Is Boutique Egg-Freezing a Scam?Latest
Illustration: Tara Jacoby
The Trellis Fertility Studio, an egg-freezing clinic in Manhattan, is bathed in that particular color that’s come to be associated with millennials on the higher end of the economic spectrum, a reflection of the color pink the way La Croix seltzer is often joked to be the ghost of fruit. This desaturated blush of aspirational simplicity is tiled across the bathroom and splashed across laminated charts illustrating the imminent decline of my child-bearing capacity. It hums from the floating backlit signs bearing the company’s name, which I’m told was chosen because a trellis, the wooden lattice that holds up flowering vines, “supports life.” There is a woman on Trellis’ brochure, smiling smugly. She crosses her arms over a sweater that is also exactly that shade.
It’s been seven years since egg-freezing was taken off the list of “experimental” medical treatments; four since a handful of monolithic startups began offering it as an employee perk, and the formerly obscure intervention has evolved into a booming industry that is said to be filling a spiritual void for people in their fertile years. A generation of companies—some more successful than others—has redecorated clinics to feel like luxury hair salons, reframed anesthesia and blood tests as long-term wellness practices rather than the clinical staples they are. And the whole thing is held together by rosy copy about seizing one’s destiny and overcoming the structural barriers that keep women alone and unfulfilled—which is how I found myself drinking a cold-pressed juice and waiting for my $350 “fertility assessment,” swaddled in this endless expanse of pink.
On the rainy morning I visit Trellis, I joke to the person I’m dating that maybe I’ll get lucky and they’ll find that I’m sterile, my personal vision of reproductive freedom being the idea that I might be impossible to impregnate. I’ve never considered how fertile I am, never mind thought about the potential for my fertility to decline: At 31, I’m not waiting to find an appropriate partner or for my career to settle down. While I am begrudgingly anxious about a number of the other clichés that haunt women as they grow older—loss of muscle tone, gray hairs, a future forever alone, etc—finding a gaping hole where a child should have been isn’t one. This makes me either the worst person to write about the wave of venture-backed startups and private equity-infused egg-freezing clinics that have opened in recent years, or the best: I obliquely recognize the terror, though am not moved by the particular cause.
Businesses like Trellis, along with its competitors like KindBody and Extend Fertility, hinge on the idea that true freedom is the opposite of the kind I imagine—that by acknowledging and reinforcing the insidious forces that tell women they must birth their own biological progeny, and by offering an option for the deferment of that dream, a person could master their fate. It’s an exchange that amounts to the literal purchasing of years. As an ad for Extend Fertility once described the procedure’s promise: “Take control of your biological future—freeze your eggs and freeze time.”
Egg-freezing studios like this have multiplied over the last years: One investor in such businesses recently estimated the market is growing 25 percent a year. Extend Fertility says it has frozen 27,000 eggs since its launch in 2016 and announced a $15 million expansion earlier this year. KindBody, which opened in late 2018 and has raised over $22 million to date, sends busses to city streets for “pop-up” fertility tests and operates three physical clinics nationwide. At Ovally, the latest venture-funded experiment in outsmarting biology, patients fly to Spain, where treatment is cheaper, to combine hormone therapy with tourism and tapas. According to one estimate, fertility businesses like these received $624 million in venture capital and private equity funding last year, a more than three-fold increase from a decade ago.
If the marketing arms of these companies are correct, across America’s coastal cities, professional women are breaking down the systemic barriers that have prevented them from publicly acknowledging their fear of infertility and taking action. If they lean in to the terror they feel when they ponder a barren future, the thinking goes, they might master those fears, opening doors previously closed to people burdened by their biology. At sponsored cocktail hours and egg-freezing-themed spin classes, they are breaking the silence around their bodies to learn what amounts to the ultimate life hack. “The people who have frozen their eggs are doing the cool new thing.,” KindBody’s marketing director of told a reporter in May, “It’s part of the ‘you don’t need a man and if you’re single you don’t have to have kids right now’ moment—a new wave of feminism.”
