Education takes longer. Housing costs have soared. Marriage and family formation are happening later. But while society has changed the timeline for reaching traditional milestones, biology hasn’t changed with it.
For some women, including U.S. Representative Alexandria Ocasio-Cortez, the solution is freezing their eggs, hoping they’re buying themselves more fertile years.
In this episode of DemograFix, Mike and Cara break down what egg freezing can and can’t do, the real costs and success rates, the lack of transparency among Canadian fertility clinics, and the misleading marketing claims that can make the procedure sound more like an insurance policy than a gamble.
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Below is an AI-generated transcript of the Missing Middle podcast, lightly edited.
Cara Stern: We all know milestones have gotten pushed back for younger people. School goes longer, people are getting married later if they get married at all, and obviously buying a home now takes years longer than it used to—if you can do it at all. All of that you can delay, but there’s one milestone that doesn’t actually bend the same way: fertility.
Mike Moffatt: There is technology, though, that can help—or at least partially. Egg freezing is a huge industry that offers hope to people that they can delay fertility while the rest of their milestones catch up.
Cara Stern: But the question we want to discuss today is: does it work? Can you really delay your fertile years?
Mike Moffatt: You may have heard about U.S. Representative Alexandria Ocasio-Cortez freezing her eggs.
She literally showed the world the process behind it, injecting herself with hormones and explaining the what and the why. We saw a lot of comments on social media that had a lot of misinformation.
We’re going to clear some of that up today, along with discussing the broad economic and social trends causing an increase in the use of the procedure.
Cara Stern: I really loved seeing AOC share her egg-freezing journey online. It was wonderful that she was so open about the process and peeled back the curtain so people could see what goes on behind it. Knowing what it is, how it affects you, and seeing someone go through it will probably lead more people to feel comfortable with the process. She did a wonderful public service, because not having information makes it so much scarier.
Mike Moffatt: Before we get into the mechanics of egg freezing, we should step back a little bit and look at why egg freezing has become so increasingly popular in the first place. There are a number of reasons why someone might want to freeze their eggs, so we don’t want to overgeneralize, but obviously one of the biggest ones is that it allows families to delay having children.
For many middle-class families in the postwar era, there was a certain pathway of events: you finished school, you started a career, you got married, you saved some money, you put a down payment on a home, and you started having kids. A lot of people deviated from that pathway in one form or another, but it was common enough that it became a stereotype for the middle class.
Cara Stern: Nowadays, there’s no clear path at all.
Mike Moffatt: You can shuffle them all around, but at the end of the day, every step on that pathway has gotten delayed. In the 1950s and 1960s, many people started careers right after high school. Then we transitioned to starting them after three or four years of undergrad or college. Nowadays, people are adding a couple more years of postgraduate work and sometimes a gap year, which often comes with student loans that need to be paid off. It takes longer to just hit financial sea level. Having to pay back those student loans and adding extra years of schooling makes it even harder to save for a house.
And, obviously, those homes are so much more expensive now, so you have to save more money. For my parents’ generation, it wasn’t uncommon to hit all of those milestones on this pathway before the age of 25. But for the current generation—millennials now going into Gen Z—they’re having to wait until age 35 or longer to hit all of those milestones.
Cara Stern: It’s such a big problem in today’s society that we require so much schooling to access jobs and incomes that never needed that much education before, and we seem to just accept that it takes longer and longer to get people to a place where they feel ready to have a kid.
I remember years ago hearing about companies—especially ones in Silicon Valley—offering their employees egg freezing as part of their benefits package. The media reaction at the time was, “This is kind of neat; it covers something so important, buys women time, and serves as a huge incentive for women to work there.” But it wasn’t long until reality set in and the narrative changed. People realized what companies were actually saying with that benefit: “We expect incredibly high workloads during your peak fertility years.” They had to offer something to compensate for that, and an egg-freezing benefit package is what they landed on.
Mike Moffatt: I don’t think that’s a very sustainable solution, and I don’t think it’s nearly as generous as it looks. I hope that societies and governments start to address all of this, because it feels like we’ve hit an equilibrium that isn’t particularly sustainable. An obvious place to start is the cost of housing: if we can get that cost down, people are going to be able to have families earlier. But until then, until we address all of these points of the pathway and how long they’re taking, families are going to increasingly opt toward egg freezing.
Bringing it back down to the individual level: Cara, you were following this much more closely than I was—what were your thoughts when you heard AOC’s story?
Cara Stern: Honestly, I was thinking that she’s probably experiencing a lot of what other people her age are experiencing, but doing it publicly. She’s the same age as me. I hear these stories among my friends, particularly ones who are still looking for a partner and are worried that they’re going to run out of time.
Something we don’t usually talk about with egg freezing is how hard it can be on your body, though we do talk about that sometimes with IVF. There’s some recognition of the emotional and physical components there. The process for egg freezing is identical to IVF for most of the timeline. Sure, you aren’t at the point where you’ve been struggling to have a kid—which adds an element of despair to IVF—but by the time most people freeze their eggs, they’re old enough that they have a massive fear of not being able to become a parent. You start thinking, “What does my life look like if I can’t become a parent, and how do I avoid that?”
