Step One: Acknowledge some difficult facts. You are a young woman. Like most everyone else around you, you might want kids — just not right now. Yet it is right now — in your twenties and early thirties — that your eggs are most viable. As a fetus, you had six million of them. By birth, this number diminished to one or two million; by puberty, to four hundred thousand. Since then, every menstrual cycle has cost you another thousand. Meanwhile, your boyfriend who won’t split the rent generates around a hundred million sperm cells. Per day.
Step Two: Get an email from an egg donation company. A couple would like to offer you $100,000 to $250,000 for your eggs. “Egg donors are typically compensated on average between $6,000 – $8,000,” the company writes. “However, with your intelligence and extraordinary accomplishments…” Dismiss the email. My body, my eggs.
Step Three: Start your PhD. Break up with that boyfriend. Date a wrestler turned Bitcoin millionaire. A neurosurgeon dabbling in venture capital. An Orthodox rabbi. Somewhere in there, meet up for drinks with your professor friend, who’s single. She just got tenure, but breaks down in tears. It’s too late to get pregnant.
Step Four: Acknowledge another difficult fact. From here on out, your eggs are declining not just in quantity but in quality. Begin studying various online calculators to figure out how many eggs you’d need to freeze at any given age for a good chance of producing one baby later. (Roughly 15 eggs at 27 years; 20 at 30; more than 30 by 35.) Realize that what you need is not just a room of your own, but an egg-freezing chamber of your own.
Step Five: But good luck paying for it. Egg retrieval is not only more invasive than sperm collection; it’s way more expensive. Learn that a single, two-week cycle requires a heady mix of drugs that you inject at home (between $4,000 and $8,000), plus regular vaginal ultrasounds and surgery under anesthesia for the retrieval (another $4,000 to $8,000), as well as yearly storage fees (free for the first twelve months, then $1,200 a year). Hear a podcast — hear every podcast — advertise a new-ish startup called Cofertility, which lets you freeze your eggs for free right now, if you donate half of them. As Faustian bargains go, this is one of the better ones. If you want your insurance to cover egg freezing, there’s just about only one thing you can do: get cancer.
Step Six: Get cancer. Sort of. This is how: get hospitalized for a blood clot that immobilizes your right leg before traveling to your left lung. So that this venous thromboembolism doesn’t instantly kill you, get a steady I.V. drip of heparin, a blood thinner others use to improve their chances of embryo implantation. Meanwhile, get tested; get scanned. Learn that you have two large tumors growing inside of you, one on each ovary. Listen as your gynecological oncologist cautions that he won’t know if they’re cancerous until he opens you up, but your tumor markers are high. Learn that no type of cancer is more closely associated with venous thromboembolisms than cancer of the ovaries.
Step Seven: Internalize some difficult facts. On the one hand, chemotherapy would obliterate your egg supply. On the other hand, egg freezing before chemo could actively encourage tumor growth.
Step Eight: Watch your mother cry. Listen as she tells you in Korean that she doesn’t care if you can have kids; she just cares that you live. Get angry at yourself. If you’re valuing your unborn children over your own life, are you so different from the pro-lifers? Think: fuck this biological family thing. Think: why not adopt?
Step Nine: Get angry. Adopt? In the wake of the Korean War, the adoption industry in South Korea — the world’s largest “baby exporter” — thrived on falsified documents that systematically separated Korean children from their biological parents so that they could be acquired as “orphans” by white families abroad. Adopt? Adoptees are four times more likely to commit suicide than non-adoptees.
Step Ten: Stay angry. Never mind that adoption, too, is a lengthy, chance-filled process marked by biases based on income, race, age, and so on. Though wealthy white women are the likeliest to benefit from assisted reproductive technology, they are not the ones who, on average, most need it. Black women are disproportionately affected by polycystic ovary syndrome, one of the leading causes of infertility, and are twice as likely to be infertile as white women.
Step Eleven: Learn that sex kills. Or, at least, estrogen does. The birth control you happened to be taking before you were hospitalized? Its manufacturer settled over two thousand lawsuits alleging that it caused life-threatening injuries — including venous thromboembolisms. Other estrogen highs that increase the risk of deadly blood clots like yours: pregnancy, gender-affirming hormone therapy, egg freezing.
Step Twelve: Discover, after waking up from surgery, that you still have two ovaries. The tumors were benign. But don’t be too relieved — they’ll likely come back. Learn that, because of this, your insurance will likely cover egg freezing. Wonder whether insurance would also cover egg freezing for trans men undergoing gender-affirming surgery.
Step Thirteen: Think, shouldn’t egg freezing be accessible to us all? Let the union organizer in you demur — what we need isn’t insurance coverage to help us delay family-building, but better working conditions so that people can start families now. But… with whom? Recall the testimonies in Marcia Inhorn’s exhaustive ethnography Motherhood on Ice (2023). Many of the women she interviewed felt compelled to extend their fertility not simply to advance their careers or gain financial footing, but because they struggled to find suitable spouses with whom to start the kinds of families they envisioned. A living wage doesn’t guarantee a life partner.
Step Fourteen: Make a prediction. If debates on access to egg freezing do emerge, they will look less like the left-right debates unfolding around reproductive choice today and more like the intra-left ones that surrounded gay marriage two decades ago — less about the moral validity of the act and more about whether it’s even worth seeking equal access to conceptions of the family that, some would argue, we should instead be working to transcend. Liberal and radical feminists agree on a person’s right to have an abortion. What’s more contested, on feminist turf, is which kinds of family projects are worth our optimism the morning after. Less my body, my choice, more my body, my dilemma.
Step Fifteen: Speaking of which, recall that email you got from the egg donation company. Think now of your friends who are getting fucked by student debt and would gladly take the money. Think of your friend, your luminous friend, for whom it’s too late. She’d rather do it with an egg donor, she says, than not at all.
Step Sixteen: Think of your mentor, Mari Ruti, who is dying of breast cancer. How she always cautions that it’s harder to “opt out” of our desires than we’d like. Think of Lauren Berlant. They’ve already died of cancer. “A relation of cruel optimism exists when something you desire is actually an obstacle to your flourishing.”
Step Seventeen: Freeze your eggs. Or don’t. Either way, lose Mari. Watch a war begin. See how the grip of fertility’s dilemmas only tightens the farther you are from the pristine white halls of the Columbia University Fertility Center. Learn that in the besieged Gaza Strip — where doctors have linked illegal white phosphorus and other chemical agents used by Israel in previous bombardments to male infertility — impoverished families take on crippling loans to undergo multiple IVF cycles, conceiving children who may well be killed in subsequent air strikes. Watch a video in which a woman cradles her dead baby, sobbing, “I took 580 heparin shots to be able to get pregnant.” A video in which a doctor reports resorting to hysterectomies to save the lives of patients giving birth. Recall that the Greek and Latin roots of “genocide” together mean, roughly, “killing the family.”
Step Eighteen: Get tested. Get scanned. Learn that another cyst is beginning to grow on your ovary. Acknowledge a difficult truth: we are all dying to get what we want. Then, don’t die. Keep living.
Nancy Ko is a writer, critic, and historian. She is based in New York and Rhodes, Greece.