Biology has a clock.
You don't have to follow it.
Fertility is the only major medical event in adult life where age alone is the diagnosis. No symptom precedes it. No test gets ordered for it at a routine physical. The first conversation most people have about ovarian reserve happens when reserve is already a problem — and by then, the decision space has narrowed considerably.
This is not a moral failing of the patient. It is a structural failing of the system that surrounds them. The information arrives late because the conversation arrives late. Most primary care visits never raise it. Most fertility clinics charge for a consultation to do so. The gap between "I have a doctor" and "I have a fertility plan" is wide enough that, for many, it becomes a regret.
We are closing that gap. Reserve testing at thirty is not pressure — it is data. Vitrification at thirty-two is not a panic move — it is a pause button on a biological process that does not pause on its own. And we are still the same practice, with the same physician, on the same chart, when those frozen eggs are used at forty-two — or never used at all.
The number of eggs a woman has at thirty is roughly twelve percent of what she had at birth. By forty, it is closer to three.
A frozen egg at thirty-two is, biologically, still thirty-two — at thirty-five, at forty, at forty-four. That is the whole proposition.
The rest is logistics, and the rest is the practice.
The biology is moving. The conversation isn't.
Reproductive timelines have shifted by roughly a decade over two generations. Career structures, partner formation, housing, and graduate education all push the median age of first child later. The biological curve has not moved to accommodate. Most patients arrive at the question too late not because they were careless — but because no one in their care team raised it earlier. We raise it earlier. That is the only structural change required.
AI runs the workflow. Doctors run the conversation.
Fertility preservation is a sequence — evaluate, decide, retrieve, freeze, store, stay — and most of its failure modes are sequence failures, not science failures. We use AI to make the sequence quiet, so the conversation gets to be loud.
The number behind the conversation.
A reserve panel — AMH, antral follicle count, FSH, estradiol — for those with ovaries; a comprehensive semen analysis including DNA fragmentation for those with sperm. Our pre-visit AI reviews your chart, age, cycle history, family history, and any prior labs to draft an interpretation before you arrive. You leave with a number, a picture, and a recommendation — not a sales pitch.
A conversation that stays a conversation.
Most fertility decisions are not made in one visit. They are made over months, with a partner, with finances, with shifting plans. Our AI surfaces decision points — your numbers in context, scenario modeling at different retrieval volumes, plain-English risk and cost — so the clinician's time is spent on what only a clinician can do: listen, answer, and not rush.
One cycle, or two. Then we stay.
Retrieval and vitrification happen at our partnered embryology lab, supervised by a board-certified reproductive endocrinologist. Storage and the long relationship happen with us. Annual storage check-ins, an updated plan as life changes, integration with the rest of your care. The clinic that froze your eggs at thirty-two is the clinic that knows you at forty-four.
Two curves bend. Vitrification holds one of them still.
A frozen oocyte does not age in storage. It carries the genetic and cytoplasmic profile it had at the moment of cryopreservation, indefinitely. The pause is real — and the biology that makes the pause possible is unforgiving of shortcuts. Vitrification, not slow-freeze, is why this conversation exists at all.
Reserve
The endocrine baseline of egg quantity. The number that turns the question into a plan.
Semen
Comprehensive semen analysis with DNA fragmentation. The half of fertility most clinics ignore until couples are already trying.
Retrieval
Stimulation and oocyte retrieval at a partnered reproductive endocrinology lab, supervised by a board-certified REI physician.
Storage
Long-term cryostorage with annual integrity audits and an annual conversation with the same physician who started the chart.
One door, four paths.
Fertility preservation is not one service — it is a small family of services with different patients, different timelines, and different costs. We are transparent about every one of them. Insurance covers most of the diagnostic work. Cash covers most of the preservation itself. Pricing below reflects current published averages for the U.S. market and is provided for orientation, not as a final quote.
The science of preservation matured. The conversation around it hasn't caught up.
The story we inherited.
- Egg freezing is for women who don't yet have a partner.
- Slow-freezing is good enough; success rates are similar.
- "You have plenty of time" — until thirty-eight, sometimes forty.
- Male fertility doesn't really decline; the focus is on the female partner.
- Genetic screening of embryos is always the smart, more thorough choice.
The medicine we practice.
- Egg freezing is a biology decision, not a relationship-status decision; partnered patients freeze too.
- Vitrification — not slow-freeze — is why post-thaw oocyte survival is now in the high-eighties to mid-nineties percent at quality labs.
- Reserve declines steeply through the mid-thirties; "plenty of time" is a phrase that costs many patients their preferred outcome.
- Sperm concentration has declined ~50% over fifty years globally; DNA fragmentation rises with paternal age. Male fertility is half of the conversation.
- PGT-A has specific, evidence-supported indications; it is not a default add-on. We use it when it helps and skip it when it doesn't.
Preservation doesn't sit in a silo. Neither does our care.
Fertility is the most visible reason a patient walks into the Preserve pillar, but rarely the only thing on the chart. Hormonal patterns that surface in a reserve panel often connect to weight, mood, sleep, and metabolic health upstream — and to perimenopause downstream. We see all of it on one chart, with one physician, in one practice.
PCOS, weight, and cycle integrity.
Many reserve evaluations surface PCOS, hypothyroidism, or hyperprolactinemia for the first time. Treating these well — sometimes with GLP-1 therapy, sometimes with targeted endocrine work — is fertility medicine, even when no one called it that.
Sleep, the gut, and gamete quality.
Sleep architecture, the microbiome, and metabolic health are now linked to oocyte and sperm quality in mounting evidence. The Prevent pillar — our sleep program, microbiome work, screening imaging — is upstream of the preservation conversation, not adjacent to it.
The same curve, one chapter later.
The biology underneath fertility preservation is the same biology underneath menopause — ovarian reserve, written forward and written backward. Our Menopause Program lives on the same chart, with the same physician, so that the transition is handled by someone who has watched the curve from the start.
Insurance for the work-up. Cash for the preservation.
Office visits, hormone panels, reserve testing (AMH, AFC), semen analysis, and follow-up are billed through insurance where covered. Preservation cycles, storage, and most fertility medications are cash-pay in most U.S. plans; we will tell you exactly what your insurance does and does not cover before any cycle is scheduled. No surprises, no upsell, no membership.
Three cities, all already yours.
A decision that
stays yours.
Start with a number. We'll run a reserve panel or a semen analysis, sit with the result, and build a plan — preserve now, preserve later, or simply have the data. Whichever you choose is the right answer, because it's yours.
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