On this week’s episode of The Cut, co-host B. A. Parker talks to journalist Anna Louie Sussman about the logistics and ethics of egg-freeze-and-share programs, where people give away a portion of their eggs in order to gain a better shot at becoming parents later in life at a more affordable price than that of traditional egg freezing. Speaking with different woman who have opted to do freeze-and-share, as well as with reproductive endocrinologist Dr. Aimee Eyvazzadeh, we look to better understand just how frustrating and invasive the process can be and if it really is worth it.
To hear more about egg freeze-and-share programs, listen below, and subscribe for free on Apple Podcasts or wherever you listen. You can also read the full transcript below.
ANNA LOUIE SUSSMAN: During the pandemic, you saw a lot of news reports about local fertility clinics seeing a big rise in demand and marketing egg freezing to people. Some of the reasons they gave were that people weren’t dating as much, that people felt like their lives were on pause, and they weren’t moving forward. So they wanted to be proactive about their future.
B. A. PARKER: And egg freezing is already a part of the cultural conversation with people like the Kardashians. And that’s great when you’ve got Kardashian money. Or when you live in California, where ten out of the 50 busiest fertility clinics in the U.S. are located. But access and affordability always come into question. To have kids right now, to even think about freezing eggs is an expensive proposition. You’ve gotta have means.
ANNA: Stand-alone egg-freezing studios in the U.S. cost anywhere from $6,500 to $9,000 or $10,000 for the procedures. There are other ancillary costs like medications, which can be anywhere from $3,000 to $5,000. There’s also a lot of testing and other kinds of poking and prodding that goes into it that you might be charged for. There are also storage costs that come after the eggs are frozen — you’ll pay an annual storage fee of between $300 and $600.
PARKER: So many people are simply priced out. Sure, they could be an egg donor for women who could afford IVF and all the other stuff that goes along with conceiving that way. But freezing their own eggs? Nah. That’s for people who make a lot more money. But what if there was a way to do both at the same time? To use egg donation as a ticket to egg freezing?
ANNA: Someone would undergo egg freezing for free and give away half her eggs and freeze the other half. The recipient of half the donor’s eggs picks up the cost for everything. Procedures, testing. All of it. Dr. Aimee, whom I spoke to, runs probably the best-known freeze-and-share program. Her clinic offers five years for free. And after that, something like $275 a year for storage.
PARKER: That’s so much pressure. I would need five years to get my shit together
ANNA: I’ve been paying since I was 34 and every year when the bill comes, I just think, Oh, another year.
DR. AIMEE EYVAZZADEH: Freeze-and-share actually came out of a situation where I had a 40-year-old patient who was an egg donor when she was 20, and she needed a donor herself. And then I just said, Enough’s enough.
PARKER: If only the donor had had a way to set aside some of their eggs when they were in their 20s! Well, Dr. Aimee’s (and other programs like hers) is that way. And with arguably problematic marketing that says things like “Preserve Your Options” and “Freeze Time,” there’s an increased demand.
DR. AIMEE: You’re going to run out of eggs. Every single woman does. And sometimes they run out before they’re done having kids. When I started my practice, the average age of first-time birth in the Bay Area was around 31 or 32. It’s continuing to creep up, where I’m seeing more and more patients who are 50 to 54 now than ever before. The patients are coming in with their first baby between 41 and 44. So it’s definitely a trend that is changing and changing rapidly.
PARKER: So how does this work? Well, the donor must undergo hormone stimulation, where a doctor hyperstimulates the production and the maturation of multiple eggs in one given menstrual cycle. And the hope of the doctor is that 15 to 20 eggs are made. Because remember, half of the eggs go to the donor and the other half go to the recipient.
DR. AIMEE: My rule is ten. In my last freeze-and-share, she made 15 mature eggs. Then we split them half and half. And if there’s an odd number, the recipient gets the extra egg. If it’s less than 10 mature eggs, I will not split them. Then the egg donor will get at no cost to herself, another egg freeze for her.
