Egg freezing for non-medical reasons became an accepted practice 12 years ago, and since then, demand has skyrocketed, with hundreds of thousands of eggs now frozen, raising big money, big hopes, and big questions. Could egg freezing offer women what previous generations only dreamed of? The chance to put that dreaded ticking of the biological clock, on ice.
Early one rainy Tuesday, Kate Sonderegger came to a fertility clinic in Midtown Manhattan to undergo a minor surgical procedure to harvest and then freeze her eggs. The next morning –
Lesley Stahl: Hi.
Katherine Schneider: Hi.
– at a different fertility center, we scrubbed up and met another egg freezing patient, Katherine Schneider.
Lesley Stahl: How are you feeling? A little nervous–
Katherine Schneider: Excited.
Her doctor, Tomer Singer, head of Northwell Health's fertility practice, escorted her into the OR.
Dr. Tomer Singer: Let's get some eggs.
Katherine Schneider: Let's go. Let's get some eggs.
Egg retrieval is the culmination of an arduous process: nearly two weeks of daily self-administered hormone injections, sometimes several a day. The shots induce the ovaries to ripen multiple follicles, the sacs that contain eggs, so that a surgeon can go in with a tiny needle, and drain the fluid in those follicles, which is then run into an adjacent embryology lab to search for the eggs.
Lesley Stahl: So the patient is right around the corner?
Dr. Tomer Singer: Correct.
We watched as a pair of embryologists did the delicate work of maneuvering tiny pipettes under a microscope to find and isolate Katherine's egg cells in the fluid.
Dr. Tomer Singer: And here are all the eggs together, see? One, two–
Lesley Stahl: Oh–
Dr. Tomer Singer: --three, four, five–
Lesley Stahl: --wait, those–
Dr. Tomer Singer: --six, seven–
Lesley Stahl: --little black–
Dr. Tomer Singer: Yes.
Lesley Stahl: --balls are–
Dr. Tomer Singer: Yeah.
Lesley Stahl: That-- those are the eggs?
Dr. Tomer Singer: Those are the eggs.
Lesley Stahl: Oh my goodness.
After a few hours, the eggs are put onto tiny special straws, then plunged into liquid nitrogen and stored in tanks at negative 320 degrees, where they will stay, possibly for years, until their owner is ready to thaw them, add sperm, and turn them into embryos, which is effectively the second half of IVF. According to the data thus far, as with IVF, there are no differences in the health of babies born from frozen eggs.
Dr. Tomer Singer: I think that egg freezing is as revolutionary as the pill was in 1960s and 70s
Lesley Stahl: It's as revolutionary as the pill?
Dr. Tomer Singer: Yeah.
Lesley Stahl: That changed everything, as you know.
Dr. Tomer Singer: I know. Women had the option of choosing who to be with, and not to accidentally get pregnant with the wrong guy. Egg freezing took it an extra level. So you don't have to have a baby at 30, because you're 30 or 35. You can delay fertility into your 40s. You'll have women having kids in their late 40s with their own eggs that were freezing in their 20s and 30s.
Lesley Stahl: There's that famous painting of the young woman with tears going down her face, "Oops. I forgot to have a baby." That won't be true anymore.
Dr. Tomer Singer: Correct. I think that-- we're pushing the envelope.
Lynsy Smithson-Stanley: I'm currently 40, I froze my eggs when I was 35.
Nameetha Jacob: The first time I did it, I was 34 years old, and the second time I was 36.
Carissa Simek: I did two cycles last year when I was 34.
We spoke to a group of women about their decision to freeze their eggs.
Lesley Stahl: Why is it a good idea?
Yasmine Higbee: I 100% know that I really would love to have children
Yasmine Higbee is 29, works in consulting, and has a serious boyfriend.
Yasmine Higbee: I'll be able to enjoy these times with my partner a bit more, instead of rushing to have kids. Because there definitely is that ticktock clock that started And I'm not ready quite yet.
Nameetha Jacob: It's an insurance. I know that, you know, I'm going to be an older mother.
Nameetha Jacob, 38, a health care administrator and strategist, isn't ready yet because she hasn't found the right partner.
Nameetha Jacob: It takes the stress away from dating. You're not pressured to find someone and settle down and get married. You don't hear the ticking.
