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The Egg Freezing Revolution? Gender, Technology, and Fertility Preservation in the Twenty‐First Century
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The Egg Freezing Revolution?
Gender, Technology, and Fertility
Preservation in the Twenty-First
Century∗
MARCIA C. INHORN
Abstract
Egg freezing is the “newest” new reproductive technology, a form of flash-freezing
that allows human eggs to be successfully stored in egg banks. Touted as a “revolution in the way women age,” egg freezing is being heralded as a way for older
career women to “rewind the biological clock.” This essay will examine the many
factors in American women’s lives—education, career, financial stability, relationship status, medical diagnosis and prognosis—that affect their egg freezing and disposition decisions. “Medical” egg freezing is being used by cancer patients, while
“social” or “elective” egg freezing is being used by professional women in their late
30s and early 40s, both of whom face the threat of future infertility. Egg freezing
among professional women represents a technological concession to ongoing gender
inequalities in American society. These include employment constraints facing career
women, the growing demographic surplus of college-educated women who cannot
find college-educated male partners, and women’s resultant delays in marriage and
childbearing. Ultimately, egg freezing reveals a new and important interface of science and society—one with major implications for human reproduction, women’s
lives, and family formation in the twenty-first century.
INTRODUCTION
Oocyte cryopreservation, or egg freezing, is the “newest” new reproductive
technology, involving a form of flash-freezing, which allows human eggs
to be successfully stored in egg banks, thereby prolonging a woman’s
reproductive life span. Egg freezing is being heralded as a “reproductive
backstop,” a “fertility insurance policy,” an “egg savings account,” and
∗ I want to thank Pasquale Patrizio of the Yale Fertility Center, Jennifer DeChello of the Yale Department
of Anthropology, and my former Yale students, Mira Vale and Ruoxi Yu, for their research assistance.
Emerging Trends in the Social and Behavioral Sciences.
Robert Scott and Marlis Buchmann (General Editors) with Stephen Kosslyn (Consulting Editor).
© 2017 John Wiley & Sons, Inc. ISBN 978-1-118-90077-2.
1
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
particularly as a way for older career women to “rewind the biological
clock” (Goold & Savulescu, 2009; Hughes, 2012; Wyndham, Figueira, &
Patrizio, 2012). Younger women, in their 20s and early 30s, could also
potentially “put their fertility on hold,” “slow down their biological clocks,”
and “postpone motherhood” until they are ready via egg freezing technology (Lockwood, 2011; Shkedi-Rafid & Hashiloni-Dolev, 2012). Indeed, the
postponement of women’s fertility through egg freezing is being heralded
as a “reproductive revolution,” equivalent to the introduction of the birth
control pill in the early 1960s (Gibbs, 2010; McDonald et al., 2011).
Yet, the development of egg freezing has not been straightforward. As with
many other low-temperature technologies used in biomedicine to “hold still”
life processes, the freezing and thawing of human eggs has proved technologically difficult. Although cryopreservation of human eggs was first tried
in the early 1980s, and the first reported frozen egg baby was born in 1986
(Lockwood, 2011), the methods of slow freezing being used at that time led to
low oocyte survival, chromosomal defects, poor embryo development, and
overall low birth rates (De Melo-Martin & Cholst, 2008).
However, since the new millennium, a novel method called vitrification,
which involves “flash-freezing” of human eggs, has been introduced (Mertes
& Pennings, 2012). Despite initial caution, vitrification has led to excellent
clinical success rates—an outcome that has encouraged some governments
to authorize egg freezing for their citizens (Garcia-Velasco et al., 2013;
Lockwood, 2011). Israel has led the way in this regard, with a 2009 policy
guideline, followed by approval of egg freezing for clinical use in early 2011
(Shkedi-Rafid & Hashiloni-Dolev, 2011, 2012; Stoop, 2010). Although vitrification technology remained experimental in the United States and most of
Europe, the American Society for Reproductive Medicine (ASRM) lifted the
experimental ban on October 19, 2012. While not enthusiastically endorsing
egg freezing as in Israel, the ASRM allowed egg freezing to be performed
in America for a variety of medical and “social” reasons (American Society
for Reproductive Medicine, 2012). Still, the ASRM urged caution—stopping
short of recommending egg freezing to postpone childbearing. As it pointed
out, there were insufficient data on safety, success rates, cost effectiveness,
and physical and emotional risks to women, who might be lulled into a false
sense of security. Furthermore, reliable data on the ultimate success of either
medical or social egg freezing are not yet available, as so few women have
yet to use their frozen eggs. In other words, the viability of egg freezing and
what it will ultimately mean for American women and their future children
remains highly uncertain.
Having said this, in vitro fertilization (IVF) clinics on both the East and
West coasts and in many American cities began in 2012 to create their own
egg freezing programs, with several commercial egg banks launched by that
The Egg Freezing Revolution?
3
time. Egg freezing also began receiving increasing US media attention. For
example, a cover story in The New York Times explained that parents were
offering to subsidize egg freezing for their single, “thirty-something” daughters in the hopes of future grandchildren (Gootman, 2012). Since then many
fashion and women’s magazines have run stories about egg freezing, and
many American celebrities have “come out” with accounts of their egg freezing experiences in the national media.
EGG FREEZING IN AMERICA: THE EARLY EVIDENCE AND DEBATES
But celebrities aside, who are the ordinary American women who might
turn to egg freezing for fertility preservation? In the United States, there
are two major categories of egg freezers: first, medical egg freezers—mostly
women diagnosed with cancer, the treatment of which will destroy their
ovarian function—and the so-called social or elective egg freezers—mostly
single women who, for educational, career, and relationship reasons, are
concerned about “aging out” of their fertility and are thus elective users of
the technology (Mertes & Pennings, 2012; Stoop, Nekkebroeck, & Devroey,
2011). In the United States, most women are elective egg freezers, in their
late 30s and early 40s, which, medically speaking, is probably too late to
preserve the highest quality, most fertile eggs (Gold, Copperman, Witkin,
Jones, & Copperman, 2006; Romain, 2012). In general, elective egg freezers
are highly educated professional women, the majority of whom have
acquired graduate degrees, often from elite institutions (Inhorn, 2016). They
include physicians, lawyers, professors, engineers, business executives and
entrepreneurs, government officials, diplomats, and women in the arts,
entertainment, and media industries. Although most American egg freezers
are Caucasian, increasing numbers of Asian, and to a slightly lesser extent,
Black and Latina professional women, are also turning to this technology
(Inhorn, 2016).
