A secure storage area at the Aspire Houston Fertility Institute in vitro fertilization lab holds smaller cryo storage containers. Each container accommodates approximately 150 egg samples immersed in liquid nitrogen. This setup was observed on February 27, 2024. Recently, Rep. Alexandria Ocasio-Cortez (D-N.Y.) highlighted issues faced by women who wish to delay motherhood until they are ready emotionally, financially, or in terms of their careers.
Ocasio-Cortez shared her personal journey of freezing her eggs on Instagram. Her actions received mixed reactions, with some praising and others criticizing her. Regardless of opinions, her story underscores the significance of egg freezing for women planning future pregnancies. As educational pursuits and career priorities delay family planning, this option gains importance. Research in reproductive health consistently indicates that as women age, fertility and successful pregnancy become more challenging. Egg freezing offers a possibility for women to pursue biological motherhood later in life.
Despite her status in Congress, Ocasio-Cortez faces similar insurance challenges as other U.S. women regarding fertility options. Her Congressional health plan does not include egg freezing, necessitating out-of-pocket expenses reaching $10,000. This mirrors the experience of many with private health insurance who find limited coverage for egg freezing. Typically, insurance policies only cover this if linked to medical conditions impacting ovulation, like chemotherapy. Elective egg freezing remains largely uncovered, complicating access for low-income women, who lack public insurance support such as Medicaid, and face financial barriers to saving for the procedure. Consequently, they often must choose between premature parenthood or foregoing motherhood entirely.
Family planning in the U.S. appears asymmetrical.
Women can access contraception easily through private insurance or public programs like Title X and Medicaid’s family planning services. Yet, assistance for timed childbearing is scarce. The focus on birth control without equivalent support for birth promotion highlights the imbalance in family planning programs.
Over the decades, U.S. birth rates have consistently declined, with predictions suggesting potential population stagnation by the mid-2050s, eventually impacting economic growth and military capabilities. Current policies mainly support fertility control but require parallel strategies encouraging population growth to ensure a balanced approach to family planning. Among few nations, the U.S. does not prioritize population growth alongside fertility control. Developing such policies could stabilize demographic and economic futures.
Leonard M. Lopoo serves as the Paul Volcker Chair in Behavioral Economics at Syracuse University’s Maxwell School and is the author of “Wanting Children: Family-Planning Policies and the Engineering of America’s Population.”