Lesley Stahl: That damn biological clock: It ticks in every woman's head.
Like it or not, says Dr. Lucky Sekhon, of fertility clinic RMA of New York, that damn clock is very real.
Dr. Lucky Sekhon: We're born with all of the eggs that we're ever going to have, and we don't make new eggs, and we can't fix or repair them. It's always decreasing over time.
Lesley Stahl: So you're born with a number.
Dr. Lucky Sekhon: Yes.
Lesley Stahl: And it starts decreasing right away?
Dr. Lucky Sekhon: It pretty much starts decreasing even before you're born. You're a fetus in your mother's womb at 20 weeks, and that's when you have the peak number of eggs, six to seven million–
Lesley Stahl: You have eggs at 20 weeks?
Dr. Lucky Sekhon: Yes.
And from then on, the number keeps going down, and the eggs keep aging.
Lesley Stahl: So when you freeze an egg, you are stopping it from aging any further.
Dr. Lucky Sekhon: Correct.
Lesley Stahl: So if you remove the egg and freeze it when you're 28–
Dr. Lucky Sekhon: Right.
Lesley Stahl: --that egg is 28 years old.
Dr. Lucky Sekhon: Yup.
Lesley Stahl: Until you thaw it.
Dr. Lucky Sekhon: Yes. It's incredible.
Because it's not just the quantity of women's eggs that decreases with age, it's also their quality, meaning their likelihood of becoming a baby. Even at peak fertility, in women's 20s, some 25% of eggs, when combined with sperm, will create embryos that are chromosomally abnormal and will likely lead to miscarriages, and the percentages rise from there.
Dr. Lucky Sekhon: As you get to 35, that number has steadily increased to about 30% to 35% of embryos being abnormal from your 35-year-old eggs. At 37, 38 years of age, 50%. That's a turning point. Things start to move more rapidly. And at 40, you're looking at 60% to 70% of embryos being abnormal. By 45, 90%.
Lesley Stahl: 90%--
Dr. Lucky Sekhon: Correct. A lot of times people think that if they've done all the right things, if they've led a healthy lifestyle, they do yoga, they've never smoked a cigarette in their life. They feel younger than their age, and they feel like their eggs will be younger than their age. And I have to explain to them that we have no data to suggest that you can influence your egg quality in that way, unfortunately.
Lesley Stahl: Is there an optimal age to freeze your eggs?
Dr. Lucky Sekhon: Yes, your 20s, because that's when you're at your lowest possible rate of genetic errors in the embryos that result from those eggs. And you also have a lot more eggs at that age.
Kate decided to freeze her eggs at the unusually young age of 22, because she's going to medical school and knows she has a long journey ahead of her.
Kate Sonderegger: You know, education for four years, training for anywhere from four to seven years after that. And so I'm not even gonna think about building a family personally until after I'm done with all of that.
Lesley Stahl: Younger and younger women are beginning to freeze their eggs.
Dr. Tomer Singer: When I started doing egg freezing in 2012, most of the women were 40, 41, 42. When I see patients today, most of them are late 20s, early 30s.
He says there used to be a stigma, as though freezing eggs meant something hadn't worked out in a patient's life. But not anymore.
Dr. Tomer Singer: It became a common thing. It's almost empowering. You come in. "I'm in my 30s. I'm not ready for a baby. I wanna freeze my eggs. I'm not gonna compromise on the wrong guy."
Freezing eggs is expensive. A single cycle, including medication, costs an average of $12,000 to $15,000, plus another $500 to $1,000 each year for storage. To thaw and fertilize the eggs later on costs an additional $10,000. Back in 2014, Apple and Facebook made headlines when they started offering egg freezing as a covered benefit for their employees. Today, more than a third of the largest corporations in the U.S., those with 20,000 or more employees, cover egg freezing, our parent company, Paramount, among them.
Carissa Simek: When I was job-searching, it was something I was really looking for.
Carissa Simek changed jobs three years ago.
Carissa Simek: More and more companies started to offer it, or I was seeing it–
Lesley Stahl: So that was a consideration–
Carissa Simek: Absolutely.
Lesley Stahl: --as to where you worked?
Carissa Simek: Yes, absolutely.