In terms of relationship status, most elective egg freezers in the United
States are single women, who have been unable to find partners committed
to marriage and childbearing. The same holds true in Western European
countries where the technology has been introduced (e.g., Belgium, Netherlands, United Kingdom). There, elective egg freezers also appear to be
high-achieving, professional women, who are single because they are unable
to find committed partners (Baldwin, Culley, Hudson, & Mitchell, 2015;
Mertes & Pennings, 2011, 2012).
Such first-generation egg freezers represent the “moral pioneers” (Rapp,
1988)—those women who are bravely venturing into the new frontier of
human egg freezing. Egg freezing allows these high-achieving professional
women to defer the end of reproductive life through the alluring promise
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
that it is “never too late to become a mother.” However, this particular
cryopreservation technology is also leading to heated debates about
technoscientific futures in which women themselves may “choose” the best
time to conceive. That women may begin to use egg freezing in a politically
transgressive manner—to “put off” marriage and motherhood in order to
achieve professional goals—is rekindling an American debate over whether
women can “have it all” (Hewlett, 2002; Sandberg, 2013; Slaughter, 2012;
Spar, 2013). Although egg freezing has yet to become widespread, feminists
are already questioning whether women should be encouraged to employ
a new reproductive technology in order to achieve both motherhood and
professional aspirations, and whether egg freezing actually helps or hinders
women’s emancipation (Martin, 2010; Petropanagos, 2010).
Drawing upon the insights from feminist anthropology, medical anthropology, and science and technology studies, this essay attempts to understand
these contemporary egg freezing debates—namely, “what is at stake”
(Kleinman, 2006) in women’s decisions to “reschedule” motherhood
(Richards, 2013). In particular, the essay focuses on three key biopolitical
issues—first, the delaying of motherhood within American work cultures
and the subsequent “fertility penalty” experienced by many high-achieving
professional women; second, the growing demographic gap between
college-educated men and women in America, leading to lopsided gender
ratios and a high proportion of educated women without partners; and
third, how egg freezing may help these single, professional women to put
their fertility on hold, while at the same time creating many uncertainties for
these very women, their future children, and society in general. The essay
will examine these issues in turn, exploring how egg freezing has evoked
tensions around gender, race, and class. The essay concludes with some
thoughts on the broader impacts of egg freezing for women’s lives in the
United States, as well as future directions for research.
DELAYED MOTHERHOOD AND THE FERTILITY PENALTY
With the rise of second-wave feminism, the meaning of motherhood has
been at the heart of a major debate set forth in anthropologist Ortner’s (1972)
famous feminist essay, “Is Female to Male as Nature is to Culture?” Ortner’s
essay set the terms for this debate by placing motherhood at the very center
of women’s universal subordination. Namely, Ortner argued that women’s
reproductive bodily functions—menstruation, pregnancy, childbearing,
breastfeeding, and maternal care—placed them closer to “nature,” while
men, as non-reproducers, were free to enact “cultural” endeavors in the
arts, politics, religion, and so forth. Whether reproduction and motherhood
represent the seat of women’s oppression or their greatest source of power
The Egg Freezing Revolution?
5
became a fundamental question for generations of feminist anthropologists,
who went on to publish a wealth of foundational texts on the politics of
reproduction. Perhaps most famously, this question was taken up by Martin
(1987) in her classic ethnography, The Woman in the Body: A Cultural Analysis
of Reproduction (now in its third edition), where she showed that women’s
reproduction was viewed metaphorically in American society as a kind of
“failed production.” Furthermore, this negative view of reproduction had
real implications for women as workers, as they struggled to bring their
reproductive bodies and motherhood in line with the rigid expectations of
workplace culture.
Decades later, these same tensions—between nature and culture, reproduction and production, motherhood and work—remain very much unresolved,
as evident in the egg freezing debates. Many proponents of egg freezing
have lauded the advantages of this technology as a feminist advancement.
Namely, because women have legitimate aspirations for education and
employment, they “defer and delay” motherhood until they are established
in their careers, finances, households, and stable relationships (Goold &
Savulescu, 2009; Lockwood, 2011; Savulescu & Goold, 2008). However,
according to other commentators, this postponement is not entirely voluntary (Mertes & Pennings, 2012), but rather is women’s concession to an
unforgiving labor market and other variables beyond their control (Smajdor,
2011). In demographic terms, the results in most Western countries are (i)
significant increases in age at first marriage; (ii) significant increases in age
at first birth (to nearly 30 in most Western European countries); (iii) smaller
family sizes; (iv) below replacement fertility levels in many nations; (v)
increasing levels of age-related infertility among women; and (vi) women’s
risk of permanent biological childlessness (Lockwood, 2011; Wyndham et al.,
2012).
Data show that this “fertility penalty” for highly educated, professional
women is real (Lockwood, 2011). For example, in corporate America,
nearly one-half (49%) of high-earning women over age 40 are childless,
even though 86% of them indicate that they want (or would have wanted)
children (Hewlett, 2002). Overall, only about 50% of women who postpone
childbearing until their 30s will conceive in the following 6 years, an
indication of women’s “difficult choices about what to prioritize at different
times in their lives—children, education, or career” (Goold and Savulescu,
2009, p. 50).
Egg freezing is being cast as a technology to counteract these effects of fertility postponement and delayed motherhood, while also assisting women in
their educational and career goals. From a feminist perspective, egg freezing
is said to be a “secondary strategy” to end gender inequities and discrimination in the workplace until the day arrives when government policies are
6
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
more favorable to mothers as workers. Some argue that this will follow when
more women gain positions of authority and influence (Lockwood, 2011). In
addition, giving women extra time on their biological clocks is deemed a corrective to male reproductive advantage. While career women who hope to
conceive in their later reproductive years have often been cast as “selfish”
for “wanting it all” (Martin, 2010), men “regularly postpone fathering children into their 40s, 50s, 60s, 70s and even their 80s, yet they face little or no
censure” (Goold and Savulescu, 2009, p. 52). Furthermore, men have been
able to freeze their sperm for more than a century (Becker, 2002). Egg freezing thus confers to women a biobanking technology already possessed by
men for decades. Given that women have a longer life expectancy than men,
they, too, should be supported in having their children later, according to
some advocates (Goold and Savulescu, 2009).
Despite these arguments in favor of egg freezing as a path to gender equality, feminist critics are already worried about the potential deleterious consequences, even backlash, that may accompany the use of this technology.
