*4 I was reminded of one of the reasons why ASRM was so reluctant to remove egg freezing’s experimental label a decade ago—that it’s quite challenging to freeze an egg.
*5 Kindbody told Bloomberg that it reports, investigates, and takes corrective action if incidents occur, including in each example the article detailed.
*6 A dilation and curettage, a procedure to remove tissue from inside the uterus, is one method of ending a pregnancy.
13 Great Eggspectations
Remy: A Sleepless Night and Seventeen Eggs
At five-thirty the morning of her egg retrieval, Remy pulled into her driveway. It was Monday, close to thirty-six hours after she’d taken the trigger shot. She was coming off an overnight shift at the hospital and had been awake for almost an entire day. She needed to be at the fertility center in an hour. She threw the Tupperware from her night shift dinner in the dishwasher, fed Sophie the cat, and gazed longingly at her Peloton, which she hadn’t been able to use for several days. She couldn’t recall the last time she’d neglected her exercise bike for this long.
In the bathroom, Remy shed her scrubs and showered, rinsing off her shift. She remembered to remove her belly button ring but forgot to wash her hair. She dressed in clothes easy to pull off and on: leggings, a loose denim button-down shirt, the brown boots she wore when she wasn’t at the hospital. She pushed her long blond hair out of her face, yawning. On a table off the kitchen sat boxes of leftover meds surrounded by crystals. Glancing at the table while she changed Sophie’s litter box, she felt relieved there’d be no more shots.
She pulled out her phone to call an Uber. The clinic’s instructions were clear: She wasn’t allowed to drive herself home from the egg retrieval, and a responsible driver had to pick her up. The clinic wanted to know ahead of time who this person would be. This had been the only hiccup so far; with no family nearby and most of her friends working at the hospital, she didn’t have someone to ask to accompany her to the retrieval and wait until it was over to drive her home. It was the only part of the egg freezing process impossible to do alone. Remy could’ve done all the injections herself if she’d had to, though she was glad she’d had Leah’s help for the trigger shot. She’d gone to all the appointments solo. She was doing this on her own, freezing her eggs for her future self. But the responsible driver requirement, at the very end of the whole ordeal, dampened her spirits a bit.
Her phone buzzed. She gasped. The driver was eighteen minutes away. “This is not going to work,” she groaned, then checked her phone again. “Come on, dude.” Prickles of anxiety fluttered in her stomach. This was why she didn’t like relying on people. She checked her watch. Then she canceled the Uber, grabbed her purse and car keys, and flew out the door.
It was a cool morning and the streets were quiet. In the car, she plugged her phone in and balanced the sheet of paper with driving and parking instructions on her lap. The sky was dark blue, the sun just beginning to come up. She raced through yellow lights. Braking hard for a red, she winced: Her breasts felt huge, and slamming on the brakes hurt. For days, she’d felt like she’d been swimming in estrogen. She’d experienced some mittelschmerz on her left side while on call the day before; she grimaced a bit at the thought of a long needle going into her vagina today. A wave of tiredness came over her. Fatigue felt different to her now; she realized she’d been masking it with coffee for years. Learning she could survive a twenty-four-hour shift at the hospital without coffee was a nice side benefit of all this. Remy held the steering wheel with one hand, her phone and the crumpled paper directions in the other. She’d followed the instructions the clinic had provided her carefully: nothing to eat or drink after midnight the night before; arrive at the clinic an hour before her scheduled procedure time; park in the indicated garage.
Inside the building, Remy was momentarily confused by the signs on the doors. She sighed, recalling how it’d never been easy to remember all the different names of the offices, labs, and companies involved in her egg freezing process.[*1] She found the door for Ovation Fertility Nashville, greeted the receptionist, and followed a nurse into a small room with bland tan walls and closed blinds. She slipped off her tall brown boots and changed into a teal hospital gown. She tied it expertly, thinking about how strange it felt to be the patient today. Her legs and bare feet dangled from the end of the exam table. She shivered, then pulled on the thick blue socks she’d been told she might want to wear during the procedure. She sat and waited. Now that she was there, the stress of the morning behind her, she wanted to get it over with.
A nurse came in to take her vitals. “Tell me you haven’t been googling ‘egg retrievals’ and reading what all the crazy people on the internet say about it.”
“I haven’t,” said Remy.
“Good girl!” the nurse replied. “People come in scared to death about the crap they read online.” She went over the post-op basics and explained that Remy would still be at risk for ovarian torsion for several days, until all the swelling went away. When the nurse got to explaining how Remy might feel later in the day after the anesthesia wore off, Remy nodded, as if she weren’t already an expert on anesthesia and its possible side effects.
