Alexandria Ocasio-Cortez is freezing her eggs – here’s what to consider if you’re thinking of doing the same

Kylie Baldwin, Loughborough University

US congresswoman Alexandria Ocasio-Cortez revealed that, at 36, she has decided to freeze her eggs. In an online social media video, Ocasio-Cortez said she chose to go through the process in order to “feel more in control of my life.” She also said that she was going to document her journey to open up conversations about fertility and normalise the process.

Ocasio-Cortez’s decision reflects a broader trend that is already taking place. The latest report from the Royal College of Obstetricians and Gynaecologists shows an increasing number of UK women are turning to “social” or “elective” egg freezing.

The report notes that the number of egg freezing cycles (the medical process of producing and collecting eggs) being undertaken each year has trebled between 2016 and 2021. The technology is now the fastest growing fertility treatment in the UK.

The picture is similar in the United States, which has seen a surge in cycles of egg freezing since 2014.

Although some women, like Ocasio-Cortez, are choosing to freeze their eggs for career reasons, my research shows that most users of the technology actually undergo the process because they haven’t found the right partner.

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These women commonly want to find a partner who is equally as committed to parenthood as themselves. Egg freezing gives them more time to find this partner, and avoid engaging in what I have termed “panic-partnering” – entering into a relationship they wouldn’t otherwise consider if they weren’t at risk of unwanted childlessness.

Other common reasons that women may choose to freeze their eggs include feeling like they’re “running out of time” to pursue motherhood, the desire to take control of their fertility and wanting to feel like they’ve done everything they can to keep the option of motherhood open.

Regardless of the reasons for freezing, here are a few things a person might want to consider before making a decision.

1. Cost

In the UK, social egg freezing is not available on the NHS. Although some women may be able to access fertility treatments through employment benefit packages, most will have to pay privately for the procedure.

The cost of egg freezing in the UK – including consultations, blood tests, ultrasounds, hormone medication and egg retrieval – is typically around £7,000–£8,000, depending on the clinic and how the patient has responded to the procedure.

In the United States, prices are even more variable – coming to between US$10,000-$20,000 (£7,000-£14,000). The national average out-of-pocket expense is roughly $14,000 to $16,000 per cycle.

Most women under 38 have around 7–14 eggs collected per cycle. They may therefore be advised to undergo multiple cycles to bank enough eggs for future use, which substantially increases costs.

Even when undergoing the procedure under the age of 38, there can be a significant difference in the number of eggs collected, meaning many women need to consider multiple cycles of treatment to store a sufficient number of eggs, which can substantially increase costs.

It also costs money to store these eggs before use. Annual storage typically costs a further £100–£300, while using the eggs to try to conceive can cost an additional £2,500–£3,500. In the US, a cycle of IVF using previously frozen eggs is on average about $23,474.

This considerable financial burden may place egg freezing beyond the reach of many women.

2. Health risks

Egg freezing isn’t without risk.

The process of ovarian stimulation needed to produce eggs carries a risk of ovarian hyperstimulation syndrome (OHSS), where the ovaries are over-stimulated following the use of hormone medication. Mild OHSS, which causes abdominal discomfort and bloating, occurs in around 20-33% of cycles. Moderate and severe OHSS, which cause more severe abdominal pain, nausea and vomiting, occurs in around 3–8% of cycles.

The egg collection process may cause further complications, including bleeding, pelvic infection, thrombosis and risks associated with anaesthesia such as dizziness and nausea.

3. Success rates

A further significant risk of the technology is also that it may not result in a live birth in the future.

The chances of having a future live birth from a previously frozen egg depends on a range of factors – including a clinic’s expertise, the age that you froze your eggs and the number of eggs stored.

Since egg quality declines as women age, older women often need to bank more eggs than their younger peers to increase their chance of a live birth with these frozen eggs.

Statistical modelling suggests that if a woman undergoes egg freezing before her 35th birthday, she may need around 20 frozen eggs to achieve almost an 80% chance of a future live birth. By contrast, a woman who undergoes the procedure when she is 39 will need 50 eggs to potentially achieve the same likelihood of success.

4. Emotional toll

Freezing your eggs can also be emotionally and practically challenging.

The process requires multiple visits to the fertility clinic for consultations, blood tests and internal ultrasounds, creating a significant time commitment alongside the financial costs of treatment.

For many, the emotional burden of undergoing the process alone is particularly challenging, especially when attending the clinic as a single person alongside patients undergoing IVF with their partners.

Some women also report feelings of stigma and embarrassment about using the technology at a stage in their life when marriage and motherhood are often still perceived as expected milestones.

Reproductive “insurance”

Despite the significant financial, physical and often emotional costs of egg freezing, evidence shows many women do not return to use their eggs. According to one UK clinic, only 14% returned to use the eggs they had retrieved – with a nearly 37% live birth rate in these patients.

But even when women don’t use their eggs to try and conceive, evidence shows they do not regret having undergone the procedure. This is because it has provided them peace of mind and greater reproductive autonomy.

While often perceived (and promoted) as a form of reproductive insurance, it’s essential that women undertaking egg freezing understand of the cost, risks and likelihood of success.

This article is republished from The Conversation under a Creative Commons license. Read the original article.