Such outcomes might include eventual employer expectations that women
workers postpone childbearing through egg freezing. Professional women
who go this route may develop a false sense of security about future reproduction when, in fact, egg freezing cannot provide guaranteed future fertility outcomes. Indeed, feminist philosopher Angel Petropanagos (2010) has
argued that promoting egg freezing as a “quick fix” technological solution
for professional women does not solve underlying structures of patriarchy.
The promotion of egg freezing may serve to reinforce patriarchy by leaving
intact various forms of gender inequality—for example, employment policies
favoring men, the “glass ceiling” on women’s advancement in the workplace,
men’s “lifestyle” choices that disadvantage women, and so on.
THE DEMOGRAPHIC GAP: EDUCATED WOMEN WITHOUT
EDUCATED MEN
Moreover, men are almost entirely absent in egg freezing discussions,
even though this is a major lacuna. In most cases, professional women are
postponing their fertility not because of work, but because they are single
and cannot find male partners, even though they want them (Baldwin et al.,
2015; Inhorn, 2016). This begs the question: Why are so many high-achieving
professional women in the United States remaining single, but not by
choice? Although women tend to blame themselves for not finding a
husband in a timely manner—or they blame American men for their lack
of marital commitment and a number of other perceived male flaws—the
answer to this question lies in demography. Namely, in the United States,
there are increasing gender disparities in college education, which are
The Egg Freezing Revolution?
7
extremely important for women’s marital prospects, but which are little
discussed.
In his prescient book, Date-onomics: How Dating Became a Lopsided Number
Game, Birger (2015) examines US census data to describe the growing gender
gap in college education. Today, for every four college-educated women in
the United States, there are only three college-educated men. For example, in
2012, 34% more American women than men graduated from college. And, at
the graduate level, for every 13 women, there were only 10 men with graduate degrees. In other words, American women have been attending college
at higher rates than men since the 1980s, and at much higher rates since the
1990s. The result is a shortage of college-educated men, or what Birger calls
“the man deficit.”
This man deficit is particularly acute for educated women in the 30–39 age
range. As Birger argues, “This explains why among college grads age 30–34,
the number of never-married women increased 31 percent between 2007 and
2012, even as the number of never-married men increased only 22 percent”
(p. 9). These gender ratio disparities among 30-somethings are especially
acute in East Coast cities, such as Washington DC and Manhattan, where professional women outnumber professional men by the thousands, according
to census data. Because educational “intermarriage” is less common today
than at any point over the past half century, many educated women who
have not married by their 30s will be unable to find educated partners, due
to what Birger calls “a massive undersupply of college-educated men” across
most parts of the country (Birger, 2015, p. 5).
In short, egg freezing is educated women’s concession to this uneven playing field. Women seem to see egg freezing as a kind of “stop-gap” measure to
stop the “ticking” of the biological clock while still holding out for the possibility of a future happy marital relationship. A “man-less world”—where
professional women find it difficult to meet educated men who are interested in them and willing to commit, and, in turn, are themselves unwilling
to commit to men who are not educated and do not seem to meet their priorities and expectations—is driving many women into egg freezing. These
“missing men” are an untold part of the egg freezing story. So is online dating, the twenty-first century mode of meeting potential partners. According to Birger (2015), online dating seems to create a limitless marketplace of
options, but one that actually works in favor of college-educated men, who,
instead of committing to one woman, “keep their options open” and “play
the field.”
Unfortunately, egg freezing may increase women’s illusions about their
ability to eventually find a “perfect” partner while putting their fertility on
hold. Furthermore, it may reinforce traditional heteronormative notions of
marriage and biological parenting within nuclear family structures, rather
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
than encouraging women to become “single mothers by choice,” or to pursue
other non-traditional family structures (e.g., parenting with other women
through the use of donor insemination).
EGG FREEZING UNCERTAINTIES AND THE FUTURE
OF MOTHERHOOD
Furthermore, there are many other uncertainties and forms of inequality
incumbent in, and engendered by, egg freezing. For one, egg freezing in the
United States is extremely expensive—between $7500–$18,000 per cycle,
depending upon the IVF clinic and the amount and cost of accompanying
medications. In the United States, where the IVF industry is privatized,
the average cost of IVF is $12,513 per cycle, the most expensive in the
world (Connolly, Hoorens, & Chambers, 2010). Moreover, only 15 US states
have laws requiring some degree of IVF insurance coverage. Even in these
so-called mandate states, egg freezing is not covered by insurance, even
for medical reasons. Because of egg freezing’s high cost, it is economically
inaccessible to the vast majority of American women, even those in the
educated middle class. However, the great expense of egg freezing is of
special concern in poorer minority communities, where women may be
financially excluded from egg freezing altogether (Culley, Hudson, & van
Rooij, 2009).
Beyond the high costs of egg freezing, the procedure itself involves a
significant degree of bodily discomfort and lifestyle disruption. Medically
speaking, egg freezing involves stimulation of a woman’s ovaries with
powerful hormonal medications—medications that must be injected daily
into the abdomen and buttocks, usually by the woman herself. These
hormones are intended to produce excess eggs in a woman’s ovaries—eggs
that will then be “harvested” through transvaginal ultrasound-guided
retrieval under anesthesia. As “half an IVF cycle,” egg freezing is time
consuming (i.e., several weeks of medication and multiple IVF clinic visits)
and potentially risky (i.e., involving rare but serious reactions to hormonal
medications).
These issues are of particular concern to medical egg freezers—generally,
young women in their teens, 20s, or early 30s, who have been diagnosed
with cancer and who are offered egg freezing as a means of fertility preservation (De Melo-Martin & Cholst, 2008). Many forms of oncological treatment,
both radiation and chemotherapy, destroy a woman’s ovarian function. Thus,
egg freezing offers young cancer patients the future possibility of biological
motherhood. However, egg freezing must occur rapidly, given the urgency
of oncological treatment, and the hormones required for ovarian stimulation
may increase the threat of some gynecological cancers (De Melo-Martin &
The Egg Freezing Revolution?
9
Cholst, 2008; Reinblatt, Barnis, Shalom-Paz, Tan, & Holzer, 2011; Simon, Joi,
Partridge, & Runowicz, 2005).
