NerdWallet's Smart Money Podcast - The Price of Parenthood: How Egg Freezing Works

Episode Date: June 22, 2023

Egg freezing lets would-be parents put their plans on ice. But is it a realistic option for everyone?  In the third episode of our nerdy deep dive into the price of parenthood, Sean and Ronita explore when egg freezing is a good option for parents — and how much it really costs.  To send the Nerds your money questions, call or text the Nerd hotline at 901-730-6373 or email [e-mail]. Like what you hear? Please leave us a review and tell a friend.

Workplace benefits have come a long way over the last decades. Safe to say that until recently, it would have been unheard of for companies to help cover one form of fertility planning. To be able to freeze your eggs for any reason, I think is a pretty new thing in the benefit world. I've been putting money away, but I was thinking more long-term thing. But hearing that that was an added benefit at work made me really kind of turn on the jets of thinking about it more. Welcome to NerdWallet's Smart

Money Podcast. I'm Sean Piles. And I'm Ronita Chaudhry-Wade. We're on to the third episode of our nerdy deep dive into the cost of parenthood. And Ronita, we talk a lot on the show about preparing for the future, right? Prepare for your retirement, prepare for kids' college fund. But this week, we're taking preparation to the next level. Yes, we are. We are preparing to procreate, perhaps sometime in the future. At a date yet to be determined. Even if it's at an older age than we thought. Yes. Today, as we make our way through the various options available to have children,

we're talking about egg freezing. Putting that chance at procreation literally on ice. Literally. Well, I think it's not really ice, but yeah, ice-ish. They're frozen. Let's just say that. Okay, close enough. And I'm going to guess that, like adoption, this doesn't come without a significant price tag. You are correct. As I'm sure you know, Sean, egg freezing is a relatively new method for preserving reproductive viability. The first human born from a frozen oocyte was in 1986, and it only became mainstream a decade ago in 2012 when the American Society for Reproductive Medicine stopped classifying the procedure as experimental, quote-unquote. It is important to say that freezing your eggs does

not guarantee that the eggs will result in a viable pregnancy. And it's still widely seen as a choice to delay childbearing or preserve healthy eggs rather than a medical necessity. So a lot of insurance companies don't cover it. And that's when you start looking at thousands of dollars in out-of-pocket costs, though that changes somewhat when you need to freeze for medical reasons like cancer treatments. Yeah, don't some states have laws requiring coverage if that's the case? They do. In fact, New York passed a law that went into effect in January 2020 that requires insurers to cover medically necessary fertility preservation or sperm or egg freezing.

All right. Well, before we get into it, listener, we would love to hear your stories around the decision to have a kid, especially around the financial aspects of that decision. Leave us a voicemail or text the Nerd Hotline at 901-730-6373. That's 901-730-NERD. Or email a voice memo to podcast at nerdwallet.com. So Renita, where do we start today? So we start today with Alexa. She's 34, lives in Texas, where she works as a lease administration manager, and she's in the process of freezing her eggs.

We agreed to use only her first name at her request for privacy reasons, and she agreed to share her story with us. Alexa, welcome to Smart Money. Hi, thank you for having me. So to start, when did you know you wanted to be a parent? I think I've always known that I wanted to be a parent. You know, I babysat as a young teenager. I've always just loved kids. And I think that I've just always known that I wanted to have my own kids one day. I have never been married. So I just have not attempted to have any

kids of my own at this point in time. But it's something I definitely know I want in the future. And can you tell us a bit about your journey towards parenthood? What's that effort been like for you? Yeah, so I know that I've always wanted children, but it's also something where I really want a family setting if at all possible. I'm not in super serious relationship. So I don't want to have children now. And I haven't been in a place where I've wanted to have children either financially or just where I was in my life. But I'm also getting older and, you know, biology doesn't change whenever the rest of the world changes. So I'm aware of my limited fertility years left. And so as a precaution and kind of just as an investment in my future,

I have chosen to go through with an egg freezing process to kind of preserve those years a little further so I can have a child when I want to. I hear you on that clock. I'm in my mid-30s myself, and that clock is loud and it does have a certain window to it. What were your expectations for the process before you started? Well, I hoped that it would be a fast process and, dare I say, easy process. I know that there's a lot involved, but I was feeling pretty optimistic about it, especially something that really kind of spurred me on to look into it further was because it became an added benefit at work under my health plan.

