Acryostorage room at the Aspire Houston Fertility Institute showcases smaller containers, each holding around 150 egg samples in liquid nitrogen. This is one of the secure storage areas used for in vitro fertilization in the lab.
In recent news, Rep. Alexandria Ocasio-Cortez highlighted the challenges faced by women who delay motherhood due to career, partner status, or financial and emotional readiness. Ocasio-Cortez has chosen to freeze her eggs and shared her experience on social media, sparking both praise and criticism. Her public account underscores the significance of egg freezing for women hoping to have children later in life, an option gaining popularity as women delay starting families.
Research consistently indicates a decline in fertility as women age, making it harder to conceive and maintain pregnancies. Egg freezing offers a chance to have biological children later. Although Ocasio-Cortez has access to many benefits as a congresswoman, her health insurance, similar to most American women’s, does not cover this option. She reported out-of-pocket costs up to $10,000. Private insurance coverage for egg freezing is rare and often requires a state mandate to include such benefits.
When states mandate coverage, it often relates to medical conditions like chemotherapy that affect ovulation. Elective egg freezing usually falls outside of private insurance policies, leaving low-income women without support through public insurance like Medicaid. With Medicaid typically not covering egg freezing, those recipients face the dilemma of having children before readiness or missing the opportunity for parenthood entirely.
This disparity highlights the imbalance in U.S. family planning. While contraceptive services are widely covered, including IUDs and birth control pills, support for planned childbearing remains scant. Public family planning programs, including Title X, cover contraceptives extensively but not egg freezing. This reflects a broader issue where programs assist in limiting childbirth but not facilitating it when desired.
The declining birthrate in the U.S., predicted to stop growing by the mid-2050s, poses risks to social programs like Social Security and affects economic growth and military strength. To counter this, the U.S. needs policies supporting population growth alongside fertility control measures. Few countries overlook the dual importance of birth promotion and control as the U.S. does.
Leonard M. Lopoo, the Paul Volcker Chair in Behavioral Economics at Syracuse University’s Maxwell School, explores these themes in his book, Wanting Children: Family-Planning Policies and the Engineering of America’s Population.