Egg freezing, furthermore, involves difficult decisions about egg disposition, either through prolonged storage, eventual disposal, donation to
other women, or donation to research (Mertes, Pennings, Dondorp, & de
Wert, 2012). For all women, egg disposition may involve a high degree of
uncertainty. However, for women with cancer, disposition decisions may
be particularly fraught. Issues of “posthumous disposition” may arise,
involving familial intervention and legal questions (Mertes et al., 2012;
Spielman, 2011). On the other hand, egg freezing may give young, single
cancer patients feelings of psychological comfort, as semen cryopreservation
has done for generations of young men with cancer (Reinblatt et al., 2011;
Ryan, 2011; Stoop et al., 2011).
Among older women who have frozen their eggs for elective reasons,
there are additional considerations about age and the limits of motherhood.
Egg freezing effectively allows women to postpone their childbearing well
into their postmenopausal years. Indeed, egg freezing gives women in their
40s and 50s—and potentially 60s, 70s, or 80s—the chance to bear children,
because “egg age” rather than “womb age” appears to be the crucial variable
in a women’s ability to carry a pregnancy to term (Goold & Savulescu,
2009; Lockwood, 2011). Whether such marked fertility postponement will
eventually happen has been questioned (Mertes & Pennings, 2012), for it
is unlikely that elderly women will want to become first-time mothers.
However, if elderly women do begin having children with their frozen eggs,
the age difference between mother and child will expand considerably. Such
significantly older mothers may have decreased energy reserves and be
poorer parents. Furthermore, their children may be orphaned early, or be
forced to care for their aged mothers while still in their childhood or teenage
years (Shkedi-Rafid & Hashiloni-Dolev, 2012).
KEY ISSUES FOR FUTURE RESEARCH ON EGG FREEZING
Given these various concerns, egg freezing is not a straightforward
reproductive panacea for either social or medical egg freezers. The development of this expensive technology may be furthering existing gender,
racial, and class disparities, thereby reinscribing reproductive privileges
for some, at the expense of others. In addition, egg freezing may be
perpetuating a hegemonic motherhood mandate, whereby older single
women are feeling unduly pressured to freeze their eggs in the hope
that, someday, they can still become biological mothers. Furthermore,
in the United States, where egg freezing remains unregulated, women
who freeze their eggs may face future legal and bioethical conundrums,
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
including complicated decisions about egg disposition among women
in their postmenopausal years, or among the surviving family members of women who have died from cancer. In short, egg freezing raises
many new uncertainties about fairness, legality, and reproductive justice in the twenty-first century. Its emergence in the United States—and
potentially in many other countries where the technology will soon
unfold—demands close scrutiny by feminists, bioethicists, anthropologists,
and other scholars deeply concerned with the intersections of gender, race,
class, and age.
As shown in this essay, egg freezing is being touted as a technological remedy for some of the most pressing social issues of our times. These include
the ongoing demographic and social constraints facing career women, resultant delayed childbearing and declining fertility, and skewed gender ratios
in American education, which are having deleterious effects on marriage,
mating, and reproduction, particularly for America’s most educated women.
Clearly, egg freezing evokes serious tensions between reproduction and production, motherhood and work that are observable in America’s “lean in”
debates (Sandberg, 2013; Slaughter, 2012). However, debates about the growing gender gap in college education in America must also be addressed, as
outlined by Birger (2015) in his important volume.
For high-achieving American women who cannot find partners because
of the “man deficit,” egg freezing may offer a feeling of “empowerment,”
creating a form of “reproductive affirmative action” in the absence of
gender equality (Goold and Savulescu 2009; Lockwood, 2011; Savulescu &
Goold, 2008; Stoop, 2010). However, while proponents of egg freezing have
expressed the advantages of this technology in terms of gender justice, the
ability of this technology to deliver upon these promises remains to be seen.
Many future research questions will need to be answered. For example, how
many frozen eggs will it take to produce one or two children, given that
most frozen eggs will not lead to viable pregnancies? Will women who have
banked their eggs actually use them in the future, or will there be millions
of stored eggs “on ice”? Will egg freezing eventually become so normalized
that younger professional women, in their mid- to late 20s, routinely bank
their eggs? What changes will occur if egg freezing is eventually covered by
insurance? Will its uptake dramatically increase among educated American
women, especially as they learn of the lopsided gender ratios that affect
their future marriageability?
Once egg-freezing technology becomes routinely available in IVF clinics
and egg banks around the world, women themselves will have to decide
upon the potential costs and benefits of this reproductive technology.
Whether egg freezing proves to be a “reproductive revolution” or not, it
is clear that this newest reproductive technology will have a potentially
The Egg Freezing Revolution?
11
momentous impact on women’s lives, family formation, and population
outcomes in the twenty-first century.
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Reinblatt, S., Barnis, A., Shalom-Paz, E., Tan, S. L., & Holzer, H. (2011). Fertility
preservation for cancer patients: A review of current opinions and their advantages and disadvantages. In J. G. Schenker (Ed.), Ethical dilemmas in assisted reproductive technologies (pp. 219–231). Berlin/Boston: de Gruyter.
Richards, S. E. (2013). Motherhood rescheduled: The new frontier of egg freezing and the
women who tried it. New York, NY: Simon & Schuster.
Romain, T. (2012). “Fertility. Freedom. Finally.”: Cultivating hope in the face of uncertain futures among egg freezing women. In C. High, A. H. Kelly & J. Mair (Eds.),
The anthropology of ignorance: An ethnographic approach (pp. 191–216). New York,
NY: Palgrave Macmillan.
Ryan, G. (2011). Preservation of fertility in children with cancer: Medical, ethical,
and legal aspects. In J. G. Schenker (Ed.), Ethical dilemmas in assisted reproductive
technologies (pp. 209–217). Berlin/Boston: de Gruyter.
Sandberg, S. (2013). Lean in: Women, work, and the will to lead. New York, NY: Alfred
A. Knopf.
Savulescu, J., & Goold, I. (2008). Freezing eggs for lifestyle reasons. American Journal
of Bioethics, 8, 32–35.
Shkedi-Rafid, S., & Hashiloni-Dolev, Y. (2011). Egg freezing for age-related fertility
decline: Preventive medicine or a further medicalization of reproduction? Analyzing the new Israeli policy. Fertility and Sterility, 96, 291–294.
Shkedi-Rafid, S., & Hashiloni-Dolev, Y. (2012). Egg freezing for non-medical uses:
The lack of a relational approach to autonomy in the new Israeli policy and in
academic discussion. Journal of Medical Ethics, 38, 154–157.
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Simon, B. L., Joi, S., Partridge, A. H., & Runowicz, C. D. (2005). Preserving fertility
after cancer. Cancer, 55, 211–228.
