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“There’s nowhere else”: Maggie Jones, “What Teenagers Are Learning from Online Porn,” New York Times Magazine, February 7, 2018, nytimes.com/​2018/​02/​07/​magazine/​teenagers-learning-online-porn-literacy-sex-education.html.

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one hundred most-frequented: Jones, “What Teenagers Are Learning from Online Porn.”

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shaping their early ideas about sex:Amaze.org is an excellent resource for reliable sex ed information for both kids and parents. Scarleteen.com offers “sex ed for the real world,” with inclusive, comprehensive info for teens and emerging adults. For parents with younger kids, It’s Not the Stork by Robie H. Harris is a great place to start.

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abortion very rarely affects: National Academies of Sciences, Engineering, and Medicine, The Safety and Quality of Abortion Care in the United States (Washington, D.C.: National Academies Press, 2018), doi.org/​10.17226/​24950; Jen Gunter, “Can an Abortion Affect Your Fertility?,” New York Times, May 30, 2019, nytimes.com/​2019/​05/​30/​well/​can-an-abortion-affect-your-fertility.html.

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“Older female age”: American Society for Reproductive Medicine, “Planned Oocyte Cryopreservation for Women Seeking to Preserve Future Reproductive Potential: An Ethics Committee Opinion,” Fertility and Sterility 110, no. 6 (2018): 1022–1028, doi.org/​10.1016/​j.fertnstert.2018.08.027.

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“Fertility meant nothing”: Ariel Levy, The Rules Do Not Apply (New York: Random House, 2018), 85.

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“We lived in a world”: Levy, The Rules Do Not Apply, 10.

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Chapter 8

nearly 115,000 healthy women: I obtained the numbers of patients who froze eggs for non-medical reasons from 2009 to 2022 from SART directly. The actual number for this 2009–2022 timeframe is higher, though. There are women electively freezing eggs and embryos in the United States who aren’t part of SART’s data set, which relies on data reporting from SART-member clinics. About 85 percent of U.S. fertility clinics are members of SART and report their ART data to SART each year. So, egg freezers from at least 15 percent of additional fertility clinics aren’t included in this figure, but there’s no way of knowing exactly how many are left out.

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the latest year: As mentioned in chapter 1, preliminary 2022 egg freezing data came out in 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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data do differentiate: SART began collecting the reason for fertility preservation from clinics in 2016. Prior to 2016, when clinics submitted their annual data to SART, they did not specify whether the egg freezing cycles they’d conducted that year were for women undergoing gonadotoxic treatments (chemotherapy or radiation) or for women freezing for non-gonadotoxic reasons (healthy women seeking fertility preservation). Now clinics do, although the field is not mandatory.

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the vast majority: In 2022, for example, fewer than 4 percent of women who froze their eggs did so because they had to get chemotherapy or other potentially debilitating treatments.

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73 percent increase: From 16,786 egg freezing cycles in 2020 to 29,083 cycles in 2022. Society for Assisted Reproductive Technology, “Preliminary National Summary Report for 2022,” 2022, sartcorsonline.com/​rptCSR_PublicMultYear.aspx?reportingYear=2022.

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40 percent: Centers for Disease Control and Prevention, “ART Success Rates: 2021 Preliminary Data,” last modified May 31, 2023, cdc.gov/​art/​artdata/​index.html.

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the low thousands: In 2022, nearly 92,000 babies were born in the United States using ART. (That includes IVF using donor eggs, fresh eggs, and frozen eggs; the data only partially differentiates among the three.) Out of those ninety thousand or so babies, around 250 were born from frozen non-donor eggs, based on data from SART. (This data isn’t publicly available; SART provided me with a year-by-year breakdown of live births from frozen eggs in the United States from 2009 to 2022.)

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only 6 percent: Karin Hammarberg, Maggie Kirkman, Natasha Pritchard, Martha Hickey, Michelle Peate, John McBain, Franca Agresta, Chris Bayly, and Jane Fisher, “Reproductive Experiences of Women Who Cryopreserved Oocytes for Non-Medical Reasons,” Human Reproduction 32, no. 3 (2017): 575–581, doi.org/​10.1093/​humrep/​dew342.

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“the average return rate”: 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): 4182, doi.org/​10.3390/​jcm12134182.

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oft-discussed scary statistic: The original ASRM report seems to have been wiped from the internet, but in 2014, major outlets, from The New York Times to The New Republic to PBS—and, more recently, in 2017 (The Washington Post)—repeated this misleading statistic, again and again.

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“While anecdotal evidence suggests”: Charlotte Alter, “The Truth About Freezing Your Eggs,” Time, July 16, 2015, time.com/​3960528/​the-truth-about-freezing-your-eggs/.

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74 percent of eggs: All frozen egg cycles performed after July 2011, which was about 70 percent of the cycles in the study, involved vitrification. The study’s first egg freezing-and-thaw cycle was performed in 2006; a sharp increase in thaws occurred after, with 70 percent occurring from 2016 to 2020. Sarah Druckenmiller Cascante, Jennifer K. Blakemore, Shannon DeVore, Brooke Hodes-Wertz, M. Elizabeth Fino, Alan S. Berkeley, Carlos M. Parra, Caroline McCaffrey, and James A. Grifo, “Fifteen Years of Autologous Oocyte Thaw Outcomes from a Large University-Based Fertility Center,” Fertility and Sterility 118, no. 1 (2022): 158–166, doi.org/​10.1016/​j.fertnstert.2022.04.013.

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The younger a woman was: Eighty percent of patients were between thirty-five and forty, and 12 percent were over the age of forty-one. Just 8 percent of patients were under the age of thirty-five when they underwent their first egg freezing cycle; the youngest patient was twenty-seven years old.

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transfer a single embryo: Embryos are graded at each point in their development to determine which ones are most likely to grow successfully when implanted. Thanks to scientific advances, doctors are now better able to select the best embryos to implant, which in turn allows them to transfer just one, rather than multiple, embryos into the womb at a time. Almost 95 percent of ART babies born in 2021 were singletons, compared to 80 percent in 2015.

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twenty eggs are recommended: E. Chronopoulou, C. Raperport, A. Sfakianakis, G. Srivastava, and R. Homburg, “Elective Oocyte Cryopreservation for Age-Related Fertility Decline,” Journal of Assisted Reproduction and Genetics 38, no. 5 (2021): 1177–1186, doi.org/​10.1007/​s10815-021-02072-w.

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“irrespective of age at freezing”: Kakkar et al., “Outcomes of Social Egg Freezing,” 4182.

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“clearly suggest that”: Chronopoulou et al., “Elective Oocyte Cryopreservation for Age-Related Fertility Decline,” 1177–1186.

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