Her egg freezing cycles were covered, as were Nameetha's. But there's also been criticism of those companies' motives.
Lesley Stahl: There are some people who feel that the companies do that to keep you at work so that you won't have a child and leave. Not to make you happy, but to keep you at your desk.
Nameetha Jacob: I personally don't see it that way. When I learned about the fact that they're offering this really wonderful benefit, it made me more dedicated and committed to my company, actually. It's a good way to retain top talent.
Tina Rampino: My insurance did not cover egg freezing at the time.
Tina Rampino, now 46, learned about egg freezing in its early days, when she went for a routine doctor's visit at age 35 and got a message she wasn't expecting.
Tina Rampino: My gynecologist said to me, "Have kids now, you're running out of time." "You can get married whenever you want to get married, but you can't have kids forever."
Lesley Stahl: Whoa.
Tina Rampino: And I went home and I-- I think I cried, and I was like, "What should I do?"
The doctor had mentioned egg freezing.
Tina Rampino: And I said, "You know, this is kind of scary," but I decided to do it.
Paying out of pocket, she froze 10 eggs, which she considered her back-up plan.
Lynsy Smithson-Stanley: I did not have a partner.
Lynsy Smithson-Stanley also paid out of pocket when she froze her eggs at 35.
A few years later, she got engaged to Paul. They want children, but not until they're married and Lynsy finishes her Ph.D. So Dr. Singer recommended thawing her 18 frozen eggs, fertilizing them with Paul's sperm, and then doing genetic testing to assess viability, which is possible once fertilized eggs grow into 5-7-day-old embryos. The results: Lynsy and Paul have four chromosomally normal embryos on ice waiting for them.
Lesley Stahl: Do they tell you the gender?
Lynsy Smithson-Stanley: We have two boys and two girls.
Lesley Stahl: You can't stop grinning.
Lynsy Smithson-Stanley: It's exciting.
Tina's story took a different turn. After the pandemic, still single, she decided to become a single mother by choice, and selected a sperm donor.
Tina Rampino: I had just turned 40, and I knew that motherhood was something that I always wanted. [gets teary] Sorry I'm like…
But the first embryo created from her frozen eggs failed to implant. But then, a second embryo from her frozen eggs did.
She gave birth to a son, Christopher.
Tina Rampino: He's such a happy, healthy boy. He's so playful, he loves people. On the day that I started my egg-freezing cycle, I screenshotted a quote that said, "Do something today that your future self will thank you for."
Lesley Stahl: Ooh.
Tina Rampino: And that is something that I think about all the time because that really was the decision that changed my life.
But not every egg freezing story has such a happy ending.
Evelyn Gosnell: It was just devastating. It's really the worst thing that's ever happened to me, by far.
Vardit Ravitsky: They think they have an insurance policy that they don't have.
More and more American women are freezing their eggs to preserve their fertility. The number of procedures has increased more than six times over, from 6,000 in 2014, to more than 39,000 in 2023, with numbers continuing to go up from there. Investors have taken notice, seeing a market that could one day include a significant percentage of all young American women.
Venture capital and private equity firms have backed egg freezing start-ups, and have bought up and invested in existing private and academic fertility clinics to consolidate them into giant networks. But not everyone is convinced that egg freezing is such a gift to young women.
Vardit Ravitsky: You're taking the financial cost, you're taking the medical cost for what? For a gamble.
Vardit Ravitsky is president of the Hastings Center, a bioethics research institute, and is a senior lecturer at Harvard Medical School.
Lesley Stahl: The women we've spoken to, they're almost giddy with this choice. They say that they're freezing the biological clock, that ticking thing is, you know, unbearable, and it's gone.
Vardit Ravitsky: I totally understand why young women are excited about it. My fear, when I hear young women say, "I froze the biological clock," is that they think this is guaranteed. They think, "I put a baby on ice, not my eggs, and I'm just going to go and thaw it when I'm ready to become a mother." It's not that. That's the problem.
She points to stories like Evelyn Gosnell's. Evelyn froze her eggs three times, at ages 32, 36, and 38, for a total of 30 eggs, considered a very safe number.
Lesley Stahl: Did you have some level of comfort?
