Today’s review is about THE BIG FREEZE by Natalie Lampert. As the rest of the title explains, this is a nonfiction account of “A Reporter’s Personal Journey Into the World of Egg Freezing and the Quest to Control Our Fertility.” The focus of this book is toward those who want to freeze eggs for non-infertility reasons. However, the content is pertinent to both broad groups. This is an incredibly informative read.

Author: Natalie Lampert
Series: None
Age Category: Adult
Publisher: Ballantine Books
Publish Date: July 16, 2024
Print Length: 432

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Official Synopsis

A fascinating investigation into the lucrative, minimally regulated, fast-growing industry of egg freezing, from a young reporter on a personal journey into the world of cutting-edge reproductive medicine

“An engaging and groundbreaking book.”–Toni Weschler, MPH, author of Taking Charge of Your Fertility

Ovaries. Most women have two; journalist Natalie Lampert has only one. Then, in her early twenties, she almost lost it, along with her ability to ever have biological children. Doctors urged her to freeze her eggs, and Lampert started asking questions.

The Big Freeze is the story of Lampert’s personal quest to investigate egg freezing, as well as the multibillion-dollar femtech industry, in order to decide the best way to preserve her own fertility. She attended flashy egg-freezing parties, visited high-priced fertility clinics, talked to dozens of women who froze their eggs, toured the facility in Italy where the technology was developed, and even attended a memorial service for thousands of accidentally destroyed embryos.

What was once science fiction is now simply science: Fertility can be frozen in time. Between 2009 and 2022, more than 100,000 women in the United States opted to freeze their eggs. Along with in vitro fertilization, egg freezing is touted as a way for women to “have it all” by conquering their biological clocks, in line with the global trend of delaying childbirth. A generation after the Pill, this revolutionary technology offers a new kind of freedom for women. But does egg freezing give women real agency or just the illusion of it?

A personal and deeply researched guide to the pros, cons, and many facets of this wildly popular technology, The Big Freeze is a page-turning exploration of the quest to control fertility, with invaluable information that answers the questions women have been afraid to ask–or didn’t know they should ask in the first place.

My Review

I received a free, digital, advanced reading copy of this book from the publisher via NetGalley. My review is my own and reflects my honest opinion about this book.

THE BIG FREEZE is an investigation on whether freezing eggs preserves fertility and the risks associated with this procedure. The author nearly losing her last ovary is the impetus of this journalistic endeavor. As a result, and because of her own indecision to freeze her eggs, she starts asking questions in an effort to educate herself and, subsequently, others.

THE BIG FREEZE is geared more toward those who seek to freeze their eggs rather than to those diagnosed with infertility. However, much of the discussion applies to both broad groups. Since the advent of egg freezing, the stigma attached to it has lessened considerably and the technology improved. Between 2015 and 2020, the number of procedures to freeze eggs more than doubled. As evidenced in the official synopsis, some clinics even host egg-freezing parties to provide information to those thinking about it.

This narrative nonfiction first takes the reader through the rise of egg freezing. Lampert recalls when the Pill became legal in the U.S. for married women (1965) and then all women (1972). She also discusses the unfortunate events that lead to the 1976 FDA regulation of all medical devices. This occurred because a very popular intrauterine device (IUD) caused the entrapment of bacteria in the uterus, resulting in infections, miscarriages, and other problems.

Lampert also discusses the various reasons some women consider egg freezing. The overarching reason comes down to controlling one’s fertility. To have a say in one’s own fertility equates to freedom. It comes as no surprise that women (and men) are delaying the decision to have children until later in life. The reasons vary and include the delay of marriage, women getting more education and work experience prior to having chilren, and the “mating gap.” It was shocking to learn that if a woman has a baby between 25 and 35, “when a woman’s prime window of fertility largely overlaps with her salary-building years,” it exacerbates the gender pay gap. The “mating gap” is the lack of partners ready for parenthood.

Also of importance to this investigation are advancements in technology. Lampert writes about some difficulties that arise when freezing eggs. One major hurdle was successfully freezing the egg without damaging it. A couple of key advancements significantly increased the success of egg freezing, the latest of which is vitrification.

This all-encompassing book also discusses the lucrative rise of “femtech” in the context of understanding one’s fertility. These mobile apps or hardware (e.g., smart watches) help hack fertility. I thought this was an incredibly important section because so many women use this tech due to its convenience. However, it is very important to know that virtually none of this femtech protects the user’s privacy. In the U.S., mobile health apps fall under consumer privacy laws, not the same laws by which hospitals must abide. Thus, these apps have lower standards of protection and lack federal safeguards for patient privacy. One could argue femtech provides a lot of data to understand women’s health. (Yes, these data can be sold to third parties who make no promises on how they handle the data.) But, at the same time, why not ask officially and obtain consent?

Arguably, one of the most important aspects of THE BIG FREEZE is the section on the failure of doctors to discuss fertility with women. This includes all aspects of fertility from how hormones influence the body, to when fertility starts to decline, to the attrition rate of the egg fertilization process if pursuing in vitro fertilization. In short, one egg doesn’t equate to one baby. All of this boils down to fully informing the patient so they can make the best decision for themselves, which doesn’t always happen.

There is so much interesting content in this book that I could go on for a while. But one other aspect I want to mention is that the lack of regulation for fertility services in the U.S. There are a few well-respected organizations that serve as de facto authoritative voices. But by and large the business of fertility is self-regulated.

One major con of this includes a lack of incentive to study health risks to egg donors because egg donation is a win for everyone involved. The clinic receives business, the donor receives compensation, and an infertile couple has a chance at conception. A cynical way of looking at it is fertility is a huge business. Unfortunately, it’s not uncommon for some clinics to push a patient toward a more expensive procedure without fully investigating the reason a patient seeks their help. However, a major pro of a lack of official regulation is that it can result in technological advancement.

THE BIG FREEZE is such an interesting look into the world of egg freezing. Lampert does a phenomenal job explaining this complex subject in an engaging manner. This is an important resource for those considering the procedure and covers a lot more than I recall in my review. The latter chapters are also an educational resource for those experiencing infertility, particularly with regard to egg/embryo storage. In short, THE BIG FREEZE sheds light on reasons why and risks of egg freezing, which has become more popular among women in today’s society.

Rating: 4.5
Content warnings: medical procedures, infertility
Reading format: Kindle e-book