The No-Bullsh*t, Not-Scary, Actually Helpful Guide to Egg Freezing

Here’s a short and incomplete list of all the shit women are constantly messaged about their fertility: Your eggs are getting old. Your biological clock is ticking. You need to find a partner so you can be happy pregnant. You don’t have forever. Which can make it feel like the only time to have a baby is Right Now—even if you’re Not Ready.

It’s *not* the only time. The U.S. has entered an egg-freezing boom, with more women than ever opting to put their reproductive futures on hold. Stats about the exact number of patients aren’t clearly tracked (hi, that should change), but it’s impossible to deny the evidence all over the country—national clinic chain Shady Grove Fertility saw a 52 percent increase in egg-freezing clients last year; at NYU Langone Fertility Center in New York City, the uptick was 41 percent—and the growing whisper network of women everywhere. Among the expanding universe of egg-freezing advocates: AOC, Emma Roberts, and Kaitlyn Bristowe.

By 2027, the global market is estimated to be around $9 billion, a threefold increase from 2020. Already, there are sleek new Insta-grid-worthy clinics and at-home testing kits and supplements to improve your egg quality. And the spike in interest—and offerings—makes sense considering all the reasons women are waiting longer to have a baby these days. Yes, the pandemic. But also getting married later or choosing to prioritize careers and friendships and goals that don’t involve procreating, like, yesterday. (Or maybe ever. An increasing number of millennials are wary of parenthood because of climate anxiety and financial insecurity.)

Women are also waiting to have kids because ever since elective egg freezing became a widespread option in 2012, they can. Just like the pill revolutionized women’s lives, egg freezing seems poised to do the same.

And yet, ask Google about egg freezing and you’ll receive an avalanche of horror stories or glowing evangelism—but rarely what you actually need to know about the deeply personal, sometimes scary, very complicated process. We talked to dozens of doctors, fertility experts, and women who’ve gone through it (including, recently, Cosmo’s editor-in-chief) to bring you all the crucial info you need all in one place.

Listen, just because you can doesn’t mean you have to—but here’s a short list of reasons to at least consider it.

• You’re in your 20s or 30s and you just don’t want to get pregnant right now.
• You’re not sure if you want kids, but you want to keep your options open.
• You want to share DNA with your future child even if you don’t know when that future is.
• You have a health condition (like endometriosis, PCOS, or uterine fibroids) that could impact your fertility.
• Your family history includes high-risk cancer genes, early menopause, or infertility issues.
• You’ve had a series of abnormal Pap smears or an STI like chlamydia or gonorrhea that could impact your ability to get pregnant.
• You’re undergoing gender-affirming surgery or taking hormones.
• You have a kid now but don’t see yourself wanting another one for a while.

Source: The American College of Obstetricians and Gynecologists

Source: The American College of Obstetricians and Gynecologists

Curious about your current egg count? Modern Fertility will mail you a finger-prick kit, analyze the blood sample you send back, and then provide you with data about your “ovarian reserve”—specifically whether you have more or fewer eggs than average for someone your age. ($159)

back to the top

Five tips for finding a clinic you click with.

Instead of asking for live-birth stats (read: the number of babies born from frozen eggs), ask what a doc will specifically do to give you the best chance at a later pregnancy.

Everyone at the clinic should feel like someone you could call in the middle of the night. This might (and TBH, probably will) happen.

Look for a place that has an on-site lab (moving eggs around can put them at risk). And ask about the clinic’s oocyte survival rate (the percentage of eggs that survive when thawed). Anything lower than 90 percent isn’t great.

You’ll be there A Lot. So try for a clinic that’s close to home or work.

Make sure it accepts your insurance or will work with you to figure out a financial plan.

What About Those Cool-Kid Clinics Tho?

Egg freezing is often done at massive medical centers that can feel impersonal. New practices like these are trying to change that.