My company added it without the need for a diagnosis of any kind, which is, it's more common to be able to cover it if you have some kind of a diagnosis that warrants it. But to be able to freeze your eggs for any reason, I think is a pretty new thing in the benefit world. I've been putting money away, but I was thinking more long-term thing. But hearing that that was an added benefit at work made me really kind of turn on the jets of thinking about it more. That's really, you don't see that very much where a company will provide it without requiring some evidence of infertility or evidence of medical treatment that might cause infertility

in the future. On that topic, can you go through what the benefit was and how much they covered? It covers testing, procedures, medication, but all within your whatever plan you select, deductible and out-of-pocket costs. But there is a lifetime max of $15,000 for procedures and $10,000 for medication. So there are some limits to it. If somebody was going to be going through a lot of fertility treatments, they might choose to do some things out of pocket or something. But it does cover a good chunk of stuff, basically. And so were you aware of how much egg freezing cost before you looked into insurance? Well, I had a different personal financial goal of saving like $10,000. That was my goal. I think I'd seen that somewhere, but I actually think that without insurance,

that's probably a really low estimate. So you put savings away to be able to pay for it in conjunction with insurance? So I have for years used a high deductible health insurance plan so that I could have the HSA that you are eligible to contribute to. And I would max out my HSA contributions every year to as a as a means of saving up for egg freezing in the future. So given all that you've just been talking about, this might sound like a really non-emotional question for a very emotional decision. But how did you go about weighing the cost against what you would potentially get out of it? Well, the other factor is time in that equation and having the opportunity to be able to have a child in the future where had I not prepared and then I get to an age where I am ready and I am not able to for whatever reason, you that could potentially come in the future, why not? It's a kind of a no-brainer question for me, honestly. So the price is worth it for me. So walk us through

your experience going through egg freezing. How did you choose your clinic? There was actually, I think, only one in my area that was in network for my insurance company, which was a little, maybe a little apprehensive at first, but my gynecologist had actually heard of this company, of this clinic before. She said that they were very good. I read Google reviews on them and I researched them kind of in depth in their success rates and things like that. So mostly it was my only option through insurance, but I did vet them out before I went ahead and went that route. And if we're looking at the process, so first there's typically medication, right? That's given to spur ovulation. And then there's egg retrieval and then egg storage. And how long does this process

take from start to finish? So I haven't done it yet. I'm actually just about to start my medication next week. I was originally going to do it last year. And it takes about a month, three weeks to a month to do the medication and the retrieval. And then, you know, freezing is just ongoing. But I was on a high deductible plan last year. And going through the costs, the cost of the procedure was pretty reasonable. But the cost of the medication was more expensive than I anticipated. It was going to be over $4,000 because that's what it was going to take to get to my out-of-pocket max for last year. So before I spent that, I just kind of took a pause. We were also coming up on open enrollment time at work. So I took a pause really quick and I just, honestly, I opened an Excel sheet and I did the math on what it would

cost because I was on the cheapest insurance plan with the lowest premium, but the highest deductible, which I'd always been on just because of I'm a healthy person and I don't spend that much money on healthcare. But so I did the math on the cost of premiums plus the out-of-pocket max for the most expensive plan, which is a regular non-high deductible plan. And then the plan that I was on. So I just compared the cost on all of those and I selected the more expensive premium plan, but it only has a $2,000 out-of-pocket max, and it was going to end up saving me, I want to say $2,500 if I just held off until this year to do it instead of last year. So I went ahead and selected the higher premium plan for this year

with the anticipation of knowing that I would probably reach my out-of-pocket max doing the egg freezing. So I haven't done it yet, but I'm about to next week start the process. Oh, wow. So, I mean, this has clearly taken a lot of planning. How are you feeling if it's starting next week? I'm excited. I'm just ready to get it over with. I'm ready to have my eggs frozen, have them retrieved, have them freezing, just to know that, you know, this goal of mine will have been completed. I'm a little nervous just with how the process will go, how I will feel during that time, you know, how the medication might affect me

