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As more women become more ambivalent about having kids, egg freezing is becoming borderline mainstream. Celebrities like Chrissy Teigen, Khloé Kardashian, and Rebel Wilson have all spoken publicly about freezing their eggs.

Quartz Obsession podcast host Kira Bindrim spoke to breaking news reporter Courtney Vinopal on how the popularity of egg freezing evolved over the last few decades. Read the full transcript of the episode.

But freezing your eggs isn’t as simple as it sounds. The procedure is far from a sure thing. And it requires time, support, and money. In the US, the total cost can easily top $15,000. That price point has attracted a lot of startups and a lot of investment dollars. But it leaves women in a tricky situation. How do you truly and effectively take control of your reproductive health without breaking the bank?

Why would you say that egg freezing is becoming more popular these days?

Courtney Vinopal: I think there are a number of factors. One, definitely, is that women are waiting later to have children. Women are also waiting later to get married. The median age at which women get married is around 28 now. And basically, I think women want to devote more time maybe to their careers, or they realize that having a child is a really significant investment, at least in the US., so they don’t feel financially ready to have a kid but maybe they can put some money toward egg freezing. And then, of course, I think one reason that a lot of people give for freezing their eggs is just that they don’t have a suitable partner. They don’t have someone in their lives that they want to have a kid with yet. You know, there are a number of different studies and data suggesting that women are having more trouble finding partners in the US now. I think that is a major factor contributing to the popularity of egg freezing now.

And egg freezing is definitely an option for the LGBTQ community. You definitely have people who are thinking, ‘Okay, I don’t know if I want to have a kid. But maybe I want to freeze my eggs in case I want to use them at some point.’ It’s also seen as an option for transgender men. So some transgender men will freeze their eggs before they transition, before they take start taking hormones for transitioning. So it can just be a good option, I think, for people who are in non-hetero relationships. And I think more companies are starting to realize that as well. And then, yes, you’ve definitely seen a spike in interest from people during the pandemic as they’re sort of sitting at home in lockdown, not going out dating, not getting any closer to finding a partner they would want to have a kid with, but at the same time, they know their fertility is declining. So you have clinics that have said they’ve seen definitely an uptick in clients over the past year and a half. NYU Langone, I believe, said that they saw an uptick in patients of 41% last summer compared to the previous year. So I think the pandemic is definitely changing people’s perspectives on having families and maybe a little bit of panic set in for some people. So you have more and more clinics that are seeing, you know, an uptick in patients during this time.

How did egg freezing become so mainstream?

Courtney Vinopal: So, well, you referred to a few celebrities at the beginning who have frozen their eggs. So I would say that can serve as somewhat of an indicator at least to show that people know what egg freezing is now and are conscious of it. So Kourtney Kardashian spoke about freezing her eggs on an episode of Keeping Up With The Kardashians. I think she actually revealed recently that she did it, so we can hold out for a Kourtney-Travis Barker baby. And then there were two contestants on The Bachelorette who’ve spoken about freezing their eggs, one when she was with a partner, one when she had just broken up with a partner. So you do see these things in the news and on social media, definitely, you see prominent figures. Then, I think, as you mentioned again, just looking on your social media feeds, you get a sense of its popularity now. So you read stories of women who will see like 25 to 30 ads for egg freezing or other fertility services on their Instagram feeds in a week. So I think social media companies, yes, they definitely have a way of tracking our data and knowing what we’re likely to click on and be interested in. But I think fertility services and egg freezing, in general, has figured out how to sort of use social media to make their services known. So I think that can kind of speak to its popularity as well.

What is the cost associated with this fertility procedure?

Courtney Vinopal: Yes. So according to the website FertilityIQ, which is it’s almost like a Yelp for fertility—they have reviews of clinics and a lot of information about the procedure and things like that. So they say a single cycle on average costs between $8,000 and $15,000. And that’s not including the money that you have to pay for the drugs that you have to take before the cycle, that can be up to $5,000. And that’s also not including storage fees. So once you freeze your eggs, you have to pay each year to store them. And in the US that can average $500 to $1,000. So once you freeze your eggs, if you paid $15,000 for one cycle, for example, and then you freeze them for five years, you’re looking at upwards of $20,000. And there are companies now that are trying to find ways to offset the cost. There are programs where you can actually donate half of your eggs and do a cycle for free. The other thing I would say is that some companies do cover it now, but that’s very dependent on where you work. So a lot of tech companies will cover at least part of the cost of egg freezing. Apple and Facebook are some of the first to do it. Many more companies are doing it now. But it’s certainly not the norm yet.

What is the success rate for the procedure?

