Egg freezing cycles jumped 31% over the pandemic. Here's why — and what the process entails.

When Sarah Robinson was approaching her 30th birthday, she began to take stock of her life. She realized she had been single for a while. Many of her friends, on the other hand, were either in serious relationships or married, and some already had children. Robinson, who is a writer for a crime podcast, had been traveling full-time for about two years and wasn’t planning on stopping. As she reflected on her life and what might lie ahead, she began to worry about her chances of becoming a mother one day.

Though Robinson was still young, she was aware that a woman’s peak reproductive years is in her 20s and that fertility gradually declines in the 30s, particularly after age 35.

“When you figure in ... the mathematics of the situation, you're going to date someone for a couple of years, you're going to be engaged for a year, you'll want to be married for a couple of years and then you start trying to get pregnant,” Robinson, now 32, tells Yahoo Life. “That would put me in my potentially early to mid-30s, so the nearer I got to 30, the more I started panicking."

Her fears intensified when the COVID pandemic began and lockdowns to curb the spread of the virus were put in place. Knowing she wasn’t going to be able to date for a while, she decided to look into freezing her eggs.

In 2021, as soon as some of the pandemic measures relaxed, Robinson reached out to a fertility clinic and underwent treatment to extract her eggs so these could be preserved for later use. She described the experience as empowering.

“I felt like I was protecting this really precious part of my future life instead of ignoring it and just hoping that it would work itself out when the time came,” Robinson says.

During the pandemic, many fertility clinics saw a rise in interest in egg-freezing procedures. According to a recent American Society of Reproductive Medicine report, the number of egg-freezing cycles in the United States increased by more than 31% a year after the COVID-19 pandemic began, from 16,786 cycles in 2020 to 24,558 in 2021.

“We've never seen a jump like that before,” Sangita Jindal, president of the Society for Assisted Reproductive Technology (SART), tells Yahoo Life.

Jindal, who is an IVF laboratory director and professor at Albert Einstein College of Medicine in New York, says egg freezing has become more widespread and has gained momentum, particularly among young career-driven women who want to delay childbearing.

About a decade ago, egg freezing was mostly available to patients undergoing chemotherapy or other medical treatments that can affect fertility. But in 2012, the American Society for Reproductive Medicine (ASRM) announced that freezing a woman’s eggs should no longer be considered an “experimental treatment.” The organization said the decision was based on evidence showing that egg-freezing cycles produced rates of pregnancy and healthy babies similar to those seen in in vitro fertilization (IVF) using fresh eggs. Since then, more women have been freezing their eggs for non-medical reasons, mainly to improve their chances of having children later in life.

Jindal explains that the rise in egg-freezing cycles in 2021 is probably due to a combination of factors such as increased awareness about the procedure, as well as the fact that many fertility clinics just got busier after having to close their doors the previous year due to the pandemic.

Dr. Jessica Ryniec, a reproductive endocrinologist and infertility physician in Chestnut Hill, Mass., tells Yahoo Life that she's certainly noticed the uptick in demand for egg-freezing services in the last two to three years.

“People are being more open and honest about infertility in general and speaking up about what they've gone through, either on social media or with friends and family,” Ryniec says. “I think that a lot of women are more exposed to the fact that infertility is very real and that infertility occurs more as we get older,” she adds.

Seeing a close friend experience infertility is what pushed Alli Kinzel, an executive assistant at a tech company in New York City, to look into freezing her eggs.

“Watching her go through that process was really heartbreaking,” Kinzel, 33, says. “She encouraged me to look into it for myself so that I didn't end up, you know, five [or] 10 years from now in the same position that she was without any other resources."

In 2022, Kinzel did her first egg retrieval, and just a month ago, she decided to give it another go to collect and freeze a few more eggs.

“It feels very cool to know that I've given myself that gift to ensure that I'm going to be a mother some day,” she says.

How does egg freezing work?

Many women often describe the process of egg freezing as empowering but also very physically, and emotionally, demanding. The process is also expensive, so it can cause financial stress for many women who have to pay for treatments and medications out of pocket.

An egg-freezing cycle usually begins either when a woman gets a period or after being on a course of birth control pills. Patients then take daily hormone injections for about 10 to 14 days to stimulate the growth of multiple follicles — small fluid-filled sacs in a woman’s ovaries that may contain an egg. During a menstrual cycle, only one mature egg is normally released from the ovaries, typically around day 14 of the cycle. But the injectable medications used during an egg-freezing cycle allow the ovaries to produce multiple mature eggs.

