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Insuring Your Health

Few Women Have Coverage For Egg Freezing

As some companies add egg freezing to their list of fertility benefits, they’re touting the coverage as a family-friendly perk. Women’s health advocates say they welcome any expansion of fertility coverage. But they say that the much-publicized changes at a few high-profile companies like Facebook and Apple are still relatively rare, even for women with serious illnesses like cancer who want to preserve their fertility.

Shady Grove Fertility, long known for IVF, is now offering egg freezing services for women with health issues or who would otherwise want to postpone childbirth to a later date. (Photo by Andre Chung for The Washington Post via Getty Images)

Shady Grove Fertility, long known for IVF, is now offering egg freezing services for women with health issues or who would otherwise want to postpone childbirth to a later date. (Photo by Andre Chung for The Washington Post via Getty Images)

News stories about company-paid egg freezing for female employees have focused on whether the benefit truly gives women and men more options for balancing work and family life or instead sends a message that they’re expected to put off having a family if they want to get ahead on the job.

But that is not the main concern for some women who, because of illness or age, are worried that time is running out for them to have children. After their mid 30s, women can still carry a pregnancy but their eggs are less viable. Egg freezing allows women to extend their fertile years.

“I’ve never met anyone who fits the mold of the stereotypical egg freezer who’s career mad and waiting for Mr. Right,” says Brigitte Adams, 42, who became the face of oocyte cryopreservation, as egg freezing is called, when Bloomberg BusinessWeek put her on its cover for a story on the subject last spring. “A lot of women will tell you, ‘I didn’t expect to be here. I just want the possibility of having a child.’”

Adams is one of those women. Divorced in her mid 30s, she froze her eggs three years ago, paying for the $12,000 egg retrieval procedure with personal savings and help from her parents. Adams pays $300 annually to store her eggs, and she’s pondering becoming a single mother. Her marketing job at a tech start-up in Los Angeles doesn’t provide any coverage for egg freezing and storage or the in vitro fertilization that will be required if she decides to go ahead.

Adams is keenly aware that there is no guarantee that the 11 eggs she’s storing will result in a pregnancy. “It’s not a silver bullet,” Adams says, “but it gave me the sense I’d done everything I could and that has helped me tremendously to just move on.”

Two years ago, the American Society for Reproductive Medicine declared that it no longer considered egg freezing to be experimental. Research shows that fertilization and pregnancy rates using frozen eggs are similar to those using fresh eggs, and children born using frozen eggs don’t have higher levels of chromosomal abnormalities or birth defects, the ASRM said in its revised practice guideline.

Yet insurance coverage for egg freezing and other infertility treatments remains spotty, says Richard Reindollar, executive director at the ASRM. “Of all the disease processes, insurance coverage is available for essentially all of them, but not for infertility,” he says. “It’s not seen as such.”

America’s Health Insurance Plans hasn’t surveyed insurers specifically about egg freezing coverage, says Susan Pisano, a spokesperson for the trade group. However, she said her understanding is that many plans cover egg freezing when there’s a diagnosed fertility problem or when an individual is at risk for infertility because of treatments like radiation therapy or chemotherapy. Coverage for non-medical reasons is much less common, Pisano says.

Roughly a third of companies with 500 or more workers provide no coverage for infertility services, according to benefits consultant Mercer’s annual survey of employer health benefits. High-tech companies are more likely to cover fertility services than other firms, according to Mercer. Forty-five percent of high-tech companies cover in vitro fertilization and 27 percent cover other advanced reproductive procedures such as egg freezing, for example. The comparable figures for non-high-tech companies were 26 percent and 14 percent, respectively.

In January of this year, Facebook began offering up to $20,000 in egg freezing coverage for medical or non-medical reasons for its U.S. employees, a spokesperson confirmed.

“Silicon Valley is probably leading the way [in coverage for egg freezing] since competition is fierce and companies are always looking for ways to attract recruits,” says Dan Bernstein, a senior consultant at Mercer’s San Francisco office, who has seen an increase in companies offering the benefit. Bernstein says a few of his clients currently offer egg freezing benefits.

Some fertility clinics and companies like EggBanxx are stepping in to offer package deals and financing options. At EggBanxx, which opened for business in May, women can get a 15 percent discount on egg retrieval and one year of storage at participating fertility clinics; some may qualify for a loan to finance the cost, says Jennifer Palumbo, vice president of patient care.

“Insurance would typically cover the consultation, diagnostic testing and some medications,” she says, “but not the retrieval and not the freezing.”

Infertility advocates would like to see more companies adopt egg freezing policies, especially for women who have cancer, for example, and are likely to become infertile as a result of chemotherapy.

“I think it’s amazing for people at these companies, but can we also get this covered for women with cancer?” says Barbara Collura, president and CEO of Resolve, an infertility advocacy group.

This column was updated to clarify details about EggBanxx’s financing.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

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