Smart Money Podcast: The Price of Parenthood: How Egg Freezing Works
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Welcome to NerdWallet’s Smart Money podcast, where we answer your real-world money questions.
This week’s episode continues our nerdy deep dive into the price of parenthood: This week, we’re focusing on egg freezing.
Check out this episode on either of these platforms:
Our take
The last two episodes of the Price of Parenthood series covered wanting to be a parent soon, but what if parenthood is something you want down the road? Egg freezing is one way to put healthy eggs literally on ice until you are ready to have kids. And with egg freezing continuing to gain popularity — whether you're looking to preserve fertility before a medical treatment like chemo, more time to find the right partner or just the peace of mind that can come with the procedure — have you wondered how much it may cost?
Ronita and Sean did wonder, so in this week’s episode, they look into the cost of egg freezing and what it involves. And, most importantly, how to pay for it. Some options are tapping good old-fashioned savings, using health care credit cards or even taking out a medical personal loan. And lately, some work benefits or insurance can help cover the cost of the procedure.
This brings us to our first conversation, with Alexa from Dallas, Texas, as she is about to start her egg-freezing procedure. They talk about how Alexa came to the decision to freeze her eggs, using her work’s health insurance and planning for the payments. Alexa also shares the emotional side of starting this process, including the relief she feels knowing her eggs will be preserved.
Then Ronita chats with Melissa Ellis, a certified financial planner and founder of Sapphire Wealth Planning in Overland Park, Kansas. Melissa has helped numerous clients think through fertility planning and she shares the questions to ask before proceeding. Melissa also talks about how to plan paying for the procedure and how to plan for when you’re ready to have kids later on.
Sean and Ronita end the episode talking about the role that companies can play in providing benefits like egg freezing coverage for hiring and retaining employees. One area that already has had progress in coverage is in vitro fertilization (IVF). The next and last episode in the series is going to be a deep dive into IVF, how much it costs and chatting with a new mom who went through it.
More about personal finance and parenthood on NerdWallet:
Have a money question? Text or call us at 901-730-6373. Or you can email us at [email protected]. To hear previous episodes, go to the podcast homepage.
Episode transcript
Sean Pyles: Workplace benefits have come a long way over the last decades. Safe to say that until recently it would've been unheard of for companies to help cover one form of fertility planning.
Alexa: 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 a 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.
Sean Pyles: Welcome to NerdWallet Smart Money podcast. I'm Sean Pyles.
Ronita Choudhuri-Wade: And I'm Ronita Choudhuri-Wade.
Sean Pyles: We're on to the third episode of our nerdy deep dive into the cost of parenthood. 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.
Ronita Choudhuri-Wade: Yes, we are. We are preparing to procreate perhaps sometime in the future.
Sean Pyles: At a date yet to be determined.
Ronita Choudhuri-Wade: 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.
Sean Pyles: Putting that chance at procreation literally on ice.
Ronita Choudhuri-Wade: Literally. Well, I think it's not really ice, but yeah, ice-ish. They're frozen. Let's just say that.
Sean Pyles: OK, close enough. I'm going to guess that like adoption, this doesn't come without a significant price tag.
Ronita Choudhuri-Wade: 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. 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.
Sean Pyles: Yeah, don't some states have laws requiring coverage if that's the case?
Ronita Choudhuri-Wade: 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.
Sean Pyles: 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-N-E-R-D, or email a voice memo to [email protected].
So Ronita, where do we start today?
Ronita Choudhuri-Wade: 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.
Alexa: Hi, thank you for having me.
Ronita Choudhuri-Wade: So to start, when did you know you wanted to be a parent?
Alexa: I think I've always known that I wanted to be a parent. 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.
Ronita Choudhuri-Wade: Can you tell us a bit about your journey towards parenthood? What's that effort been like for you?
Alexa: 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 a super serious relationship, so I don't want to have children now. 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 biology doesn't change whenever the rest of the world changes. So, I'm aware of my limited fertility years left. So as a precaution and just as an investment in my future, I have chosen to go through with an egg freezing process to preserve those years a little further so I can have a child when I want to.
Ronita Choudhuri-Wade: 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?
Alexa: 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 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 a long-term thing, but hearing that that was an added benefit at work made me really turn on the jets of thinking about it more.
Ronita Choudhuri-Wade: 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?
Alexa: 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 that, basically.
Ronita Choudhuri-Wade: So were you aware of how much egg freezing cost before you looked into insurance?
Alexa: Well, I had a different personal financial goal of saving $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.
Ronita Choudhuri-Wade: So you put savings away to be able to pay for it in conjunction with insurance?
Alexa: 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 as a means of saving up for egg freezing in the future.
Ronita Choudhuri-Wade: So given all that you've just been talking about, this might sound like a really nonemotional question for a very emotional decision, but how did you go about weighing the cost against what you would potentially get out of it?
Alexa: 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 can't go back in time. So if I can do something right now for something that I know that could potentially come in the future, why not? It's a no-brainer question for me, honestly. So the price is worth it for me.
Ronita Choudhuri-Wade: So walk us through your experience going through egg freezing. How did you choose your clinic?
Alexa: There was actually I think only one in my area that was in-network for my insurance company, which made me a little apprehensive at first, but my gynecologist had actually heard of this clinic before. She said that they were very good. I read Google reviews on them and I researched them 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.
Ronita Choudhuri-Wade: If we're looking at the process, so first there is typically medication, that's given to spur ovulation, and then there's egg retrieval and then egg storage. How long does this process take from start to finish?
