The big freeze A reporter's personal journey into the world of egg freezing and the quest to control our fertility

Natalie Lampert

Book - 2024

"A fascinating investigation into the lucrative, minimally regulated, fast-growing industry of egg freezing, from a young reporter on a personal journey into the world of cutting-edge reproductive medicine"--

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  • List of Abbreviations
  • Author's Note
  • Introduction
  • Part I. The Consultation
  • 1. Young, Fertile; and Fabulous
  • 2. An Intimate Geography
  • 3. Egg Freezing's Rise
  • Part II. The Orientation
  • 4. Hacking Our Hormones
  • 5. Why Women Freeze
  • 6. Optimizing Fertility
  • 7. Not Our Bodies, Not Ourselves
  • Part III. The Stimulation
  • 8. Ready, Set, Trigger Shot
  • 9. The Femtech Revolution
  • 10. Ovaries in Overdrive
  • Part IV. The Retrieval
  • 11. Scar Tissue
  • 12. Fertility-Industrial Complex
  • 13. Great Eggspectations
  • Part V. The Freeze
  • 14. Unviable
  • 15. Reproduction Reimagined
  • 16. A Journalist and Her Ovary
  • Acknowledgments
  • Notes
  • Index
Review by Publisher's Weekly Review

Journalist Lampert debuts with a trenchant investigation of the egg freezing industry and the commodification of women's reproductive health. Doctors first recommended Lampert freeze her eggs when she was in her early 20s, shortly after an emergency operation on her remaining ovary (the other had been removed because of unrelated complications when she was 12). Providing a critical look at the egg freezing industry, Lampert reports on the scientific conferences, medical consultations, and promotional events she attended while deciding on whether to undergo the procedure as she entered her early 30s. For instance, she recounts going to an educational seminar at a venture capital--backed fertility clinic and contends that its claims to provide "insurance" against infertility promise more than the clinic can deliver (one freezing cycle has only a 75% chance of leading to a live birth). Despite this, Lampert suggests egg freezing still has significant benefits and describes how one of her interview subjects felt less pressure to settle for a romantic partner because freezing her eggs afforded her time to find a better match. Lampert ultimately chose not to undergo the procedure, but her evenhanded reporting will help those considering it sift the science from the hype. This will open readers' eyes. Agent: Elias Altman, Massie & McQuilkin Literary. (July)

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Review by Kirkus Book Review

An investigation into a little-understood element of reproductive medicine. In her informative debut book, Lampert combines health journalism and personal history to offer a close look at a significant innovation in assisted reproduction: egg freezing. After she lost an ovary when she was still a girl, and almost lost the other when she was in her 20s, a doctor urged her to protect her ability to have biological children by freezing her eggs. Contemplating that step, she writes, "became the main impetus behind the deep dive that resulted in this book." Egg freezing, she discovered, is a lucrative business, costing an average of $16,000 per cycle for the typical egg freezer, "a highly educated professional woman in her thirties, well established in her career by the time she walks into a fertility clinic," but lacking "a suitable partner with whom to start a family." Egg freezing, its proponents enthusiastically claim, lets women take control of their reproduction. Lampert, though, suspicious of the hype, sought reliable medical advice about the technology of egg freezing and storage, the nitty-gritty of the procedure, and its short- and long-term risks. Along the way, she gained new insights into the workings of her body, the history of birth control (the first pills were approved by the FDA in 1960), the development of pregnancy tests, the process of in vitro fertilization, and the probability of a live birth from frozen eggs. That statistic is hard to determine, Lampert found, because most women who freeze their eggs don't use them. Of those that do, according to one study, the chance of a live birth was 39%. Lampert recounts the widely varying experiences of several women who opted for egg freezing, and she reflects in candid detail on the process of her own decision-making process. An engaging and well-researched book. Copyright (c) Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.

