The mission of Issues in Perspective is to provide thoughtful, historical and biblically-centered perspectives on current ethical and cultural issues.

New York Times reporter Emma Goldberg recently posted a fascinating article on the growing practice of egg freezing among women in the US.  She put her report in the context of women who seek to improve themselves and who seek to slow the reproductive clock:  “There is always a market for products, from skin care to weight loss, promising to ease the angst of womanhood. Efforts to slow down the reproductive clock are no different. The business of egg extraction is thriving, among the privileged group of people who can access it.”

She gives special focus to Spring Fertility, a clinic in Midtown Manhattan:  “Across Spring’s clinics nationwide, the number of egg freezing cycles undertaken last year jumped 37 percent from the year before. That surge is visible at fertility clinics around the country, according to data from the Society for Assisted Reproductive Technology. The prototypical patient also seems to be getting younger, doctors say, a change coinciding with a steady uptick in corporate benefit packages that cover fertility preservation. In 2015 just 5 percent of large employers covered egg freezing; in 2023, nearly one in five did.  Some medical technologies spread slowly, but the embrace of fertility preservation has grown at a remarkable rate. In 2015 there were about 7,600 egg freezing cycles recorded nationwide, and by 2022, that number hit 29,803, a nearly 300 percent increase.”

Several important questions about the fertility procedure known as egg freezing:

1. How does the procedure work?  “An egg freezing cycle starts when a woman injects herself once or twice a day with hormones that stimulate the production of multiple eggs and ends about two weeks later when a physician extracts those eggs with a needle. Some patients go through multiple cycles in the hopes of getting more eggs, which are then preserved in liquid nitrogen tanks, a mad science experiment enabling deferred motherhood.”
2. How recent is the procedure of egg freezing?  “Egg freezing has been around since the 1980s, but for decades it was primarily used by cancer patients before undergoing treatment that might damage their fertility. The American Society for Reproductive Medicine lifted the treatment’s experimental label in 2012. In the decade that followed, the vast majority of people who froze their eggs fell into one defined demographic, painted vividly in anthropologist Marcia Inhorn’s book Motherhood on Ice: Women in their late 30s who hadn’t settled down with romantic partners and wanted to preserve the option of becoming a mother. Ms. Inhorn called egg freezing a solution to the ‘mating gap,’ the lack of eligible male partners for educated women.”
3. Why do some women pursue egg freezing?  In recent years the motivations offered for freezing eggs have gotten more varied:

• “There are those who see it as a way to spend their early 30s focused on career, untethering professional timelines from reproductive ones.”
• “There are those who have seen friends freeze their eggs and figure they may as well do the same.”
• “Others see egg freezing as something ineffably empowering, all the more so following the Supreme Court’s Dobbs v. Jackson decision, which has led to states around the country curbing access to reproductive health care; in vitro fertilization has recently become a legal and religious target too.”
• “And some view elective fertility treatments simply as a way to exert control over the uncontrollable: their aging bodies.”
• “All of these rationales are made more possible with corporate benefits.”  Forbes revealed its expanded health care policy in 2024, joining a host of other companies chasing female workers by promising to help secure their fertility. Starbucks announced in 2019 that it would increase its lifetime cap for fertility treatments to $25,000, with another $10,000 for fertility medications. Match Group, which owns dating apps like Tinder and Hinge, increased its benefit in the United States to $10,000 from $5,000 in 2022. Amazon last summer expanded to more than 1 million employees its fertility benefits, which are administered through the benefits platform Progyny and include covering what roughly amounts to two cycles of treatment.  Goldberg writes: “Mine is the first generation with access to a technology that promises to slow, a little bit, the biological clock, and, for those lucky enough, bosses who will foot the bill. That brings with it a magical thinking that we’re already accustomed to: for every difficulty we saw our parents grapple with, there’s an app for that . . . Of course egg freezing didn’t make everything snap into place. But it did bring, at least temporarily, a sense of relief and power.”

4. How much does this type of fertility treatment cost?  Fertility treatments are expensive. “A single cycle of I.V.F., medications included, can cost upward of $20,000, and doctors often recommend multiple cycles to increase the chance of success. Egg freezing can cost between $4,500 to $8,000for medical appointments and another roughly $5,000 for medication, on top of $500 annually for storage.”
5. How successful is freezing eggs and later in life actually getting pregnant?  “Preserving eggs at a younger age could increase the chance of later successfully putting them to use. A 2022study on live births from frozen eggs . . . found that the overall success rate of having a baby from a frozen egg was only 39 percent, but it rose to 70 percent for women who were not yet 38 when their eggs were extracted and who were able to thaw 20 or more eggs.”  But, the procedure is not always successful:  “In 2011, when she was 39, Brigitte Adams froze 11 eggs. She was single and working late nights as a marketing executive. Five years later, she was feeling fed up with dating and being ghosted, and was past ready to have her own children. She decided to thaw the eggs. She found that only one was viable — a not uncommon experience, research shows, particularly for women who are older when they freeze their eggs — and when she implanted it, she lost the pregnancy within four days.”

