Egg Freezing Boutiques Look Like Trendy Spas. But Are They Legit?
New egg freezing boutiques may look great on Instagram, but should you trust them with your future fertility?
Five years ago, when marketing exec Jennifer Huang was 36, fresh off a breakup, and single, she decided to freeze her eggs. Huang chose a large, prominent New York fertility clinic with a reputation for helping women conceive or, in the case of egg freezing, helping women render their eggs impervious to the march of time.
But overall, Huang describes the experience as "cold and distant." "I felt like I was one of hundreds of women—and certainly the only single woman in the waiting room. Some had their husbands or even their kids. I felt alone and scared," she says.
Today, Huang is chief marketing officer for NYC's Trellis, one of a sprinkling of egg freezing studios that have popped up in recent years. These decidedly non-clinical-feeling boutiques cater to elective egg freezers with spa-like atmospheres, including features like Insta-friendly backdrops, phone chargers, and co-working space, in uber-convenient locations.
Another similar studio, Kindbody, has brick-and-mortar locations in Midtown plus a mobile fertility tour featuring a large walk-in bus painted a can't-miss Gen Z canary yellow and bearing the hashtag #MyKindOfCare. It makes pit stops throughout NYC as well as on the West Coast. The bus offers testing—sometimes for free—for anti-Müllerian hormone (AMH), considered an indicator of the quantity of a woman's remaining healthy eggs. Kindbody CEO Gina Bartasi recently told TheVerge.com that when selecting the next pop-up location, she asks herself, "Where is SoulCycle opening up?" and "What is Drybar doing?"
A new take on fertility preservation
Freezing eggs—"oocyte cryopreservation" in medicalese—isn't new, but with more women delaying childbearing, it has gained popularity for its seeming ability to freeze time. Now often referred to as social egg freezing or Millennial family planning, it's en route to becoming the go-to option for strategically delayed motherhood.
About 475 women froze their eggs in 2009, according to the Society for Assisted Reproductive Technology (SART). In 2012, the organization, along with the American Society for Reproductive Medicine (ASRM) announced it no longer considered elective egg freezing—that is, freezing eggs in an effort to thwart age-related fertility decline—experimental.
By 2016, the number of egg freezers had jumped to nearly 7,300; the following year, more than 10,000. Cut to August 2018, when Kindbody opened up 100 appointments for a midtown Manhattan fertility pop-up—all were booked within 20 minutes.
The egg freezing process traditionally takes place at a fertility clinic—often one that's private or associated with an academic institution—where it's one of a long roster of fertility-related protocols, including intrauterine insemination, in vitro fertilization (IVF), surrogacy, and pregnancy with donor eggs. But at most of these new studio boutiques, it's all egg freezing, all the time. That means less overhead, passed onto clients in the form of reduced costs. Kindbody, for example, charges $6,000 for a single cycle, substantially less than the U.S. average of $10,000 to $15,000 per cycle. (Neither figure includes the costs of medication and annual oocyte storage, which easily can tack on thousands more.)
And unlike the alienating atmosphere Huang recalls experiencing, studios pull out all the stops to make women confident and comfortable: Walls are emblazoned with messages of female empowerment like "Make ova your future" (at Chicago's Ova Egg Freezing Specialty Center); social media feeds feature self-assured cryopreserving influencers and celebs like musician Rita Ora, who froze her eggs in her early 20s. At Trellis, women don soft bathrobes during vaginal ultrasounds and are offered a choice of fresh juice combinations that would rival what you might find on a high-end cleanse.
Are egg freezing boutiques legit?
Allison K. Rodgers, M.D., a reproductive endocrinologist at Fertility Centers of Illinois, says she appreciates that these boutiques are improving access to family planning technology. Dr. Rodgers, who has personally benefitted from fertility treatments (but not egg freezing) for two of her three children, recognizes the comfort they may give to women who are not considered traditional fertility patients. "It can be nice to not have to sit in a fertility clinic filled with women and their partners," she says. "Some patients may feel bad about being single or not in the place in their life where they expected to be."
Paula Brady, M.D., a reproductive endocrinologist/infertility specialist at Columbia University Fertility Center in New York City, summarizes her overall take on the trend by saying, "the general movement towards women getting more information about fertility and reproductive aging is a good thing. Information is power; it allows you to plan and prioritize." Studios, she adds, seem to be democratizing the egg freezing process with their reduced fees.
But both experts cite concern over the validity of the intel women may be receiving. Dr. Brady said AMH, a heavily emphasized biomarker at fertility studios (sometimes the only biomarker checked) should not be used as a single predictor of fertility. Other factors, most importantly age, must be considered.
