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Can Egg Freezing Really Delay Your Biological Clock? · The Missing Middle Podcast

• 0:00
  SPEAKER_03: We all know milestones have gotten pushed back for younger people.
• 0:03
  SPEAKER_03: School goes longer, people are getting married later if they get married at all.
• 0:07
  SPEAKER_03: And obviously buying a home now takes years longer than it used to if you can do it at all.
• 0:13
  SPEAKER_03: And all of that you can delay.
• 0:15
  SPEAKER_03: But there's one milestone that doesn't actually bend the same way, and that's fertility.
• 0:21
  SPEAKER_00: There is technology, though, that can help.
• 0:23
  SPEAKER_00: Well, at least partially.
• 0:25
  SPEAKER_00: Egg freezing is a huge industry that offers hope to people that they can delay fertility while the rest of their milestones catch up.
• 0:32
  SPEAKER_03: But the question we want to discuss today is: does it work?
• 0:36
  SPEAKER_03: Can you really delay your fertile years?
• 0:38
  SPEAKER_02: Demographics, hosted by Mike Moffitt and Kara Stern.
• 0:42
  SPEAKER_00: You may have heard about U.S.
• 0:44
  SPEAKER_00: Representative Alexandria Ocasio-Cortez.
• 0:47
  SPEAKER_02: Congresswoman Alexandria Ocasio-Cortez is freezing her eggs as she considers her political future.
• 0:53
  SPEAKER_00: Literally showing the world the process behind it as she injected herself with hormones and explaining the what and the why behind it.
• 1:01
  SPEAKER_00: Now, we saw a lot of comments on social media that had a lot of misinformation.
• 1:06
  SPEAKER_01: Some conservative commentators like Matt Walsh criticized Ocasio Cortez's choice, calling out the 36-year-old for her age and saying her choice is baffling and calling it backwards and ridiculous.
• 1:17
  SPEAKER_00: So we're going to clear some of that up today, along with discussing the broad economic and social trends causing an increase in the use of the procedure.
• 1:25
  SPEAKER_03: I really love seeing AOC share her egg freezing journey online.
• 1:29
  SPEAKER_03: It was really wonderful that she was so open about the process in the sense that she peeled back the curtain so people could see what goes on behind it.
• 1:36
  SPEAKER_03: And I suspect knowing what it is and what it like how it affects you and seeing someone go through it would probably lead more people to feel comfortable with the process.
• 1:46
  SPEAKER_03: And so I think that she did a wonderful public service because not knowing the information makes it so much scarier to people.
• 1:52
  SPEAKER_00: You know, before we get into the mechanics of egg freezing, we should step back a little bit and look at why egg freezing has become so increasingly popular in the first place.
• 2:01
  SPEAKER_00: You know, there are a number of reasons why someone might want to freeze their eggs.
• 2:05
  SPEAKER_00: So, you know, we don't want to overgeneralize, but obviously one of the biggest ones is that it allows families to delay having children.
• 2:12
  SPEAKER_00: You know, for many middle class families in the post-war era, you know, there was a certain pathway of events that happened.
• 2:18
  SPEAKER_00: You know, you finished school, you started a career, you got married, you saved some money, you put a down payment on a home, and you started having kids.
• 2:26
  SPEAKER_00: Now, a lot of people deviated from that pathway in one form or another, but you know, that pathway was common enough that it became basically a stereotype for the middle class.
• 2:35
  SPEAKER_03: Nowadays, like there's no clear path at all.
• 2:37
  SPEAKER_00: Yeah, you can shuffle them all around, but at the end of the day, like every step on that pathway has gotten delayed.
• 2:44
  SPEAKER_00: You know, we went from, you know, in the 1950s and 1960s to many people, you know, starting careers after high school.
• 2:50
  SPEAKER_00: Then we kind of transitioned to starting them maybe three or four years of undergrad or college.
• 2:56
  SPEAKER_00: You know, nowadays people are adding a couple more years of uh postgraduate work, you know, sometimes adding a gap year.
• 3:02
  SPEAKER_00: And that often comes with student loans that need to be paid off.