Slaughter, A.-M. (2012). Why women still can’t have it all. The Atlantic, July/August
1–22.
Smajdor, A. (2011). The ethics of IVF over 40. Maturitas, 69, 37–40.
Spar, D. L. (2013). Wonder women: Sex, power, and the quest for perfection. New York,
NY: Sarah Crichton Books.
Spielman, B. (2011). Posthumous reproduction: Ethical and legal perspectives. In J. G.
Schenker (Ed.), Ethical dilemmas in assisted reproductive technologies (pp. 289–296).
Berlin/Boston: de Gruyter.
Stoop, D. (2010). Social oocyte freezing. Facts Views & Visions in ObGyn, 2,
31–34.
Stoop, D., Nekkebroeck, J., & Devroey, P. (2011). A survey on the intentions and attitudes towards oocyte cryopreservation for non-medical reasons among women of
reproductive age. Human Reproduction, 26, 655–661.
Wyndham, N., Figueira, P. G. M., & Patrizio, P. (2012). A persistent misperception:
Assisted reproductive technology can reverse the “aged biological clock.” Fertility
and Sterility, 97, 1044–1047.
MARCIA C. INHORN SHORT BIOGRAPHY
Marcia C. Inhorn is the William K. Lanman, Jr. professor of anthropology and
international affairs at Yale University, where she teaches courses in gender
and health, reproduction and reproductive technologies, feminist theory and
masculinity studies, and ethnographic research design and methods. She is
the author of six books, including, Cosmopolitan Conceptions: IVF Sojourns in
Global Dubai (Duke University Press, 2015), as well as the editor of ten books
on gender, technology, and health (www.marciainhorn.com).
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-
The Egg Freezing Revolution?
Gender, Technology, and Fertility
Preservation in the Twenty-First
Century∗
MARCIA C. INHORN
Abstract
Egg freezing is the “newest” new reproductive technology, a form of flash-freezing
that allows human eggs to be successfully stored in egg banks. Touted as a “revolution in the way women age,” egg freezing is being heralded as a way for older
career women to “rewind the biological clock.” This essay will examine the many
factors in American women’s lives—education, career, financial stability, relationship status, medical diagnosis and prognosis—that affect their egg freezing and disposition decisions. “Medical” egg freezing is being used by cancer patients, while
“social” or “elective” egg freezing is being used by professional women in their late
30s and early 40s, both of whom face the threat of future infertility. Egg freezing
among professional women represents a technological concession to ongoing gender
inequalities in American society. These include employment constraints facing career
women, the growing demographic surplus of college-educated women who cannot
find college-educated male partners, and women’s resultant delays in marriage and
childbearing. Ultimately, egg freezing reveals a new and important interface of science and society—one with major implications for human reproduction, women’s
lives, and family formation in the twenty-first century.
INTRODUCTION
Oocyte cryopreservation, or egg freezing, is the “newest” new reproductive
technology, involving a form of flash-freezing, which allows human eggs
to be successfully stored in egg banks, thereby prolonging a woman’s
reproductive life span. Egg freezing is being heralded as a “reproductive
backstop,” a “fertility insurance policy,” an “egg savings account,” and
∗ I want to thank Pasquale Patrizio of the Yale Fertility Center, Jennifer DeChello of the Yale Department
of Anthropology, and my former Yale students, Mira Vale and Ruoxi Yu, for their research assistance.
Emerging Trends in the Social and Behavioral Sciences.
Robert Scott and Marlis Buchmann (General Editors) with Stephen Kosslyn (Consulting Editor).
© 2017 John Wiley & Sons, Inc. ISBN 978-1-118-90077-2.
1
2
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
particularly as a way for older career women to “rewind the biological
clock” (Goold & Savulescu, 2009; Hughes, 2012; Wyndham, Figueira, &
Patrizio, 2012). Younger women, in their 20s and early 30s, could also
potentially “put their fertility on hold,” “slow down their biological clocks,”
and “postpone motherhood” until they are ready via egg freezing technology (Lockwood, 2011; Shkedi-Rafid & Hashiloni-Dolev, 2012). Indeed, the
postponement of women’s fertility through egg freezing is being heralded
as a “reproductive revolution,” equivalent to the introduction of the birth
control pill in the early 1960s (Gibbs, 2010; McDonald et al., 2011).
Yet, the development of egg freezing has not been straightforward. As with
many other low-temperature technologies used in biomedicine to “hold still”
life processes, the freezing and thawing of human eggs has proved technologically difficult. Although cryopreservation of human eggs was first tried
in the early 1980s, and the first reported frozen egg baby was born in 1986
(Lockwood, 2011), the methods of slow freezing being used at that time led to
low oocyte survival, chromosomal defects, poor embryo development, and
overall low birth rates (De Melo-Martin & Cholst, 2008).
However, since the new millennium, a novel method called vitrification,
which involves “flash-freezing” of human eggs, has been introduced (Mertes
& Pennings, 2012). Despite initial caution, vitrification has led to excellent
clinical success rates—an outcome that has encouraged some governments
to authorize egg freezing for their citizens (Garcia-Velasco et al., 2013;
Lockwood, 2011). Israel has led the way in this regard, with a 2009 policy
guideline, followed by approval of egg freezing for clinical use in early 2011
(Shkedi-Rafid & Hashiloni-Dolev, 2011, 2012; Stoop, 2010). Although vitrification technology remained experimental in the United States and most of
Europe, the American Society for Reproductive Medicine (ASRM) lifted the
experimental ban on October 19, 2012. While not enthusiastically endorsing
egg freezing as in Israel, the ASRM allowed egg freezing to be performed
in America for a variety of medical and “social” reasons (American Society
for Reproductive Medicine, 2012). Still, the ASRM urged caution—stopping
short of recommending egg freezing to postpone childbearing. As it pointed
out, there were insufficient data on safety, success rates, cost effectiveness,
and physical and emotional risks to women, who might be lulled into a false
sense of security. Furthermore, reliable data on the ultimate success of either
medical or social egg freezing are not yet available, as so few women have
yet to use their frozen eggs. In other words, the viability of egg freezing and
what it will ultimately mean for American women and their future children
remains highly uncertain.
Having said this, in vitro fertilization (IVF) clinics on both the East and
West coasts and in many American cities began in 2012 to create their own
egg freezing programs, with several commercial egg banks launched by that
The Egg Freezing Revolution?