Evelyn Gosnell: Absolutely. Even my, doctor was like, "That's insane." Like, "You're, this is gonna be a breeze. Totally. No problem."
But when Evelyn and her now-fiance Edward went to use her 30 frozen eggs, only 19 survived the thaw, an unusually poor result. Even worse, once those 19 eggs were fertilized, only one grew to be an embryo. Anxiously hoping for positive results, they sent a few cells off for genetic testing to see if the embryo was viable.
Evelyn Gosnell: So I was at work. And got this message saying, "We have your test results. Before we give them to you, just confirming if you want to know the sex."
Lesley Stahl: Boy/girl?
Evelyn Gosnell: I just started to think, "Oh, wow. They've asked me this, if I wanna know the sex. It means that there's a real embryo there. It means that this is real. It's normal. It's gonna be fine--"
Lesley Stahl: It worked–
Evelyn Gosnell: "It's all gonna be good." And then, boom, I get the report. And I open it. And it's abnormal. And it was a girl.
There was no chance the embryo could become a baby. Stories like Evelyn's are heartbreaking. And though rare, there have also been incidents where a storage tank has malfunctioned and thousands of eggs and embryos have been destroyed.
Dr. Lucky Sekhon says she explains to all her patients that frozen eggs can never be a guarantee, because just as in naturally occurring pregnancies, there is drop off at every step along the way. She calls it an inverted pyramid.
Dr. Lucky Sekhon: You start out with this many eggs and then this many fertilize. This many turn into embryos. This many embryos are actually genetically healthy. And this many embryos actually implant.
Vardit Ravitsky: You're taking a bet. It's a gamble that you'll actually need these eggs. It's a gamble that it would work. And even if you manage to get pregnant, the older you are, the riskier it is to be pregnant. So you're taking multiple risks. You're gambling on multiple stages.
Lesley Stahl: But are you saying don't do it?
Vardit Ravitsky: You know, Lesley, I'm not saying don't do it. I'm saying it's probably a good option for some people. But I would like young women to really have options.
She believes that society pushes high-achieving women to get so much accomplished before they have children that they run out of time. And it would be better if they could become mothers younger.
Vardit Ravitsky: The optimal time from a biological/medical perspective is in your 20s or early 30s. But the socially optimal time is later than that. So I think we're telling women, "Oh, in your 20s focus on your education, your career, finding a partner, having financial stability, relationship stability, so that when you do have a baby you can be a responsible mother."
Lesley Stahl: I mean, you're making it sound as if that's wrong. I-- it sounds pretty right to me. What's wrong with that?
Vardit Ravitsky: I think elective egg freezing sends women a message of OK, don't worry, we have a solution for you. Delay motherhood. It will cost you thousands of dollars, it does involve medical risks. There's a good chance it won't work at the end, and if it does work your pregnancy will be riskier for you and for your baby, but that's OK. We have a solution.
A better solution, she argues, would be to have policies like paid parental leave, flexible hours, child care at the workplace, to make it easier for women to have babies younger.
Lesley Stahl: Who's dating? [women raise hands, chuckle]
But these women told us they weren't ready to have children younger.
Carissa Simek: Still active in trying to find the right person.
And say they understand there's never certainty.
Lesley Stahl: How did they explain that it's not a guarantee?
Lynsy Smithson-Stanley: They said exactly those words: "It is not a guarantee."
So what are the chances of success if you freeze your eggs? A 2022 study from one large fertility center found that 70% of women who froze at least 20 eggs before the age of 38 had a baby, but success rates dropped off considerably the older women were and the fewer eggs they froze.
Which means that many women, like Carissa and Nameetha, do more than one round of egg freezing to bank more eggs. And that brings us back to the money. Business is booming in the field of fertility, and egg freezing is a big part of it. Companies target women with catchy ads on social media, host fun events like fitness classes, even a manicure, to give women information, and draw them in.
Dr. Marcelle Cedars: What I've seen is a transition in my own field.
Dr. Marcelle Cedars, a fertility specialist with the University of California San Francisco, and a past president of the American Society for Reproductive Medicine, says getting women information is great, but she worries that the emphasis on profits she is seeing in private equity-backed fertility companies is creating warped incentives.