• 3:05
  SPEAKER_00: So it takes longer to just hit financial C level.
• 3:08
  SPEAKER_00: So you've got to pay back those student loans.
• 3:11
  SPEAKER_00: You've got those extra years of schooling, which makes it even harder to save for a house.
• 3:16
  SPEAKER_00: And, you know, obviously though those homes are so much more expensive now.
• 3:19
  SPEAKER_00: So you have to save more money.
• 3:21
  SPEAKER_00: You know, so for my parents' generation, it wasn't uncommon to hit all of those milestones on this pathway uh before the age of 25.
• 3:29
  SPEAKER_00: But for the current generation, millennials kind of now going into Gen Z, they're having to wait until age 35 or longer to hit all of those milestones.
• 3:38
  SPEAKER_03: It's such a big problem in today's society that we require so much schooling to access jobs and incomes that never needed that much education before.
• 3:46
  SPEAKER_03: And we've just seem to accept that it takes longer and longer to get people to a place where they feel ready to have a kid.
• 3:52
  SPEAKER_03: I remember years ago hearing about companies, especially ones in like Silicon Valley, that were offering their employees egg freezing as part of their benefits package.
• 4:00
  SPEAKER_03: And the immediate reaction I saw on the media was like, this is kind of neat.
• 4:04
  SPEAKER_03: Like they would cover something so important, and that is so wonderful.
• 4:08
  SPEAKER_03: It buys women time.
• 4:09
  SPEAKER_03: It is just like such a gift and such a huge incentive for women to work there.
• 4:15
  SPEAKER_03: And then it wasn't that long until reality kind of set in and the narrative changed.
• 4:20
  SPEAKER_03: People realize what they're actually saying with that is we're expecting incredibly high workloads during peak fertility years.
• 4:26
  SPEAKER_03: So they had to offer something to compensate for that.
• 4:28
  SPEAKER_03: And an egg-freezing benefit package is what they landed on.
• 4:32
  SPEAKER_00: Yeah, and I don't think that's a very sustainable solution uh to this.
• 4:36
  SPEAKER_00: And I don't think it's nearly as generous as it looks.
• 4:39
  SPEAKER_00: So I hope that societies and governments start to address all of this because it feels like we've hit uh an equilibrium that isn't particularly sustainable.
• 4:47
  SPEAKER_00: Now, an obvious place to start is the cost of housing.
• 4:50
  SPEAKER_00: If we can get that cost down, then you know people are going to be able to have families earlier.
• 4:55
  SPEAKER_00: But until then, until we address all of these points of the pathway and how long they're taking, families are going to increasingly opt towards egg freezing.
• 5:04
  SPEAKER_00: So, you know, that brings us back down to the individual level.
• 5:06
  SPEAKER_00: So, you know, Kara, you know, you were following this much more closely than I was.
• 5:11
  SPEAKER_00: Like, what were your thoughts when you heard AOC's story?
• 5:14
  SPEAKER_03: Honestly, I was thinking that she's probably experiencing a lot of what other people her age are experiencing, but doing it publicly.
• 5:20
  SPEAKER_03: And like that, she's the same age as me.
• 5:22
  SPEAKER_03: I hear these stories amongst some of my friends, particularly ones who are still looking for a partner and are worried that they're going to run out of time.
• 5:29
  SPEAKER_03: And something we don't talk about when it comes to egg freezing usually is how hard it can be on your body, because we do talk about that sometimes with IVF.
• 5:36
  SPEAKER_03: I think there's some, there's some recognition of the like kind of emotional component there as well as the physical component.
• 5:43
  SPEAKER_03: But the process for egg freezing is identical to IVF for most of the time.
• 5:47
  SPEAKER_03: Like, sure, you aren't at the point where you're trying to have a kid and you've been struggling.
• 5:51
  SPEAKER_03: And that adds like, I there's no other way to describe it, but like an element of despair to IVF.
• 5:56
  SPEAKER_03: But most people, by the time they're freezing their eggs, they're old enough that they've got this massive fear that they're going to not be able to become a parent.
