Oocyte cryopreservation — egg freezing — produces clinically meaningful live birth rates when oocytes are retrieved before age 35, with steep age-related decline thereafter. Cobo et al.’s 2016 Human Reproduction cohort of 9,149 warming cycles found cumulative live birth rates of 43.7% per warming cycle for women under 35, 22.6% for ages 35–37, and 11.6% for ages 38–40. The ASRM Practice Committee has endorsed elective oocyte cryopreservation as a standard (no longer experimental) option for fertility preservation, noting the consistent finding in clinical data that women who attempt conception in their late 30s or early 40s after not having frozen oocytes frequently express regret about not preserving fertility earlier. Hammarberg et al.’s 2017 follow-up survey of 414 egg-freezing patients found approximately 84% satisfaction at 1–3 years; the 16% who expressed regret or ambivalence most commonly cited high cost and inadequate oocyte yield — problems predominantly affecting women who froze after 37.
The asymmetry in the regret data is stark. Among women already in infertility treatment, Wennberg et al.’s 2016 survey found 34% wished they had frozen eggs at a younger age; among women who had undergone multiple failed IVF cycles, that figure rose to 48%. The barrier to earlier action was not primarily cost or procedure anxiety — it was lack of awareness that elective freezing was available and effective, combined with the culturally reinforced assumption that fertility decline was “not yet relevant” in one’s late 20s or early 30s. This is a textbook inaction-regret pattern: the action (freezing) has a modest regret rate driven by uncertainty about whether the eggs will ever be needed; the inaction (waiting) has a higher regret rate concentrated in those who discover they needed eggs they no longer have, or that freezing later produced far fewer viable oocytes than freezing earlier would have.
Sperm freezing presents a simpler version of the same decision. Male gamete cryopreservation is substantially cheaper (typically under $1,000 vs. $10,000–$20,000 for oocyte cycles), requires no invasive procedure or hormone stimulation, and does not face the same age-related quality decline until the late 40s or 50s. For men in circumstances where biological parenthood is a desired but uncertain future goal, sperm banking resolves the optionality question at low cost and burden. The asymmetry in action vs. inaction regret is likely wider for sperm than for oocytes precisely because the cost of acting is so much lower relative to the regret of not having acted.