PARKER: It’s a physically involved process that can take up to two weeks with costs that can end up in the $30,000 range. And all of this — the money, the time, the meetings, the negotiations, the emotional labor, and the physical prodding — for just a couple of eggs.
ANNA: Your body will select the juiciest, ripest egg and grow it to maturity. I think the scale of it is even more of a head trip. When you think about the fact that they’re barely visible to the naked eye and they cost that much. They’re so tiny and yet so expensive.
PARKER: And beyond economic access, freeze-and-share put the idea of planning in front of people who may not be thinking that far ahead. Women in their early 20s looking to make extra money may someday be people in their 40s ready to have children. Remember Dr. Aimee’s patient? The one who was a donor and then had to use a donor? And for the recipient families? Dr. Aimee sees no drawbacks.
DR. AIMEE: I think sometimes people read these like scary stories, or if they’ve seen these scary movies where the husband runs off with the egg donor or something stupid like that, which never ever happens. Sometimes people are scared of things that are not a possible reality, and the reality is actually really beautiful.
ANNA: There’s the possibility that if you can’t afford egg freezing in your mid-to-late 20s, you may not be able to afford the cost of doing IVF and using the eggs later on, if for some reason there is some mishap, or the eggs that you froze don’t work, or there’s a clinic malfunction.
PARKER: Or an even bigger problem. The program is all about increasing accessibility, but it’s also about desirability. So someone can go through the process, meet a recipient family and just not be what they’re looking for. And just like that, they can’t use the program.
ANNA: Sperm donation is a market. There are more “desirable” candidates and attributes that, if you don’t match with what the paying patient is looking for, it’s not gonna work for you.
PARKER: There’s also the question of how attached one is to one’s genetic material. After all, the point of that egg that you donated is that it becomes a human being. One that’s half you. Turns out, a lot of donors do care … but many also don’t.
ANNA LYON: They always had a psychologist talk to me. Usually, they asked the same questions. Like, Are you going to feel like a mom? Are you going to feel upset if they have your genetic children and then, later in life, you can’t have your genetic children? There’s a sort of script that you get fed from your agency that I think donors use. I used it. When you sign up and they ask questions about being a donor, they give you these lines. Like, Well, most of our girls say it’s just, ‘I was going to flush it down the toilet anyway. So why don’t I give it to somebody else who can use it?’
ANNA: Did you feel that way?
ANNA LYON: When I was answering those questions, I don’t think I thought about it super-critically. When I was in my early 20s, I bought into the narratives that industry people would give me. So I repeated to them what they told me without really digging into how I felt in my heart. And I think I was just too young. At 21, I was not in any way worried that I would someday struggle to conceive my own children. Whereas, at 29, I did a freeze-and-share because I had become worried about that.
The one question that really got me, the only question that ever made me sort of stop and feel like I did need to dig in a little bit, was during my fifth cycle. She said something about how if the child needed an organ transplant, it was their policy that the family could reach out and ask me for an organ.
PARKER: In her earlier cycles of donation, Lyon was an anonymous donor, even though she wanted it to be open. But now that she’s participating in the freeze-and-share program, she is allowed to be an open donor — so she can know about the future children that came from her eggs. Lyon’s freeze-and-share donation hasn’t resulted in any children yet. It’s too recent. But in a lovely twist, Lyon did recently receive news about an egg donation from a few years ago.
ANNA LYON: My phone went off, and I opened it and got this message saying, “Thank you so much for what you’ve done for me. My child was born. He is healthy. I’m so grateful to you.” I just started weeping. I felt filled with joy in a way that I never have before.
PARKER: She wept because it was the first time she’d received ANY news about the outcome of one of her eggs and just learning a few details allowed her to envision who the child was.
ANNA LYON: I feel a sense of responsibility that I’m creating children into the hands of people I think should be raising children.