doing my job, you know, or interacting with people. So I'm a little apprehensive, but I'm mostly excited. You also mentioned work earlier. How do you think this process might affect your work life while you're going through it? You know, I'm going to be taking hormonal medication. And to be quite honest, I don't like, I don't know what if I can't keep it together during meeting or during a meeting or something, because I am being injected with hormones on a daily basis. I don't know. I did share with my boss last year that I was going to be going through this process just to like give her a heads up. And she was very supportive of it. She thought it was great that I was utilizing that benefit. And I was, you know, she's a mother and so she,

she understands hormones and things. And I also will have to, they're usually very quick, but you do have to have frequent doctor visits during this time to check on how you're progressing to see if they need to make any medication adjustments or anything like that. So it will require me to have a more flexible schedule at work for just a few weeks. But I honestly don't anticipate that being too much of an issue just because I can go pretty early in the morning. So it shouldn't affect my work schedule that often. But yeah, those are things that I'll just have to kind of roll with when it comes to work and this process. And lastly, what advice would you give to someone who's considering egg freezing?

Don't hold off. Do your research, make your decisions, and then take action. As we get older, our biology textbooks weren't lying to us. Our egg count does decline. And so that's just a fact. And then seek out reputable people to get your information from, like fertility specialists, doctors, endocrinologists, people of that nature, and take your action. Don't wait. Alexa, I know you mentioned you've only shared this with a few of your friends, and now you've shared it with the Smart Money audience. So thank you so much for sharing your story, your process, and good luck next week once it all starts. Thank you. I appreciate it. What I'm left with from that conversation is how much self-determination it takes to go this route.

Egg freezing is a long and expensive process, but for Alexa, it's the best route she's found to become a parent, a goal of hers since she was young. Alexa's story is another reminder that for many, becoming a parent requires intention and a good amount of savings. I couldn't agree more. I mean, one thing that stands out for me about Alexa is that she knows how to get things done and how to plan. And it was important to her as someone that's doing this on her own to make sure she worked out the numbers and used her insurance to her advantage, even if that meant holding off for a few months to get the procedure done. Yeah, she's really fortunate to work for a company that has generous benefits for her, but not everyone is so lucky, right? Oh, definitely not. In fact, an egg freezing clinic in New York called Extend Fertility conducted a survey in 2019, and only 3% of women respondents said their workplace had egg freezing benefits.

And I think what is also important to consider is the emotional and mental relief egg freezing provides. To know that you have that safety net so you have healthy eggs when you're ready to be a parent. Personally, I think I would have gotten it done in my late 20s or early 30s if it was prevalent then. But of course, there's a question of how to pay for it. So next, we're going to hear from Melissa Ellis. She's a certified financial planner and founder of Sapphire Wealth Planning in Overland Park, Kansas. So she's worked with many women and couples who wanted to know more about the option of delaying childbearing by freezing eggs. Melissa Ellis, thank you so much for joining us on Smart Money. Well, thank you for having me. I appreciate it.

So we're going to be talking with you this week about egg freezing, and then you'll rejoin us next episode to guide us through IVF. Can you talk a little bit first about what egg freezing involves? Absolutely. What I've learned is really from my clients. I'm not a medical professional. However, I've looked at the financial costs for my clients that are interested in this, and it is a lot more involved than what I thought it might be because they require fertility testing to make sure that there are viable eggs to freeze. There's some medication that patient will need to take so that it will be a successful process. And then also we have the things about storage and all that that we'll talk about later. But the actual procedure, you know, it's a medical procedure where there's that preparation time, then they actually do the procedure of extracting the eggs,

then they're frozen, and then they're stored for use later. And what are some of the reasons a woman might want to make this choice? Well, there are quite a few. In the case of my most recent clients that we were talking about this, they're just not ready to have children yet. They're in their early 30s. They both have businesses that they're trying to launch off the ground. And this is just not a great time to start a family. However, they don't want to lose that opportunity. But I think they're also considering the fact of maybe they don't want to lose that opportunity. But I think they're also considering the fact of maybe they don't want to have children. And this will give them that opportunity that they can have