"I have patients coming in saying, 'I just had my AMH tested and I'm freaking out because it's low,' but it needs a more nuanced look," she says. A study published in the Journal of the American Medical Association in 2017 looked at 750 women between the ages of 30 and 44 without a history of infertility and found that low AMH levels were not associated with reduced fertility. "AMH tells you how many eggs are in the ovaries…but it doesn't tell you anything about your egg quality...the proportion of eggs that are genetically healthy and can lead to pregnancy," says Dr. Brady. (That number, she says, is tightly related to age and starts declining at 35.) "I think some patients might rush into egg freezing because their AMH is low according to one of these boutique tests," she adds.
There's also the question of whether fertility boutiques might be offering a false sense of hope. No matter where a woman opts to freeze her eggs, Dr. Brady says, it's important to understand from the start that one frozen egg does not guarantee a future baby. Some boutiques, like Extend Fertility in New York City, make a point to emphasize this. Yet widespread marketing efforts, including targeted social media ads comparing the amortized cost of egg freezing to that of a weekly mani/pedi may make the procedure seem like a surer bet than it is.
"As with all medical decision-making, you want to ensure that this isn't being relegated to something as mundane as getting your hair colored," says Ramani Durvasula, Ph.D., professor of psychology at California State University, Los Angeles. "By putting it under the rubric of a 'boutique,' there may be some risk in it being viewed as an everyday occurrence, with little regard for each individual woman having the opportunity to explore whether a particular boutique, or even the timing of egg freezing, is right for her."
The promise of "eggsurance"
For women younger than 38 years old, each frozen egg has between a 2 and 12 percent chance of resulting in a live birth. That may not sound promising, Dr. Rodgers acknowledges, but she emphasizes that that figure looks at a single egg's chances. Research shows women in their early 30s who freeze 30 eggs have a greater than 90 percent chance of a live birth. Not all women will be able to get 30 eggs, Dr. Rodgers says, and those who do will likely need multiple cycles of stimulation and retrieval.
Egg freezing follows essentially the same protocol as the first half of IVF: Hormone injections to stimulate the ovaries and ripen multiple eggs; removal of eggs via a needle inserted through the vagina while under sedation; and freezing of the eggs until the patient is ready to start a family. Eggs can then theoretically be thawed, fertilized in a lab with a single sperm, and the resulting embryo or embryos deposited into the uterus, hopefully resulting in a birth nine months later.
Dr. Rodgers says a clinic's or studio's thawing method is critical to success. "Eggs are very delicate, and it takes a lot of expertise to freeze and then thaw them. Not all fertility labs, clinics, and centers do a good job." She recommends asking any studio or clinic for their successful thaw rate—anything above 80 percent is ideal. At Trellis, it's above 95 percent, Huang says.
Of the eggs that survive thawing, "about 70 percent fertilize," says Dr. Brady. About half of those become embryos, then further drop-off occurs after embryo transfer to the patient's uterus. "The older you are," Dr. Brady adds, "the more eggs you need frozen to account for that."
Nonetheless, "I think that women can be very successful with egg freezing, even if they may need to do multiple cycles," Dr. Rodgers says, citing a current patient of hers who froze her eggs in her late 30s, ultimately retrieving 12 eggs via four cycles. "She got married, tried [conceiving] on her own, it didn't work, so she thawed her eggs. Of those, only one became an embryo. She's pregnant now, at 42. If she's hadn't frozen her eggs, she almost certainly would not have been successful getting pregnant on her own."
Dr. Rodgers encourages women to do the requisite research before committing to freezing, be it at a boutique, clinic, or academic institution. Aside from the thaw rate, ask if the studio handles solely cryopreservation, or IVF, too. If it's the latter, ask how many cases they have handled (ideally it's in the thousands, she says) and request success rates. Read the pricing fine print; it's not uncommon for a studio to charge $6,000 per cycle. That price, however, doesn't include the cost of bloodwork or medications, which, if not covered by insurance, typically runs between $2,000 to $5,000. Also, inquire about annual storage fees.
Austin, Texas-based certified sex therapist Rhiannon Beauregard estimates she spent about $12,000 total freezing her eggs with Extend Fertility to net the 20 eggs she now has chilling on ice. She was 33, single, and ambivalent about having kids. "But I also knew the health of my eggs would decline as I got older," she says. "And in the dating world, I didn't want to have that 'Where do you see this going?' conversation right away." Beauregard had also recently been diagnosed with polycystic ovary syndrome, a hormonal condition that can impact one's ability to conceive.
Now 36, Beauregard is mom to a smiley 5-month-old baby, no frozen eggs necessary. (The pregnancy was a surprise.) Now, she says, those eggs have a different meaning. "They're not 'my last chance at starting a family;' they're an opportunity to use a 33-year-old's eggs if we choose to expand our family when I'm, say, 41. I hate to add to the fear women have about not being able to get pregnant the older we get, but there's no more ticking time bomb."