AOC joins the growing number of women freezing their eggs. Here’s what to know
By Jen Christensen, CNN
(CNN) — US Rep. Alexandria Ocasio-Cortez is freezing her eggs to “feel more in control of her life,” she announced on social media Saturday. The 36-year-old has not said whether she plans to have children but said she had been saving up for the process.
Egg freezing, formally called oocyte preservation, is one of the clearest ways to extend a woman’s childbearing years. It involves extracting eggs from the ovaries and preserving them until the woman hopes to become pregnant.
Elective egg freezing has become much more popular over the past decade as the technique has gotten better and more women have chosen to delay pregnancy. Ocasio-Cortez, a New York Democrat, joins media personality Kourtney Kardashian, actor Rebel Wilson and actor Florence Pugh, among others, in sharing plans to freeze eggs. Here’s what to know about the process.
When to freeze
Egg freezing is most effective in a woman’s 20s or early 30s, when she typically has more viable eggs.
“The answer is typically, the younger the better,” said Dr. Pardis Hosseinzadeh, assistant professor of gynecology and obstetrics at Johns Hopkins Medicine. “Women who do this procedure before the age of 35 typically have better outcomes in terms of the quality and quantity of the eggs that are retrieved. Both the number of eggs and the quality of those eggs decline with age.”
Unlike men, who produce new sperm every day, women are born with all the eggs they will ever have. Over time, the number and quality of her eggs decline.
A female baby is typically born with about 1 million to 2 million eggs. That number drops by about 10,000 a month before puberty and by about 1,000 a month after puberty.
Factors such as smoking and medication use can also affect that supply. By age 30, a woman has about 70,000 eggs left; by 40, about 18,000. After 40, about half are abnormal and unlikely to result in pregnancy. By menopause – which typically happens between the ages of 45 and 55 – the remaining eggs are not fertile.
What happens with egg freezing
A woman interested in freezing her eggs first has a physical exam to determine whether she is a good candidate. A doctor reviews her medical history, orders blood and hormone tests, and performs a transvaginal ultrasound to estimate egg supply. A poor candidate might be someone who has a low number of eggs, uncontrolled medical issues or a hormone-sensitive cancer.
If she qualifies, a doctor prescribes hormones, based mostly on her age and egg reserve, Hosseinzadeh said. The patient injects them for up to two weeks to encourage the ovaries to produce as many healthy eggs as possible.
They include follicle-stimulating drugs such as Gonal-F and Follistim, which help ovarian follicles – tiny fluid-filled sacs inside a woman’s overy that each hold one immature egg – grow. FSH and menotropin stimulate egg production in the follicles and prompt the ovaries to release eggs. GnRH antagonists block hormones in the pituitary gland to prevent the patient from ovulating early.
Regular blood tests and ultrasounds track the patient’s progress to help signal when the eggs have matured. Then, 36 hours before the eggs are retrieved, the patient takes trigger medication such as Lupron, Ovidrel, Novarel or Pregnyl to initiate final egg maturation.
A doctor retrieves the eggs through an ultrasound-guided outpatient procedure under general anesthesia. The procedure takes 10 to 30 minutes, and most women can return to work the next day, said Dr. Mindy Christianson, chief of the Reproductive Endocrinology and Infertility Practice at Cleveland Clinic Fertility Center.
An embryologist checks whether the eggs are mature enough to be fertilized later. They then undergo vitrification, a rapid-freezing process that uses liquid nitrogen, and are stored until the patient is ready to use them.
How long eggs last
Because egg freezing is relatively new, it’s not clear exactly how long eggs can be stored, but it’s believed to be decades.
Liquid nitrogen storage pauses cellular activity, so the egg should not degrade over time.
Risks and side effects
Fertility hormone injections can cause some discomfort, but side effects are usually mild. Some people have mood swings, headaches, nausea or hot flashes. Once the hormone shots stop, these symptoms typically go away.
In extremely rare cases, hormone injections can trigger a condition called ovarian hyperstimulation syndrome. The ovaries may swell, and fluid can leak into the abdomen. Mild cases can be treated with rest, fluids and electrolytes. Severe cases may require hospitalization and fluid drainage.
