The illusion of control alters our perspectives. We like to think we have much more of it than we do. I thought about this often after Ben and I broke up. In time and with therapy, I would come to see how I had spent so much time and energy looking for egg freezing answers in part because I did not want to confront the difficult, in-my-face issues in my relationship. I had wanted to remain in the driver’s seat, commanding the narrative—and avoiding our problems helped me do that, until, of course, it didn’t.
But I became tired of trying to control it all, know it all, check all the boxes. And I was tired on behalf of all the women trying to do the same. Anxiety bubbles up in every corner of our lives, and it is exhausting how we attempt to secure everything while trusting in so little, how we don’t allow ourselves the Right Now because we’re so caught up with the Future. In my egg freezing journey and in my life, it felt as if I’d been spinning around in dizzying small circles across a wide field for a long time, trying to get my bearings. I wanted to loosen my grip, to feel things come into focus. I wanted to quit pretending everything—my ovary, my heart, my fertility—would be fine.
Maybe egg freezing was a way to reclaim some control. But I wasn’t sure I wanted it.
The Economics of Parenthood
When I was young, I’d sometimes wait for my parents to arrive home from work, my nose pressed against the glass of the front door. They always looked the same walking up the driveway: my father in a dark suit, briefcase in hand, and my mother in her camouflage uniform and patrol cap. My parents, although two very different people, were a team—with a heck of a romantic meet-cute story—who had been married for seven years before having children. For most of my childhood, my entrepreneurial father managed his own business while my military mom managed a battalion and then a brigade. Our father nursed our playground cuts and bruises and taught us how to ride bikes. Our mother cheered us on at weekend sports games and read out loud to us at bedtime. Our parents’ teamwork formed the rhythm of our lives, and my brother, sister, and I grew up assuming this was how the world worked, a close-knit family led by two full-time working parents who loved their jobs.
For the mid- to late twentysomethings of my parents’ generation, a job was a major, stable part of your identity. If you landed a good one, you’d stick with it until retirement. Entering your prime childbearing years, you knew with a good deal of confidence where you’d be and what you’d likely be earning ten years down the road—as long as you showed up on time, made your bosses happy, and continued progressing up the totem pole. Maybe you didn’t plan to continue working after you had children, and that was possible because your partner had one of these jobs and that sort of security. Today, it is only the rare, exceptional young adult who can count on any of these things. In the past, having this kind of stability made it inestimably easier to make long-term decisions. But while millennials earn more money than any other generation has at their age, they hold much less wealth, largely because the cost of living has outpaced wage increases.[*4] For the most part, young women today are not simply capricious, commitment-phobic dreamers who want to delay childbearing until the last possible second in the name of career ambition or total equality with men. They—and the men, women, partners they love—are embarking on adult life on far different terms than their parents did.
I have always planned on being a parent someday. But especially lately, I’ve wrestled with ideas I have about the level of financial stability and career success I should attain before starting a family. I am incredibly privileged to have spent my twenties in school and on airplanes, studying and traveling while working. I attended a private liberal arts college. I earned a graduate degree without being crippled by student loans. I want these things for my future children, too, and it’s easy to convince myself I’m being responsible by waiting to have kids until I have at least some savings. But waiting would also mean feeling burdened by timeline pressures, gnawing worries about my eggs expiring, and pursuing my career while stressing that I’m sacrificing my parenting prospects.
I’m not alone. A rising share of U.S. adults who are not already parents—44 percent—say they’re unlikely to ever have children, according to a recent Pew Research Center survey. A few years ago, The New York Times asked: Why are young adults in America having fewer children than their ideal number? They surveyed 1,858 men and women ages twenty to forty-five. Most of the respondents said they delayed or stopped having children because of concerns about not having enough money or time.[*5] Financial insecurities are altering the choices of today’s generations, and money is a major factor affecting fertility decisions. Another is climate change. In a 2023 survey of about one thousand parents in India, Mexico, Singapore, the United States, and the United Kingdom, more than half of parents—53 percent—said that climate change affects their decision about having more children. And a 2022 survey by Modern Fertility of nearly three thousand American women—mostly Gen Z and millennials—found that 58 percent of women have adjusted their family planning because of concerns about climate change. The respondents said they are worried, in particular, “about the world [their] kids will inherit.”