• 6:04
  SPEAKER_03: It starts being this thing where you start thinking about like, what does my life look like if I can't become a parent?
• 6:10
  SPEAKER_03: And how do I, how do I avoid that?
• 6:12
  SPEAKER_03: And often they're still single at the age when they thought they'd have a kid.
• 6:16
  SPEAKER_03: I mean, we could just look at AOC who like she brought viewers into her journey at the same time as her breakup with her fiance became public.
• 6:22
  SPEAKER_03: I'm sure she's like dealing with the same thoughts that a lot of people her age are who probably didn't expect to be single at this age.
• 6:29
  SPEAKER_03: And that's a perfect time for people to start thinking about egg freezing, or at least it's a natural time to do it because they're thinking, you know, I believe she's like she's 36, almost 37.
• 6:38
  SPEAKER_03: Like she's probably thinking, I need to find a partner.
• 6:40
  SPEAKER_03: I need the time to be sure they're the one to make the decision I want to marry them and to try for a kid.
• 6:45
  SPEAKER_03: And everyone knows that that can take time.
• 6:48
  SPEAKER_03: And, you know, I only have a few years to do it.
• 6:50
  SPEAKER_03: I can see how she would decide that now is the right time to do it, the same way that many other people reach this conclusion at this age.
• 6:57
  SPEAKER_00: Yeah.
• 6:57
  SPEAKER_00: And when you lay it out like that, it makes sense at an individual level, sort of the the pieces fit together.
• 7:02
  SPEAKER_00: And you can see that, you know, being common for a lot of people, not just AOC.
• 7:07
  SPEAKER_00: And I think it shows why this has become such a huge business uh across North America and globally.
• 7:12
  SPEAKER_00: And it's also like an unusual part of the healthcare industry because, you know, it's not in response to a medical concern, uh, but rather it's people trying to proactively fight their their biological clock, um, you know, opting for a procedure like this.
• 7:28
  SPEAKER_00: Because ultimately it comes down to trying to force biology to match the way that our society has changed, you know, where all of these markers of adulthood, all that sort of pathway, including starting a family, has really been pushed back and doesn't really work that well uh, you know, with our biological development as humans.
• 7:47
  SPEAKER_03: It's also a weird part of the healthcare system in that the people delivering the service, like they know this is a very emotional decision.
• 7:54
  SPEAKER_03: I think that there's an tendency for companies to kind of prey on this extremely huge thing in a woman's life, whether she'll be a mom one day.
• 8:02
  SPEAKER_03: And I remember being concerned with that question before I was a mom.
• 8:05
  SPEAKER_03: I still remember that like the sense of dread coming over me, like thinking, like, what does my life look like if that doesn't happen?
• 8:12
  SPEAKER_03: And what are like who am I if that doesn't happen?
• 8:14
  SPEAKER_03: Because that was so much of the path that I thought I was on.
• 8:17
  SPEAKER_03: Like, and I wasn't even close to 40 at that time.
• 8:19
  SPEAKER_03: So I've and I see it from people close to me, how much anguish there can be as the years pass by and you inch closer to 40.
• 8:25
  SPEAKER_03: A lot of people see 40 as kind of like the cutoff for when your fertility years end.
• 8:29
  SPEAKER_03: And in many cases, it's true.
• 8:30
  SPEAKER_00: You've got this situation where you you've got a ticking clock, people have to make uh decisions.
• 8:37
  SPEAKER_00: Uh, and that creates the environment where providers can start to make big promises and high pressure sales.
• 8:44
  SPEAKER_00: To be clear, we're not suggesting any one particular provider does that.
• 8:48
  SPEAKER_00: Obviously, there's a lot of uh responsible companies out there, but it at least creates the incentive uh for providers to do high pressure sales.
• 8:58
  SPEAKER_03: We're lucky that there are some numbers on this in Canada, and that's thanks to reporters at the Investigative Journalism Bureau who worked with the National Post and spent eight months going through the websites and the social media of 42 Canadian fertility clinics that market egg freezing.