The cost of egg freezing
Some high-profile tech companies, including Meta and Apple, have advertised egg freezing as an employee perk. but most insurance does not cover the cost unless there is a medical reason, such as ahead of cancer treatments that will damage or destroy a woman’s eggs. One 2024 survey of large-company employee benefit plans found that about 21% covered elective egg freezing.
Even AOC said she had to save for the procedure because her insurance doesn’t cover it. Prices vary and can climb into the thousands of dollars.
“Ballpark, I would say it is around $10,000 to $15,000,” said Dr. Jen Eaton, president of the Society for Assisted Reproductive Technology.
Egg storage is typically billed separately and can cost up to about $1,000 a year, depending on the facility. Eaton advises checking local facilities for specific costs and remembering that those costs do not include in-vitro fertilization treatment if the patient later chooses to use the eggs.
Why freeze eggs
Elective egg freezing can offer more flexibility and control over reproductive health. Surveys show that women freeze their eggs for many reasons; they might want to finish school, become more financially stable or advance their careers before having children.
“Many times, they don’t have immediate plans to pursue fertility, but they do have this intense desire or dream to become a mother, and it’s something that is weighing on them as they are pursuing other things like career or education, of they haven’t found the right fit [in a relationship], and they don’t want this to be a reason to settle for a relationship that’s not right,” Hosseinzadeh said.
A 2026 National Science Foundation survey found what researchers called a “mating gap.”
In a commentary about the survey, Marcia Inhorn, a Yale University anthropologist and author of “Motherhood on Ice,” described it this way: “Highly educated, heterosexual, professional women want the three P’s of partnership, pregnancy and parenthood, but are missing the three E’s of eligible, educated and equal male partners. Thus, they turn to egg freezing to preserve and extend their fertility while waiting for a mate who may or may not materialize.”
Growing interest
Egg freezing has become much more common in the past decade, Eaton said. In 2024, there were more than 39,000 egg retrieval or freezing cycles in the United States, up from 6,090 in 2014.
Christianson said she has seen an uptick in interest at her practice in Beachwood, Ohio. About 25% of the patients she sees are people interested in freezing their eggs.
“We definitely see when celebrities freeze their eggs, and also when people’s friends start freezing eggs, more people come in, as well,” she said. “When they hear about others doing it, it validates their decision and interest.”
People are also having children later, Christianson said, which has increased interest in egg freezing. The average woman with a college degree now has her first child after age 35, a shift from decades ago, when many had children in their 20s.
Patients often worry that the process will be daunting, Hosseinzadeh said, but clinics offer support throughout.
What happens when someone wants to use their eggs
When a person wants to use her eggs, they are thawed and fertilized with sperm from a partner or a donor through IVF.
So far, relatively few people who freeze their eggs have gone ahead with using them, a February study found. But study co-author Dr. Mabel Lee said more women are doing so as the procedure becomes more common.
“Even anecdotally, in my practice, it has become more frequent to have people come in saying, ‘I have eggs frozen from back in the day, and I want to use them now,’ ” said Lee, a reproductive endocrinologist and infertility specialist at HRC Fertility.
Elective egg freezing was considered experimental until about 2013, when freezing techniques improved. Earlier attempts often damaged eggs because ice crystals formed during freezing; flash-freezing helps avoid that problem.
Managing expectations
Daily injections may sound intimidating or “scary,” Lee said, and it is an intensive two-week period, “but I feel like most of the time, the feedback that I get from patients who are going through this is, ‘oh, that was so much easier than I expected.’ ”
Patients should remember that freezing eggs does not guarantee pregnancy, Eaton said.
She appreciates that celebrity disclosures have raised awareness about the procedure, but she said they can also send the wrong message if they make egg freezing seem like a simple insurance policy against infertility.
”I think increasing awareness around this is great. I would just caution people against thinking that it’s a guarantee. I think a lot of celebrities unfortunately convey it like it is, that now they don’t have to worry about their fertility anymore,” said Eaton, who is also chief of reproductive endocrinology and infertility and director of the Fertility Center at Brown University.
Freezing may help preserve eggs, but a person’s uterus still ages, raising their risk of pregnancy complications.
Hosseinzadeh said she typically tells patients to think of egg freezing as a kind of insurance plan. If they’re younger, they may not even need to use their frozen eggs, since they may be able to get pregnant the natural way when they’re ready. “On the other hand,” she said, “don’t wait too long.”
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