What if you could push pause on your fertility?
Egg freezing is certainly not a fail-safe way to delay childbearing — but it can buy time and peace of mind for some women. "Buy" being the operative word. Because it will cost you.
"Egg freezing is an insurance plan," said Michele Purcell, director of egg freezing services at Shady Grove Fertility, a clinic with locations in Maryland, Virginia, Pennsylvania and Washington, D.C. Women should view it primarily as "a back-up plan," she said.
Let's say you don't work at Apple or Facebook, companies that offer egg freezing benefits to its female employees. Most health insurance programs don't cover egg freezing. How will you cover the cost? How will you evaluate the costs' risks and rewards for you?
Mic spoke with Purcell, who broke down the costs of egg freezing, step-by-step. These costs are not standardized across the field, but Shady Grove's fees should give you a good idea of how to budget for egg freezing.
Here's the don't-get-screwed guide to paying for a fertility back-up plan.
Does freezing eggs work? Know the scientific realities.
As you might know, fertility fades in your 30s, specifically after age 35, according to the American Society of Reproductive Medicine.
A healthy, fertile 30-year-old woman has a 20% chance of getting pregnant. Or to put it another way: If there are 100 fertile 30-year-old women trying in a cycle, 20 will get pregnant and the other 80 will have to try again.
A decade later, at age 40, only five will be successful each month.
So when is the best time to freeze your eggs to get the most out of it?
The sweet spot is in your early 30s, says Purcell.
"Unfortunately, your body doesn't give you a heads up and say, 'Hey your ovaries are going to start deteriorating!'" says Purcell.
Egg freezing is not advised for women in their early and mid-20s, Purcell said, because the younger you are — sure, the better your eggs are — but the more likely you are to not need to freeze your eggs.
And while there are women in their late 30s and even 40s who do bank eggs, by the time they are 40, ovarian function will likely have diminished such that they'll likely need to do several cycles to retrieve eggs, will likely have fewer eggs on each attempt and will need to take more hormones — all adding to the cost.
The average woman who has her eggs frozen with Shady Grove Fertility is 36 and 1/2 years old, said Purcell. This lines up with research that suggests 37 is the best age to get the most benefit.
And the number of women freezing their eggs is growing — rapidly.
The experimental label was only removed from egg freezing in 2012, and already a growing number of women are retrieving healthy eggs and freezing them until they are ready — which at Shady Grove can be any time before their 51st birthday.
Only about 500 women froze their eggs in 2009 in the U.S.
By 2013, almost 5,000 did, according to the Society for Assisted Reproductive Technology. And that growth is expected to continue. EggBanxx, a network that works with fertility clinics, projects that 76,000 women will be freezing their eggs by 2018.
Look into fertility consultation: It's often covered by insurance.
Unlike getting pregnant, freezing your eggs is not an all-in plunge.
Instead, there are several discrete steps along the way, each with pull-off points to evaluate new information and decide whether to go on — or get out.
The good news is that you can pay for each step as you go.
A first low-risk and low-expense step is to find out what is going on with your fertility. How many eggs do you have? And how hard are your ovaries working to produce these eggs?
This diagnostic test, called ovarian reserve testing, involves using blood-work and an ultrasound to determine a woman's overall ovarian function.
The lab work and doctor exam costs $325 at Shady Grove Fertility. But Purcell says that for 90% of patients, insurance covers visits because it is deemed diagnostic.
After the doctor has had a chance to look at you and learn about your medical history, in addition to evaluating the ovarian screen, you will have a significant amount of personal information on which to base your next decision.
Are you going to go for it?
You'll need to do your own physical and emotional soul searching, but the information will help you evaluate future costs.
How many eggs should you freeze? Here's how to start a freezing cycle.
Purcell said that for an average 37-year-old-or-younger woman with good ovarian function, Shady Grove recommends freezing 20 eggs.
Once you've decided to freeze your eggs, you'll want to ask your clinicians about how many retrieval cycles you should expect to go through, given your ovarian function, said Purcell.
The doctor can't predict with certainty, of course, but can give you some guidance based on your profile. This can be the difference of thousands of dollars between one cycle and two — or three, or four!
It will also determine the number of hormone injections you will need prior to the retrieval.
"The cost of the hormone medication can vary greatly," said Purcell, adding that the average cost is between $4,000 to $5,000.