• 9:13
  SPEAKER_03: And they looked into the promises that these clinics made and they found that five out of every six use language that reporters judge to be misleading or overstated.
• 9:22
  SPEAKER_03: And those are phrases like a guaranteed baby program or telling women egg freezing lets them, quote, take control of the reproductive future.
• 9:30
  SPEAKER_00: Yeah, and this is a clear sign that at least some providers are responding to those incentives to do a hard sell, you know, noting the mindset of their potential customers.
• 9:42
  SPEAKER_00: And in fact, as these reporters indicated, only 25% of the embryos created from frozen eggs actually turn into a live birth.
• 9:51
  SPEAKER_03: To get a little more into the data, the Canadian Assisted Reproductive Technologies Registry, they noted that at each step of the process, from thawing to fertilization and transfers, you lose eggs.
• 10:02
  SPEAKER_03: And ultimately, between 2013 and 2023, 4.1 million babies were born in Canada.
• 10:09
  SPEAKER_03: And out of that, the number of babies confirmed to be born from frozen eggs was only 70.
• 10:15
  SPEAKER_00: Now, there's a huge caveat to this number that most of the people who have frozen their eggs haven't tried to make a baby from them.
• 10:21
  SPEAKER_00: Now, the rates of people freezing their eggs have more than doubled from 2020 to 2024.
• 10:27
  SPEAKER_00: So a lot of the money spent on egg freezing may be from people who still hope to use them one day.
• 10:32
  SPEAKER_00: Or for some, they're using it as an insurance policy, but still try using their body's own eggs when trying for a kid.
• 10:40
  SPEAKER_03: I suspect a big part of that increase after 2020 was people having, you know, time to reflect on their lives during the pandemic, plus the disruption it gave to dating.
• 10:48
  SPEAKER_03: Like I'm sure it made a lot of people wonder how long it would take them to find a partner when it we're in a period where like no one's really meeting.
• 10:55
  SPEAKER_03: And I can see how they would have concluded that egg freezing was a good option to kind of take back those years as much as they could.
• 11:01
  SPEAKER_00: Yeah, the pandemic really did accelerate a lot of trends that were already happening prior to the pandemic, you know, from people working from home to families moving out of cities and to smaller communities and so on.
• 11:12
  SPEAKER_00: And this may just be another example of that.
• 11:14
  SPEAKER_03: There's just so little data out there on success rates of each clinic.
• 11:18
  SPEAKER_03: They're not required by anyone to publish the results.
• 11:20
  SPEAKER_03: It's very hard to know if you're looking for one to know is this the right one to use?
• 11:24
  SPEAKER_03: And it's so much money.
• 11:25
  SPEAKER_03: Of the small number of Canadian women who have gone all the way through the process, the Carter data showed that in the decade leading up to 2024, there were only 70 babies born in total.
• 11:36
  SPEAKER_03: And that number shocked me when I heard it.
• 11:38
  SPEAKER_03: I kept thinking that like there's so much money being spent right now, and so few babies actually being born from it over the course of a decade.
• 11:46
  SPEAKER_00: Yeah, that shocked me as well when you showed me.
• 11:48
  SPEAKER_00: Like I would have guessed the number was closer to 7,000 or maybe 70,000 rather than just 70.
• 11:54
  SPEAKER_00: You know, out of everyone who came back to actually try and use their frozen eggs, roughly only a third ended up with a baby.
• 12:01
  SPEAKER_00: Now, that's a substantial number of people, but it's a long way from marketing it as an insurance policy, which is the exact phrase that a lot of Canadian clinics use in their own marketing.
• 12:11
  SPEAKER_03: Yeah, the lack of data is just a huge problem.
• 12:13
  SPEAKER_03: Like it's not a quick decision you can make, but a lot of people do want to make the decision quickly once they've decided to freeze their eggs.
• 12:19
  SPEAKER_03: But it's a long process.
• 12:20
  SPEAKER_03: It often starts out earlier with tests.
• 12:22
  SPEAKER_03: You've got to time it all out to your cycle.
