This article was updated on June 7 with additional reporting.
More than a year ago, when it became clear that initial stay-at-home orders would last a while, speculation began about a looming covid-19 baby boom. It certainly made sense at the time: a bunch of couples stuck at home, little to do.
Instead, many procreation plans were put on literal ice.
Even as New York City’s businesses — restaurants, bars, gyms, retail — were slammed by the pandemic, New York University’s Langone Fertility Center has seen an 83 percent increase in women freezing their eggs when comparing January to May 2021 numbers to the same time period in 2019.
James A. Grifo, the center’s director, has an explanation for the surge: In a time when people feel so helpless, he says, freezing eggs could be one way to restore a sense of control.
“Covid has really pushed the needle in terms of people freezing their eggs,” Grifo said. “A lot of women are afraid to try and get pregnant. Because of this delay, they wanted to do something to protect their fertility, so they froze eggs as a way to say, ‘Okay, I can’t get pregnant now. I’m afraid of this virus, but I’ll do something.’ ”
Grifo said the center has had their busiest year-and-a-half ever despite the pandemic. Even accounting for the early stay-at-home orders, they conducted 300 more retrievals in 2020 than the previous year. And they established stringent safety methods to protect against covid-19, Grifo said, so that only 7 out of 2,000 retrievals in 2020 were canceled due to the patient contracting the infectious disease. (All seven patients were asymptomatic or had mild symptoms, according to Grifo.)
Egg-freezing (or, to be technical, oocyte cryopreservation) was developed in the 1980s to allow cancer patients to preserve their eggs before undergoing chemotherapy. When the American Society for Reproductive Medicine declared the procedure no longer “experimental” in 2012, it gave women a new opportunity to take charge of their reproductive lives, especially as the average age a woman gives birth to her first child steadily increases.
Freezing eggs allows women to better their odds at the table and to redraw their timelines.
Thirty-one-year-old Becca Kufrin, the lead on the 2018 season of “The Bachelorette,” called it quits with fiance Garrett Yrigoyen during stay-at-home orders. She decided to put her eggs on ice as an investment in her future self. She wasn’t worried about genetics but figured, she said, that “I’m not getting any younger.”
The demanding egg-freezing process — which involves a cocktail of hormones to inject and ingest over a few weeks to stimulate the ovaries to grow as many eggs as possible — requires downtime, though, and in February 2020, Kufrin was in a new city every night for a “Bachelor Live” tour. The pandemic, as it turned out, gave her an opening to start.
“I think the thing that really pushed me over the edge to move forward with it is the fact that I just got out of a two-year engagement,” Kufrin said. “Now that I’m out of that relationship and I don’t know when I’ll be in a good, committed relationship to start a family one day, why not take this step? I’m an independent woman. I have the means to do this right now at this time for myself.”
She received “really heartwarming” support after making the decision, she said, from family and friends and inbox-flooding Instagram followers alike. “To share something similar, especially something that’s so intimate with our bodies, has been really special that I didn’t originally expect going into this,” she said.
And the early returns have been a success: Of the 24 eggs her doctor retrieved from her, Kufrin says, 19 were mature enough for fertilization and ready for the freezing process. According to her doctor, that puts her at a 90 percent take-home baby rate and a 70 percent chance of two babies at the time of her choosing.
“In the perfect world, one day I would find the right partner for me to be able to get pregnant‚” Kufrin said. “But if that doesn’t happen, if I don’t find a partner or if I can’t get pregnant on my own, it feels good knowing that I have a few eggs on reserve.”
When it comes to freezing eggs, the younger a woman is, generally speaking, the more eggs she tends to have. And the greater the number of eggs, the greater the odds of a baby. The outcome of egg-freezing is no sure thing, though, even if it is often marketed as such. That means many will shell out thousands of dollars or more for a procedure based on unrealistic expectations, regardless of their fertility composition and timeline.