“Around the world, economic, social and environmental conditions function as a diffuse, barely perceptible contraceptive,” writes Anna Louie Sussman in a New York Times opinion essay titled “The End of Babies.” She expounds on how such conditions are inimical to starting families—“our workweeks are longer and our wages lower, leaving us less time and money to meet, court and fall in love”—and notes the pervasive anxiety that plagues many would-be parents when thinking about the sort of life they might provide for their children. A generation’s economic opportunities impact pretty much all of life’s fundamentals: work, sex, love, family. The economics of modern parenthood are, in a word, brutal. Millennials and Gen Zers are the most educated generations ever, a distinction that perhaps should but does not make us rich or secure. And adulthood, it seems to me, is about achieving security. Career, relationships, housing, healthcare. Some of my friends have 401(k)s and paid-off mortgages; others have credit card debt and crushing student loans. For women, add fertility to the list of their financial worries. While it is a luxury to be able to worry about fertility at all, many women do, in addition to everything else on our minds.
As young women lean into their ambitions and burgeoning careers in their twenties and thirties, many begin to sacrifice their fertility—whether they realize it or not. For those who are aware that the aforementioned “motherhood penalty” means they’ll lose professional and economic power after they have kids, egg freezing looks like an empowering solution. The increasing number of companies offering fertility benefits has been one of the biggest developments in egg freezing’s story over the last several years. But company-paid fertility preservation is not the next great equalizer many hoped it would be, and in some ways it distracts from true solutions that working women need, such as publicly funded, high-quality childcare and moderate-length paid parental leave. Ideally, employers would offer fertility benefits while simultaneously addressing the factors that drive their female employees to postpone starting families. As it is, egg freezing is advertised as one more tool in a woman’s tool belt, when actually there should be more support given to women who have children and less pressure on women to have them if they don’t want to.
People across all salary brackets choose to delay or forgo parenthood for a variety of reasons—career, travel, relationships, money, climate change, or perhaps no reason at all. Our assumptions about what shapes and motivates the lives of women are so hardwired that the notion that some women do not want children can be difficult for others to wrap their minds around. According to a 2023 CDC report, nearly half of U.S. women between the ages of fifteen and forty-four don’t have biological children. This is in part because waiting to have biological children can increase the likelihood of not having them; delayed childbearing—having a first child at age thirty-five or older—has been associated with the decades-long trend in which the number of births in the United States has been declining. But it’s also because many women simply choose not to have children. It should go without saying—but it doesn’t, frustratingly, so I’m saying it—that for women, parenthood is not the only or the primary role from which they derive meaning and identity. When it comes to being child-free by choice, Gloria Steinem summed it up well: “When I was much younger I assumed I had to have children. I assumed everyone had to have children. But someone said once that not everyone with vocal chords [sic] is an opera singer. And not everyone with a womb needs to be a mother. When the Pill came along we were able to give birth—to ourselves.”
The Little Ovary That…Could?
For a few years now, I had been struggling to articulate the reasons for and against freezing my eggs. The lists of pros and cons no longer cut it, but they were all I had. I tried to balance egg freezing’s positives—the peace of mind, the diminished pressure when it came to the biological clock—with the success-rate unknowns, the potential health risks, and the hard-to-swallow price tag. But while the money and potential dangers of fertility medications were significant deterrents, they weren’t the whole story. The decision point is different for every individual. And the sticking point for me, the one determinant that seemed as if it would tip the scales when it came to deciding yes or no about egg freezing, was my ovary.
I remained afraid that if I chose to move ahead with the process of freezing my eggs, something would happen or not happen that would leave me living in a constant fog of regret. If I went through with it and any one of the worst-case scenarios came to be—I lose my remaining ovary; I get only a few eggs, nowhere near enough to feel confident about their chances of producing a baby, then live with the low-level anxiety brought on by the possibility of health issues down the road caused by the injections; I freeze a ton and when I go back to use them in my late thirties, they don’t work—it could be my comeuppance. I would blame my body but I would also blame my brain, because I had chosen to freeze my eggs after several years of learning about the very real upsides and benefits while disregarding the very real facts about the risks and potential downsides.
But not freezing my eggs also left the door open for deep regret, and this was something I came to understand only late in this journey. When I interviewed reproductive endocrinologists and fertility experts, the fact that I had one ovary and personal reasons for investigating egg freezing sometimes came up. And so I’d ask them their opinion, always with the disclaimer that I understood they were not my doctor and thus couldn’t offer me specific medical advice. After telling Dr. Natalie Crawford, a reproductive endocrinologist in Austin, Texas, and host of the popular podcast As a Woman, about my history of reproductive surgeries and desire to have biological children someday, she said that if I froze my eggs, I’d need to be very careful about the risk of ovarian torsion, but that “it’s extremely unlikely for someone with one ovary to get OHSS,” which I was surprised and so relieved to hear. “You don’t have room to spare,” she said, referring to my sole ovary, telling me I may well want to “buffer this risk by getting some eggs or embryos in the freezer.”
