assign probabilities to egg freezing: R. H. Goldman, C. Racowsky, L. V. Farland, S. Munné, L. Ribustello, and J. H. Fox, “Predicting the Likelihood of Live Birth for Elective Oocyte Cryopreservation: A Counseling Tool for Physicians and Patients,” Human Reproduction 32, no. 4 (2017): 853–859, doi.org/10.1093/humrep/dex008.
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That’s pretty good: It’s worth noting, however, that in the paper’s conclusion the authoring physicians conceded that the numbers may be too optimistic, given “the paucity of validation data” available from women who have actually used frozen eggs to try to become pregnant.
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publicly available calculators: The one I like best is Spring Fertility’s, found at springfertility.com/eggcalc/.
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“when it comes to”: Jessica Hamzelou, “How Do I Know if Egg Freezing Is for Me?,” MIT Technology Review, January 27, 2023, technologyreview.com/2023/01/27/1067333/how-do-i-know-if-egg-freezing-is-for-me/.
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Chapter 9
Additional resources for topics mentioned in this chapter:
Comprehensive breakdown of egg freezing’s costs, including average costs by region:
fertilityiq.com/egg-freezing/the-costs-of-egg-freezing
Navigating specialty pharmacies:
resolve.org/learn/what-are-my-options/medications/specialty-pharmacies/
If you’re a self-pay fertility patient, be sure to ask the clinic(s) if they have discounted self-pay options for patients not using insurance. Speak with the specialty pharmacy where you’re buying fertility meds from about discounts, too.
State-by-state information about fertility insurance coverage laws (updated regularly):
Financial resources and financial assistance programs for fertility treatment:
resolve.org/learn/financial-resources-for-family-building/
allianceforfertilitypreservation.org/financial-assistance-programs/
Grants and charities:
fertilityiq.com/topics/fertilityiq-data-and-notes/free-ivf-grants-and-charities
Refund and “freeze-and-share” programs:
fertilityiq.com/topics/cost/ivf-refund-and-package-programs
cofertility.com/freeze-learn/the-ultimate-guide-to-the-split-program
“How do you build”: Kaitlyn Tiffany, “The SoulCycle of Fertility Sells Egg-Freezing and ‘Empowerment’ to 25-Year-Olds,” The Verge, September 11, 2018, theverge.com/2018/9/11/17823810/kindbody-startup-fertility-clinic-egg-freezing-millennials-location.
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“Just like Uber”: Angelina Chapin, “Egg Freezing for Millennials: The Latest Start-up Trend,” The Cut, February 28, 2017, thecut.com/2017/05/egg-freezing-clinics-for-millennials-a-new-start-up-trend.html.
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roughly $16,000 per cycle: As egg freezing has exploded in popularity over the last several years, I’ve seen cost estimates ballparked as low as $7,000 and as high as $20,000. One reason it’s hard to get a handle on the costs is that many clinics are not transparent about their pricing. Another is that the cost of egg freezing varies due to several factors: where in the country a woman is doing it; the amount of hormone medications required for her particular cycle; how long she pays to keep them stored on ice; what the clinic charges for ultrasound monitoring, anesthesia, and lab processing; and more. Also, fertility treatment prices across the board have gone up in recent years as materials and operating costs have increased. Finally, women often end up paying more for egg freezing than the sticker price they’ve seen advertised. The current cost estimates I explain here take all this into account.
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And they’re going up: Yeganeh Torbati, “With Egg Freezing Increasingly Common, Fertility Clinics Hike Storage Fees,” Washington Post, April 14, 2023, washingtonpost.com/business/2023/04/12/egg-freezing-storage-prices/.
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on average, 2.1 cycles: FertilityIQ, “Egg Freezing: The Costs of Egg Freezing,” accessed January 8, 2023, fertilityiq.com/egg-freezing/the-costs-of-egg-freezing.
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“Welcome to the fertility casino”: Ron Lieber, “A Baby or Your Money Back: All About Fertility Clinic Package Deals,” New York Times, April 14, 2017, nytimes.com/2017/04/14/your-money/baby-fertility-clinic-package-deals.html.
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“Meet Prelude Fertility”: Miguel Helft, “Meet Prelude Fertility, The $200 Million Startup That Wants to Stop the Biological Clock,” Forbes, October 17, 2016, forbes.com/sites/miguelhelft/2016/10/17/prelude-fertility-200-million-startup-stop-biological-clock/?sh=7c175af87260.
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“envisioned a new norm”: Anna Louie Sussman, “The Promise and Perils of the New Fertility Entrepreneurs,” New Yorker, May 19, 2021, newyorker.com/tech/annals-of-technology/the-promise-and-perils-of-the-new-fertility-entrepreneurs.
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Bundl also promises: Bundl, “Peace of Mind with Shared Risk IVF,” accessed August 27, 2022, bundlfertility.com/peace-of-mind-with-shared-risk-ivf/.
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“We are now targeting”: Ruth La Ferla, “These Companies Really, Really, Really Want to Freeze Your Eggs,” New York Times, August 29, 2018, nytimes.com/2018/08/29/style/egg-freezing-fertility-millennials.html.
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“The more friends”: OVA, “OVA Programs,” accessed November 18, 2022, ovaeggfreezing.com/programs/.
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“freeze and share”: Kristine Thomason, “New Programs Allow Women to Freeze Their Eggs for Free—As Long as They Donate Half of Them,” Women’s Health, womenshealthmag.com/health/a43621157/egg-freezing-donation-programs-national-infertility-awareness-week-2023/.
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package or “shared risk” programs: When patients do multiple IVF cycles, the costs climb fast. To offset this, roughly half of U.S. fertility clinics offer the chance to pay up front to buy a package of treatments at a discount, sometimes with a refund if the patient doesn’t “succeed,” i.e., go home with a baby. This is a gamble on the patient’s part. If you need to use these extra treatments, you purchased them at a discount. But if you have a baby or get pregnant before using all these cycles, you don’t get your money back.
The title suggests a setting or situation where cold, both literal and metaphorical, plays a key role, possibly involving a harsh winter, a natural disaster, or even a personal "freeze" in relationships or emotional growth.