This stage of the process requires frequent visits to the doctor’s office because the patient’s ovaries must be monitored using vaginal ultrasounds. Once the follicles in the ovaries reach a certain size, the eggs are ready to be extracted.

The egg-retrieval process is an ambulatory procedure that takes about 20 minutes. Patients are usually sedated to ensure they feel no pain or discomfort during the process.

Using an ultrasound probe, a doctor guides a needle through the vagina and uses it to withdraw the egg from each follicle. The oocytes are then examined by an embryologist who will select those that can be frozen. Only mature eggs are selected because only these can be fertilized later on when the patient decides to use them to become pregnant.

When is the best time to freeze one's eggs?

Women are born with a lifetime supply of eggs, also known as an ovarian reserve. As a woman ages the number and quality of eggs decline, impacting natural fertility and her odds of successful fertility treatment. However, low ovarian reserve can occur at different ages for women.

Ryniec says that the majority of patients she sees for egg freezing these days are between 30 and 34 years old. This age range, she explains, is optimal for the procedure.

“After 34 to 35 certainly can still have good egg quality, but it does start to decline a little bit,” Ryniec says. “The early 30s tend to be kind of a nice sweet spot for both [egg] quality and quantity."

Freezing eggs in the early to mid-30s, and not earlier, is also ideal because at that age women are more likely to end up using these eggs.

“If you do it younger than that, sure you probably will have higher numbers and even better quality to a point, but you're also less likely to eventually need to use or want to use the eggs. Whereas between 30 and 34, at that point, it's more realistic that these eggs would be potentially a real plan for you,” the infertility physician says.

The number of eggs a woman should freeze depends on various factors including her ovarian reserve, and the number of children she plans to have. But Ryniec says that 10 to 20 eggs tend to be a good number for many people.

Although egg freezing is not a guarantee that someone will be able to have children, Jindal says freezing as many good-quality eggs as possible will give a woman the best chance of having a baby.

“If you're under 35 and you have a good number of eggs frozen, your best estimated live birth rate is around 70%, which is very high,” Jindal notes.

For women who are older than 35, the process can be a little more challenging, however. Ryniec explains that as women age, there’s an increase in abnormal genetics of the eggs. Because of this, many of these patients often need to go through multiple extractions to collect more eggs to achieve that same estimated live birth rate.

What happens when a patient wants to use their eggs?

A person who is ready to conceive using their frozen eggs will undergo IVF. During this process, the eggs will be thawed and fertilized in a lab either with partner or donor sperm to create embryos. Although it is possible for some eggs to not survive the thawing process, with today’s advanced techniques this is rare.

“If eggs are frozen and thawed in the same lab with the same hands and the same protocol, they have a very good chance of surviving, up to 95%,” Jindal says.

Once fertilized, some eggs develop into embryos which can then be transferred to a woman’s uterus. If successfully implanted, a pregnancy will result. Doctors generally implant only one or two embryos in the uterus at once.

In terms of how long someone can keep their eggs or embryos frozen, Ryniec says that with the cryopreservation techniques that are used today, these can be stored for a long time.

“They typically are able to stay frozen until you're ready to use them,” she says.

What are the costs?

Egg-freezing prices vary from clinic to clinic but according to some estimates, costs can range from $6,000 to $20,000 per cycle. Prices also depend on the type of protocol and medications a patient needs. In addition to the cost of treatments, patients also need to pay storage fees which can go up to $2,000 a year.

When Robinson completed her first egg-freezing cycle her insurance plan at the time wouldn’t cover any portion of the treatment, so she paid approximately $12,000 out of pocket. Now that she has better insurance, she says she is considering doing another round.

Kinzel, on the other hand, worked for a company that offered her up to $15,000 toward egg freezing.

“I would've done it without the fertility benefit. It just would've been obviously much more stressful,” she says.

More companies are offering egg-freezing benefits these days. According to a national survey of employer-sponsored health plans conducted by Mercer, as of 2020, almost 19% of large U.S. employers offered egg freezing, while 42% offered coverage for IVF treatment.

Now that she has gone through the process, Kinzel says she has made it her mission to educate other women about it.

“I started a Slack channel at work called #Eggs-eggs-eggs and I talk to women all the time about their fertility journeys,” Kinzel shares. “I work with 23-, 24-year-old women who have this gift of $15,000 toward egg freezing. … It's become a really important thing for me to just have these conversations openly and candidly with women and men that I work with."

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