Jean Smith

Egg freezing is expensive and college sophomores are not known for being especially wealthy.

Nor is the process especially fun, so given a choice between IVF and sex with a romantic partner, most women would opt for the latter.

But another reason is that the entire fertility industry is built around infertile women in their mid to late 30s and most doctors just don't have a clear mental model for how to deal with women in their mid-20s thinking about egg freezing.

There are countless examples of this blind spot, but one of the most poignant is the fertility industry almost completely ignores all age-related fertility decline that occurs before the age of 35, to the point where they literally group every woman under 35 into the same bucket when reporting success metrics for IVF.

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This is far from the only issue.

We not only ignore differences between 24 and 34-year-olds, but the way we measure success in IVF is fundamentally wrong, and this error specifically masks age-related fertility decline that occurs before the age of 35.

If you go to an IVF clinic, create five embryos, get one transferred, and that embryo becomes a baby, you can go back two years later and get your second embryo transferred to have another child.

If that works, your second child will be ignored by official statistics.

Births beyond one that come from the same egg retrieval are not counted, so these differences in outcomes that come from having many viable embryos literally don't show up in success statistics.

This practice specifically masks the benefits of freezing eggs in your mid-20s instead of mid-30s, because most of the decline between those two ages comes from having fewer viable embryos.

What happens if we measure success differently?

What if we instead measure the expected number of children you can have from a single egg retrieval and show how that changes as a function of age?

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The answer is the difference between freezing eggs at 25 and freezing them at 37 becomes much more stark.

There's a 60% decline in expected births per egg retrieval between those two ages, and no one in the IVF industry will tell you this.

Worse still, by age 35, over 10% of women won't be able to have ANY children from an egg freezing cycle due to various infertility issues which increase exponentially with age.

So for a decent portion of egg freezing customers, they will get no benefit from freezing their eggs and they often won't find this out until 5 to 10 years later when they go back to the clinic and find that none of the eggs are turning into embryos.

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Polygenic embryo screening.