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For her new book Motherhood on Ice: The Mating Gap and Why Women Freeze Their Eggs, Yale University professor Marcia C. Inhorn talked to more than 150 women who had pursued egg freezing. I chatted with Inhorn this week about what popular culture gets right and wrong about women freezing their eggs. Below is a portion of our conversation, edited for clarity and length.
Reason: When did egg freezing start being considered an effective technology?
Inhorn: It took until the first decade of this century for research scientists to successfully freeze human eggs. The American Society for Reproductive Medicine on October 19, 2012, issued a statement saying that egg freezing could be moved from the experimental category to the category of clinical use in American medicine. So, it’s been available in America since late 2012 and has taken off ever since then.
There’s this prevailing assumption that women who freeze their eggs do so because they want to continue climbing the career ladder before having kids. What did you find in your research about this?
That was basically my hypothesis. And there is still an assumption that women are doing this as selfish, ambitious career women. But that is so not what I found in my study. It ended up being very much about what I call “the mating gap.” Basically, women freezing their eggs tend already to be educated, successful professional women who…want partnership, pregnancy, parenthood. They want to be moms, with partners, but they’re lacking what I call the three Es: eligible, educated, and equal male partners.
It’s really about gender disparities. They cannot find men who are willing to partner with them and have children. Underlying that is a big demographic disparity now growing in our country, and in many countries around the world. Women are just getting more educated than men. Right now, in the critical reproductive years for women—from their early 20s to their late 30s—there are millions more women with a four-year college or university education than men.
What are some other common tropes or stereotypes about egg freezing that didn’t match what you found in your research?
The big problem with egg freezing [is] it’s just economically not accessible for so many people. It’s about $15,000 to go through one cycle. I wasn’t really sure what I was going to find, but I’m going to say that, overall, it’s an elite population of American women who can afford egg freezing.
That kind of speaks to the fact that these are women really invested in this idea. It’s not something where gullible young women are simply swallowing marketing about egg freezing.
No. There’s this big assumption that women are going to graduate college, their parents are going to give them money to go off and freeze their eggs. That is really not the story. Most women, before they even consider doing it, they do a lot of research and a big thought process about, “Why would I do this? What is it going to bring to my life?”
You just wouldn’t go into it lightly because it takes at least a month of life; it takes using powerful hormonal medications and injecting them into your own body; it takes money. Some women are not going to get enough eggs and they’re going to have to go through two, sometimes three, sometimes even four cycles of it. It is not a technology you would enter into lightly. But when women do freeze their eggs, I found in my study, that it gave a lot of psychic comfort and relief to women who are really feeling up against the biological time clock. In my study, the average age at which women first went into egg freezing was 36.6.
There’s also this idea that egg freezing is this easy, foolproof route to put off reproduction, and your book really challenged that idea.
Yeah, it’s not a guarantee. And in vitro fertilization [IVF], too—the oldest of the assisted reproductive technologies—still fails more often than it succeeds. All of these reproductive technologies are challenging, so women are encouraged to get 15, 20 eggs and store them. But I had stories, really painful stories, in the book about women who had stored more than that—25, 30 eggs—and when they went to rewarm and thaw them, none of the eggs achieved the creation of viable embryos.
The term “fertility insurance” is often used to describe egg freezing. It is not a guaranteed form of fertility insurance. It is not. Having said that, I have stories in my book of women who had successful frozen-egg babies. It does work for some women, but it is just not 100 percent effective.
You write in your book about people who critique this on feminist grounds. Can you go into that a little bit?
There are different feminist positions about egg freezing. I think [feminist critique] was especially vociferous when some large Fortune 500 employers back around 2013, 2014—especially the big tech firms in California—began offering egg freezing as a fertility benefit of employment. The assumption, the feminist critique, was “Oh, these big companies are just trying to make women work harder and longer and not pursue their reproductive desires and goals. It’s a way for employers to put down women and their other aspirations in life.” But what I learned in my study, because I did interview quite a few women in tech, [was that] a lot of women in tech fought to get egg freezing benefits because it made them very upset, as single women, when they saw their married women colleagues getting health insurance subsidized IVF. I interviewed quite a few women who had really fought hard in the big tech firms to have egg-freezing subsidized for them, feeling that it was discriminatory not only for single women, but also for LGBTQ women workers who couldn’t prove that they were having one year of unprotected sexual intercourse.
I think a more important feminist critique has been what we’d call the intersectional feminist critique, which is that basically because this is such an expensive technology, it is prohibited for so many women. There are some really valid feminist critiques of this technology.
But having said that, now that we’re a dozen years into egg freezing, and every year more and more women are using it, clearly it is benefiting some proportion of the American population. And egg freezing has taken off around the world. It’s a global technology at this point in time.
Your assessments from the women who had done it, they were largely positive, right?
Yeah. I interviewed women who’d already done egg freezing, at least one round of egg freezing. And I asked, “Now that you’ve done it, how do you feel about it?”And there was this outpouring. I had this huge chart with more than 200 positive things women said in about a dozen different categories. It gave them peace of mind, tremendous psychological relief. It made them feel that they had affected their reproductive timing. They had more time on their side. It gave them a sense of technological optimism. There were just many different categories in which women felt that egg freezing benefited them. So, for the most part, they were happy that they had done it.
Some were not. I think that in the media, we’ve seen over the years more and more women unhappy about the results of their egg freezing coming forward and saying, “It’s not a technological panacea. It doesn’t always work. I wish I hadn’t spent $50,000 on it.” And those are legitimate, too.
But for the most part, women in my study who had done egg freezing were very relieved that they had done it and felt that it gave them this reprieve. For a lot of women that actually also meant like, “If I don’t find a partner, if that little dream doesn’t come true for me, am I able to carry it off on my own? Can I become a so-called single mother by choice?” And some women in my study did make that decision, as well.
Egg freezing, there’s been a lot of critique. Various kinds of critiques about it. But when women have the desire to have children, they have strong reproductive desires, I see it just as another technological tool that some women can use, at least, to try to achieve their own reproductive dreams and aspirations.
