Introduction to Egg Freezing

Aging really messes with your head. One minute, you’re spiraling about the years flying by; the next, you’re hyping yourself up with affirmations like, “You’re only as old as you feel!” Personally, I feel 25 even though my feet are firmly planted in 30-something territory. Unfortunately, biology doesn’t care about my feelings, and lately, I’ve been wondering if my fertility agrees.

Considering Egg Freezing

During a recent trip to my gynecologist, I admitted I was (quite) single and not currently interested in kids, but had been thinking about egg freezing in case I want them in the future. Unfortunately, cost — it can be up to $20,000 a cycle without insurance — is a major issue for me.

I expected my doctor to aggressively push me to find a way to come up with the cash, so I was surprised when he told me not to worry because “40 is the new 30” for pregnancy and that I didn’t have to assume my eggs would be dust in eight years. While that was comforting to hear, I wanted to dig deeper.

Trends in Pregnancy and Fertility

In recent years, more women have been having children at older ages. For the first time, in 2023, there were more births among women 40 and older than teenagers, according to a report from the National Center for Health Statistics released earlier this year. It’s part of a decades-long trend of American women, especially those under 30, having fewer children. But the driving factor isn’t that fewer women are seeing fertility declines in their 40s — it’s more about medical advancements, changing societal attitudes around motherhood and the cost of raising kids, experts told NBC News.

Postponing Parenthood

Dr. Lucky Sekhon, a reproductive endocrinologist in New York City, tells TODAY.com that in her practice she’s noticed people postponing having kids because they “want to be responsible and wait until they’re financially stable” and to find the right partner. So, if you’re in your 20s or 30, considering fertility preservation but hesitant to pursue it just yet, here’s what to know.

When Does Female Fertility Start to Decline?

While more women have been having children at older ages in recent years, “the harsh reality is that biology has not changed,” Dr. Sigal Klipstein, chair of the American Society for Reproductive Medicine’s ethics committee and infertility treatment expert, tells TODAY.com. The main aspects of female fertility that decline with age are egg quality and quantity — the uterus doesn’t age, Sekhon says — but the rate and extent of the decline can vary from person to person. Since every individual is different, “age is the best we can do to guess someone’s potential egg quality” before they undergo fertility treatments, Sekhon explains.

Best Reproductive Years

Although getting pregnant can be difficult at any age, for women, the “best reproductive years” are the 20s, according to the American Society for Reproductive Medicine. Fertility then starts to decline in the 30s, especially after age 35. The average 30-year-old woman without fertility issues has a 20% chance of getting pregnant in a given cycle, compared to less than 5% at 40, the organization notes. “Half of women who attempt to conceive in their 40s will face difficulties,” says Klipstein. Of course, some people will be able to get pregnant unassisted in their 40s, but being in this age group “does increase the chance that they will need to rely on fertility treatments such as IVF (in vitro fertilization),” she adds.

Best Age to Freeze Eggs

Sekhon says the best age to freeze your eggs is “your late 20s to your very early 30s.” When a woman freezes her eggs in her 20s, there’s a baseline 20-25% chance of them creating abnormal embryos, Sekhon explains. That number goes up to 30% in the mid-30s, and by 37-40 years old, there’s a 50-70% chance of abnormal embryos. “When we freeze eggs, we’re still working within the confines of a very inefficient system,” Sekhon explains. This is because each egg has a low conversion rate of egg to healthy embryo.

Factors Affecting Fertility

So, the older you are when you freeze your eggs, the more eggs you’ll need to feel confident in the outcome down the line, but the harder time you may have getting as many high quality eggs as you want. Essentially, the older you are when you freeze your eggs, the less likely it is that you’ll have a healthy pregnancy from those eggs, according to the American Society of Reproductive Medicine.

Race and Fertility

Some research has suggested that women of certain races experience higher rates of fertility than other populations, such as Black and Hispanic women. Lack of access to or delaying medical care may play a role, but some research has still found higher rates of infertility in Black women even with access and adequate health insurance coverage, Klipstein explains. Based on her experience, Sekhon says one explanation may be a systemic bias among providers, who may falsely believe that Black women are immune to infertility, which “goes back to the days of slavery,” when enslaved Black women were forced to reproduce. As a result, a doctor “might inadvertently delay someone from getting the care they need,” Sekhon adds.

Extending Fertility Naturally

“(Fertility treatment) is a significant expense and not everyone has access to it, and it isn’t fair,” says Sekhon. Reducing costs has to be legislated, she adds, but in the meantime, she encourages people who work for companies that may be in a position to cover it to start that conversation with HR. There are also some grants that can help with treatment coverage. But for people who simply can’t afford to pay for egg or embryo freezing, is there a natural way to extend fertility? While fertility does decline with age, research has found that certain lifestyle choices — like maintaining a healthy weight, limiting alcohol and smoking, moderating caffeine, exercising sensibly and managing stress — can all play a role in supporting fertility. Smoking in particular can decrease your egg count and quality, Sekhon points out.

Conclusion

If you’re deciding whether egg or embryo freezing is the right path for you, both Klipstein and Sekhon believe it’s a choice that requires a lot of thoughtful consideration. “This decision is a highly personal one, and I recommend that women have honest and in-depth conversations with their physicians regarding the best options for their particular situations,” says Klipstein. No matter which path you choose, Sekhon says to remember you can only “control things to a point,” and you’ll never know how something will work out until you try.

FAQs

• Q: What is the best age to freeze eggs?
  A: The best age to freeze eggs is in the late 20s to early 30s.
• Q: Does race affect fertility?
  A: Yes, research suggests that women of certain races may experience higher rates of fertility issues.
• Q: Can lifestyle choices extend fertility?
  A: Yes, maintaining a healthy weight, limiting alcohol and smoking, moderating caffeine, exercising sensibly, and managing stress can support fertility.
• Q: How much does egg freezing cost?
  A: Egg freezing can cost up to $20,000 per cycle without insurance.
• Q: Is egg freezing a guarantee of a healthy pregnancy?
  A: No, egg freezing is not a guarantee of a healthy pregnancy, but it can increase the chances of a successful pregnancy in the future.