Lesley Stahl: Have you heard, in any companies that are owned by large firms, that the doctors are being pressured to encourage more cycles. Encourage things that will lead to more revenue?
Dr. Marcelle Cedars: I would hope it's not universal, but that is definitely occurring in some companies. How quickly do you get someone? How many cycles do you get per patient? That's how revenue is based. That's how payment and compensation is based. And so that's what the motivation becomes.
Lesley Stahl: It becomes much more a business.
Dr. Marcelle Cedars: It does. I mean, I have always bristled when I hear my specialty called an industry. And I think in the past it wasn't. But I do think it is becoming that. And it is painful to me.
Dr. Marcelle Cedars in lab: Pink, number 14.
She also worries about the unfairness when lower income women, and those who don't work for large companies, can't afford egg freezing. Vardit Ravitsky agrees.
Vardit Ravitsky: The majority of women who freeze their eggs electively are White and well-resourced. And there's a significant gap in your options and your reproductive autonomy if you have resources or you don't.
Lesley Stahl: Everyone cannot do this.
Dr. Lucky Sekhon: Right.
Lesley Stahl: Poor women..
Dr. Lucky Sekhon: I think we have a lot of work to do as a field. We don't yet know how to properly drive down the cost. It's a very expensive endeavor.
Lesley Stahl: If this is being done just for someone's peace of mind–
Dr. Lucky Sekhon: Right.
Lesley Stahl: --Should they go through this?
Dr. Lucky Sekhon: I think it depends on their age and attitude towards family building. If someone says to me, "I'm 35. I know I want children." Then yes, I think they should absolutely do this. Especially if they say, "I want to have more than one child." Because, you know, they might be ready at 37, 38 and have no trouble at all. But when are they gonna be ready for n-- baby number two?
Speaking of baby number two, Tina gave birth to a second little boy, Christopher's baby brother Theo, in July —from the final embryo from her frozen eggs. Egg freezing technology, Northwell's Dr. Singer thinks, will get better and better.
Lesley Stahl: Do you think that one day, virtually every young woman will do this as-- it would be routine?
Dr. Tomer Singer: I really do think so. Once it's gonna be affordable, covered by insurance I'm a big believer that egg freezing, and IVF, is gonna be the way our next generation will expand. I think that having timed intercourse, or unprotected intercourse for reproduction is gonna be falling out of favor in the next generation or so.
Lesley Stahl: What? Wait. Wait. What?
Dr. Tomer Singer: Yeah. I think–
Lesley Stahl: What did you just say?
Dr. Tomer Singer: I said that sex is gonna be for fun, and for pleasure, but most likely in a generation from now, when couples wanna have kids, most likely they're gonna be using artificial reproductive technique. You'll have frozen eggs–
Lesley Stahl: Wait. Are you saying that we won't have sex to have children?
Dr. Tomer Singer: I'm sure my 2-year-old will ask me, "Mom, Dad, you had unprotected intercourse. What about chromosomal abnormalities, miscarriages, twins? What were you doing? Russian Roulette?"
Lesley Stahl: Dr. Singer thinks in the future all women will freeze their eggs so that the only reason to have sex is for fun.
Lynsy Smithson-Stanley: He would say that.
While they didn't seem entirely convinced of that, they are definitely with him on egg freezing, and the need for more education.
Lesley Stahl: Should gynecologists talk about this when you go in and you're young?
Tina Rampino: Yes
Carissa Simek: Absolutely
Lynsy Smithson-Stanley: Yes.
Lesley Stahl: I wonder why they don't.
Carissa Simek: I think our health classes were always, "This is how you don't get pregnant." And I think opening the conversation to, "This is how your body works. This is, you know, at what age you might want to consider this if you want a family." Knowledge is just power in this circumstance.
Lesley Stahl: If a woman goes to her gynecologist, do you think that doctor should introduce the subject?
Dr. Lucky Sekhon: I think it's a good idea. I do. It's a very sensitive topic, so you have to kind of navigate it carefully. You don't wanna be judgmental. Not everyone has to freeze their eggs. Not everyone has to have children. But everyone should take the moment to consider their options and really think about what they want.
Produced by Shari Finkelstein. Associate producer, Collette Richards. Broadcast associate, Aria Een. Edited by Sean Kelly.