The nurse left. Remy reached for her phone to check her texts and send a quick message to her parents. A few minutes later, Dr. Lewis knocked and opened the door. Gray scrubs, same glasses and blond straightened hair. Remy put down her phone and sat up straighter on the table. “Hi!” she said brightly, relief in her voice. She trusted Dr. Lewis and always felt better in her presence.
“Alrighty,” said Dr. Lewis. “Here we go—you ready?”
“Ready,” Remy replied. “But it’s so weird being on the other side of all this.”
The reason I can tell you all this word for word is not because Remy remembers it all so clearly—which she doesn’t; she was nervous, and the anesthesia meant she didn’t remember much once it was all over—but because I was with her during every part except for the retrieval itself, during which I sat in the waiting room. When Remy’s retrieval was over—it lasted thirty minutes—a nurse led me back to Remy’s room. I opened the door and Remy looked over at me from her gurney, where she was waking up. I crossed the room to talk to her. “Thank you, Natalie,” she said groggily, reaching for my hand and squeezing it. She was crying, tears streaming down her temples. “It really means a lot that you’re here.”
“Thank you for letting me be here,” I said, looking down at our hands. It was a powerful moment, the slow-motion kind that you realize as it’s happening you likely won’t ever forget. I looked at Remy and didn’t know which part of me was doing the looking: the journalist, the potential egg freezer, the woman. “I’m so happy,” Remy murmured groggily. “Relief. I feel such relief.” Her voice was raspy and low, thick with emotion. “I really want to know how many eggs I got. How many do you think? A lot. I hope it’s a lot.” She closed her eyes and sank back into the pillow, pulling the blanket up to her chin.
Several minutes later, the embryologist came in and introduced herself. When she told Remy seventeen eggs had been extracted, Remy gasped. “Awesome.” Remy was instructed to call a phone number, a voice mailbox, later in the day to find out how many of her retrieved eggs were in suitable condition to be frozen. When the embryologist left, a nurse popped her head into the room. “Ready to try to pee?” Afterward, she gave Remy more sheets of paper. Discharge instructions, prescriptions, more phone numbers. Then she was cleared to go home.
Remy had asked Rachel, a fellow anesthesia resident, to drive her home after the retrieval. She knew Rachel had been on call all night and might not be able to. But then Rachel, who was nursing her second kid, texted: On my way! Sorry if you get flashed. I’m pumping and have no shame…The valet guys might be concerned. Remy hated having to bother a colleague, especially one coming off a long overnight shift. She was tempted to break the rules and drive herself home; her car was already in the clinic’s parking garage, after all. But Rachel insisted. Two young doctors, very little sleep between them; one lactating, one post–egg harvest. In the car, Remy talked excitedly, telling Rachel about the morning and getting lots of eggs. They stopped at a gas station so Remy could get Gatorade, though what she really wanted was a smoked rosemary latte. Also, a long nap. She took a deep breath and let her shoulders sink back against the passenger seat. Except for the logistics stress and last-minute change of transportation plans the morning of her retrieval, her egg freezing process couldn’t have gone more smoothly.
Relief: palpable, overwhelming relief. Remy had felt only nervous anticipation in the days leading up to the retrieval, but as soon as she woke up from the procedure, it rolled over her in a euphoric wave. Of the many emotions she felt today, in the days and months to come it would be this feeling of relief she’d remember most.
Later that day, she called the voice mailbox to learn the fate of her eggs. All seventeen of them ended up being mature and frozen.
Peace of Mind and the Illusion of Control
Remy had been single for the past seven months and had learned to love her alone time, to relish arriving home to her bohemian sanctuary, where it was just her and Sophie. No drama, no tiptoeing, no fights. She’d made many concessions with the partners she had dated long-term, and now she was no longer willing to give up who she was for the sake of connection. Which, she figured, meant it was going to be harder to meet the right person—and finding the right person was already hard enough. Still, she was excited to start dating again, and even more excited that egg freezing had freed her from the pressure she usually felt to be hyperfocused on finding a partner.
The statistics and current data, as we’ve seen, lead to the conclusion that you can’t count on having kids with your frozen eggs. Nevertheless, many women see egg freezing as insurance for the future. Mandy, Remy, and Lauren certainly did. But frozen eggs are not an insurance policy. So if egg freezers aren’t getting that guarantee, what exactly are they getting?