Often, they’re still single at the age when they thought they’d have a kid. Look at AOC, who brought viewers into her journey at the same time her breakup with her fiancé became public. I’m sure she’s dealing with the same thoughts as a lot of people her age who didn’t expect to be single at 36 or almost 37. She’s probably thinking, “I need to find a partner, I need the time to be sure they’re the one, make the decision to marry them, and try for a kid.” Everyone knows that takes time, and if you feel you only have a few years to do it, it makes sense why she decided now was the right time—just like many other people reach that same conclusion at this age.
Mike Moffatt: When you lay it out like that, it makes sense at an individual level. The pieces fit together, and you can see that being common for a lot of people, not just AOC. It shows why this has become such a huge business across North America and globally.
It’s also an unusual part of the healthcare industry because it’s not in response to a medical concern; rather, people are trying to proactively fight their biological clock by opting for a procedure like this. Ultimately, it comes down to trying to force biology to match the way our society has changed, where all these markers of adulthood—including starting a family—have been pushed back and no longer align with our biological development as humans.
Cara Stern: It’s also a weird part of the healthcare system in that the providers know this is a very emotional decision. I think there’s a tendency for companies to prey on this massive question in a woman’s life: whether she’ll be a mom one day.
I remember being consumed by that question before I was a mom. I still remember the sense of dread coming over me as I thought, “What does my life look like if that doesn’t happen? Who am I if that doesn’t happen?”—and I wasn’t even close to 40 at the time. I see from people close to me how much anguish there can be as the years pass and you inch closer to 40. A lot of people see 40 as the cutoff for when your fertile years end, and in many cases, it’s true.
Mike Moffatt: You’ve got a situation with a ticking clock where people have to make decisions, and that creates an environment where providers can start making big promises and using high-pressure sales tactics. To be clear, we’re not suggesting any one particular provider does that—obviously, there are a lot of responsible companies out there—but it creates the incentive for providers to use high-pressure sales.
Cara Stern: We’re lucky that there are some numbers on this in Canada, thanks to reporters at the Investigative Journalism Bureau who worked with the National Post. They spent eight months going through the websites and social media of 42 Canadian fertility clinics that market egg freezing, looking into the promises these clinics made. They found that five out of every six used language that reporters judged to be misleading or overstated—phrases like “guaranteed baby program” or telling women egg freezing lets them “take control of your reproductive future.”
Mike Moffatt: That’s a clear sign that at least some providers are responding to incentives to do a hard sell, knowing the mindset of their potential customers. In fact, as these reporters indicated, only 25% of the embryos created from frozen eggs actually turn into a live birth.
Cara Stern: To get a little more into the data, the Canadian Assisted Reproductive Technologies Register noted that at each step of the process—from thawing to fertilization and transfers—you lose eggs.
Ultimately, between 2013 and 2023, 4.1 million babies were born in Canada, and out of that, the number of babies confirmed to be born from frozen eggs was only 70.
Mike Moffatt: There’s a huge caveat to that number: most people who have frozen their eggs haven’t tried to make a baby from them yet. The rate of people freezing their eggs more than doubled from 2020 to 2024. A lot of the money spent on egg freezing is from people who still hope to use them one day, or who are using it as an insurance policy while still trying to use their body’s fresh eggs when trying for a kid.
Cara Stern: A big part of that increase after 2020 was people having time to reflect on their lives during the pandemic, plus the disruption it caused to dating. I’m sure it made a lot of people wonder how long it would take them to find a partner in a period where no one was really meeting up, so egg freezing seemed like a good option to take back those years as much as they could.
Mike Moffatt: The pandemic really accelerated a lot of trends that were already happening, from people working from home to families moving out of cities to smaller communities. This may just be another example of that.
Cara Stern: There’s so little data out there on the success rates of individual clinics because they aren’t required to publish their results. It’s very hard to know if the clinic you’re looking at is the right one to use, and it costs so much money. Of the small number of Canadian women who have gone all the way through the process, the registry data showed that in the decade leading up to 2024, there were only 70 babies born in total. That number shocked me. There’s so much money being spent right now, yet so few babies were actually born from it over the course of a decade.
Mike Moffatt: That shocked me as well when you showed me—I would have guessed the number was closer to 7,000 or maybe 70,000 rather than just 70. Out of everyone who came back to actually try and use their frozen eggs, roughly only a third ended up with a baby. That’s a substantial number of people, but it’s a long way from marketing it as an “insurance policy,” which is the exact phrase a lot of Canadian clinics use in their marketing.
Cara Stern: The lack of data is a huge problem. It’s not a quick decision you can make, but a lot of people want to move fast once they’ve decided to freeze their eggs. It’s a long process that often starts with tests, and you have to time everything to your cycle. By the time a lot of people try freezing their eggs, they’re already racing against time, let alone trying to parse through non-existent data in Canada to find the best clinic.
Of the people who try to freeze their eggs, 40% are between 35 and 37, and another 22% are between 38 and 40. Most of them are starting later than the optimal timing that clinics agree on, which is below 35. The younger you are, the better the chances it will work out. When looking at clinic recommendations, they all generally agree that your late 20s is the ideal time.
