In a candid new interview with Allure, Jennifer Aniston shared publicly for the first time that she had undergone in vitro fertilization (IVF) treatments years prior, sharing that, for her, "the baby-making road" was "really hard."
Of course, Aniston's admission comes in the aftermath of years of tabloid speculation, which felt equal parts cruel, intrusive, and sexist — all of which she has addressed head-on in recent years. Of the "challenging road" bookmarked by endless public scrutiny, the 53-year-old said, "All the years and years and years of speculation... It was really hard. I was going through IVF, drinking Chinese teas, you name it. I was throwing everything at it. I would've given anything if someone had said to me, 'Freeze your eggs. Do yourself a favor.' You just don't think it. So here I am today. The ship has sailed."
Aniston's admission that she wishes someone had suggested egg freezing as an option resonated with me strongly, since I'm currently wondering what my own options are when it comes to delaying the prospect of parenthood. Should I freeze my eggs?
When I turned 30, I broached the topic with my gynecologist. She simply said, "You've got plenty of time. If you're still on the fence about babies when you're 36 or 37, we'll talk then." I felt a flood of relief to hear that, but now that I'm halfway towards her goalpost, I still have questions. I can't (and won't try to) speak to Aniston's experiences specifically, but egg freezing remains this big mystery. What does it entail? Is it expensive? Is it invasive? Is there a right time to do it? And why hadn't my doctor even mentioned it as an option?
I know I'm not alone in my concerns, especially in a post-Roe America, where so many people's reproductive rights and access are diminishing right before our eyes. In our current landscape, it's a privilege to even be able to choose when and how to have a child, let alone to receive equitable healthcare — none of which I take lightly.
The Money Factor
Of course, it's unsurprising to me that cost is one of the reasons doctors don't broach the topic of egg freezing to patients, as Dr. Priyanka Ghosh tells Scary Mommy. Ghosh, a fertility specialist at Columbia University Fertility Center, explains that the process of egg freezing — more on that in a sec — has multiple costs, including medications, the monitoring process (which includes ultrasounds and bloodwork), the procedure itself, and then storage of these eggs. Dr. Anate Brauer, reproductive endocrinologist and IVF director at Shady Grove Fertility in New York, adds that a retrieval cycle on its own costs anywhere between $6,000 to $10,000, and medication costs can range between $2,000 and $6,000. Egg storage typically has an annual fee that varies by clinic of around $800 to $1,500.
Some insurance policies might cover parts of the process, with Ghosh citing cancer diagnoses as an example, but it's not a given. "It is, unfortunately, the reality of our healthcare landscape that this procedure is not universally covered, and our hope is that with ongoing advocacy efforts, this will change,” Ghosh says. “But the truth is, many are still unaware of the impact of age on fertility, and any opportunity to discuss future fertility should always be taken."
It's also worth pointing out that if patients like Aniston and myself — both wealthy, healthy white women with ample access to healthcare — are not even presented with all of our options, there is little hope for patients in marginalized communities, such as BIPOC patients, patients with disabilities and chronic health concerns, and those who are LGBTQIA+, who already face stigma and discrimination at every turn. It's simply another example of how our healthcare system repeatedly fails those who need it most.
Egg Freezing: Fact vs. Fiction
Though egg freezing is often cited as an "insurance policy" for the future, it's a lot more complicated than that. As Brauer explains, we're born with all the eggs we will ever have, losing them over the course of our lifetimes. "As we age, not only do we lose them, but the eggs that we retain age, increasing genetic abnormalities which lead to decreased pregnancy rates and increased miscarriage rates," she says.
Egg freezing involves a series of self-administered injections over an average of 10-14 days in an effort to "stimulate the ovaries in hopes of causing multiple follicles in the ovary to grow and hopefully develop multiple eggs," says Ghosh. "These eggs are then extracted through an egg retrieval process and frozen using a process known as vitrification. Eggs are then thawed in the future and fertilized to create an embryo or embryos." Brauer notes the procedure itself lasts around 20 minutes under anesthesia.
Like so much of the reproductive process, age can be the deciding factor, says Brauer. "Freezing eggs at a younger age (ideally in the 20s and early 30s) when quantity and quality are better preserves options for fertility in the future in circumstances where childbearing may be delayed or if there is a desire for multiple children." So while Ghosh notes "there is no 'right' candidate for freezing," age can have an impact on the process. "As a result, it is not at all uncommon for an older individual with a lower ovarian reserve to go through the process more than once depending on one's goals," she says.
Even if the process isn't cost-prohibitive to a patient, there's no guarantee that a single egg retrieval will result in a healthy pregnancy, says Ghosh. "Given the complexities of pregnancy, even a single good quality embryo does not guarantee success, so it may require multiple attempts, which in turn requires more eggs. Freezing eggs does, however, allow one to preserve eggs in time and thwart some of the issues with egg quantity and quality known to occur over time. Freezing eggs also does not mean you must use them in the future. Many individuals who freeze eggs often ultimately conceive on their own, but these frozen eggs can function as a backup."
Brauer recommends that anyone considering delaying childbearing should chat with a reproductive endocrinologist for testing and to map out a plan for the future, but this again requires access, time, and costs that many patients might not have. Hopefully, by public figures like Aniston shedding light on their lived experiences, the trickle-down effect will include lawmakers realizing how vital it is to protect reproductive rights for every patient, whether they're on the cover of glossy magazines or not.