ANNA: How was the pregnancy of the first couple? Was everything healthy? How was the birth?
RYAN MOODY: I did not follow along.
PARKER: Ryan Moody is an engineer in her 20s who has donated her eggs twice through a freeze-and-share program. And she takes the meeting process very seriously. Because while she wasn’t engaged in the birthing process, she did want the child to be born and raised in a loving and tolerant home.
RYAN: I asked, Are you good people? Do we have similar values and that kind of stuff? But I also was asking the questions of, What would you do if your child ended up loving somebody that you didn’t want, and what would you do if your child was not the gender that you wanted? Or they identify differently than you … that kind of stuff, just to ensure that we were similar.
PARKER: See, Ryan didn’t want money. As a Black woman and a descendant of American slavery, the idea of exchanging her genetic material for money felt … icky. She didn’t want to be part of a commercial transaction, and she didn’t want the child to feel that way in the future. So the prospect of getting half of her eggs frozen seemed … less icky.
RYAN: I had tried to communicate that the only reason I wanted to do this was for me to have my own donation cycle at no cost. It was less about, Can I have this money in my pocket?
PARKER: So while Ryan wasn’t emotionally connected to her eggs, she did want to respect her ancestry. She talked to Anna Louie Sussman about the experience of flying out to meet a child that was born from her donation
RYAN: Of the hour and a half we spent together, I probably spent the first 45 minutes trying to not even look at their child. I was like, I’m only interested in you two, as the parents. So I’m just asking them about their current life and how they’ve been doing, everything that did not have to do with a baby. That’s the only reason I’m here, is because we share this child in common, in some kind of way, but I’m trying to focus on things that have nothing to do with their kid.
ANNA: How did it feel for you to see the baby?
RYAN: It felt a lot like seeing a friend’s child. I felt surprisingly more ambivalent than I thought. I thought that I might feel some sort of kinship with their child, and I really didn’t, honestly. I feel a little bit bad for it because I think that a lot of the blogs and stuff that I had read were like, Sometimes a kid will grow up and feel like this really strong connection to you. So I hoped and imagined that if this child does feel strongly connected to me that I can reciprocate that. I kind of wonder if I might feel that way. If I felt they had a personality similar to mine, like, Oh my God, I do that too, then maybe I would feel that, but truly, I felt like I was just seeing a baby.
It made me want to have a biological kid more. I was very interested before, and now I’m like, That’s kind of cool, the miracle of life. It made me think a lot about that. I still don’t want to be pregnant, especially after hearing graphic details of her birth story, but it really did make me think of the miracle of life. The first family wants two kids, the second family wants two kids. Maybe this third family wants two — and then say something crazy happens and then I want two kids of my own. I just need to think about how many people I’m putting in the world.
ANNA: Egg freezing has grown by leaps and bounds but from a very small base. It’s something like 20 to 25 percent growth per year, but you’re starting from a minuscule number. The last data I saw was something like 16,000 or 18,000 women in the U.S. had frozen their eggs. One doctor pointed out to me something interesting, which was that he started a freeze-and-share at his program because he needed more egg donors for his infertile patients. But because his program also offers a 0 percent interest monthly payment plan for egg freezing, most people who wanted to freeze their eggs went with that program rather than taking advantage of the freeze-and-share option. In his view, he thinks they want their eggs and they want all of them, so if they can pay over time with no interest, they would rather do that.
PARKER: I don’t know if I have the gumption to walk around the Upper East Side and see, like, a dorky Black kid with vision problems and be like, Oh, that quite possibly could be my biological child. I don’t know.
ANNA: I think it really depends on the person. You can get these, unexpected issues or unanticipated situations, depending on what your relationship is to your genetic material and to the people who were the recipients of it. It’s still a fairly novel technology. People are definitely thinking hard about how to bring this to more people. I think that presents a new kind of ethical choice for the people at whom it’s targeted.