Data on egg-freezing is lacking, but Grifo said he and his Langone team completed a 15-year study in September 2020 that reports final outcomes useful for patient counseling, using data from patients with an average age of 38. The study showed that 74 percent of eggs survived the freezing process and nearly 70 percent of those surviving eggs were successfully fertilized, with a live birthrate of 34 percent. This rate is similar to the success rate of in vitro fertilization, or IVF, where fresh, mature eggs are collected from ovaries and fertilized by sperm in a lab to create an embryo that is then transferred to a uterus (no freezing required).
And while a 34 percent birthrate may not sound all that successful, Grifo and his team say otherwise. “This percentage shows that the technology is viable, even with women freezing their eggs at an age much older than is ideal,” Grifo said.
Sometimes even those right at the “ideal” age can benefit.
But that gift doesn’t come cheap. Egg-freezing and IVF are both considered elective procedures, and few medical-insurance policies cover such costs. For egg-freezing, women must undergo daily hormone injections, office visits and anesthesia, often leaving them with bills averaging $15,000 out of pocket per cycle, according to CNY Fertility. That figure does not include the annual fee that clinics charge to store eggs in liquid nitrogen. While initial egg-freezing costs usually include the first six months to a year of storage, yearly fees average around $650 per year after that, depending on the clinic. It’s also important to note that more than 30 percent of patients are doing more than one cycle, realizing that their chances of a baby are better with multiple cycles, according to Grifo.
Some women are finding ways to manage the costs. Rochelle Gapere, a 39-year-old happiness coach and Jamaican native, decided to freeze her eggs in Barbados, where the procedure cost just $7,000. She assumed that her odds of meeting a partner during the pandemic were slim and wanted to keep her reproductive options open. “I’ve always been a confident person, but there is a sense of relief that I have that as I approach 40, I can date and get to know someone organically without the pressure of my ticking biological clock,” Gapere said.
Meghan Smith, a reproductive endocrinologist at the University of Southern California, said pandemic economics have actually encouraged some women who were considering the procedure to act. Some workers who were furloughed, Smith said, decided to use their insurance savings accounts for such procedures before they lost them, or in case they were not quickly rehired.
“One of the biggest things I’ve observed is women are using these benefits and becoming single mothers by choice a lot more frequently than before the pandemic,” Smith said.
In all, the daunting price tag means egg-freezing is hardly an equal-opportunity venture. The Society for Assisted Reproductive Technology analyzed nearly 30,000 egg retrievals and found that just 4 percent of women who undergo the procedure identify as Hispanic, while just 7 percent, like Shauneik Hargrove, are Black.
Hargrove, a 37-year-old mother of two, was diagnosed with Stage 3 invasive breast cancer last August. She said she understood the battle to come: 24 weeks of chemotherapy and, depending upon the results, surgery. Her job as a medical assistant and recent pursuit of a nursing degree had prepared her for that. But what came next was a different shock.
“On top of all that, I was told I could possibly go into menopause. I’ve always wanted another child,” Hargrove said. She was determined to freeze her eggs before undergoing treatment. Because of limitations in insurance coverage, and even with the help of grants specifically for cancer patients facing such decisions, there was still a substantial out-of-pocket cost for treatment, Hargrove said.
Her co-worker, a nurse practitioner pregnant with twins, shared Hargrove’s story on GoFundMe last September. They raised more than $5,000, which was enough for Hargrove to have the procedure. “It was a blessing. It let me know people do care,” she said.
As with her chemotherapy treatments, Hargrove went to every appointment and retrieval alone because of coronavirus restrictions. Hargrove woke up from the procedure to hear that 36 eggs are now on ice for her, for whenever she is ready.
Across the board, in a tempestuous time, egg-freezing was able to gave these women control.
“Covid has made me live more intentionally,” Gapere said. “I am so grateful that I don’t have to succumb to society’s timelines or be with someone who doesn’t deserve me, just to have a child. The power of choice is incredible.”