• 12:23
  SPEAKER_03: So by the time a lot of people even try freezing their eggs, they're ready racing against time, let alone trying to sit there being like, which is the best clinic?
• 12:30
  SPEAKER_03: How do I parse through this data when Canada doesn't really collect it?
• 12:34
  SPEAKER_03: And the people who are going to try to freeze their eggs, 40% are between 35 and 37, and another 22% are between 38 and 40.
• 12:43
  SPEAKER_03: So most of them are later than the optimal timing that a lot of clinics agree on, is below 35.
• 12:48
  SPEAKER_03: And honestly, it seems like the younger you are, the better chances it'll work out.
• 12:52
  SPEAKER_03: When I was looking at some fertility clinics, they all kind of have different ages recommended, but they all pretty well agree it's somewhere in your late 20s that's the ideal time.
• 13:00
  SPEAKER_03: But most women aren't even thinking about egg freezing at this point.
• 13:03
  SPEAKER_03: Like it's very normal to not have a kid in your 20s these days, especially if you're living in an urban area, the numbers push later.
• 13:09
  SPEAKER_03: And I would think that most are not even thinking about fertility decline at that point because you're probably thinking, even if you're single in your late 20s, you're still on track with modern timelines to find a partner and have kids without having to go through the stressful process of egg freezing.
• 13:22
  SPEAKER_00: Yeah, when you lay it out like that, it really is no wonder why birth rates are falling in so much of Canada, you know, particularly in our cities.
• 13:29
  SPEAKER_03: Clinics do suggest that below 35 is the ideal time to freeze your eggs, which makes sense given what we know about big drops in fertility after that age.
• 13:37
  SPEAKER_03: And in order to get a good chance of a successful pregnancy, you might need multiple egg retrievals.
• 13:42
  SPEAKER_03: And the odds of needing that increase with age, and it's going to cost at least$10,000 per cycle, often more like$20,000 with medication.
• 13:50
  SPEAKER_03: So the earlier you do it, the better.
• 13:51
  SPEAKER_00: Yeah, and there's a really grim irony here that egg freezing is becoming more in demand because people in their 20s can't afford a house, which also means that they're unlikely to be able to afford egg freezing either.
• 14:02
  SPEAKER_00: So we're we're trying to solve a problem uh with a solution that is, you know, uh has the same issues as the problem we're trying to solve.
• 14:12
  SPEAKER_00: Plus, the median number of eggs retrieved in one cycle isn't even enough for a clinic to consider it likely uh to result in a pregnancy.
• 14:20
  SPEAKER_00: That probably has something to do with the median age that people are going in for these treatments.
• 14:24
  SPEAKER_00: But honestly, people need to realize that it's gonna cost them, you know,$20,000 or$40,000 or even more and not likely to uh be successful or at least, you know, be far from a slam dunk.
• 14:36
  SPEAKER_03: In Canada, public health coverage for egg freezing is virtually zero if you're doing it for age-related or personal reasons.
• 14:42
  SPEAKER_03: There is some coverage in some provinces if you're going to lose your fertility because of something like cancer treatments, but no one funds it if you're just trying to buy more time.
• 14:50
  SPEAKER_03: And your best bet to get funding is in your workplace benefits package, but even then you're paying a substantial amount out of pocket.
• 14:56
  SPEAKER_00: Yeah, and when women do come back to use the eggs they froze it, like a third of those women are between the ages of 38 and 40, and just over 40% are older.
• 15:05
  SPEAKER_00: So, you know, the vast majority are over the age of 38.
• 15:09
  SPEAKER_00: And that's of course, if they come back to use them at all.
• 15:12
  SPEAKER_03: I want to go back to clearing up some of the misinformation that's out there.
• 15:15
  SPEAKER_03: The biggest myth I see, especially in comment sections under videos like AOCs, is that once you've frozen your eggs, you're basically set.
• 15:22
  SPEAKER_03: Don't let anyone tell you you're aging out of having kids.
• 15:25
  SPEAKER_03: But freezing your eggs doesn't freeze the whole process.
