I am indebted to Kelsey Lannin, who shouldered the challenging task of fact-checking this book and left no stone unturned, and to Kelsey Kudak, who provided significant fact-checking support and did so with sensitivity. Endless thanks to you both for making these pages incalculably better. Thank you also to Sarah Stodder, researcher extraordinaire, who tumbled down many-a-rabbit-hole with me early on.

This book was supported by a grant from the Alfred P. Sloan Foundation Program for Public Understanding of Science and Technology, and I am eternally beholden to them for making it possible for me to do fact-checking and additional research. Sincere thanks to FASPE and the lessons and professional connections the illuminative fellowship provided. For the gift of space and time to figure out what this book could be, I am enormously grateful to the Logan Nonfiction Program and the Carey Institute for Global Good. Thank you also to the talented writers and creatives of my Logan cohort for seeing what was needed, and to Adrian Nicole LeBlanc, Rafil Kroll-Zaidi, and Mark Kramer, who helped me untangle the threads.

My sincere gratitude to the reproductive endocrinologists, embryologists, founders, and other experts, many of whom are mentioned in the book or cited in the Notes, who shared their knowledge and time with me and played crucial roles in the reporting. I am grateful to the journalists, authors, and scholars whose writing on reproduction and fertility I’ve referenced, and whose work in this space have been both helpful and inspiring, especially that of Marcia C. Inhorn, Anna Louie Sussman, and Rachel E. Gross. Enormous thanks also to the following people for their expertise and fact-checking assistance, often with little or no advance warning, and for helping me identify some of my own blind spots and omissions: Temeka Zore, Lora Shahine, Leslie Ramirez, Natalie Crawford, Julie Lamb, and Anate Brauer. For providing and helping me interpret egg freezing statistics, thank you to Amy Sparks, Timothy Hickman, and especially Ethan and Pat with the Society for Assisted Reproductive Technology.

A heartfelt thank-you to Bridget Jameson and Jenn Brown for reading an early draft and offering valuable contributions; to Alex Brokaw, for the tough love; and to my mother, who is the first person to read anything I write and was this book’s first reader as well. Many thanks also to Susan Knoppow for her support and gracious feedback when this book was merely a smattering of Google docs, and to Shannon Offerman for her helpful comments.

Several friends and family members very kindly provided editorial service, and I am grateful for their help. Michael Pearl, Hannah Stadlober, Katrina Lampert, and Molly Varoga transcribed interviews; Rachel Wood fielded numerous reproductive health–related medical questions; and Sean O’Connor helped generate ideas for the cover and offered shrewd insights along the way. Thank you to Elena Horn, Michael Orleans, and Peter Cooper for accompanying me on reporting trips in Italy and Ghana, and to DeeDee Montgomery for facilitating an important discussion.

A special thanks to all those who gave me a table to write at and a bed to crash on in various cities while I was reporting and writing portions of this book, especially the Brokaw, Montgomery, and Corrao families. Thank you to my former therapists in Colorado and New York who helped me maintain my sanity along the way: Nancy, Evan, Rich, Marjorie, and Emily. Thank you also to the publications that gave portions of this book’s reporting early homes and the talented editors I’ve had the privilege of working with, especially Jessica Reed at The Guardian, Erik Vance at The New York Times, and Bijan Stephen, then at The New Republic.

Many incredible humans, too numerous to name here, buoyed me up with their friendship during this arduous endeavor, especially in the home stretch. A few must be singled out: Rachel Wood, Alex Brokaw, Jenn Brown, and Sam Kern, who keep me going on a daily basis. Endless thanks to Andrew Hyde for your out-of-this-world generosity, and for providing a haven, patronage, and Dram when I needed it the most. To Sarah Maslin, Lindsey Smith, Laura Orland, Christine Cassaro, Hannah Stadlober, Lauren Lambert, and Emily Montgomery—amazing women I’m lucky to have in my life—who gave me a steady stream of support. To Kyle for the puddles-on-the-floor moments and for being a cheerleader when I needed it the most. To Julie for the ways in which you always lifted me up, and to Maggie for nourishing me with words and popcorn for years.

Hugs one, two, and five hundred to the Brumbaugh/Hiller clan, whom I am so grateful to call family. Thank you for the laughs, the warmth, and for accepting and loving me in all the ways that you do.

My grandparents are in the spaces between these words. My mother’s mother, Patricia Jameson, passed away while I was writing this book; I miss your laugh and wit, Grandma. I am eternally thankful to my father’s parents, Lauren and Sidney Ann Lampert, who helped put me through college and graduate school and made it possible for me to pursue a career as a writer. Granddaddy: How I wish I could place a copy of this book in your hands.

It is very hard to write this part, because I don’t know that my dear grandpa, George “Bud” Jameson, will still be with us when this book comes out. But Grandpa, if you’re reading this, know that there is no one I am more excited to see hold this book than you. Thank you for long being one of my biggest fans. You, and the life you’ve lived, will forever be an inspiration to me.

A last deep bow and eternal gratitude to my family: Peter Lampert, Alison Jameson, Katrina Lampert, Ben Lampert, Ali Lampert, Pete Groves. (Also, Indy, Bear, and Teddy. And Piper: We miss you, sweet girl.) Your love and support are the foundation of everything good and true in my life.

I am profoundly fortunate to have parents who raised me to pursue my passions and who taught me that a spirit of adventure will usually suffice. Their unwavering faith and encouragement mean more than I’ll ever be able to say. Mom, you are the wind beneath my wings. Dad, my rock; you’ll always be my first call. Hugs and pats forever.

