Recently, Megan invited Extend Fertility—the egg-banking company launched last summer by Christy Jones, who developed the business plan as part of her Harvard M.B.A.—to present an egg-freezing explainer session for “85 Broads,” an elite network of women who hold M.B.A.’s from top programs. On the night of the program, there was a torrential downpour, the kind that cancels flights across the metro area and floods the subways. Megan assumed no one would show up, but the Cornell Club was packed with women—some in their twenties, some pushing 40, some married, some single, all panicked.
“When we turned it over for questions,” says a nurse who spoke at the session, “25 hands shot up immediately. ‘I’m 34. How much time do I have left?’ . . . ‘I’m 32, and I’m on a partner track. What can I do?’ ”
What if it were possible to stop eggs from aging, to keep them in suspended animation? A 47-year-old woman could be her own egg donor—a gift from her 30-year-old self.
Nadine, who was in the crowd, says that the worst moment was when an Extend Fertility doctor started throwing out statistics about how swiftly fertility plummets as women approach 40. “Everyone gasped,” she says. “Your normal gynecologist will say you are young and healthy and take care of yourself. But it doesn’t matter how healthy you are—those eggs are 35!”
“I think for successful women this is the piece that doesn’t fit into the equation,” says Megan. “It comes time for us to have kids and you’re looking around saying, ‘But I’m still working so hard! This doesn’t fit in.’ ” Or worse, you look around and realize that you can’t have kids anymore. “This is a topic that really gets people emotional,” she says. “These issues play on women’s fears. The idea that there is this option is just huge.”
Egg extraction is far from a Penthouse-and-a-plastic-cup experience, so every candidate for freezing must attend a self-medication seminar run by a nurse. A few weeks after our first meeting, I join Nette at NYU for her training day.
She’s in good spirits. Her hair is in a glammy twist, but her casual Friday flip-flops and army-green Capris make it look like she’ll cut out to the beach when this is done. She’s brought a pregnant friend along for moral support, and we three are brought into a boardroom with a movie screen. Nette is handed a complex four-page consent form to sign. In bold letters on page one, it says, “I understand that there is no guarantee my eggs will survive the freezing and/or thawing processes.”
The nurse explains that because egg freezing is so new, we’ll be seeing the standard IVF PowerPoint presentation; she’ll just tell us what to ignore. The process is very similar: There are two weeks of self-administered gonadotropins—hormone shots—which are used to stimulate the ovaries and prompt the maturation of multiple egg-laden follicles in a cycle, rather than the one or two women normally produce each month. The eggs are then sucked out through the vaginal wall with a needle while the patient is under anesthesia.
The nurse casually mentions that the drugs can cost several thousand dollars—beyond the other costs of extraction and storage. Nette looks a little green. “I thought it would be a couple hundred dollars,” she says, looking across the table at her friend. The nurse plunges on, reminding her that she is required to come in daily for ultrasounds and blood work to monitor progress and watch for “hyperstimulation syndrome,” a condition in which too many eggs are released, making the woman very ill. She explains that the daily shots Nette will be giving herself must be mixed carefully and taken at exactly the right time. Otherwise, she could screw up her cycle.
Nette is asked to pick which brand of hormones she wants to take. It’s not clear, other than cost, how she is supposed to choose. Nette picks Gonal-F, a syringe-and-vial kit, based on the fact that she will only have to stick herself once a day. The nurse mimes mixing and administering the drugs using empty bottles, real syringes, and a rubber abdomen. “I have a gut,” says the nurse, cheerfully grabbing her own stomach, “but I prefer to give it in the leg.” The final shot must be delivered intramuscularly, in the patient’s backside, with a needle that’s several inches long. Nette looks nauseated. Her BlackBerry whirs beneath the table, unchecked.
At the end of the two-and-a-half-hour session, Nette is led to a billing cubby where she learns that payment is due—in full—at the start of treatment. “It’s just overwhelming,” she says in a small voice, before hailing a cab.
A week later, she calls with bad news. She’s not stimulating well. “They only found five follicles,” she says, trying to sound upbeat, “and I’m in the seventh day of the fourteen-day cycle.” She should have had more by now, she says, and she might have to cancel and start again, perhaps with a higher hormone dosage, rather than go through with the expensive extraction with so few eggs. According to NYU, she needs ten, at least, by the end of the cycle. The outlook is grim.
Many people in the fertility field believe that women like Nette are setting themselves up for disappointment. “Especially in our field, sometimes the technology gets ahead of the findings,” says Kutluk Oktay, Rosenwaks’s colleague at Cornell and one of the doctors who helped shape the ASRM’s cautious position on egg freezing. “Egg storage does not equal pregnancy.”