Alexa: 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 freezing is just ongoing. But I was on the 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 took a pause.
We were also coming up on open enrollment time at work, so I took a pause really quick and I honestly, I opened an Excel sheet and I did the math on what it would cost, 'cause I was on the cheapest insurance plan with the lowest premium, with 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 health care.
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.
Ronita Choudhuri-Wade: Oh, wow. So this has clearly taken a lot of planning. How are you feeling if it's starting next week?
Alexa: 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 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, how the medication might affect me doing my job or interacting with people. So I'm a little apprehensive, but I'm mostly excited.
Ronita Choudhuri-Wade: You also mentioned work earlier. How do you think this process might affect your work life while you're going through it?
Alexa: I'm going to be taking hormonal medication, and to be quite honest, I don't know. What if I can't keep it together 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 give her a heads-up and she was very supportive of it. She thought it was great that I was utilizing that benefit. She's a mother and so she understands hormones and things.
I also, 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, there are things that I'll just have to roll with when it comes to work and this process.
Ronita Choudhuri-Wade: Lastly, what advice would you give to someone who's considering egg freezing?
Alexa: 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. 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.
Ronita Choudhuri-Wade: 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.
Alexa: Thank you. I appreciate it.
Sean Pyles: 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.
Ronita Choudhuri-Wade: I couldn't agree more. One thing that stands out for me about Alexa is that she knows how to get things done and how to plan. 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.
Sean Pyles: Yeah. She's really fortunate to work for a company that has generous benefits for her, but not everyone is so lucky, right?
Ronita Choudhuri-Wade: 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. 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've 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 has worked with many women and couples who wanted to know more about the option of delaying child bearing by freezing eggs. Melissa Ellis, thank you so much for joining us on Smart Money.
Melissa Ellis: Well, thank you for having me. I appreciate it.
Ronita Choudhuri-Wade: 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?
Melissa Ellis: Absolutely. What I've learned is really from my clients. I'm not a medical professional; however, I have 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 the patient will need to take so that it will be a successful process. Then also we have the things about storage and all that that we'll talk about later, but the actual procedure, 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.
Ronita Choudhuri-Wade: What are some of the reasons a woman might want to make this choice?
Melissa Ellis: 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 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.
Ronita Choudhuri-Wade: Right. It sounds like it's able to take some of the pressure off, whether it's for work or a health issue or —
Melissa Ellis: Exactly, but there's some other things, too. It was 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, "Are you with the right partner? Is there a chance that maybe you won't stay married to this person?" 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?
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. 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 had never had before? So we talked about the merits of freezing eggs and/or embryos.
Ronita Choudhuri-Wade: It also broadens the number of things to think about when you're making these choices.
Melissa Ellis: Absolutely.
Ronita Choudhuri-Wade: 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.
Melissa Ellis: Right. So the actual egg freezing procedure, extraction of eggs can be anywhere from $6,000 to $8,000. 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. 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 two to $3,000 that you're looking at for storage.
Ronita Choudhuri-Wade: Those are some big numbers.
So if you don't have insurance coverage, what are the ways to finance egg freezing?
Melissa Ellis: 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 if you weren't able to make those payments. 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 upfront, but not everybody is able to do that. A lot of times we're talking about, we're 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.
Ronita Choudhuri-Wade: Are you familiar with CareCredit? 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?
Melissa Ellis: That would be an option to use. The biggest drawback I see to doing that is usually CareCredit is a low interest rate or a 0% interest rate for a period of time that you need to pay that off. If we're talking a large expense, it might be difficult to pay that off and the time frame 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.
Ronita Choudhuri-Wade: If we can switch gears, can you talk us through some of the emotional and psychological benefits of egg freezing?
Melissa Ellis: I thought it was interesting whenever I was talking with clients about this, yeah, it's a deeply personal decision to do this. A lot of what surrounded this in the end was the questions that came up. 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 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? 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 your 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.
Ronita Choudhuri-Wade: It seems like to make these decisions it's really about understanding where you are financially, where you are 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.
Melissa Ellis: You're right, it's a huge decision. It's probably a bigger decision than 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.
Ronita Choudhuri-Wade: Lastly, 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?
Melissa Ellis: I think that's where your financial planner can really help you out by laying out a long-term plan. I'm saying the next five to 10 years, look at the cost 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 $30,000 that you budget for it and then know that you have that storage cost over time. 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. 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.
Ronita Choudhuri-Wade: 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.
Melissa Ellis: Well, thank you for having me. It was great.
Sean Pyles: Ronita, 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.
Ronita Choudhuri-Wade: Completely. Just like our other chats on becoming a parent, there's a lot to consider here.
Sean Pyles: 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.
Ronita Choudhuri-Wade: 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'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. 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.
Sean Pyles: Yeah, that is interesting. 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, Ronita, tell us what's coming up in episode four of the series.
Ronita Choudhuri-Wade: 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.
Tess [guest]: I knew I had three chances where I would only be paying a copay, and I had in-network coverage. So I couldn't just 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.
Sean Pyles: 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-N-E-R-D. You can also email us at [email protected]. Visit nerdwallet.com/podcast to get more info on this episode. Remember to follow, rate and review us wherever you're getting this podcast.
Ronita Choudhuri-Wade: This episode was produced by Tess Vigeland and myself. Sean Pyles helped with editing. Kim Lowe helped with fact-checking, Kaely Monahan mixed our audio, and a big thank you to the folks on the NerdWallet copy desk for all their help.
Sean Pyles: 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.
Ronita Choudhuri-Wade: With that said, until next time, turn to the Nerds.
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