MATE FERTILITY: The start-up is focused on making the egg-freezing process more affordable—as in, not just a luxury for a select few. One cycle, including monitoring, retrieval, freezing, and one year of storage (not meds, though, FYI), is a flat $5,000.

SPRING FERTILITY: These Bay Area clinics offer patients a deal: If you freeze 20 eggs before age 35 or 30 between ages 35 and 37 and those eggs don’t lead to a successful pregnancy in the future, they’ll give you a refund.

Source: 2020 Fertility Clinics & Infertility Services Industry (U.S.) Report

PRELUDE: This national network of clinics has a big emphasis on fertility education. It offers all the reproductive information you wish you had learned in health class plus all the medical services you need to freeze your eggs.

KINDBODY: Come for the millennial-chic decor, stay for the thoughtful docs and the wellness focus. This national group provides fertility services, gynecology, therapy, meditation, and also coaches who can school you on nutrition.

Also…check the reviews! FertilityIQ, aka the Yelp of fertility clinics, rates doctors based on patient experiences. You can also search its database for highly ranked fertility experts near you.

back to the top

Maybe. Egg freezing is getting a lot more popular, but it’s still really expensive—and really inaccessible to a lot of people (especially people without health insurance or who live in underserved or rural areas without any clinics). Costs for the uninsured range anywhere from $6,000 to well over $20,000, with the average out-of-pocket bill looking something like this:

back to the top

Covering the cost without draining your bank accounts.

Time to email your HR rep.

Some employers have started offering fertility-related health care benefits as a work perk, often through providers like Carrot or Progyny (Cosmo’s parent company, Hearst, uses the latter). Egg freezing is often largely covered under these plans.

Pay even less by…making sure it’s actually covered. If your employer doesn’t cover egg freezing as part of its benefits, Stork Club can work with your company to expand coverage. Drop them a line through their website and they’ll reach out to your HR department for you.

Ask your fertility doctor if they can help you get that process going.

Many clinics work with financial partners and fertility-specific lenders that are fluent in what you’ll need.

Pay even less by…skipping the bank. See if you can borrow from…your clinic. Centers like Spring Fertility offer a no-money-down, no-interest payment plan option, while CNY Fertility offers a lump financing fee between $250 and $1,000, based on the length of your repayment contract.

The good news is that you won’t be stuck with a years-long bill.

But before you shell out major bucks, make sure to shop around—the site Freeze allows you to compare costs across clinics.

Pay even less by…doing it for someone else. If you are open to donating eggs and meet the eligibility requirements (these include age, BMI range, and a health screening), check out freeze-and-share options like MyEggBank or Freeze and Share, where you could receive a free cycle in exchange for some of your eggs.

If your parents are down to help out… The lender Future Family offers a friends and family plan that allows people to take out a loan on your behalf (hey, if they want grandkids so badly…).

FYI to your future self: Egg-freezing costs are just part one of the process. It could later cost more than $15,000 to turn your eggs into embryos and transfer them to your uterus.

Source: 2020 Journal of Assisted Reproduction and Genetics Study

Source: FertilityIQ

back to the top

Egg-freezing fact vs. egg-freezing fiction.

Fact check: It’s far from a promise that all will go exactly as planned. You might not be able to use your eggs because they don’t survive thawing or do survive but can’t be fertilized into embryos. The odds vary depending on a lot of factors, but generally: If you freeze 10 eggs before age 35, your chances for one kid are around 70 percent.

Fact check: Egg freezing is not for everyone, and it’s not a decision to take lightly. It’s a financial investment…and a physical and emotional one too. The cash you’re committing to the procedure, the side effects of the meds, the buzzing back and forth to the doctor’s office, the recovery—it all adds up.

Fact check: You’ve seen ads luring you to tropical locales to freeze your eggs. And bundling a vacay with a less pricey procedure does sound like a great plan in theory. But medical treatments aren’t times to bargain shop, and you’d have to store your eggs abroad or have them shipped back—a gamble, per most docs.

back to the top

TL;DR: As much or as little as you want to, but it’s a good idea to set yourself up for support.