As an egg freezing patient, Remy was more in the know than most. But even she was confused about what happened when her eggs left her body and embarked on their tenuous journey. She hadn’t been counseled on attrition rates or the inverted pyramid detailing the multistep process involved in turning thawed eggs into viable embryos and then a healthy baby. Yet she wasn’t concerned. Remy may not have been clear on the scientific intricacies behind egg freezing, but she was quite clear about what egg freezing would give her. “I just don’t want to settle,” she’d said to me more than once, referring to dating. “And now I don’t feel like I have to.” That’s what egg freezing was really about, I realized. Not the guarantee of frozen eggs producing healthy children in the future. Not actual insurance, but assurance.
I considered Remy’s certainty. I hadn’t heard her express doubt, not even once, about her seventeen eggs on ice becoming babies.[*2] Just as strong was the sense of relief—which she’d felt immediately after her egg retrieval—at being able to step away from her romantic future as a project she had to actively work on. I wanted to know if Remy’s experience, particularly her strong emotions post-freeze, were in line with those of other women freezing eggs for non-medical reasons. I asked Jake and Deborah if FertilityIQ had this sort of data. They didn’t, but they agreed to conduct a survey to help me learn more.
Nearly half of the survey’s seventy respondents said the decision to freeze eggs caused them to change their timeline and delay childbearing. In other words, they were giving themselves more and better options moving forward. When asked if they’d still be glad they froze eggs even if those eggs never led to a baby, nearly three-quarters of respondents said yes. Later, I found more data on the psychological benefits—which felt like a small win after my slog with the paltry data on success rates. In one survey of 224 egg freezing patients, 60 percent reported feeling less time pressure while dating after they’d frozen their eggs, with many patients saying they felt “more relaxed, focused, less desperate and with more time to find the right partner.” A whopping 96 percent said they would recommend egg freezing to others. A study published in 2020 that surveyed women who underwent egg freezing between 2008 and 2018 found that 91 percent of egg freezers reported no regret, even if they got pregnant without having to use their frozen eggs.[*3]
A study in the American Sociological Review provided context for all these stats. The authors, sociologists Eliza Brown and Mary Patrick, found that egg freezing helps women manage anxieties surrounding the demands of biology and time in part because it helps them disentangle the notion of finding the right partner from the notion of having children. By temporarily separating romance from the biological clock, egg freezers in the study “hoped to bracket long-term childbearing goals, change the experience of their partnership trajectory, and signal to prospective partners that they were not ‘in a rush’ to find a long-term partner and have children,” the sociologists wrote. Single women, this and similar ethnographic studies show, see egg freezing as an aspirational technology, allowing them to imagine future motherhood while also giving them the time to find and fall in love with the person with whom they’ll have their future children. Valerie, the Chicago woman who started an egg freezing blog after her positive experience, put it to me like this: “It’s like I’m thirty again,” she said of the decision. “It’s like I was given an additional seven years to date to try to find the right person.”
So perhaps we should be asking a different question that focuses on the freezing instead of the thawing: Were women happy they froze? In a word, yes. Frozen eggs make many women feel more empowered in terms of their fertility, whether they ever use them or not. And that’s significant. Egg freezing can change how a woman dates—for quality instead of speed—and, perhaps most powerfully of all, can protect against regret down the line. Simply having a backup option—even a shaky one—shifts how a woman considers the demands of biology and time, and can transform her personal life in profound ways by offering a sense of independence here and now, as well as a feeling of assurance about the future.
The primary benefit of egg freezing, it turns out, isn’t a baby—it’s peace of mind. It’s a considerable chunk of change to spend on a backup you hope not to use, and that might not work if you do, but taking the edge off the biological clock is hard to put a price on. And so, for many women, egg freezing provides a sense of hope that is well worth the physically taxing process, the exorbitant costs, and the uncertain chances of success.
A few months after her egg retrieval, Remy texted me: Those precious frozen egg babies of mine helped snap some sense into me & end this past relationship (which I had hoped hoped hoped would be “the one”) without the pressure of having to settle, her message read. He would have made GORGEOUS babies. But he would have driven me insane. In the back of my mind those eggs are the best insurance policy against settling. The text ended with a string of emojis: .