3
time. Egg freezing also began receiving increasing US media attention. For
example, a cover story in The New York Times explained that parents were
offering to subsidize egg freezing for their single, “thirty-something” daughters in the hopes of future grandchildren (Gootman, 2012). Since then many
fashion and women’s magazines have run stories about egg freezing, and
many American celebrities have “come out” with accounts of their egg freezing experiences in the national media.
EGG FREEZING IN AMERICA: THE EARLY EVIDENCE AND DEBATES
But celebrities aside, who are the ordinary American women who might
turn to egg freezing for fertility preservation? In the United States, there
are two major categories of egg freezers: first, medical egg freezers—mostly
women diagnosed with cancer, the treatment of which will destroy their
ovarian function—and the so-called social or elective egg freezers—mostly
single women who, for educational, career, and relationship reasons, are
concerned about “aging out” of their fertility and are thus elective users of
the technology (Mertes & Pennings, 2012; Stoop, Nekkebroeck, & Devroey,
2011). In the United States, most women are elective egg freezers, in their
late 30s and early 40s, which, medically speaking, is probably too late to
preserve the highest quality, most fertile eggs (Gold, Copperman, Witkin,
Jones, & Copperman, 2006; Romain, 2012). In general, elective egg freezers
are highly educated professional women, the majority of whom have
acquired graduate degrees, often from elite institutions (Inhorn, 2016). They
include physicians, lawyers, professors, engineers, business executives and
entrepreneurs, government officials, diplomats, and women in the arts,
entertainment, and media industries. Although most American egg freezers
are Caucasian, increasing numbers of Asian, and to a slightly lesser extent,
Black and Latina professional women, are also turning to this technology
(Inhorn, 2016).
In terms of relationship status, most elective egg freezers in the United
States are single women, who have been unable to find partners committed
to marriage and childbearing. The same holds true in Western European
countries where the technology has been introduced (e.g., Belgium, Netherlands, United Kingdom). There, elective egg freezers also appear to be
high-achieving, professional women, who are single because they are unable
to find committed partners (Baldwin, Culley, Hudson, & Mitchell, 2015;
Mertes & Pennings, 2011, 2012).
Such first-generation egg freezers represent the “moral pioneers” (Rapp,
1988)—those women who are bravely venturing into the new frontier of
human egg freezing. Egg freezing allows these high-achieving professional
women to defer the end of reproductive life through the alluring promise
4
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
that it is “never too late to become a mother.” However, this particular
cryopreservation technology is also leading to heated debates about
technoscientific futures in which women themselves may “choose” the best
time to conceive. That women may begin to use egg freezing in a politically
transgressive manner—to “put off” marriage and motherhood in order to
achieve professional goals—is rekindling an American debate over whether
women can “have it all” (Hewlett, 2002; Sandberg, 2013; Slaughter, 2012;
Spar, 2013). Although egg freezing has yet to become widespread, feminists
are already questioning whether women should be encouraged to employ
a new reproductive technology in order to achieve both motherhood and
professional aspirations, and whether egg freezing actually helps or hinders
women’s emancipation (Martin, 2010; Petropanagos, 2010).
Drawing upon the insights from feminist anthropology, medical anthropology, and science and technology studies, this essay attempts to understand
these contemporary egg freezing debates—namely, “what is at stake”
(Kleinman, 2006) in women’s decisions to “reschedule” motherhood
(Richards, 2013). In particular, the essay focuses on three key biopolitical
issues—first, the delaying of motherhood within American work cultures
and the subsequent “fertility penalty” experienced by many high-achieving
professional women; second, the growing demographic gap between
college-educated men and women in America, leading to lopsided gender
ratios and a high proportion of educated women without partners; and
third, how egg freezing may help these single, professional women to put
their fertility on hold, while at the same time creating many uncertainties for
these very women, their future children, and society in general. The essay
will examine these issues in turn, exploring how egg freezing has evoked
tensions around gender, race, and class. The essay concludes with some
thoughts on the broader impacts of egg freezing for women’s lives in the
United States, as well as future directions for research.
DELAYED MOTHERHOOD AND THE FERTILITY PENALTY
With the rise of second-wave feminism, the meaning of motherhood has
been at the heart of a major debate set forth in anthropologist Ortner’s (1972)
famous feminist essay, “Is Female to Male as Nature is to Culture?” Ortner’s
essay set the terms for this debate by placing motherhood at the very center
of women’s universal subordination. Namely, Ortner argued that women’s
reproductive bodily functions—menstruation, pregnancy, childbearing,
breastfeeding, and maternal care—placed them closer to “nature,” while
men, as non-reproducers, were free to enact “cultural” endeavors in the
arts, politics, religion, and so forth. Whether reproduction and motherhood
represent the seat of women’s oppression or their greatest source of power
The Egg Freezing Revolution?
5
became a fundamental question for generations of feminist anthropologists,
who went on to publish a wealth of foundational texts on the politics of
reproduction. Perhaps most famously, this question was taken up by Martin
(1987) in her classic ethnography, The Woman in the Body: A Cultural Analysis
of Reproduction (now in its third edition), where she showed that women’s
reproduction was viewed metaphorically in American society as a kind of
“failed production.” Furthermore, this negative view of reproduction had
real implications for women as workers, as they struggled to bring their
reproductive bodies and motherhood in line with the rigid expectations of
workplace culture.
Decades later, these same tensions—between nature and culture, reproduction and production, motherhood and work—remain very much unresolved,
as evident in the egg freezing debates. Many proponents of egg freezing
have lauded the advantages of this technology as a feminist advancement.
Namely, because women have legitimate aspirations for education and
employment, they “defer and delay” motherhood until they are established
in their careers, finances, households, and stable relationships (Goold &
Savulescu, 2009; Lockwood, 2011; Savulescu & Goold, 2008). However,
according to other commentators, this postponement is not entirely voluntary (Mertes & Pennings, 2012), but rather is women’s concession to an
unforgiving labor market and other variables beyond their control (Smajdor,
2011). In demographic terms, the results in most Western countries are (i)
significant increases in age at first marriage; (ii) significant increases in age
at first birth (to nearly 30 in most Western European countries); (iii) smaller
family sizes; (iv) below replacement fertility levels in many nations; (v)
increasing levels of age-related infertility among women; and (vi) women’s
risk of permanent biological childlessness (Lockwood, 2011; Wyndham et al.,
2012).
