Dear Dr. Maslow,

I’m 32 and single. I’ve been dating for 10 years. Most of my high school and college friends are married and on their way to starting large families. I feel like my world has moved on without me.

All I’ve wanted my whole life was to have children. While I’m making do with the life I have right now, it all feels like a waiting game until I meet the right guy. I’ve heard others talk about egg freezing as an “insurance policy.” I used to think it was only for women who cared more about their careers than having children. Is it something I should consider? It’s so expensive, and I hear it might not even work. I read about women who call it “empowering,” but all I can think about is how sad I am that this is where I am in life.

Dear Feeling Bummed,

The emotions you are experiencing are totally normal. I see hundreds of women just like you who come to discuss egg freezing every year. While some are enthusiastic and “empowered,” as you describe, the vast majority share some version of a story like yours. Studies have shown that <80% of women who freeze their eggs aren’t actively delaying childbearing. Like you, they would love to have children but haven’t found a partner with whom to have a family. (Inhorn, 2018) When I see a patient for an egg-freezing consult, I’m usually the last person she wants to talk to. Like you, most women do not have “egg freezing” on their list of life goals. It’s a Plan B (… or C … or H!).

Nevertheless, egg freezing can be a valuable tool. Female fertility declines with age, primarily because the eggs we were born with start to develop errors in their chromosomes over time. Chromosomally abnormal eggs are not able to produce healthy babies. Egg freezing allows you to preserve a group of eggs with a higher proportion of healthy eggs than you might have in the future. If you ever need fertility treatments in the future, this may help. Alternatively, maybe you won’t have problems with a first child but may run into difficulty with a subsequent attempt at pregnancy. Regardless of the circumstances, your chance of success is directly related to the age of the eggs being used. For example, if you were 40 but got to use your 32-year-old eggs, you’d have the success rate of a 32-year-old, which is two to three times higher than a 40-year-old.

Yes, it’s true that it does not always work. The more eggs you freeze and the younger they are, the better the chances. However, no matter how many eggs you freeze, there is never a guarantee. I published a study that showed that almost all women >35 were able to achieve a reasonable chance of future success with only one or two cycles. (Maslow 2019) Many women are also surprised to learn that an egg-freezing cycle can be completed from start to finish in under two weeks. So the time commitment is manageable for most women.

Yes, it’s also expensive. Some companies offer egg-freezing coverage as part of their health plan or employee benefits, so make sure to check! It’s also an investment. A recent study showed that egg freezing before the age of 33 was the most cost-effective when balancing the potential number of cycles needed and the likelihood of using the eggs in the future. (Bakkensen, 2022)

It’s a process, one that involves an investment of time plus financial and emotional resources.

For women waiting to start their families, especially those who desire larger families, we know there is a good chance they may be trying to conceive in their late 30s or early 40s when fertility rates are decreasing. I’ve had plenty of patients who were able to conceive initially on their own, but the fact that they had frozen eggs was the difference between two kids and three or four kids.

We never know what life has in store for us. The best thing we can do is leave as many options open as possible to achieve our dreams.

Wishing you much success in all your future endeavors!

Dr. Bat-Sheva L. Maslow, MD, MSCR, is a reproductive endocrinologist and an expert on the intersection of reproductive medicine and Jewish life. To schedule an appointment with her at Reproductive Medical Associates (RMA) of New Jersey’s Englewood or the brand new Jersey City location, see www.rmanetwork.com/NJ . You can invite Dr. Maslow to speak in your community or learn more about her educational projects on her website www.batshevamaslow.com  and @blmaslowmd on Instagram.