All of this ideological dressing is a crucial feature, considering that these companies’ long-term viability depends on how quickly they can reproduce. In order to generate successful statistics, egg-freezing businesses must attract greater numbers of women at younger ages—research having suggested that the younger a person is when they freeze their eggs, the greater the chances are they will have at least one live birth. Uncertain success rates printed on glossy pamphlets are offered as a solution to the grim realities of bearing children in a country where only 40 percent of women qualify for maternity leave; where people who take time off to raise kids are punished with lower wages; where childcare costs tens of thousands of dollars a year. The answer is allegedly the deferment of all of these problems: To work more, and use those hard-earned dollars to pay for the privilege of continuing to work. But when you’re wearing a soft pink robe and sipping blended fruit, it’s not supposed to feel as dark as all that. It’s supposed to feel like treating yourself.
In Trellis’s waiting room, “It’s up to each of us to invent our own future” is written in purple cursive on the wall. The wall is a backdrop best suited for Instagram: Aya Kanai, the fashion director for Hearst Publications, professional wellness influencer Melanie Phillips Torres, and Katia Pryce of the fitness studio Dance Body have all posed next to the inspirational quote this year. It’s credited to Michelle Obama, who during her transformation from First Lady into civilian feminist icon spoke about conceiving with the help of IVF. The disclosure, on Good Morning America, was briefly heralded as a brave testimony on the forbidden subject of fertility: “The biological clock is real,” Obama said at the time. But the quote on Trellis’s wall is plucked from an earlier speech, a 2012 appearance at Virginia Tech: The future Obama spoke of inventing was meant to apply to students who were healing from a school shooting that left 33 dead.
Sitting on a plush couch next to this quote, Jennifer Huang, Trellis’s marketing officer and a former executive at L’Oreal, used fitness tropes to explain her company’s role: Think of it like you’re at Equinox, she said, and you want to do spin, but they don’t offer spin at the right time. A dedicated spin program, like the at-home streaming program Peloton, might be better, she suggested. This was intended to illustrate, I assume, that programs exquisitely catered to a single service should be preferable both in wellness and in more clinical matters of health. This fixation on the clean lines and habitual practices that turn working out into a “lifestyle” is, apparently, industry-wide: Last year, Extend Fertility’s founder described his services as “a personal trainer for your eggs.” Reimagining a medical procedure as a perk at a luxury gym accomplishes a few goals, not least of which is that it’s a metaphor eagerly embraced by investors: Working out is an aspirational contribution towards an imagined future self, better applied to a subscription model than a single lump sum.
Egg-freezing businesses speak of their education programs in terms pioneered by the women’s health movement of the ‘70s and ‘80s: Kindbody’s Prosecco-fueled meet-and-greets and Trellis’s “fertility bootcamp” are rendered as moments in which women gather with other women to discuss bodily matters the patriarchy has ignored, sharing intimate knowledge unavailable through other avenues. Huang told me she considers it a “privilege” to “reach out and educate” women on subjects that have “been in a vacuum for such a long time.” Trellis really appreciates “the bravery of all the women that come in and are ready to talk about it,” she said. In part, this is a reflection of broader market trends towards associating the purchasing of saleable health-adjacent experiences with gendered courage. It’s also part of a massive, self-perpetuating shift in how fertility treatments are understood and sold.
In 2018, a group of researchers published an analysis of several hundred U.S. media articles that mentioned egg freezing between 2012 and 2015. They found that since Apple and Facebook offered insurance coverage for the procedure to their employees, news items about the new medical frontier were generally “overwhelmingly positive portrayals” described “as means to challenge the work-family balance.” This runs counter to what research typically suggests, which is that a large portion of people who freeze their eggs do so because they are waiting for the right person with whom to raise a child—not because they lack the financial stability to have children, or are otherwise distracted by their careers. But that data point about the “lonely woman” doesn’t lend itself particularly well to an empowerment-focused clinic in millennial pink. It’s more fashionable to be planning for procrastinated parenthood because you’re busy stacking cash and living your dreams.
One of those researchers, Lisa Campo-Engelstein, took this idea further in a later paper, explicitly tying the market success of egg-freezing businesses to the popularity of Sheryl Sandberg’s Lean In—Sandberg being, of course, the chief operating officer at one of the first companies to offer the option of egg freezing at all, and “lean-in” feminism being the idea that a person could railroad systemic injustices by being more assertive. Egg-freezers, wrote Campo-Engelstein, “are no longer viewed as potential victims of an exploitative, for-profit, fertility industrial complex that reinforces women’s anxieties about aging along with their desires for genetically related children,” but are considered “brave” in their efforts to succeed in the workplace against stacked odds. Coincidentally, these are the messages the egg-freezing business has attempted to enshrine through their marketing, and efforts that benefit the industry at large.