Data show that this “fertility penalty” for highly educated, professional
women is real (Lockwood, 2011). For example, in corporate America,
nearly one-half (49%) of high-earning women over age 40 are childless,
even though 86% of them indicate that they want (or would have wanted)
children (Hewlett, 2002). Overall, only about 50% of women who postpone
childbearing until their 30s will conceive in the following 6 years, an
indication of women’s “difficult choices about what to prioritize at different
times in their lives—children, education, or career” (Goold and Savulescu,
2009, p. 50).
Egg freezing is being cast as a technology to counteract these effects of fertility postponement and delayed motherhood, while also assisting women in
their educational and career goals. From a feminist perspective, egg freezing
is said to be a “secondary strategy” to end gender inequities and discrimination in the workplace until the day arrives when government policies are
6
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
more favorable to mothers as workers. Some argue that this will follow when
more women gain positions of authority and influence (Lockwood, 2011). In
addition, giving women extra time on their biological clocks is deemed a corrective to male reproductive advantage. While career women who hope to
conceive in their later reproductive years have often been cast as “selfish”
for “wanting it all” (Martin, 2010), men “regularly postpone fathering children into their 40s, 50s, 60s, 70s and even their 80s, yet they face little or no
censure” (Goold and Savulescu, 2009, p. 52). Furthermore, men have been
able to freeze their sperm for more than a century (Becker, 2002). Egg freezing thus confers to women a biobanking technology already possessed by
men for decades. Given that women have a longer life expectancy than men,
they, too, should be supported in having their children later, according to
some advocates (Goold and Savulescu, 2009).
Despite these arguments in favor of egg freezing as a path to gender equality, feminist critics are already worried about the potential deleterious consequences, even backlash, that may accompany the use of this technology.
Such outcomes might include eventual employer expectations that women
workers postpone childbearing through egg freezing. Professional women
who go this route may develop a false sense of security about future reproduction when, in fact, egg freezing cannot provide guaranteed future fertility outcomes. Indeed, feminist philosopher Angel Petropanagos (2010) has
argued that promoting egg freezing as a “quick fix” technological solution
for professional women does not solve underlying structures of patriarchy.
The promotion of egg freezing may serve to reinforce patriarchy by leaving
intact various forms of gender inequality—for example, employment policies
favoring men, the “glass ceiling” on women’s advancement in the workplace,
men’s “lifestyle” choices that disadvantage women, and so on.
THE DEMOGRAPHIC GAP: EDUCATED WOMEN WITHOUT
EDUCATED MEN
Moreover, men are almost entirely absent in egg freezing discussions,
even though this is a major lacuna. In most cases, professional women are
postponing their fertility not because of work, but because they are single
and cannot find male partners, even though they want them (Baldwin et al.,
2015; Inhorn, 2016). This begs the question: Why are so many high-achieving
professional women in the United States remaining single, but not by
choice? Although women tend to blame themselves for not finding a
husband in a timely manner—or they blame American men for their lack
of marital commitment and a number of other perceived male flaws—the
answer to this question lies in demography. Namely, in the United States,
there are increasing gender disparities in college education, which are
The Egg Freezing Revolution?
7
extremely important for women’s marital prospects, but which are little
discussed.
In his prescient book, Date-onomics: How Dating Became a Lopsided Number
Game, Birger (2015) examines US census data to describe the growing gender
gap in college education. Today, for every four college-educated women in
the United States, there are only three college-educated men. For example, in
2012, 34% more American women than men graduated from college. And, at
the graduate level, for every 13 women, there were only 10 men with graduate degrees. In other words, American women have been attending college
at higher rates than men since the 1980s, and at much higher rates since the
1990s. The result is a shortage of college-educated men, or what Birger calls
“the man deficit.”
This man deficit is particularly acute for educated women in the 30–39 age
range. As Birger argues, “This explains why among college grads age 30–34,
the number of never-married women increased 31 percent between 2007 and
2012, even as the number of never-married men increased only 22 percent”
(p. 9). These gender ratio disparities among 30-somethings are especially
acute in East Coast cities, such as Washington DC and Manhattan, where professional women outnumber professional men by the thousands, according
to census data. Because educational “intermarriage” is less common today
than at any point over the past half century, many educated women who
have not married by their 30s will be unable to find educated partners, due
to what Birger calls “a massive undersupply of college-educated men” across
most parts of the country (Birger, 2015, p. 5).
In short, egg freezing is educated women’s concession to this uneven playing field. Women seem to see egg freezing as a kind of “stop-gap” measure to
stop the “ticking” of the biological clock while still holding out for the possibility of a future happy marital relationship. A “man-less world”—where
professional women find it difficult to meet educated men who are interested in them and willing to commit, and, in turn, are themselves unwilling
to commit to men who are not educated and do not seem to meet their priorities and expectations—is driving many women into egg freezing. These
“missing men” are an untold part of the egg freezing story. So is online dating, the twenty-first century mode of meeting potential partners. According to Birger (2015), online dating seems to create a limitless marketplace of
options, but one that actually works in favor of college-educated men, who,
instead of committing to one woman, “keep their options open” and “play
the field.”
Unfortunately, egg freezing may increase women’s illusions about their
ability to eventually find a “perfect” partner while putting their fertility on
hold. Furthermore, it may reinforce traditional heteronormative notions of
marriage and biological parenting within nuclear family structures, rather
8
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
than encouraging women to become “single mothers by choice,” or to pursue
other non-traditional family structures (e.g., parenting with other women
through the use of donor insemination).
EGG FREEZING UNCERTAINTIES AND THE FUTURE
OF MOTHERHOOD
Furthermore, there are many other uncertainties and forms of inequality
incumbent in, and engendered by, egg freezing. For one, egg freezing in the
United States is extremely expensive—between $7500–$18,000 per cycle,
depending upon the IVF clinic and the amount and cost of accompanying
medications. In the United States, where the IVF industry is privatized,
the average cost of IVF is $12,513 per cycle, the most expensive in the
world (Connolly, Hoorens, & Chambers, 2010). Moreover, only 15 US states
have laws requiring some degree of IVF insurance coverage. Even in these
so-called mandate states, egg freezing is not covered by insurance, even
for medical reasons. Because of egg freezing’s high cost, it is economically
inaccessible to the vast majority of American women, even those in the
educated middle class. However, the great expense of egg freezing is of
special concern in poorer minority communities, where women may be
financially excluded from egg freezing altogether (Culley, Hudson, & van
Rooij, 2009).