children later. And if they decide not to have the children, then they haven't lost that opportunity either way. Right. It sounds like it's able to take some of the pressure off, whether it's for work or a health issue or... Exactly. But yeah, there are some other things too. It was kind of interesting. This is a married couple that is considering egg freezing and embryo freezing as well. But one of the questions that she was asked by the doctor was, you know, are you with the right partner? Is there a chance that maybe you won't stay married to this person? And so that was where they came into the question of freezing embryos or freezing eggs, which I thought that was an interesting viewpoint. Because what if you're in a marriage that isn't great, and that's why you

don't want to have children, perhaps. And so if you freeze your eggs, then if you are with the right partner later, you have that opportunity with them. But then the question of freezing the embryos came up in that conversation. And we talked about a couple of reasons why to freeze the embryos. And one would be, what if something happened to your partner? What if he died in a car crash suddenly and you had those embryos frozen? You'd still be able to have that child with that person that maybe you'd never had before. So we talked about, you know, the merits of freezing eggs and or embryos. And it also broadens the number of things to think about when you're making these

choices. Absolutely. And I mean, let's get to some numbers here. What is the typical cost of egg freezing? And what are some factors that contribute to the overall cost? You had mentioned storage before. Right. So the actual egg freezing procedure, extraction of eggs can be anywhere from six to $8,000. And that's not including medications that the patient needs to take prior to having that procedure done, that can be several thousand dollars depending on the person. So I would say if you're looking at that, and that's just for one round of freezing, a lot of times they want to go two rounds at least so that they know that they have multiple eggs that are viable that they can use at any point in time. So you're looking at, if you do two rounds, probably saving at least $20,000, if not up to $30,000 for that procedure down the road.

And then the storage, if you want to store them, say, for the next five years, that's about $500 per year. So that's another $2,000 to $3,000 that you're looking at for storage. And I mean, those are some big numbers. And so if you don't have insurance coverage, what are the ways to finance egg freezing? I haven't found financing privately for this other than any type of a personal loan or taking out, say, a home equity line of credit. Not the best way, in my estimation as a financial planner to finance this because at that point you're putting your house at risk, right? If you weren't able to make those

payments and a personal loan right now, the interest rates are pretty high. So that would add to the cost of doing this. The best way of course always is to save the money up front, but not everybody is able to do that. And a lot of times, you know, we're talking about a short time frame here. So if you really needed to finance it, I would look at either a personal loan as probably the second resort. The first resort would probably be a home equity line of credit if that's a possibility for you. It would be a lower interest rate. Are you familiar with care credit? I know it's a

credit card with deferred interest that some medical providers offer as a way to pay for health expenses that aren't covered by insurance. Can you tell me more about that? That would be an option to use. The biggest drawback I see to doing that is usually care credit is a low interest rate or a zero percent interest rate for a period of time that you need to pay that off. And if we're talking a large expense, it might be difficult to pay that off in the timeframe that you need before their large high interest rate kicks in, which is around 29 to 30% of what I've seen for clients that have other medical costs that are covered through CareCredit. I think CareCredit is a great option if there's something that you need

immediately and you can't wait, say, I don't know, you need cataract surgery or an appendectomy and you're not covered by insurance for some reason. Something like that that's immediate. CareCredit is a great way to be able to cover that cost and then find a way to either refinance it later or just get it paid off in that time frame. But that's the biggest drawback is the interest rate that they charge beyond the introductory period. But that would be another possibility. You're right. And if we can switch gears, can you talk us through some of the emotional and psychological benefits of egg freezing? I thought it was interesting whenever I was talking with clients about this. It's a deeply personal decision to do this. And a lot of what surrounded this in the end was the questions that came up.

And we mentioned earlier about the question, are you with the right partner? Will you be with this person the rest of your life? That alone is a question that a lot of people don't consider, right? You just live your life day to day, but then all of a sudden you think, what if I'm not with this person? The second part of that is, would you want to raise a child as a single person or, you know, with someone else that you're not together? The other thing about it, too, is the question is, if you have eggs that are frozen and you use one or two out of, say, 10 or 20 that have been harvested, what happens to those eggs? And the bigger question is, if you have

embryos that are frozen, what happens to those embryos? There's also the question of you can donate your eggs or embryos to somebody else. But then that's the question of somebody could out in the world be walking around with your child and you have never met them and you don't know them. There are a lot of both moral and just very emotional questions that surround this whole procedure. It seems like to make these decisions, it's really about understanding where you are financially, where you are, you know, with a partner or not, and then also identifying whether now or later is a better time to then be the best parent you can be. It's a lot of things to decide on. You're right. It's a huge decision. It's probably a bigger decision than even to whether to get married or not get married, to buy a house or not buy a house.