Dr. Crawford and other fertility specialists I spoke with about my personal situation weren’t pushing egg freezing on me and had nothing to gain if I decided to do it. Given my medical history, they simply saw a compelling reason for me to freeze.
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Amid all these conflicting thoughts, I caught up with Mandy, Remy, and Lauren. I wanted to know what life looked like for them now and if their thoughts about egg freezing had changed.
Mandy was approaching her mid-thirties and going through a job transition. When we spoke on the phone, she told me that she remained grateful that she froze her eggs when she did and didn’t succumb to the pressure to start a family when she and her husband weren’t ready. The feeling of bought time still mitigated her anxiety. “I did everything I was supposed to do, what my doctors told me to do—but it turned into a feeling of more not knowing,” Mandy told me. “If you have lots of resources and things go really well, it seems like egg freezing is a no-brainer. But if your resources are limited and your path isn’t as smooth, this can be such an emotional and confusing journey.” She and Quincy were contemplating starting a family soon. “Thinking of conceiving brings up all these feelings again about egg freezing,” she told me. “I’m back to over-googling and overanalyzing. What if it takes me a long time to conceive? How long should I try before using our frozen embryos? What’s it all going to cost?”
When I talked to Remy over video a few weeks before her thirty-fifth birthday, she’d just gotten home from work. She wore blue scrubs, her long blond hair gathered to one side. She had recently moved to a studio apartment in North Carolina and was completing an OB/GYN fellowship at Duke University. I asked Remy what had been the most challenging part of the whole process, from when she first decided to freeze her eggs until now. “Number one, no caffeine. Number two, money,” she replied. “The hardest part was the financial stress, figuring out and navigating how to pay for it.” Remy was still paying annual fees to store her eggs, on top of $640 every month toward the loan she’d taken out to pay for the procedure. She told me egg freezing never really felt financially feasible for her, even though she’d managed to do it. Still, she said, “freezing my eggs was one of the smartest decisions I’ve ever made.” Her mom brags about it to her friends who have daughters Remy’s age, saying, “They should freeze their eggs like Remy did!” When the subject of kids is broached on dates, Remy tells men that because she froze her eggs, she’s not in a rush to start a family.
As for Lauren, well, life looked very different indeed. One humid afternoon before I left Houston, I visited Lauren at her house. Bentley, her twelve-year-old bulldog, greeted me at the door and followed us into the living room, where we sat and talked. Lauren had chosen not to go back on birth control after freezing her eggs; she felt more levelheaded and even-tempered off the Pill and decided she felt better not taking it. She’d been on the Pill since she was fourteen and, until now, bled every month like clockwork—every fourth Tuesday at 9 a.m., to be exact. She had no idea how long her normal menstrual cycle was and had never tracked period symptoms. If she had, what happened next might not have.
Right around the time of Lauren’s second egg freezing attempt, she went to dinner with the man she’d long ago lost her virginity to and he, in fact, had administered her trigger shot. “I was like, ‘Can you give me this shot in my ass? Great to see you again,’ ” Lauren told me with a wry smile as she recounted the story. They rekindled a romance that night and began to date. A few months later, Lauren unexpectedly got pregnant. She was so shocked she had accidentally conceived naturally that she took five pregnancy tests before accepting it was real. Now she was eight months pregnant with a healthy baby boy. She had told me she was pregnant before I’d come over to hear the story, but seeing her now—reclined in a rocking chair, huge and glowing, her bare feet resting on an ottoman—I almost couldn’t believe how egg freezing had changed her life in such an unexpected way. “If he’s anything like he’s been inside me—he’s been partying for nine months—this kid is going to be a blast,” Lauren said. “I accidentally got knocked up, and since the moment I found out I was pregnant, I’ve been happier than I’ve ever been in my entire life.”