Courtney Vinopal: Yeah, so I will say this was maybe the most frustrating part of my research here, is that it really, really varies in terms of how effective egg freezing is once you’ve chosen your egg. Part of that is because most women who freeze their eggs still never unfreeze them, still never use them. So there’s not a whole lot of data on how likely eggs are to produce successful pregnancies. But what the science says, and the data that we have indicates is that it’s really dependent on how young you are when you freeze your eggs and how many eggs you freeze at the time. So I’ve looked at studies that put success rates as low as 4%—like an egg would have a 4% chance of turning into a viable pregnancy once you freeze it—or as high as 90%. But the data is going to look a lot more promising if you freeze your eggs when you’re 29 and you’re able to freeze 15 of them., versus if you freeze them when you’re 40 and are only able to freeze five, for example. And you really don’t know how fertile your eggs are going to be until you unfreeze them. So you won’t know until you until you actually use them.

What are some of the big players in the egg freezing space in the private sector?

Courtney Vinopal: I think companies started to see a lot of promise in the IVF industry when they realized it’s growing at a pretty rapid pace, and it’s pretty fragmented. So there are opportunities to buy up clinics and form networks, essentially. So that’s how you see more startups sort of come on the scene and offering egg freezing in recent years. A few that I would point out. One is Prelude fertility. So this is a startup that was founded in 2016. It was founded by an entrepreneur named Martin Varsavsky. And he actually says he was inspired to start this company after he and his wife had trouble conceiving, and were helped with IVF technologies. So I think what is sort of interesting about Prelude, and sort of indicative of the direction a lot of newer startups are going with egg freezing is they really encourage women to freeze their eggs in their 20s and early 30s, so at quite a young age. And I think the idea there is that they want to offer services in a bundle. So they want to offer not only egg freezing, but also combine it with sperm, and make the embryo once you’re ready. They will implant the embryo. They do genetic testing on the embryos. So they’re not just offering egg freezing, they’re offering this whole bundle of services. And the idea is that the sooner you do it, the better chance of success you have. So that is one company that I think is kind of leading the charge and really encouraging women to do it at a young, a younger age.

Another is a company called Kindbody. So this company was just founded in 2018. And I think what’s interesting about Kindbody is the way they sort of market their services. I think at one point one of their marketing directors told The Atlantic that they want to seem like a lifestyle brand, not so much like a fertility clinic, even though that means the services they’re offering are probably not so different than any other clinic that offers egg freezing. So you look at pictures of their clinics, and they look so nice. It looks like a combination of like SoulCycle and that women’s workspace The Wing—it’s like a lot of millennial pink, just a really nice place. And I think they’ve sort of recognized what an unkind or sort of scary place doctors offices can be for women and they’re trying to make their services seem different from that and, you know, set themselves apart from that.

How are fertility companies trying to recruit customers for egg freezing?

Courtney Vinopal: Yeah, so I would say that they’re trying to market to a certain type of client, right? They want to mark it to sort of go-getter, career-minded person who is thinking about their future and wants to make a smart decision about their future, but wants to focus on things other than pregnancy right now. So Prelude, actually, their advertising, it encourages you to find that right person, focus on your career, finish your education, and then use our services so that you can do that and have the option to get pregnant with your good eggs later. They also stress in their advertising that the age of your eggs (not you) is the number one cause of infertility. So it’s interesting, I think, with this advertising, you see they try to make it empowering and give you a way of taking control of your fertility in a world where you really don’t have much control of it.

But also there are messages that are a little bit anxiety-inducing, where they want to convey the message that you’re born with as many eggs as you’ll ever have, and you know, it’s best to make to do this now rather than later. One other interesting way that I think some of these companies market their brands as they do want them to see more accessible and more cost effective, right? So a few years ago, you had this company called Extend Fertility that had an ad  circulating that had a picture of an açaí bowl pictured next to a frozen egg. And it just said, ‘Frozen açaí and frozen eggs’ and then it marketed its services as ‘Egg freezing for the price of a healthy snack.’ So to me that says, ‘Okay, we have customers that are likely to buy açaí bowls, maybe there’s a way to market this to them.’ I think that it’s pretty obvious an açaí bowl is probably going to run you less than freezing your eggs, but that’s just sort of an interesting way that they’re trying to market their services. I do think this marketing has a way of sort of glossing over just how complex the process is, and just how much the success rates vary. Maybe some of that is because the marketing seems to be really focused on the present. Like they want to emphasize that they want you to focus on your career and your education and finding a good partner and everything but pregnancy. So I think sort of what they’re promising is that if you freeze your eggs, you can put anxieties surrounding pregnancy and your declining fertility out of your head for a little bit. It’s like a peace-of-mind promise, almost.