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“I live in a freezer now”: Susanna Fogel, “Your Frozen Egg Has a Question,” New Yorker, May 15, 2017, newyorker.com/​magazine/​2017/​05/​22/​your-frozen-egg-has-a-question.

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nine hundred babies: N. Noyes, E. Porcu, and A. Borini, “Over 900 Oocyte Cryopreservation Babies Born with No Apparent Increase in Congenital Anomalies,” Reproductive BioMedicine Online 18, no. 6 (2009): 769–776, doi.org/​10.1016/​s1472-6483(10)60025-9.

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A 2013 study: Paolo Emanuele Levi Setti, Elena Albani, Emanuela Morenghi, Giovanna Morreale, Luisa Delle Piane, Giulia Scaravelli, and Pasquale Patrizio, “Comparative Analysis of Fetal and Neonatal Outcomes of Pregnancies from Fresh and Cryopreserved/Thawed Oocytes in the Same Group of Patients,” Fertility and Sterility 100, no. 2 (2013): 396–401, doi.org/​10.1016/​j.fertnstert.2013.03.038.

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technically, in the United States: Denmark has a five-year limit on cryopreservation storage of embryos. Switzerland, the United Kingdom, New Zealand, and some Australian states have enacted ten-year storage limits.

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increased health risks: A few examples:

A 2019 study of more than one million children born in Denmark found that “the use of frozen embryo transfer, compared to children born to fertile women, was associated with a small but statistically significant increased risk of childhood cancer.” Marie Hargreave, Allan Jensen, Merete Kjær Hansen, Christian Dehlendorff, Jeanette Falck Winther, Kjeld Schmiegelow, and Susanne K. Kjær, “Association Between Fertility Treatment and Cancer Risk in Children,” Journal of the American Medical Association 322, no. 22 (2019): 2203–2210, doi.org/​doi:10.1001/​jama.2019.18037.

“The risks of heart defects, musculoskeletal and central nervous system malformations, preterm birth, and low birth weight are increased in children conceived by vitro fertilization (IVF).” Michael von Wolff and Thomas Haaf, “In Vitro Fertilization Technology and Child Health,” Deutsches Ärzteblatt International 117, no. 3 (2020): 23–30, doi.org/​10.3238/​arztebl.2020.0023.

The main risks for these children are poorer perinatal outcome, birth defects, and epigenetic disorders. However, whether ART procedures or subfertility itself had led to these changes is still unresolved. The health situation for the next generation of ART-conceived children is an important question. In brief, there are still a number of unanswered questions, and well-designed studies on the topics described above are urgently needed. Yue-hong Lu, Ning Wang, and Fan Jin, “Long-Term Follow-up of Children Conceived Through Assisted Reproductive Technology,” Journal of Zhejiang University Science B 14, no. 5 (2013): 359–371, doi.org/​10.1631/​jzus.B1200348.

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“A working knowledge of”: Noyes, Porcu, and Borini, “Over 900 Oocyte Cryopreservation Babies Born.”

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considers whether: Paul Kalanithi, When Breath Becomes Air (New York: Random House, 2016).

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Other limited guidance: In its 2018 Ethics Committee opinion on egg freezing, ASRM says consent forms should include information about “potential and uncertain risks along with the limited safety and outcome data” and that “providers should disclose their own clinic-specific statistics, or lack thereof, for successful freeze-thaw and for live birth.” See ASRM, “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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more than 85 percent: 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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not working: A few examples:

A woman who thawed and fertilized ten eggs in 2020 learned none developed into viable embryos (New York Times, 2022). Gina Kolata, “ ‘Sobering’ Study Shows Challenges of Egg Freezing,” New York Times, September 23, 2022, nytimes.com/​2022/​09/​23/​health/​egg-freezing-age-pregnancy.html.

A woman in her early forties spent $50,000 on two cycles and ended up with no viable eggs (Good Morning America, 2019). Katie Kindelan, “When Freezing Your Eggs Does Not Work: What Women Should Know,” Good Morning America, September 6, 2019, goodmorningamerica.com/​wellness/​story/​freezing-eggs-work-women-65125606.

A thirty-five-year-old woman who also did two rounds and learned the same (New York Times, 2022). Alisha Haridasani Gupta and Dani Blum, “Hope, Regret, Uncertainty: 7 Women on Freezing Their Eggs,” New York Times, December 23, 2022, nytimes.com/​2022/​12/​23/​well/​family/​egg-freezing-fertility.html.

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“I tried to have”: Lena Dunham, “False Labor: Giving Up on Motherhood,” Harper’s Magazine, December 2020, harpers.org/​archive/​2020/​12/​false-labor-lena-dunham-fertility/.

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Dayna: She asked for her name to be changed because of her profession (lawyer) and because her legal case about her lost frozen eggs is not yet resolved.

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Chapter 15

39 percent increase: Anne E. Martini, Samad Jahandideh, Ali Williams, Kate Devine, Eric A. Widra, Micah J. Hill, Alan H. DeCherney, and Jeanne E. O’Brien, “Trends in Elective Egg Freezing before and after the COVID-19 Pandemic,” Fertility and Sterility 116, no. 3 (2021): e220, doi.org/​10.1016/​j.fertnstert.2021.07.596.

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a 95 percent increase: Ali Williams, Shady Grove Fertility marketing team, email message to the author, December 3, 2021.

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Kindbody quadrupled: Mary Pflum, “Egg Freezing Has Boomed during the Pandemic, as Women Opt to Wait Out Family Life,” NBC News, April 24, 2021, nbcnews.com/​business/​business-news/​egg-freezing-has-boomed-during-pandemic-women-opt-wait-out-n1264211.

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three times the number of women: “Frozen Eggs More Efficient Option Than In Vitro Fertilization for Women Starting Families Later,” NYU Langone Health NewsHub, May 26, 2022, nyulangone.org/​news/​frozen-eggs-more-efficient-option-in-vitro-fertilization-women-starting-families-later.

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60 percent increase: Human Fertilisation and Embryology Authority, “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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Fatima: She asked for her name to be changed because, she told me, for South Asian women it’s often considered taboo to talk openly about topics like fertility and egg freezing. But she chose to share her story because she wants the subject to be talked about more.

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“When women come back”: 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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tools to help people considering egg freezing: Michelle Peate, Sherine Sandhu, Sabine Braat, Roger Hart, Robert Norman, Anna Parle, Raelia Lew, and Martha Hickey, “Randomized Control Trial of a Decision Aid for Women Considering Elective Egg Freezing: The Eggsurance Study Protocol,” Women’s Health 18 (2022), doi.org/​10.1177/​17455057221139673.

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monitor the safety: Such as surveilling the environment inside the tank to see if the temperature is changing by even one degree, checking the tank’s motion tilting, and monitoring the electric current in and out of the machine.

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