• 15:28
  SPEAKER_03: Everything that happens after, you know, thawing, the fertilization, the embryo transfer, the pregnancy itself, it all still happens at whatever age you actually are when you come back.
• 15:39
  SPEAKER_03: So it does help, but it's nothing close to a sure thing.
• 15:42
  SPEAKER_03: And it's not something we should start to count on as a society as a reasonable thing for women to do to push their fertility years later.
• 15:48
  SPEAKER_00: Yeah, absolutely.
• 15:49
  SPEAKER_00: And the higher risks of complication are still the same as you get older, even if the eggs are younger.
• 15:54
  SPEAKER_03: Another piece of misinformation I saw with AOC's posts were from people thinking she was too old for freezing her eggs.
• 16:00
  SPEAKER_03: There are lots of comments on her posts with people saying things like, What eggs is she freezing?
• 16:05
  SPEAKER_03: She's almost 37.
• 16:06
  SPEAKER_03: She has no good eggs left.
• 16:07
  SPEAKER_03: And that's not true either.
• 16:08
  SPEAKER_03: You're playing the odds and the odds become worse as you age, but it's still very viable to freeze your eggs and have a decent shot of it helping if you're in your mid to late 30s.
• 16:17
  SPEAKER_03: It might just take more cycles for it to work.
• 16:19
  SPEAKER_03: One thing that would make the situation a lot better is if Canada would start regulating the clinics.
• 16:25
  SPEAKER_03: You want to know whether you're about to spend tens of thousands of dollars, which is like I keep thinking, like one cycle could be a full year's worth of rent money.
• 16:33
  SPEAKER_03: You want to know if they have good success rates or not.
• 16:36
  SPEAKER_03: Clinics don't have to publish their results.
• 16:38
  SPEAKER_03: And Quebec does have a public registry, but it's an outlier in this country.
• 16:42
  SPEAKER_03: So I'd like to see other provinces start taking this seriously.
• 16:44
  SPEAKER_03: I don't know if it should be a federal thing or if it's just the provinces need to step up, but we do need to see change here.
• 16:49
  SPEAKER_03: We need some regulations to make sure that people are understanding what they're doing when they're taking the this giant step in their life.
• 16:56
  SPEAKER_00: Yeah, increased transparency seems like an obvious uh first step here.
• 17:00
  SPEAKER_00: And to be clear, like none of this is about telling anyone not to freeze their eggs.
• 17:05
  SPEAKER_00: You know, for some people, especially in their early 30s, who haven't found the right partner yet and know that they want kids, it's absolutely a reasonable thing to try.
• 17:13
  SPEAKER_00: But you know, you need to understand the odds and we we need to have that level of transparency before people are handing over their money.
• 17:20
  SPEAKER_03: In the end, the big story here is that egg freezing can work, especially if you're younger, if you have the time and resources to do multiple cycles.
• 17:29
  SPEAKER_03: It's not a full pause button on your biological clock, but it absolutely can help.
• 17:34
  SPEAKER_03: Just go into it with realistic expectations.
• 17:37
  SPEAKER_00: I agree with all of that, but I'd also say that, you know, technology might improve and it might increase your odds of having a kid, but we'd be better off fixing those problems that are pushing back these uh milestones in life if we want people to stop delaying uh having kids rather than looking for a technological solution.
• 17:56
  SPEAKER_03: Yeah, it doesn't really fix those underlying problems.
• 17:58
  SPEAKER_03: I keep thinking of it as it's like this big expensive attempt to buy time in our system that's just like it's out of whack with our biology.
• 18:06
  SPEAKER_03: And there's a lot of changes that need to be made for us to get back on track.
• 18:10
  SPEAKER_03: Thank you so much for watching and listening.
• 18:12
  SPEAKER_03: Our producer is Meredith Martin, and this episode was edited by Canadian Civil.
• 18:16
  SPEAKER_00: If you have any thoughts or questions about the best pathways to take in the game of life, please send us an email to missingmetal podcast at gmail.com.
• 18:24
  SPEAKER_03: And we'll see you next time.