In a 2013 article in the Wall Street Journal, Sarah Elizabeth Richards summarized the case for egg freezing.  She wrote: “Between the ages of 36 and 38, I spent nearly $50,000 to freeze 70 eggs in the hope that they would help me have a family in my mid-40s, when my natural fertility is gone.  For this baby insurance, I obliterated my savings and used up the money my parents had set aside for a wedding.  It was the best investment I ever made.”  She also wrote that egg freezing has the effect of making a “woman more open to using science to explore alternate routes to creating their families.  One woman decided to stop waiting for the right man at the right moment and explored using donor sperm to have a baby on her own, using her frozen eggs.  And several other women who began the egg freezing process firmly opposed to using donor eggs turned to those when their own failed.”  She also mentioned that if your frozen eggs do not survive thawing or fertilization or fail to grow into robust embryos, it is possible to go online to one of the commercial egg banks available and order a batch of frozen eggs donated by a woman who looks like you.

So, with the growing practice of egg freezing and the growing financial support of the procedure through employer health insurance benefits, are there ethical issues about which we should be concerned?

1. Freezing eggs does not jeopardize the life of a human being, because before fertilization there is no human being.  But, after the thawing of eggs, in vitro fertilization (IVF) is used to produce the embryo.  Normally, IVF involves multiple fertilizations and thereby multiple embryos, with those not implanted in the womb being destroyed or frozen.  What happens to the remaining embryos that are not implanted or frozen is an ethical problem. Psalm 139:16 makes it quite clear that God values even embryonic life.   As Christine Rosen of the New America Foundation has argued, egg freezing and IVF will likely increase preimplantation sex selection and genetic diagnosis.  If a woman thaws her eggs and practices IVF, why should she not also be certain she gets the kind of child she wants—in terms of gender and other quality traits?
2. Rosen further suggests that “The emphasis on parental control in egg freezing could lead to subtle shifts in our attitudes about having and raising children.  Control changes our expectations. . . The more control we have, the more we expect the end result—the child—to turn out the way we want it to, and the greater our disappointment when he does not.”  Such increasing control enables women and parents in general to indulge their personal hubris and assume that they truly are in charge.  They are not!
3. Furthermore, with IVF and the production of multiple embryos, some embryos not implanted in the mother’s womb are then frozen.  The existence of frozen embryos raises profound ethical and legal challenges.  The Bible presents the case that the human embryo is a person with infinite value and worth (e.g., Psalm 139:16).  Therefore, the existence of frozen human embryos requires reflection and serious biblical thinking.  Two conclusions seem warranted:

• Since one of our goals as Christians must be the protection of embryonic life, if “spare embryos” are produced through IVF and they are not used for implantation, it is ethically acceptable for these embryos to be frozen, provided that they are used, via future implantations, to produce a baby, not for experimentation.  (This, however, should not be understood to condone IVF, which I believe is ethically wrong.  Once human embryos are produced through IVF, their existence is not an ethically neutral issue.  Since God is concerned about the human embryo (again see Psalm 139:16), as good stewards, we must be too).
• Once the embryos are frozen, the major ethical guideline must be to protect them from harm.  It is ethically unacceptable to permit these frozen embryos to be used for experimentation of any kind.  Rather, the only ethically sound option for frozen embryos is quick implantation in a mother’s womb.  Ethicists John and Paul Feinberg write that “. . . while we believe an IVF-conceived embryo has been produced by immoral means, once it exists, there is still an obligation to treat it morally.  Killing it or allowing it to die is immoral.  Freezing it and later implanting it . . . at the current state of our technology . . . seem the most likely ways to protect the child, and that must be the overriding concern.”  [Ethics For A Brave New World, p. 240.  Also see Robert P. George and Christopher Tollefsen, Embryo: A Defense of Human Life, pp. 19-26]

God in His common grace has enabled humanity to understand the science and implement the techniques that produce egg freezing and IVF.  But the fallen nature of humanity means that increasingly such technologies will be used for selfish, self-indulgent reasons that have little to do with the miracle of procreation and the privilege of rearing children.  These procedures seek to pursue the miracle of life on our terms, often for self-centered reasons.  When we think we are in total control, then we make wrong ethical choices sometimes resulting in tragic consequences. The message of genuine biblical Christianity is that God is in control—and that He is the ultimate author of life.  That proposition should produce a needed degree of humility and dependence on Him, not only on reproductive technologies.

See Emma Goldberg in the New York Times (30 June 2024); Sarah Elizabeth Richards in the Wall Street Journal (4-5 May 2013); Hannah Seligson, “To Be or Not To Be (a Parent),” and Ruth La Ferla, “Freeze Your Assets. Enjoy Life,” in the New York Times (30 August 2018); and Sarah Elizabeth Richards in the Wall Street Journal (4-5 May 2013).