1 Young, Fertile, and Fabulous Walking into the Future My official introduction to the future of fertility was courtesy of EggBanxx, a start-up company offering financing options to potential customers to freeze their eggs. One afternoon in early September, I read on Twitter about an informational "Let's Chill" event in Lower Manhattan, hosted by EggBanxx, where women would be gathering to learn about egg freezing while liquoring their anxieties with cute cocktails. I wasn't sure what to expect, but I registered for the event online and promptly received a confirmation email: Forget sweating in the hot summer sun looking for Mr. Right!, the invitation read. It's fall now and smart women will be staying cool at the EggBanxx party tomorrow night! We hope you're as excited as we are to sip our Banxxtinis while talking about the three F's: Fun, Fertility, and Freezing! It wasn't just idle curiosity. Fertility--and my eggs and sole ovary, in particular--had lately been very much on my mind. The following night, I headed down to the Crosby Street Hotel to learn more. "Ladies, you are young and fertile and fabulous!" chirped Dr. Serena Chen, a reproductive endocrinologist at the event. Her white coat and smooth dark hair emanated authority as she smiled at the attractive group of attendees. The hundred or so women around me pecked at popcorn and sipped raspberry-filled flutes of champagne. Several women sat on the edge of their seats in anticipation of . . . of what? I wasn't sure. Most appeared to be in their thirties or forties, fashionably dressed, with tan faces and flowing blow-dried hair. I noticed many sparkling diamond rings and designer handbags. It felt like a scene from a Sex and the City episode. I, meanwhile, wore a backpack--I'd just started graduate school at New York University--and was probably the youngest in the room by at least five years. It was 2014, and EggBanxx, which had launched a couple of years earlier, was now attracting major attention in New York for its series of swanky cocktail parties. The company acted as a matchmaker between doctors and patients in the market for state-of-the-art fertility treatments. "We will be like Uber, but for egg freezing," said Gina Bartasi, EggBanxx's founder, in a Washington Post article. An early pioneer in the fertility marketing space, EggBanxx--the two x's represent female chromosomes--negotiated with fertility doctors to provide lower treatment prices for patients and offered discounts and low-interest loans to women wanting to freeze their eggs. "We've learned that millennials don't like paying retail," Jennifer Palumbo, who was then director of patient care at EggBanxx, told me in an interview. Palumbo, who had struggled with infertility in her thirties, froze her eggs before taking a job at EggBanxx. Bartasi also had faced difficulties conceiving naturally; she now has twin boys, courtesy of IVF, which is when a sperm and egg are merged to become an embryo in a lab and then implanted in a woman's uterus. Midway through the presentation, the audience was totally attentive, cocktails forgotten. As I looked around, a part of me felt profoundly out of place. And yet my uterus made me feel as if I belonged, as if it were my ticket to some sort of ladies-only club. Here we were, a bunch of women on an early fall evening in New York City, listening to a handful of fertility doctors talk about our eggs. There was something delightfully strange about it all. I scribbled phrases in my notebook I'd never heard before: thaw data, dehydration protocols, autologous cycles. In the margins, I made notes of things to clarify later: embryo = fertilized egg, yes? In between speakers, pockets of quiet chatter filled the room. I sensed a we're-all-in-this-together kind of camaraderie in the air that I hadn't felt since my college orientation session for new first-year students. Dr. Chen reached the last slide of her presentation and took questions. Someone asked if there was any sort of refund policy if a woman became pregnant naturally after freezing her eggs. Dr. Chen replied that there was not. More hands shot up. "I'm not quite sure how to put this," a woman in the back began. "What happens if your eggs become . . . poached?" The crowd erupted in cathartic laughter. I smiled, too, but the quip gave me pause. Were we really using cooking metaphors to describe our potential future children? I raised my hand. A few minutes later--it was a big room, and a bunch of questions got answered before it was my turn--someone handed me a microphone. "Hi," I said. "I'm Natalie, I'm twenty-five, and I'm wondering what happens if I'm living in, say, the South Pacific in five or ten years and want to start a family but my frozen eggs are here in New York." "Once you figure out where you are and what you want to do, we can ship the eggs to you," Dr. Chen replied. "They'll get sent in a container of liquid nitrogen, and, well, hopefully no one leaves them on the shipping dock alone. . . ." A few women around me giggled. Dr. Chen went on: "But if people are transporting precious things like eggs, we usually recommend you buy the eggs a ticket to take them to wherever you're going." Several women in the room nodded, seeming to find Dr. Chen's response sensible. Speechless, I sat down and passed off the microphone. As if getting shot up with thousands of dollars' worth of hormones wasn't financially crippling enough, now I had to factor in airfare for my own eggs? I had hoped my logistical query would prompt an easy answer, something reassuring and straightforward amid all the talk of viscosity and thaw data. No wonder our questions--sometimes flippant, if well-intentioned--were laced with awkward metaphors: We didn't fully understand the slides or what these doctors were telling us. We were trying to mask our ignorance and discomfort with laughter, the same way we'd giggled at enlarged pictures of penises in elementary sex ed. Back then, we'd sat on hard classroom chairs or cross-legged on cold gymnasium floors; now, it was plush seats, high heels, and one leg crossed dutifully over the other. Being older and sophisticated didn't change the fact that many of us were as unaware of the facts now as we were then--and just as eager to hide it. The only thing separating me from these women, I realized, was a decade and a backpack. Like them, I felt dazzled by this exciting technology and the thought of taking matters of reproductive biology into my own hands. But there was a sense of unease, too, a gnawing feeling that I--and these women--had missed the boat at some point, as if we'd ducked out of a movie and missed crucial plot information. The PowerPoint resumed; other fertility specialists took the stage. One asked us to follow her on Twitter. ("A bit of shameless self-promotion," she said. "I'm trying to get more followers.") The presentations concluded with a "reality check" from Dr. Chen. "With the exception of the twenty-five-year-old in the back of the room," she said, wagging her finger admonishingly at the crowd, "all of your eggs are old, ladies." Not so fertile and fabulous after all. Afterward, audience members and doctors mingled in the lobby, fresh drinks in hand. I retreated to a corner of the bar, my brain buzzing. In the days to come, with my doctor's years-earlier recommendation that I freeze my eggs at top of mind and my questions about reproductive basics mounting, I would see this night as the official beginning of my quest for information. Near the end of the evening, I met a fertility doctor who, after hearing my story and asking my age, pushed a business card into my hand and told me to call her office to schedule an appointment. On my way out, an EggBanxx rep handed me a goodie bag. Inside, wedged between a lime-green mug and a handful of chocolate candy eggs, was a $1,000 voucher to put toward a cycle of egg freezing. I was on my way. Excerpted from The Big Freeze: A Reporter's Personal Journey into the World of Egg Freezing and the Quest to Control Our Fertility by Natalie Lampert All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.