This is a huge decision with all the emotional, the financial, and then also just it changes your life to have children. And lastly, you know, right now I have friends a little bit younger than me, maybe they're in their early 30s, who are really considering egg freezing, but they are also very aware they're at the start of their careers. It costs a lot. What advice do you have for women who are considering egg freezing, but are concerned about the financial burden of treatment? I think that's where your financial planner can really help you out by laying out a long-term

plan. And I'm saying, you know, the next five to 10 years, look at, you know, the costs to have the procedure, put that into your plan that this is the year that we would do this and it's x amount of dollars so say it's thirty thousand dollars that you budget for it and then know that you have that storage cost over time and then you also have costs on the back end because once you're ready to have the children you have to have those eggs implanted again right so you have a cost then to do that. All that needs to go in the plan. But also you want to consider everything else you're doing. A lot of people that are in their 30s are still paying down student loans. So that has to factor

in. A lot of times they're purchasing a home. If you have all of that in your financial plan, you will see how much of a cash shortage you might have. And so you'll know how much you need to save or finance to be able to do this. You don't ever want to get into a position where you make a decision and then later on you realize you can't afford it. That plan should extend out once the children are born as well, just so that you know exactly what this is going to cost you going forward. Well, Melissa, this is a very complex topic, but thank you so much for your insight into it and providing some advice on how women can pay for egg freezing. Thanks for joining us today on Smart Money. Well, thank you for having me. It was great. Renita, Melissa gave me what I've been really wondering about.

What's the actual price tag for egg freezing? Not surprisingly, it is a big one. But what did surprise me is that the expenses associated with egg freezing are in a similar price range to adoption. Completely. Just like our other chats on becoming a parent, there's a lot to consider here. You know, there's been such an evolution around fertility coverage and workplace benefits. IVF is a good example. And I wonder if egg freezing will eventually become a more commonplace method that is covered. Yeah, maybe. Personally, I would hope so. But as we noted, it really is seen as a choice, an elective procedure, so to speak. Unless there's

a medical necessity, you don't have to do it. But I can think of a few other things insurance companies cover that also aren't medically necessary. I can definitely think of some for men. So who knows? Maybe it'll happen in the future. But my take is that there is a missed opportunity for employers to provide this coverage. I mean, I've been writing about egg freezing for a couple of months now, and everyone I've spoken with about it has said that they would be more inclined to join a company if egg freezing was covered for them. And, you know, this is clearly anecdotal, but there's something here, I think, for companies to think about

when looking to bring on talent or just retain employees. Yeah, that is interesting. And it also says a lot about this country that many folks' ability to afford having children or have medical care or parental leave for that matter is dependent upon the generosity of their employer. Part of me is wary of going even further down this path, making the ability to have children contingent upon

landing a good job, but it does seem like that's the direction things are going. All right, so Renita, tell us what's coming up in episode four of the series. Well, Sean, we're taking the next step in this process and fertilizing the egg. We're going to be hearing all about in vitro fertilization, or commonly known as IVF. I knew I had three chances where I would only be paying a co-pay. And I had in-network coverage, so I had to find, you know, I couldn't just like pick the doctor that was available or nicest or that I felt most comfortable with, it had to be someone on my insurance because otherwise it's like $35,000 if you pay out of pocket for one round. For now, that's all we have for this episode.

Do you have a money question of your own? Turn to the nerds and call or text us your questions at 901-730-6373. That's 901-730-NERD. You can also email us at podcast at nerdwallet.com. Visit nerdwallet.com slash podcast to get more info on this episode. And remember to follow, rate, and review us

wherever you're getting this podcast. This episode was produced by Tess Figland and myself. Sean Piles helped with editing. Kim Lowe helped with fact-checking. Kaylee Monaghan mixed our audio. And a big thank you to the folks on the NerdWallet copy desk for all their help. And here's our brief disclaimer.

We are not financial or investment advisors. This nerdy info is provided for general educational and entertainment purposes and may not apply to your specific circumstances. And with that said, until next time, turn to the nerds.