You don’t have to agree with AOC’s politics to support the public conversation she started for American women

It’s not every day that you see a sitting congresswoman giving herself hormone shots on social media. But last week, Representative Alexandria Ocasio-Cortez (AOC) went further by taking her millions of social media followers along with her–documenting every shot, her unfiltered thoughts, and bringing awareness to fertility education that us fertility doctors have been trying to achieve for over a decade. 

The vision of her administering fertility shots in the green room before going on air to discuss her future political career sent the internet in a tailspin. Why was she doing this? What was her motivation? Do frozen eggs even work? Was this simply a political stunt?

AOC’s decision to take a personal fertility journey public was a pivotal moment for women’s health. People were talking about fertility and not just in the privacy of their bedroom or doctor’s offices–but in public. And, across party lines. As fertility doctors, we were excited to see a topic we have devoted our professional careers to finally receiving the attention it deserves. In just one Instagram post, AOC amplified a message we had been trying to spread nearly a thousand fold. She inspired countless women to ask questions about the technology, their bodies and start to ponder their reproductive futures. Pretty exciting stuff. But, the reality is, AOC is actually late to the party.

When AOC announced on social media that she was freezing her eggs, she performed a huge public service by shining a spotlight on fertility preservation. As two female physicians who spend our days freezing women’s eggs to give them greater control over their reproductive futures, we feel compelled to underscore one critical fact: When it comes to egg freezing, younger is better. The decline in ovarian reserve that occurs with advancing age is no joke. In fact by the time a woman is 32, she has lost 90 percent of her eggs. And it isn’t just egg number that declines with age but egg quality as well, with 70 percent of a woman’s eggs being genetically abnormal at age 40. Therefore, egg freezing should ideally be initiated in your 20s or early 30s when both egg quality and quantity are at their peak – not at 36 like AOC. 

The concept of fertility preservation should not be a Hail Mary or alast ditch effort. Fertility is finite. All women will reach an age where it is too late to intervene, and this is exactly the reason why conversations about fertility and egg freezing deserve to be held in public. Eggs frozen at younger ages result in significantly higher chances of success when thawed. The reality is, fertility declines with age. This is not a political opinion. This is fact. 

As fertility doctors with patients in red and blue states, we believe girls should be talking about their bodies in health class and learning about their fertility alongside how to not get pregnant. Fertility testing should be offered to all women proactively–just like a pap smear or a breast exam at an annual exam. The notion of fertility preservation should be presented early and often. Egg freezing is an investment in your future fertility. We have retirement plans, why not make fertility plans? 

More women now are more aware that egg freezing exists (thank you social media) and more women have coverage from their workplace. In our own practices over the past five years, we have seen the average age of our egg freezing patients drop from 37 to 33. Improvements in technology coupled with higher quality eggs led success rates to rise dramatically. In fact, data on pregnancy rates from frozen eggs are 80-90 percent in women under age 35–a statistic that is truly remarkable. Simply stated, egg freezing works when eggs are frozen at the right age. 

Egg freezing is not a guarantee or an insurance policy for your fertility. But it is an investment in you, and just like all investments, the ROI will not be known until the future. Any eggs frozen are an opportunity for your future that otherwise may not exist. Egg freezing is the best option we have for women who desire to delay childbearing pursuing professional and personal paths. Without egg freezing, the rates of infertility will undoubtedly continue to rise in the U.S. while the overall birth rate falls. These are issues that affect all Americans, regardless of political affiliation. 

Some women will freeze their eggs and never need them. Some will freeze their eggs and, when they eventually use them, they will not result in a pregnancy. And some will freeze their eggs and ultimately have the child they hoped those eggs might help them have. We don’t know which woman will be which. But what we do know is that younger eggs have better reproductive potential. 

We practice in different states—one red, one blue. We care for different patient populations and don’t always agree on fertility treatment strategies. But we are completely united when we say women deserve to understand their fertility early enough to have meaningful choices. The conversation needs to start sooner. 

You may not agree with AOC’s politics or like the messaging she espouses, but you cannot dislike her desire to spread awareness about the need to address a woman’s future fertility. 

After all, there’s a reason why IVF has overwhelming bipartisan support. 7 out of 10 Americans may not agree with AOC, but they do support IVF. 

Everyday we hear patients tell us that they wish they were sitting in front of us before they felt the pressure of time. Before the should-a, would-a, could-as take over. While we can never promise an outcome, we can help a woman preserve an opportunity. That matters.

As female physicians, our careers exist because extraordinary women challenged expectations, entered medical schools that once excluded them, and paved a path we now have the privilege to walk. 

Today’s trailblazers look different. 

They are the women who, like AOC and many others, are brave enough to make their personal medical decisions visible so that the young women watching realize they have choices, too. That visibility matters.

So thank you, AOC for fueling the conversation we have been having. For making women on both sides of the aisle ask questions about their bodies, and for helping the next generation understand something we wish every woman already knew: Your fertility is finite, but you can take steps to preserve your future today.

Dr. Jaime Knopman is the national director of fertility preservation at CCRM Fertility and author of “Own Your Fertility.” Dr. Natalie Crawford is co-founder of Fora Fertility, CEO and co-founder of Pinnacle, and author of “The Fertility Formula.“

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