One egg freezing cycle at Shady Grove costs $7,500. This includes appointments to monitor your hormones and ovaries in the build-up to retrieval, IV anesthesia, retrieval of the eggs and the first year of egg storage.
While the fee is the same for all women, the true value will be different for each woman.
How should you pay for freezing your eggs? Choose a package that fits your needs and budget.
A woman may have all 20 eggs retrieved in the first cycle, but more commonly a woman will need to do two cycles, Purcell said.
Clinics all across the country are making an effort to bring prices down and create pricing plans. But those plans move away from the pay-as-you-go model and carry some financial risk, as well as some savings.
For example, Shady Grove has an optional pricing plan, Purcell said, that charges a $12,500 flat fee for a guarantee that women will be able to undergo four freezing cycles — or retrieve 20 eggs — whichever comes first.
She added that if, all 20 eggs are gathered on the first cycle, the woman receives $4,000 back. (But that will still leave you paying $1,000 more than you would have otherwise.)
Alternatively, if you decide to pay as you go — and you end up needing four cycles — you will shell out $24,000 at Shady Grove. But if you had instead purchased the $12,500 flat-fee package, you'd have gotten the four cycles almost half off.
There are other clinics working to get the price of egg freezing down.
In New York City, Extend Fertility has gotten the cost of egg retrieval down to a flat rate of $4,990.
This sounds great until you learn that will get you only 12 eggs in 4 cycles (which the clinic recommends for women 30 and younger; women over 30 ought to retrieve 12 to 24 eggs).
The cost also doesn't include required hormone medicines — which, again, vary greatly in price, but on average ring in around $4,500 — or the storage fee, which is $450 a year.
But this is the budget version — you'll get fewer eggs, but you'll need to put up "only" about $11,500 to retrieve them and store them for five years.
Note that clinics like Extend specialize only in egg retrieval: You'll need to go elsewhere for egg thawing.
Shady Grove does both egg retrieval and thawing. Here's the break-down of costs at Shady Grove, from initial consultation to final thaw.
$250......Ovarian ultrasound and doctor visit (often covered by insurance)
$75.......Ovarian hormone testing, blood work (often covered by insurance)
$7,500.......First egg retrieval cycle and first year of egg storage
$4,500......Hormone injection medications (usually between $4,000-$5,000)
$3,710........Eight years of egg storage at $530 a year (first year not included)
$6,500......First egg thawing cycle
$400......Hormone medications (usually around $400)
$22,935...Total full cycle egg freezing, storage and thawing
This only includes one cycle of retrieval and one cycle of thawing, and often women need to do two or more on each end.
That's why some places have a money-back guarantee on the use of the eggs: At Shady Grove Fertility, Purcell said, there is a program assuring you that you will take home a baby or receive a 100% refund.
This is important, because for some women none of the eggs will work.
There is not a lot of data about live births that have resulted from frozen eggs, because this is such a new — and time-suspended — field. But according to data reported in Time, only 83 of the 353 egg-thaw cycles in 2012 resulted in a live birth. In 2013, 99 babies were born of the 414 thaws.
If you're looking at the odds, each year is right at a 24% chance of having a baby.
The data, which comes from the Society for Assisted Reproductive Technology, comes with the note that some of these eggs may have been frozen with an older freeze method that has a lower success rate.
With a money-back agreement, you can take your refund if things don't work out — and put it toward exploring other options, like adoption.
How do you choose a clinic? Be an educated consumer when it comes to eggs.
Purcell advises women to do loads of research and stay informed.
"Anyone can freeze an egg," she said, "The question is, 'how well do they thaw?'"
Women should look at how successfully a prospective clinic has transitioned the frozen eggs into babies, Purcell said. The freezing and thawing process is difficult and takes experience, she said, and if there is any deviation from protocol, the eggs may not be viable.
You should seek out a egg-freezing clinic network near you: Egg Banxx, for example, has a tool to search for clinics in the New York area by zip code and to comparison shop among various clinics.
When gathering information from fertility clinics that offer egg freezing services, be sure to ask how many cycles the clinic has done. Also ask how many patients have come back and used the eggs they froze — and how many women got pregnant.
You'll want to see the clinic's track record in transitioning frozen eggs into babies.