Beyond the high costs of egg freezing, the procedure itself involves a
significant degree of bodily discomfort and lifestyle disruption. Medically
speaking, egg freezing involves stimulation of a woman’s ovaries with
powerful hormonal medications—medications that must be injected daily
into the abdomen and buttocks, usually by the woman herself. These
hormones are intended to produce excess eggs in a woman’s ovaries—eggs
that will then be “harvested” through transvaginal ultrasound-guided
retrieval under anesthesia. As “half an IVF cycle,” egg freezing is time
consuming (i.e., several weeks of medication and multiple IVF clinic visits)
and potentially risky (i.e., involving rare but serious reactions to hormonal
medications).
These issues are of particular concern to medical egg freezers—generally,
young women in their teens, 20s, or early 30s, who have been diagnosed
with cancer and who are offered egg freezing as a means of fertility preservation (De Melo-Martin & Cholst, 2008). Many forms of oncological treatment,
both radiation and chemotherapy, destroy a woman’s ovarian function. Thus,
egg freezing offers young cancer patients the future possibility of biological
motherhood. However, egg freezing must occur rapidly, given the urgency
of oncological treatment, and the hormones required for ovarian stimulation
may increase the threat of some gynecological cancers (De Melo-Martin &
The Egg Freezing Revolution?
9
Cholst, 2008; Reinblatt, Barnis, Shalom-Paz, Tan, & Holzer, 2011; Simon, Joi,
Partridge, & Runowicz, 2005).
Egg freezing, furthermore, involves difficult decisions about egg disposition, either through prolonged storage, eventual disposal, donation to
other women, or donation to research (Mertes, Pennings, Dondorp, & de
Wert, 2012). For all women, egg disposition may involve a high degree of
uncertainty. However, for women with cancer, disposition decisions may
be particularly fraught. Issues of “posthumous disposition” may arise,
involving familial intervention and legal questions (Mertes et al., 2012;
Spielman, 2011). On the other hand, egg freezing may give young, single
cancer patients feelings of psychological comfort, as semen cryopreservation
has done for generations of young men with cancer (Reinblatt et al., 2011;
Ryan, 2011; Stoop et al., 2011).
Among older women who have frozen their eggs for elective reasons,
there are additional considerations about age and the limits of motherhood.
Egg freezing effectively allows women to postpone their childbearing well
into their postmenopausal years. Indeed, egg freezing gives women in their
40s and 50s—and potentially 60s, 70s, or 80s—the chance to bear children,
because “egg age” rather than “womb age” appears to be the crucial variable
in a women’s ability to carry a pregnancy to term (Goold & Savulescu,
2009; Lockwood, 2011). Whether such marked fertility postponement will
eventually happen has been questioned (Mertes & Pennings, 2012), for it
is unlikely that elderly women will want to become first-time mothers.
However, if elderly women do begin having children with their frozen eggs,
the age difference between mother and child will expand considerably. Such
significantly older mothers may have decreased energy reserves and be
poorer parents. Furthermore, their children may be orphaned early, or be
forced to care for their aged mothers while still in their childhood or teenage
years (Shkedi-Rafid & Hashiloni-Dolev, 2012).
KEY ISSUES FOR FUTURE RESEARCH ON EGG FREEZING
Given these various concerns, egg freezing is not a straightforward
reproductive panacea for either social or medical egg freezers. The development of this expensive technology may be furthering existing gender,
racial, and class disparities, thereby reinscribing reproductive privileges
for some, at the expense of others. In addition, egg freezing may be
perpetuating a hegemonic motherhood mandate, whereby older single
women are feeling unduly pressured to freeze their eggs in the hope
that, someday, they can still become biological mothers. Furthermore,
in the United States, where egg freezing remains unregulated, women
who freeze their eggs may face future legal and bioethical conundrums,
10
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
including complicated decisions about egg disposition among women
in their postmenopausal years, or among the surviving family members of women who have died from cancer. In short, egg freezing raises
many new uncertainties about fairness, legality, and reproductive justice in the twenty-first century. Its emergence in the United States—and
potentially in many other countries where the technology will soon
unfold—demands close scrutiny by feminists, bioethicists, anthropologists,
and other scholars deeply concerned with the intersections of gender, race,
class, and age.
As shown in this essay, egg freezing is being touted as a technological remedy for some of the most pressing social issues of our times. These include
the ongoing demographic and social constraints facing career women, resultant delayed childbearing and declining fertility, and skewed gender ratios
in American education, which are having deleterious effects on marriage,
mating, and reproduction, particularly for America’s most educated women.
Clearly, egg freezing evokes serious tensions between reproduction and production, motherhood and work that are observable in America’s “lean in”
debates (Sandberg, 2013; Slaughter, 2012). However, debates about the growing gender gap in college education in America must also be addressed, as
outlined by Birger (2015) in his important volume.
For high-achieving American women who cannot find partners because
of the “man deficit,” egg freezing may offer a feeling of “empowerment,”
creating a form of “reproductive affirmative action” in the absence of
gender equality (Goold and Savulescu 2009; Lockwood, 2011; Savulescu &
Goold, 2008; Stoop, 2010). However, while proponents of egg freezing have
expressed the advantages of this technology in terms of gender justice, the
ability of this technology to deliver upon these promises remains to be seen.
Many future research questions will need to be answered. For example, how
many frozen eggs will it take to produce one or two children, given that
most frozen eggs will not lead to viable pregnancies? Will women who have
banked their eggs actually use them in the future, or will there be millions
of stored eggs “on ice”? Will egg freezing eventually become so normalized
that younger professional women, in their mid- to late 20s, routinely bank
their eggs? What changes will occur if egg freezing is eventually covered by
insurance? Will its uptake dramatically increase among educated American
women, especially as they learn of the lopsided gender ratios that affect
their future marriageability?
Once egg-freezing technology becomes routinely available in IVF clinics
and egg banks around the world, women themselves will have to decide
upon the potential costs and benefits of this reproductive technology.
Whether egg freezing proves to be a “reproductive revolution” or not, it
is clear that this newest reproductive technology will have a potentially
The Egg Freezing Revolution?
11
momentous impact on women’s lives, family formation, and population
outcomes in the twenty-first century.
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MARCIA C. INHORN SHORT BIOGRAPHY
Marcia C. Inhorn is the William K. Lanman, Jr. professor of anthropology and
international affairs at Yale University, where she teaches courses in gender
and health, reproduction and reproductive technologies, feminist theory and
masculinity studies, and ethnographic research design and methods. She is
the author of six books, including, Cosmopolitan Conceptions: IVF Sojourns in
Global Dubai (Duke University Press, 2015), as well as the editor of ten books
on gender, technology, and health (www.marciainhorn.com).
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