In Colorado, I’d moved into a small apartment in Boulder, nestled at the base of the Rocky Mountains. I tried to settle down some, find my footing amid the light and space and snowcapped peaks. One afternoon, I sat on the floor of my living room with a thick green folder that belonged to Remy. To undergo fertility treatment of any kind requires a certain grit—and a considerable amount of patience for paperwork and phone calls. Remy and I had talked about this, and when I was in Nashville she had referred several times to a folder she’d been keeping that contained every scrap of paperwork from her egg freezing journey. After her retrieval, Remy mailed me the folder. I opened it now, spreading its contents across the carpet. The tab of the folder was labeled Eggs. Almost every inch of the folder itself was covered in Remy’s neat, all-caps handwriting. There were phone numbers and reminders to call the phone numbers. Credit card receipts. Sticky notes with prices, scratched-out math, and so many dollar signs. Signatures galore. Printed-out Google Maps directions. Retrieval Day instructions, folded up and creased as if they’d been read over many times. “Custody and transportation of reproductive materials—client’s initials,” a line from the sheet read. Question marks on insurance documents. Notepaper from Freedom Pharmacy with the slogan “We’re very transparent.” Printouts about needles, ice packs, overnight shipping. Notes Remy scribbled to herself: Anti-mullerian hormone # = how many eggs in bank. Infertility does not apply to max out of pocket if…Be mindful w/ physical activity b/c big juicy ovaries. Images of her follicles, captured in eight black-and-white ultrasound printouts. The terms “out-of-pocket” and “deductible” written everywhere.
Sitting with Remy’s handwriting, noticing her extraordinary attention to detail, and seeing these dozens of documents took me back to our first meeting. How we’d talked excitedly over rosemary lattes in Nashville, where her warmth and pep lit up the small café. Nearly every time I was around Remy, I’d notice her energy, her self-assuredness—and sitting now with her egg freezing paper trail was no different. The green folder says, I’ve got this. It says, I am in control of my fertility. There are phone numbers to call, bills to pay, medicines to receive by mail and refrigerate, precise instructions for shots. Figure out the prices, stay on top of the where and when, read every paragraph carefully because she is a doctor, after all, a whip-smart, career-driven, independent woman accustomed to taking matters into her own hands, to sacrificing time, money, and emotional energy for her future family. This is matter-of-fact mom mode, and there is a process, a clear plan, and a personalized protocol for women like Remy to go about this. Whether it was Remy’s training as a doctor or her training as a woman—or both—didn’t matter as much as what taking action did for her. At the beginning, the only unknown was how well egg freezing would work, which is to say, how many eggs would be frozen. She’d gotten seventeen. Any future unknowns—whether her eggs will survive the thaw, whether they will fertilize successfully with the sperm of the man she’ll marry, whether she will use them or never see them again—are for later. Later.
In her book Don’t Call Me Princess, Peggy Orenstein writes that the existence of IVF “has created a new drive, as profound as either the biological or psychological: call it the techno-medical imperative, the need to exhaust every ‘option,’ to do ‘whatever you can’ to have a baby—regardless of the cost to self, marriage, or pocketbook—or feel that you have not done enough. It is now possible to remain hostage to perpetual hope for years.” She goes on: “How will you know unless you try? And if you don’t, will you be left always wondering what might have been? The uncertainty is agonizing.” Egg freezing purports to protect against this agonizing uncertainty, but it also moves up the starting line from which women begin years of chasing these techno-fertility dreams. Some egg freezers, like Remy, have names for their future children picked out. Others, like Mandy, relish the way that egg freezing offers a break from thinking about someday kids and starting a family. What all egg freezers are buying into is the notion that fertility is not stagnant but an active state with its own narrative. The prospective, forward-looking manner underlying an egg freezer’s motivations is perhaps the most important facet of the technology’s story. “I just want to know that I did everything I could,” Mandy had told me. It’s a sentiment that explains why many find the process liberating, though it’s easy to see how a young egg freezer’s do-whatever-you-can mentality would later feed into the drive that Orenstein depicts, obsessively pursuing IVF and exhausting every avenue to ensure that one’s frozen eggs, and ART in general, delivers on its promises.
“It’s the best thing we have to help people delay fertility, but it’s far from perfect,” Dr. Lamb, the reproductive endocrinologist in Seattle, had said when we discussed egg freezing being misconstrued as an insurance policy. “My biggest hope for patients is for them to not have to use their frozen eggs.”
Whoa. In spite of everything I’d already learned, to hear a fertility doctor tell me this blew me away. She was boldly declaring an irony that I find frustrating and, at times, overwhelming: Trust egg freezing technology to preserve my ability to have biological children, but don’t rely on it so much that I alter my life choices or avoid seriously considering other options, like adoption or not having kids at all. Is this self-delusion at best? Egg freezing optimists would say no—at least for now. Even if it’s not guaranteed, the possibility of agency over one’s biological timeline is still worth it to most women. So long as they don’t ignore the reality of the success rates and limited data that are currently available.
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