Your newish partner: “My boyfriend and I were three months in and all of a sudden, I had, like, eight bombs to drop on him: I might be infertile! Because I might go through menopause early! So the kids thing might be now or never! Will you shoot me up with hormones twice a day? Also, we can’t have sex! He was—as I should have expected and run the other way if he weren’t— an unflappable partner. His view: I was taking care of myself and preserving my options for the future and there are zero bad things about that. Damn right.” —Jess, Cosmo’s EIC

Your friends: “I got Some Feedback when I shared my plan, and honestly, I should have clarified that I was looking for comfort, not opinions. I cooled things down by asking them to just hold off on the baby-fever TikToks for a while.” —Maria

Your mom: “True story: If you don’t imagine your mom being supportive, you don’t have to tell her. For me, I told mine the gist of what I was doing but also that no, I didn’t want to talk about potential grandchildren.” —Grace

Your job: “I kept it short because I felt like my boss was not entitled to know the specifics of me being poked and prodded with needles and ultrasound wands. Instead, I informed her that I was dealing with a not-serious medical thing and that I’d need some flexibility for a few weeks. I also scheduled the day of my procedure off.” —Naomi

back to the top

While it differs for everyone, here’s an example of what a cycle can look like.

Prep Appointment

Maybe you did a virtual consult or an at-home hormone panel already, but now that you’re Officially Freezing Your Eggs, you’ll head to the doctor for an appointment where they’ll do blood work (to assess your anti-Müllerian hormone, or AMH, level, which is an indicator of how many eggs you have) and a transvaginal ultrasound to peek at the follicles in your ovaries. They’ll also write you a prescription for meds, give you a highly specific schedule for using them, and (whew) provide you with your plan for in-office follow-ups over the next two weeks. Oh, and be prepared for paperwork, including insurance forms, consent forms, storage forms, and plans for where your eggs would go if something happens to you or you decide you don’t want to use them.

Everything kicks off at the beginning of your menstrual cycle. Starting now, you’ll be injecting yourself daily with meds—a follicle-stimulating hormone and possibly a luteinizing hormone—so you can produce multiple eggs. Now off-limits: alcohol, per many docs (boo), plus sex and exercise—a side effect of hormone drugs are “friable” (aka prone to bleeding) ovaries that physical activity could cause to painfully twist.

Another day, another shot (or multiple shots) and possibly some bruising. Icing the area for a few minutes before and after each injection can help.

Back to the doctor! You’ll be going for checkups, typically in the mornings, about every other day so your MD can keep an eye on your estrogen, maybe adjust your meds, and monitor the growth of your follicles.

Some folks will be totally fine at this point, but others might start feeling the effects of the medications—think: bloating, headaches, nausea—so if all you want to do is eat Cheetos and watch YouTube, absolutely go for it.

More estrogen + maturing eggs = your body getting ready to ovulate. Which is why you’ll now introduce a new med (a gonadotropin-releasing hormone antagonist) into your routine to prevent that from happening too soon.

Now’s the moment to book a buddy to accompany you home from your procedure next week, which, good news, takes less than an hour. You’re going to be groggy after the anesthesia, and an escort (who will also hopefully show up with your favorite comfort treat) is required for you to leave the premises. While you’re at it, plan for a potential PTO day next week too.

It’s trigger time, which your doctor determines by measuring your follicles (they should each contain one egg and be about the size of a grape; depending on your body and age, you may have between 5 and 20 mature eggs). This shot, usually a dose of human chorionic gonadotropin, signals it’s almost ovulation time.

Egg retrieval will happen about 36 hours after your trigger shot. At the clinic, you’ll gown up, settle in stirrups, and be put under for the best nap of your life, during which an ultrasound wand with a long needle will be inserted through your vaginal wall and into your ovaries to retrieve your microscopic eggs.