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By the time Ben and I had been broken up for a year, I’d gone back and forth on my egg freezing decision what felt like a hundred times. I wanted to believe that if I froze my eggs it would go as well as it did for Mandy, Remy, and the many women who came out all smiles, more or less, and with a bounty of eggs. Or even if I experienced significant complications while freezing my eggs, as Lauren did, maybe egg freezing would be the catalyst for a journey into motherhood I otherwise couldn’t have imagined, like it was for her. The factor of my sole ovary loomed large. Mandy, with two partial ovaries, was lucky to have beaten the odds as well as she did; no one, not even her doctors, would have predicted she’d have twenty eggs retrieved and eight chromosomally normal embryos frozen. I believe in my little ovary with all my heart, and I believe it would be up to the task of doing double duty to pump out as many eggs as it possibly could. But I had to face it: I couldn’t be sure I’d be as fortunate as Mandy if I decided to freeze.
The truth—that I was finally starting to allow myself to inhabit—was that I never wanted to make the decision. I wanted it to be made for me. I wanted my body to decide: Ovaries gone; it’s too late now (although at the same time I of course didn’t want anything bad to happen to my ovary). I wanted my heart to decide: He’s the one; time for babies. Most of all, I wanted my head to decide, because after all this time reporting, researching, and poking at this question with every sharp object I could find, I should have been able to logically determine the right choice.
“I’m the kind of person who tries to prevent regret, to control life in a way that optimizes the best outcome,” Mandy had told me once. “That’s what my embryo freezing decision was: a way to prevent the worst from happening.” That resonated with me deeply. I saw myself in Mandy’s rationalizing, the way her fear of the unknown prompted action. More than at any other point in this journey, when I imagined freezing my eggs now, I pictured the future me I’d be doing it for: years from now, trying so hard for a second or third child, regretting more than I’ve ever regretted anything not freezing my younger eggs when I’d had the chance. I felt caught between the promises and risks of egg freezing, the remaining gaps in our knowledge, and the pressure to protect against future regret. I was about to be reminded, however, that taking concrete action now is never a guarantee of future certainty.
Skip Notes
*1 Remy did her initial egg freezing appointments at a different center and location than the clinic where she underwent her egg retrieval.
*2 Some of Remy’s conviction, I should mention, had to do with the fact that she is a crystal-carrying physician who believes in astrological signs and the hormonal swings associated with full moons (her menstrual cycles, she told me, have always been synced to the full moon). “I’m definitely part hippie, part scientist when it comes to something like egg freezing,” she’d said to me the first time we met. “In the big scheme of things, it’s just more fun to believe in this kind of magic.”
*3 Twenty percent of the patients in this study had successfully had a baby or were pregnant at the time of the survey; half had conceived naturally and a quarter had used their frozen eggs.
*4 As a 2021 Business Insider article astutely notes, “Two recessions before the age of 40 and student debt haven’t helped matters.”
*5 Their reasons: “childcare is too expensive” (64 percent); “waited because of financial instability” (43 percent); “no paid family leave” (38 percent).
14 Unviable
Tank Failures and Hidden Risks
Soon after lunchtime on March 3, 2018, temperatures rose inside a cryogenic storage tank inside a laboratory at University Hospitals Fertility Center in Cleveland, Ohio. The liquid-nitrogen-filled tank held more than four thousand frozen eggs and embryos belonging to nearly one thousand people. It was a Saturday, and the clinic’s lab workers had left for the day forty minutes earlier. At 5:06 p.m., an alarm on the tank went off. Anyone within earshot would have heard it and immediately discovered that the temperature had risen to –156 degrees Celsius, forty degrees above normal—but the lab wasn’t staffed on Saturday evenings. No one heard it. It would be many hours until anyone knew the tank had malfunctioned, damaging all the eggs and embryos inside.
The next day, 2,500 miles away, a cryotank inside a lab at Pacific Fertility Center in San Francisco also failed, compromising about 3,500 eggs and embryos and impacting nearly four hundred individuals and families. And so, over a single weekend, an unprecedented disaster had hit fertility clinics—twice. Despite the eerie timing, the incidents were not related.
The nightmare began in earnest for the Ohio patients when, four days after the incident, University Hospitals Cleveland Medical Center—which oversees the fertility clinic—sent letters to patients informing them that “an unexpected temperature fluctuation” had occurred in the tank where their eggs or embryos were being stored. In this case, “fluctuation” is putting it mildly; an uncontrolled rise in temperature can have catastrophic consequences for frozen reproductive cells. In Pacific Fertility’s case, the liquid nitrogen levels inside Tank 4 dropped too low, destroying the thousands of eggs and embryos inside. Tank 4 housed up to 15 percent of Pacific Fertility’s total cryopreserved tissue. No alarms or phone alerts notified the clinic’s lab staff of the malfunction; the problem was discovered by an embryologist during a routine walk-through at the end of the day. The California clinic began informing patients about the tank failure seven days later.
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