When it first became possible to preserve a human oocyte in the 1980s, it seemed, for a moment, as though it might soon be possible to precision-schedule pregnancy around your career. Or your hobbies. Babies on demand. But it quickly became clear that this option was open only to a sliver of the wealthiest people—often those least in need of the flexibility afforded by egg freezing. Even today the process usually costs between $10,000 and $15,000.
Only in recent years has egg freezing begun to be democratized, especially as employers like Facebook, Google, and Apple have offered to cover that bill. Demand for frozen eggs spiked, and the idea went from niche to near-mainstream. One fertility clinic, EggBanxx, has projected that in 2018, around 76,000 people will freeze their eggs.
With that demand comes new providers and new questions—about corporate decimation of the human lifecycle, and about a culture that puts too much emphasis on work and too little on human connection. Egg freezing has been decried as less of an empowering option than requisite incursion of risk and cost onto women in competitive industries. But how much of this would be an issue if it were radically less expensive, and if outcomes were closer to guaranteed?
That’s what intrigued me about a new clinic called Extend Fertility. Having just opened its doors in midtown Manhattan, Extend is advertising an “all-inclusive” price of $4,990. If you’re healthy and young enough to undergo the process, the doctors promise a dozen frozen eggs for that price. As in, even if the team has to repeat the procedure three or four times, you will get your eggs. (Limits of human physiology apply.)
That is a novel idea in American health care, where clinics charge by the procedure (fee for service) as opposed to charging by the outcome. A model for this in medicine has been LASIK eye surgery, where competitive markets have forced ophthalmologists to guarantee that they can improve your vision—and, if not, will repeat the procedure at no cost.
How could it be, though, that a chic clinic in Manhattan would be able to cut the cost of this procedure in half? If that’s right, this is a model that might be considered for many other areas of health care. So I visited Extend Fertility in this week’s episode of If Our Bodies Could Talk. The clinic feels like a spa with a phlebotomy room and ultrasound machines:
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James Hamblin, M.D., is a staff writer at The Atlantic. He is also a lecturer at Yale School of Public Health and author of the forthcoming book Clean.