But most women aren’t even thinking about egg freezing at that point—it’s very normal not to have a kid in your 20s these days, especially in urban areas where the timeline pushes later. Most people in their late 20s aren’t thinking about fertility decline because, even if they’re single, they assume they’re on track with modern timelines to find a partner and have kids without going through egg freezing.
Mike Moffatt: When you lay it out like that, it’s no wonder birth rates are falling in so much of Canada, particularly in our cities.
Cara Stern: Clinics suggest that below 35 is the ideal time to freeze your eggs, which makes sense given the big drop in fertility after that age. To get a good chance of a successful pregnancy, you might need multiple egg retrievals, and the odds of needing multiple cycles increase with age. It costs at least $10,000 per cycle, and often more like $20,000 with medication, so the earlier you do it, the better.
Mike Moffatt: There’s a really grim irony here: egg freezing is becoming more in demand because people in their 20s can’t afford a house, which also means they’re unlikely to be able to afford egg freezing. We’re trying to solve a problem with a solution that shares the exact same affordability issues as the problem itself.
Plus, the median number of eggs retrieved in one cycle often isn’t enough for a clinic to consider it likely to result in a pregnancy, which probably has something to do with the median age of patients going in for these treatments. People need to realize that it’s going to cost $20,000, $40,000, or even more, and it is far from a slam dunk.
Cara Stern: In Canada, public health coverage for egg freezing is virtually zero if you’re doing it for age-related or personal reasons. There is coverage in some provinces if you’re going to lose your fertility due to something like cancer treatment, but no one funds it if you’re just trying to buy more time. Your best bet for funding is a workplace benefits package, but even then, you’re paying a substantial amount out of pocket.
Mike Moffatt: When women do come back to use the eggs they’ve frozen, about a third are between the ages of 38 and 40, and just over 40% are older—so the vast majority are over the age of 38, assuming they come back to use them at all.
Cara Stern: I want to go back to clearing up some of the misinformation out there.
The biggest myth I see, especially in comment sections under videos like AOC’s, is that once you’ve frozen your eggs, you’re basically set and won’t age out of having kids. Freezing your eggs doesn’t freeze the rest of the process: thawing, fertilization, embryo transfer, and pregnancy itself all happen at whatever age you actually are when you come back.
It helps, but it’s nothing close to a sure thing, and it’s not something we should start counting on as a society as a standard way for women to push their fertile years later.
Mike Moffatt: Exactly. The higher risks of pregnancy complications as you get older are still the same, even if the eggs themselves are younger.
Cara Stern: Another piece of misinformation I saw with AOC’s post was from people thinking she was too old to freeze her eggs. There were comments saying things like, “What eggs is she freezing? She’s almost 37, she has no good eggs left.” That’s not true either.
You’re playing the odds, and while the odds become worse as you age, it’s still very viable to freeze your eggs in your mid-to-late 30s and have a decent shot at it helping—it just might take more cycles for it to work.
One thing that would make the situation a lot better is if Canada started regulating these clinics. If you’re about to spend tens of thousands of dollars—where one cycle could be a full year’s worth of rent money—you want to know if a clinic has good success rates or not. Clinics currently don’t have to publish their results. Quebec has a public registry, but it’s an outlier in this country. I’d like to see other provinces start taking this seriously. Whether it should be a federal initiative or individual provinces stepping up, we need regulations to make sure people understand what they’re getting into when taking this giant step.
Mike Moffatt: Increased transparency seems like an obvious first step. To be clear, none of this is about telling anyone not to freeze their eggs. For some people—especially in their early 30s who haven’t found the right partner yet and know they want kids—it’s a reasonable option to try. But you need to understand the odds, and we need transparency before people hand over their money.
Cara Stern: In the end, the big story here is that egg freezing can work, especially if you’re younger or if you have the time and resources to do multiple cycles. It’s not a complete pause button on your biological clock, but it can help. You just have to go into it with realistic expectations.
Mike Moffatt: I agree with all of that, but I’d also say that while technology might improve your odds of having a kid, we’d be far better off fixing the underlying problems that are pushing back these life milestones in the first place, rather than relying on a technological workaround.
Cara Stern: It doesn’t fix those underlying problems. It’s like a big, expensive attempt to buy time in a system that’s out of whack with our biology, and a lot of changes need to be made to get us back on track.
Thank you so much for watching and listening. Our producer is Meredith Martin, and this episode was edited by Canadian Civil.
Mike Moffatt: If you have any thoughts or questions about the best pathways to take in the game of Life, please send us an email to [email protected].
Cara Stern: And we’ll see you next time.
Additional Reading/Listening that Helped Inform the Episode:
Fertility Inc - Investigative Journalism Bureau
Elective Egg Freezing for Age-Related Fertility Decline
Mount Sinai Fertility - What to know about egg freezing
With Big Choices Ahead, Ocasio-Cortez Navigates New Territory
Ocasio-Cortez’s decision riles some on right, while also winning admiration
AOC’s egg-freezing posts on Instagram
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