THE LINE WAS FLAT UNTIL THE AGE OF 34, WHEN IT CURVED LIKE A STEEP ROLLER COASTER AND EVENTUALLY, JUST BEFORE MIDDLE AGE, CRASHED INTO THE GROUND.
Business investment in the nascent science of egg-freezing accelerated right around the time these messages about the bravery of egg-freezers and the plucky gospel of feminism-through-capitalism mainstreamed. Trellis is actually an offshoot of IntegraMed, one of the nation’s largest networks of fertility clinics, which was itself purchased by Sagard Capital, a private equity fund, in 2012, the same year the American Society for Reproductive Medicine stopped referring to egg-freezing as “experimental.” At the time, the ASRM’s committee recommended the procedure only to people who had clear medical reasons for wanting to freeze time: for instance, those who were about to undergo chemotherapy. “There are no yet sufficient data to recommend [egg freezing] for the sole purpose of circumventing reproductive aging in healthy women,” they wrote. “Marketing this technology for the purpose of deferring childbearing may give women false hope.”
The society changed this position recently, in 2018, as the idea that freezing one’s eggs could combat gendered societal ills was popularized by fertility companies and the press—the committee’s most recent recommendation highlights the practice’s ability to “promote social justice by reducing the obstacles women currently face,” such as lower pay and little opportunity for parental leave.
Among the businesses built around offering this particular balancing of the social scales, Trellis’s mission is particularly tight: Unlike Extend Fertility or Kindbody, Trellis declined to offer fertility services like IVF. According to the company’s market research, “women who want to freeze their eggs are different than women being treated for infertility,” Huang told me. “They’re younger, single, thinking about their future.” The data indicated women going in for egg-freezing didn’t want to sit next to a couple, or children, an experience which might sour this “safe space for these single proactive women,” Huang said, women who are “like, not moved by pictures of babies, right?”
Despite the ambitions expressed in all this marketing, the medicalized portion of my assessment at Trellis was restrained. I wore a pink robe as a nurse gave me an ultrasound in a lofty room with a skylight, showing me my ovarian reserve on a screen and pointing out the gray blurs that indicated how high-yield my potential harvest could be. Later, another nurse would take my blood for an Anti-Müllerian Hormone test, which can indicate how many potential egg cells a woman has left—a slightly different way to take the same measurement. But it appeared that neither of those tests were particularly necessary for me, a relatively healthy woman just entering her thirties. When I sat down with a reproductive endocrinologists, he showed me a graph that estimated a woman’s ovarian reserve according to her age. The line was more or less flat until around the age of 34, when it curved like a steep roller coaster and eventually, just before middle age, crashed into the ground.
From the initial meeting, Trellis offered a six-stage treatment plan in which a person could “map out family planning goals and wellness options” with a “fertility coach,” through the after-care stage in which they would “indulge in some ‘me’ time” and plan for the future use of their eggs. In between, over six weeks or so, they would be taught how to administer the medications that they’d inject themselves with daily, the hormones that hyperstimulate the body and cause as many as five times the usual number of eggs to grow, visiting the pink studio occasionally to ensure those medications weren’t sending the body into a dangerous overdrive. Then they’d visit a partner clinic, where a doctor would guide a needle into the body, puncture the ovary, and suck out the eggs. The endocrinologist told me that if I chose to do all of this, I could go back to work after a day. The side effects of the hormones, he told me when I asked, were not usually too intense. He was sober and friendly, a former IVF doctor who had recently moved to New York.