And, finally, to Jonathan, aka the Filmmaker: Our story has been the most unexpected and wonderful part of this journey. When I told you about this book on our first hike six years ago, I couldn’t have imagined that we’d be getting married three weeks before it published. You’ve lived with this book almost as long as I have and believed in me in times when I forgot to. Thank you for everything, but especially for braving with grace and patience the long days I had to “be in the book cave” and for seeing me through the hardest bits. More today, now more than ever—I love you.

Notes

Introduction

a third of American adults say: Pew Research Center, “A Third of U.S. Adults Say They Have Used Fertility Treatments or Know Someone Who Has,” July 17, 2018, pewresearch.org/​short-reads/​2018/​07/​17/​a-third-of-u-s-adults-say-they-have-used-fertility-treatments-or-know-someone-who-has/.

GO TO NOTE REFERENCE IN TEXT

Sperm freezing is on the rise: Gururaj M. Borate and Ajay Meshram, “Cryopreservation of Sperm: A Review,” Cureus 14, no. 11 (2022), doi.org/​10.7759/​cureus.31402.

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Chapter 1

“We will be like Uber”: Danielle Paquette, “How Fear Fuels the Business of Egg Freezing,” Washington Post, March 6, 2015, washingtonpost.com/​business/​economy/​how-fear-fuels-the-business-of-egg-freezing/​2015/​03/​06/​87fd068c-c294-11e4-9271-610273846239_story.html.

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the impact of mining industries: Aboka Yaw Emmanuel, Cobbina Samuel Jerry, and Doke Adzo Dzigbodi, “Review of Environmental and Health Impacts of Mining in Ghana,” Journal of Health and Pollution 8, no. 17 (2018): 43–52, doi.org/​10.5696/​2156-9614-8.17.43.

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By all accounts: A 2023 study published in the Journal of Clinical Medicine summarized egg freezing’s growth plainly: “It has been indisputably evident from the current data that the demand for social egg freezing has been growing exponentially over the last decade.” See Pragati Kakkar, Joanna Geary, Tania Stockburger, Aida Kaffel, Julia Kopeika, and Tarek El-Toukhy, “Outcomes of Social Egg Freezing: A Cohort Study and a Comprehensive Literature Review,” Journal of Clinical Medicine 12, no. 13 (2023), doi.org/​10.3390/​jcm12134182.

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a mere 482: A note on reporting the number of distinct egg freezing patients versus the number of egg freezing cycles: It’s easy to misinterpret the published data, and many people—including journalists—have. The Society for Assisted Reproductive Technology collects and publishes online the number of egg freezing cycles each year, but neither SART nor the CDC publicly reports the number of women freezing their eggs, i.e., distinct egg freezing patients. Also, many women do multiple cycles, which is one reason that the cycle numbers in the official annual egg freezing reports are higher. I obtained the numbers of patients who froze eggs for non-medical reasons from 2009 to 2022 from SART directly.

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the latest year: Preliminary 2022 egg freezing data came out in early 2024. There’s typically a two-year lag when it comes to compiling ART statistics. It takes a while to wait for live-birth outcomes, and then there’s the collection of the data by the fertility clinics, which SART audits before submitting it to the CDC for analysis and official publication.

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22,967 did: I obtained the numbers of patients who froze eggs for non-medical reasons from 2009 to 2022 from SART directly.

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The United Kingdom has also seen: Human Fertilisation and Embryology Authority (HFEA), “Fertility Treatment 2021: Preliminary Trends and Figures,” 2023, hfea.gov.uk/​about-us/​publications/​research-and-data/​fertility-treatment-2021-preliminary-trends-and-figures/.

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“one of the most significant”: Sonia Allan et al., “International Federation of Fertility Societies’ Surveillance (IFFS) 2019: Global Trends in Reproductive Policy and Practice, 8th Edition,” Global Reproductive Health 4, no. 1 (2019): 51, doi.org/​10.1097/​grh.0000000000000029.

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young users extol: Naomi May, “Gen Z Are Freezing Their Eggs. Why?,” Vice, July 20, 2023, vice.com/​en/​article/​bvj7nz/​why-gen-z-are-freezing-eggs.

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“I would’ve given anything”: Danielle Pergament, “Jennifer Aniston Has Nothing to Hide,” Allure, December 2022, allure.com/​story/​jennifer-aniston-december-2022-cover-interview.

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in the next twenty to forty years: Henry T. Greely, The End of Sex and the Future of Human Reproduction (Cambridge, MA: Harvard University Press, 2016).

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Remy: She asked for her name to be changed to protect the privacy of her family.

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“geriatric pregnancy” and “advanced maternal age”: Historically, “advanced maternal age” has been defined as women who are thirty-five years of age or older at estimated date of delivery. This—rudely—used to be called a “geriatric pregnancy.” The age cutoff was based on evidence of declining fertility and concern surrounding increasing risks for genetic abnormalities identified in the offspring of pregnant women older than thirty-five. As of 2022, “pregnancy at age 35” is the term preferred by the American College of Obstetricians and Gynecologists. To simplify things, ACOG recommends that doctors and researchers indicate patients’ age in five-year increments (35–39 years, 40–44 years, etc.), which better stratifies the possible pregnancy risks associated with advancing age. See “Pregnancy at Age 35 Years or Older,” American College of Obstetricians and Gynecologists 140, no. 2 (2022): 348–366, doi.org/​10.1097/​aog.0000000000004873.

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Chapter 2

bacterial vaginosis: Bacterial vaginosis, or BV, is the most common vaginal condition in women ages fifteen to forty-four. Douching, not using condoms, and having new or multiple sex partners can upset the normal balance of vaginal bacteria and increase a woman’s risk of getting BV.

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since sex ed was introduced: Jonathan Zimmerman, Too Hot to Handle: A Global History of Education (Princeton, NJ: Princeton University Press, 2015).