The results are in: You’ll know how many eggs were retrieved and how many were mature enough to freeze. If you’re around age 30, you’ll generally want at least 10 eggs banked for every future kid you hope to have. Some women will hit that number in a single cycle; others might need to repeat the process.

You’re probably (definitely) pretty crampy and bloated (constipated too). Tylenol and a heating pad should help. If you’re up for it, a little light activity is okay! By this time next week, you’ll be well on your way to fully recovered.

Two-ish weeks after your procedure, you’ll get your period. One expert referred to it as “the period from hell,” but your next one should be back to normal. On the upside, sex and exercise are on the table again.

back to the top

These, and we went ahead and got some answers for you.

• I have a medical condition. Can I even do this? Go to the MD who manages your condition first because they may need to approve you for treatment. If you’ve had cancer, for instance, make an appointment with your oncologist before you see a fertility specialist.
• Are there risks? Between 3 and 8 percent of women undergoing fertility treatment will develop moderate or severe ovarian hyperstimulation syndrome, typically one to two weeks after their trigger shot. This is when your ovaries swell and leak fluid into the body. While painful, it’s rarely life-threatening.
• Do I need to get off birth control? If you’re on the pill, you’ll need to stop taking it, since it prevents ovulation. Your IUD can stay, since it works differently. You can resume birth control about two weeks after the procedure.

So about those shots: Sigh, yes, there’s no avoiding it: Needles—and kind of a lot of them—are a necessary part of the process. At least once a day, you’ll be sticking yourself in the stomach, thigh, or butt (switching up injection sites can help minimize pain). It’s true that the shots may sting, but most of these needles are small and feel more like a pinch than a prick. You CAN do this.

If the whole needle thing is freaking you out: You can always tap your clinic to do it for you. Just remember that you’re gonna have to go to them unless, of course, they offer at-home visits for a fee (which some actually do).

If you hit a snag: Your prescreening should have flagged any potential issues, but if your follicles aren’t progressing, your doctor might decide that you should “cancel” this cycle. It’s rare, though, occurring only 5 percent of the time.

back to the top

*It’s not actually over, sorry! A few final to-dos.

Tired of all the egg-freezing ads following you around on all your accounts? Teach the social media overlords that you’re over it by hiding ads when they pop up and unfollowing all those fertility companies.

From here on out, you might find yourself evaluating romantic prospects (and possibly even your current partner?) through the lens of, “Does this person deserve my eggs?” It’s okay if sometimes the answer is…no.

Make sure you keep all your info updated with your cryobank. This is one bill you definitely don’t want lost in the mail—or worse, accidentally winding up in debt collection. Once that’s done, your last official task: Take a deep breath and relax for a while!!!

back to the top

Say Hello to Our Very-Expert Panel of Egg-Freezing Experts

Nataki Douglas, MD, PhD, chair of the Modern Fertility Medical Advisory Board

Aimee Eyvazzadeh, MD, reproductive endocrinologist in San Ramon, California

James Grifo, MD, PhD, director of NYU Langone Fertility Center

Tia Jackson-Bey, MD, reproductive endocrinologist at RMA of New York

Tiffanny Jones, MD, reproductive endocrinologist at Conceive Fertility Center

Richard Paulson, MD, director of USC Fertility

Fahimeh Sasan, MD, founding ob-gyn at Kindbody

Emily Seidler, MD, reproductive endocrinologist at Boston IVF

back to the top

Editor: Andrea Stanley. Fact-Checker: Lauren Dzubow. Copy Editor: Estee Brooke Friedman. Photography: Disco Cubes and Leslie Kirchhoff. Styling: Shelby Kay. Visual director: Kristin Giametta. Creative director: Andy Turnbull. Art Director: Katie Buckleitner.

Elizabeth Kiefer

Elizabeth Kiefer is a features editor at Cosmopolitan, where she focuses on enterprise stories, narrative reporting, and cultural coverage for the magazine's print and digital platforms.