US Rep. Alexandria Ocasio-Cortez says one trade-off she has made is not owning a home, because she saved up to preserve her fertility. The 36-year-old Democrat is freezing her eggs, a process she says can cost roughly $15,000 (£11,250) in some places.

She is documenting the cycle on social media and has called the experience 'very daunting'. Ocasio-Cortez shared a video of her first injection and says she wants to reduce stigma, as women have little information.

How Egg Freezing Works

A cycle typically takes around two weeks and involves daily hormone injections and ultrasound monitoring to track the body's response and when to collect the eggs.

A trigger injection helps the eggs complete their final maturation before they are collected, usually about 36 hours later in a procedure performed under sedation or anaesthesia.

The eggs can be stored for future use in in vitro fertilisation (IVF) cycles, subject to applicable storage laws and regulations.

Success Rates Depend on Age

Dr Alex Polyakov, an associate professor at the University of Melbourne and a fertility specialist, said freezing eggs in younger women effectively stops the timing. Fertility begins to decline after 35, with more eggs becoming genetically abnormal.

No number of frozen eggs guarantees a baby, he cautioned. Attrition can occur at every step, from eggs surviving the thaw to fertilisation to embryo development.

Fertility clinic data show the overall chance of a live birth from a frozen egg is 39 per cent, rising to 51 per cent for women 38 and younger. It reaches 70 per cent for those 38 and younger who freeze at least 20 eggs.

A systematic review of 10 studies published between 1999 and 2020 found that 11.1% of patients returned to use their frozen eggs. Across the included studies, the estimated live-birth rate per patient was 28%.

It was higher among patients who froze their eggs at age 35 or younger, at 52%, and lower among those who froze them at age 40 or older, at 19%. These estimates should be interpreted in the context of the study populations and available data, rather than as guarantees for individuals.

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The Financial Toll

Ocasio-Cortez said she was lucky to be able to save, but asked herself whether it was worth it. The answer, she noted, is not the same for everyone and the process is not guaranteed.

Estimates put one cycle at $4,200 to $8,000 (£3,150 to £6,000), with medications adding $2,000 to $6,000 (£1,500 to £4,500). Storage runs $500 to $1,000 (£375 to £750) per year, and some need several cycles to collect enough eggs.

Medical Risks to Weigh

A paper reviewing social egg freezing said ovarian stimulation can cause ovarian hyperstimulation syndrome. Mild cases involve fatigue, nausea, headaches and abdominal pain.

Severe cases affect 0.1 to 2 per cent of patients and can cause blood clots, shortness of breath and dehydration requiring hospital admission. Reports linking stimulation to cancer are limited and conflicting, with further research needed.

Later pregnancies carry risks too. IVF can bring multiple pregnancy, high blood pressure, premature delivery and low birth weight, while pregnancy at an advanced age raises the risk of gestational diabetes and pre-eclampsia.

The American Society for Reproductive Medicine (ASRM) removed the experimental label from egg freezing in 2012. Its 2013 guideline nevertheless said there was insufficient evidence to recommend the procedure solely to circumvent reproductive ageing in healthy women.

Fertility Testing Has Limits

Ocasio-Cortez called a fertility check 'a great small step'. Many experts stress that the anti-Müllerian hormone (AMH) test is not accurate for measuring fertility.

The test does not reveal the chance of natural pregnancy or how long a woman has left, the specialist added. He noted many women in their late 20s with low AMH get pregnant without issues.

Ocasio-Cortez said she was aware sharing her journey carried political risk, but felt empowered. Women, she added, are not taught or prepared for puberty, pregnancy or menopause.

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