Ten pathways to elective egg freezing: a binational analysis



What are the specific pathways that lead women to freeze their eggs? In this binational study, women were asked directly about the life circumstances that led them on the path to elective egg freezing (EEF).


From June 2014 to August 2016, 150 women (114 in the USA, 36 in Israel) who had completed at least 1 cycle of EEF were interviewed by two medical anthropologists. Study participants were recruited through four American IVF clinics (two academic, two private) and three in Israel (one academic, two private). Interviews were audio-recorded, transcribed verbatim, and entered into a qualitative data management program (Dedoose) for analysis.


The majority (85%) of women in the study were without partners, while 15% had partners at the time of EEF. Six pathways to EEF were found among women without partners (being single, divorced, broken up, deployed overseas, single mother, career planner), with career planning being the least common pathway to EEF. Among women with partners, four pathways to EEF were found (relationship too new or uncertain, partner not ready to have children, partner refusing to have children, or partner having multiple partners). With only one exception, the pathways and their frequencies were similar in both countries.


Partnership problems, not career planning, lead most women on pathways to EEF. These pathways should be studied in a variety of national settings, and fertility clinics should offer patient-centered care for single women pursuing EEF in the couples-oriented world of IVF.

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The authors would like to thank Jennifer DeChello, Jeannine Estrada, Rose Keimig, Sandee Murray, Tasha Newsome, Mira Vale, and Ruoxi Yu for various forms of editorial, study recruitment, and transcription assistance.


This study was funded by the US National Science Foundation, BCS-1356136.

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Correspondence to Marcia C. Inhorn.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Inhorn, M.C., Birenbaum-Carmeli, D., Westphal, L.M. et al. Ten pathways to elective egg freezing: a binational analysis. J Assist Reprod Genet 35, 2003–2011 (2018). https://doi.org/10.1007/s10815-018-1277-3

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  • Fertility preservation
  • Oocyte cryopreservation
  • Pathways
  • Partners
  • USA
  • Israel