Even as a girl, Sarah Elizabeth Richards seemed maternal. The oldest of four, she was the most sought-after babysitter on her San Diego block. Her friends figured she'd be the first among them to have kids. And one day, she always assumed, she would. But at 36, Richards found herself single in New York City and consumed with the fear of that prospect dimming with each passing month.
After years of mounting worry about her biological clock, Richards found a way to free herself – and her fertility. Over the next two years, she spent $50,000 (her savings plus the wedding fund her parents set up for her) on eight rounds of egg freezing – a process that lets a woman use her younger, and ostensibly healthier, eggs when she's ready to conceive.
"What else is there that I would want to spend money on that would be more important than this?" says Richards, now 42, who describes her experience and that of three others in her recently-released book, "Motherhood Rescheduled: The New Frontier of Egg Freezing and the Women Who Tried It."
Richards is at the forefront of a crusade she hopes will spare women the heartache of fertility angst – and has sparked controversy for taking that stand. Her recent essay for The Wall Street Journal, "Why I Froze My Eggs (And You Should, Too)," generated hundreds of impassioned comments. But her voice reflects a shifting sensibility about the unprecedented opportunities afforded by egg freezing at a time when women are increasingly becoming mothers later in life.
"Today, there's been an explosion" of interest and activity in the field, says Mitchell Rosen, director of the University of California San Francisco Fertility Preservation Program and Reproductive Laboratories. Rosen attributes the trend to more experience and success with the procedure (a new flash-freezing technique removes the ice crystals that can harm the egg) and the decision last fall by the American Society of Reproductive Medicine to remove the experimental label from egg freezing.
In 2006, a landmark trial at NYU Langone Medical Center found that frozen eggs could be used to achieve the same pregnancy rates as fresh eggs, used for in vitro fertilization, using egg and sperm to create an embryo in a lab that is then transferred into a woman's uterus for pregnancy. "So all of a sudden now, it became an option," says Jamie Grifo, lead author of the study and program director of the NYU Fertility Center. His team is now researching how to screen eggs for chromosomal normality to better achieve successful pregnancies.
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Whether using fresh or frozen eggs, both procedures use IVF, which requires hormone injections that enable a woman to produce multiple eggs each month, which are extracted for fertilization. Frozen eggs require a process called intracytoplasmic sperm injection, in which a single sperm is injected into the egg.
The success rates of producing a baby from one round of IVF is about 60 percent at age 30, 27 percent at age 40 and drops to 6 percent between ages 40 and 44, says Grifo, attributing the declining success rates to the fact that a woman's eggs develop abnormalities with age. And therein lies the hope of this new technology. "Egg freezing is a way to be your own egg donor," Grifo says.
As to the cost of the process, the procedure plus doctor's visits, medication and egg storage can run from $5,000 to $20,000, depending on the lab and the medical practice.
Egg freezing had been used in this country as a "semi-standard of care" when a woman's medical condition would require treatment that could jeopardize her reproductive health, Rosen says. But even two or three years ago, offering the procedure purely to enhance a woman's reproductive potential worried him. "I didn't want to give an empty promise," he says. Plus, he feared it would lead women to prolong getting pregnant and waste fertile years. But the stream of women who sought the procedure disabused him from that notion. "I was constantly told by patients, 'Believe me, I want to get together. I want to be in a relationship ... If it's in front of me, I'm gonna get it.'"
In her research, Richards found that when a woman freezes her eggs, she becomes more committed to pursuing motherhood and more empowered on the path to get there. "You're more relaxed, but at the same time, you're more focused." Or, as she puts it: "You're not this sad 38-year-old whose options are dwindling" but someone who's "got it going on." With fertility fears out of the way, she says "you can talk about all the other stupid stuff you talk about on dates, flirt and drink martinis."
For her part, the experience left Richards feeling more calm and confident. "If I could figure out how to stop my eggs from aging, I could figure out Match.com," she says. These days, she's settled into a 10-month relationship with a divorced dad who wants to have more kids. And, of course, she has her younger eggs in the bank, ready when she is.
"My whole idea of this has changed tremendously," Rosen says. While most of the women who see him are pushing 40, "anyone is a candidate," he says. And the younger the patient, the better the outcome – although most 20-year-olds likely aren't worried yet about safeguarding their fertility, he notes. "If you're thinking about it, I think you should see somebody for a consultation," he says, explaining that women who ruminate about it for five years wish they had acted five years ago. A recent study by the Free University of Brussels in Europe found that among 86 women who had frozen their eggs, 96 percent said they would do it again, but 71 percent said they wish they'd done it sooner.
By 34, "if you know you're not going to have children within a few years, find the money and freeze," Richards says. "Let's say you have a baby in your late 30s, you may want those frozen eggs for a second baby." Although she bemoans the price tag for the procedure, she says that as you get older, "you're gonna have to pay money for fertility at some point, so you might as well do it now when you have a good chance of lowering birth defects."
"It feels like a shame, when women get together and they talk about it – the anxiety and the freak-out and the sadness of it. And I just want to say, 'Let's stop having those conversations. Let's stop letting the panic control our lives.'" She draws from her own experience, in lambasting the years wasted on this worry – "especially when now we have something we can do about it ... That's where you can really 'lean in,' you know?"
Clarified on 07/12/2013: A previous version of this story failed to specify the medical facility where a landmark study took place.