The Atlanta Journal-Constitution
Why fertility 401(k) is good idea
The process of making babies is, biologically speaking, designed to be pretty dang glorious.
But this isn’t a column about sex. It’s about efforts to expand the business of having babies later in life, an exercise sometimes loaded with anxiety and steep costs for would-be parents.
An Atlanta-based medical practice backed by big investors wants to become a national powerhouse with a pitch to would-be moms: Freeze your eggs in your 20s or early 30s when they are likely to be healthiest and store them for when you’re ready to have kids.
“It’s about transforming the marketplace,” Susan Hertzberg, the new CEO of Prelude Fertility, told me. “We want to massively educate the market.”
I worry about the line between education and hyping yet another worry for an anxiety-filled generation.
“I don’t want to scare anybody,” Hertzberg told me when I raised that concern. “But at least know what the risks are.”
Freezing eggs and embryos has been an option used for years, particularly for people facing health issues. But the trend of women waiting later in life to become moms is driving more elective freezing. Prelude is just one of a number of clinics nationally offering the service. It may, though, be among the best funded in trying to grow the business.
Aging does matter on the fertility front. A Centers for Disease Control report concludes the risk of infertility rises as women age, in part because of diminished egg quality. It cites data indicating that 7 to 9 percent of childless women who are 15 to 34 years old experience infertility, compared to 25 percent among 35 to 39 year olds and 30 percent among 40 to 44 year olds.
So the egg-freezing option suggested by Prelude and competitors is sort of like setting up a fertility 401(k) with hopes that it will reduce the chances of dealing with more expensive infertility challenges in the future.
But egg freezing ain’t cheap. Prelude charges $11,250 to $13,600 to retrieve eggs, provide medications and cover storage for four years. And that price doesn’t include another $8,700 if the eggs are ever actually used, which would trigger “warming of the egg, embryo creation and transfer costs.”
Success can’t be guaranteed. Patients still might not get pregnant with thawed eggs. Or they may never choose to use them if they get pregnant the old fashioned way.
Not enough data
The American Congress of Obstetricians and Gynecologists concludes that while egg freezing to defer pregnancy remains an appealing option, there isn’t enough data to recommend it for healthy women solely to improve chances for pregnancy later in life.
Prelude was launched by a tech entrepreneur, Martin Varsavsky, with $200 million in investor commitments. It started by acquiring Atlanta-based
Reproductive Biology Associates, a well-known in vitro fertilization clinic, and sister operation My Egg Bank North America.
Hertzberg, the chief executive, told me she intends to acquire 12 or 15 other major clinics around the nation over the next two years.
As for patients, she’s aiming at women in their late 20s and early thirties. Marketing plans include spreading the word to OB/GYNs and attracting influencers on social media. They also are designing some of RBA’s offices near Northside Hospital to look less like a doctor’s office and “more like if you were going to a day spa.” That sounds very relaxing. At least until young women realize the boatload of money they’ll have to pay. But for many people, parenthood is one of those big dreams of life, which makes the whole issue of fertility fraught with angst.
Several young and middleaged women I spoke with wondered if suggesting elective egg freezing to healthy 20-somethings is unnecessarily anxiety inducing.
Prelude prefers to see it as empowering. Its taglines include: “Knowledge is reproductive power” and “It’s time to take charge of your fertility.”
But then comes the implicit warning.
Hitting a cliff
“The reality of the situation is we are losing our fertility in the late 20s and we hit a cliff at 35,” Prelude’s
Hertzberg told me.
Success rates for in vitro fertilization fall as women get older. But having babies later in life is becoming more common. Birthrates for women in their 30s and 40s are the highest they’ve been since the 1960s, while the rates for teens and women in their 20s are down, according to the National Center for Health Statistics.
Hertzberg told me she doesn’t think the shift would be changed if more companies offered paid maternity and paternity leave. (Only about 17 percent of employers offered paid family leave last year, according to the Society for Human Resource Management.) Instead, she says decisions are swayed by everything from challenges in finding the right partner, focus on careers, hopes for greater financially stability and interest in pursuing other goals first.
Egg freezing is likely to be a tough sell for many would-be parents. Few employers offer insurance that covers even part of the costs.
“I don’t see freezing as an option because I couldn’t afford it,” Nyaboke Machini told me.
She’s 37, single and feeling the draw to be a mother soon.
“I would love to have a traditional life: meet somebody, fall in love, get married, have a baby. That is really not working out for me right now, so what’s Plan B? I don’t feel like waiting for a man to have what I desire the most.”
The budget option
She told me she plans to try a less expensive route than freezing: enlisting the services of a sperm bank.
“In my late 20s I felt like I had time. Early 30s, I felt like had time. It wasn’t until I was 33 or 34 that I started feeling concerned.”
Jake Anderson-Bialis’ wife had a history of ovarian cysts. So the couple studied up and tried in vitro fertilization, including having embryos frozen, to improve their chances of pregnancy later.
The couple later co-founded an ad-free website called FertilityIQ to provide detailed information on IVF and related topics, including egg freezing. Elective freezing is growing quickly, with some New York IVF clinics seeing it account for 25 percent of their volume, up from maybe 1 percent just five years ago, Anderson-Bialis said.
“I think many women are led to believe that if they freeze their eggs they have in effect bought an insurance policy to have a child down the road. That is false in every way.”
Still, “for some people it can be a fabulous thing,” he said, especially if freezing young eggs helps avoid far more expensive infertility treatment in the future.
As it turns out, he and his wife conceived their first child the traditional way. They might, though, end up relying on one of their frozen embryos next time around.