Until recently, Trellis charged $50 a month to store the frozen eggs at its partner clinic. A “fertility coach” went over the financing options with me: Egg freezing and anesthesia for a single cycle and retrieval cost $9,250. A second cycle, discounted, would be $5,625. Medications, according to Trellis, run between $3,000 and $6,000 per procedure, bringing the price of stopping time to at least $12,500. Trellis, like other businesses of its kind, offers financing through a third party. But my fertility coach told me most people didn’t opt to use it: While advertisements for egg-freezing companies have suggested the process has been democratized through programs that bring the cost to as little as an acai bowl or a smoothie every day—a tactic that distances the procedure from an association with medical bills—the people who visited Trellis appeared to have already anticipated the clinic’s significant cost.
Trellis also hosted patient stories on its website. “For Devin,” one read, “planning ahead is a form of self-care. While Devin doesn’t necessarily know if she wants to have children, she does want to give herself options in the future.” In 2009, 475 people gave themselves this brand of “self-care” by freezing their eggs. By 2016, that number was 7,276. Currently, an estimated 20,000 Americans have gone through the procedure, but three-quarters of them haven’t yet thawed or attempted to use their eggs. Given that the vast majority of people intending to use egg-freezing haven’t had the chance to go through this crucial step, official “live birth” rates from frozen eggs that are implanted are either nonexistent, or fantastically low: One European study from the Human Fertilisation and Embryo Authority estimated that the live birth rate for embryos transplanted into women who have frozen their eggs was 19 out of 100. But no one study has proven anything in particular, and the statistics companies offer generally focus on the success rates when the eggs are thawed—not what happens after, which is in itself a complex medical process with an entirely different set of ways to fail.
LIFE IS FULL OF DISAPPOINTMENTS, AND THE VAST MAJORITY OF THEM ARE MONETIZABLE.
Companies like Extend Fertility say freezing techniques like Cryotech—pioneered by a Japanese veterinarian—have a success rate near 100 percent, which accounts for the thawing of a healthy egg, though not its fertilization or implantation. With long-term success rates still so uncertain, and one of the only reliable metrics being a woman’s age, businesses like Trellis and Extend are introducing not just a clinic, but a distinct life stage, for people who can afford the selective deferment of their desires: That moment in a person’s life, sometime in their late twenties or early thirties, when they visit their local “fertility studio” and spend money against the chance that they will find their future disappointing. This is a self-sustaining model, and one that could lead to an entire lifetime of loyalty to a clinic, with all the subscription fees and medical bills that entails: Recently, I spoke to Karey Harwood, a sociologist who has studied the “infertility treadmill”—the tendency for couples with the means to continue to try infertility methods like IVF, even if they didn’t work. “It was work,” she told me, “emotional work, physical work that drained them financially… but it was a right of passage. If they could afford to do it they felt like they had to do it, to give themselves permission to not have kids, or to adopt.”
When I brought some of these concerns to Trellis’ Huang, she grounded the importance of options, the universal solution for all that ails women: “If you are in your mid-thirties and you’re not ready to have a baby, other than egg- and embryo-freezing, what choice do you have?” The question was rhetorical, and I didn’t answer it, though it did occur to me that there are other options, and that framing the ability to birth a child who looks like you as the gravest of possible mandates—one in which there is only one viable option—felt narrow to the point of being absurd. Life is full of disappointments, and the vast majority of them are monetizable. But then again, I don’t want to have kids.
When I visited Trellis’s softly lit clinic, the company wouldn’t tell me how many patients it had seen, but that it had helped “thousands of women.” The trend forecasting that birthed the company, however, may have somewhat overstated the need: By the time I finished this story, the company had announced its 10-person office would soon close down. IntegraMed told me “enrollment numbers were not sufficient to keep pace with the rising cost of doing business in New York City.” The website has been replaced with an FAQ page. Eggs frozen with Trellis will continue to be stored at a partner clinic, which will “honor all valid financial agreements.” The storage rate will be set at $600 a year until 2021. Meanwhile, KindBody just announced a new clinic in Santa Monica, and Extend Fertility launched another expansion, along with the marketing slogan “Fearlessly Take on Your Fertility.” Those companies will likely pick up the patients Huang spoke about, the ones who feel they have no options, and for whom the only apparent choice is picking between the businesses who will maybe, someday, give them a biological child.
A previous version of this story misstated Sheryl Sandberg’s role at Facebook—she is COO, not CTO. It also originally misspelled Peloton, the name of the at-home stationary bike company that claims to sell “happiness.” Jezebel regrets the error.