Susan Roth always believed that having a baby was part of her life plan. “I figured a partner would happen and kids would occur,” she says. Years passed; she was in her late 30s, with no partner in sight. She considered freezing her eggs.
Then COVID-19 provided an unexpected push.
“The pandemic made me hit fast-forward,” says Roth, now 42, a Philadelphia scientist who works in vaccine development. “I had time for self-reflection, to focus on what I wanted. When I had that space to reflect … it became really clear that [having a baby] was the only thing I wanted to do.”
Roth, who gave birth to a son on Sept. 8, has plenty of company, in a trend that has surprised fertility specialists around the country. They expected to see client loads fall during a rise in health-related fears, uncertainty, and financial upheaval. Instead, they saw a surge in business overall – and especially in the number of single women seeking to become parents on their own.
Research published in JAMA Network in October 2021 showed “a rapid and sustained increase” in the use of assisted reproductive services after April 2020 – a surge that surpassed pre-pandemic levels and exceeded the pent-up demand caused by temporary suspension of procedures during early lockdowns.
The California Cryobank, one of the nation’s largest sperm banks, which ships 38,000 vials of sperm annually to clients in 40 countries, noted a 34% increase in single women’s requests for donor sperm between 2020 and 2021, says Jaime Shamonki, MD, the cryobank’s chief medical officer.
Other fertility clinics across the U.S. note similar surges, an increase they attribute to more flexible work schedules, reduced travel (and, therefore, more disposable income for some), and a private reckoning about life’s priorities.
Jane Mattes, founder and director of Single Mothers by Choice, a national network of groups that provide support and advocacy for single moms, noted an uptick in interest after the first jolt of COVID-19 lockdowns.
“We went dead for a little while during the beginning of the pandemic, and then we saw a big rise in activity,” she says. “Definitely, people re-evaluated their situations and made huge changes. [Also], we saw younger women coming in than we had seen previously. They seemed to have a whole different mindset about careers and motherhood: Some wanted to [pursue parenthood] sooner; some wanted to freeze their eggs.”
In a 2020 Guttmacher Institute survey about how COVID-19 affected women’s reproductive choices, 17% of respondents said they wanted to have a child sooner or wanted to have more children because of the coronavirus pandemic.
Roth, who had traveled all over the world – Belize, Turkey, Greece, Australia, New Zealand, Thailand, Peru – found herself marooned at home during months of quarantine. Health insurance through her employer, a large pharmaceutical company, covered most of the fertility services she would need.
For months, she injected herself with medications to boost her ovaries’ production of eggs, then had constant monitoring to find the ideal time for intrauterine inseminations or IVF transfers. “Your routine is completely dictated by your medication schedule. If I wasn’t working at home, I don’t know how I would have been able to do this: going to the fertility office two to three times a week.”
For unpartnered women who were considering motherhood, the pandemic made it challenging, if not impossible, to meet someone and begin a relationship.
“It became very difficult to date,” says Rosanna Hertz, PhD, a professor of sociology and women’s and gender studies at Wellesley College and author of Single by Chance, Mothers by Choice. “You couldn’t go to local pubs; they were closed. … Some women were saying: I don’t want to wait any longer. I don’t want to postpone motherhood. But other single women turned to egg-freezing, hoping that when the world opened up again, they would be able to meet a suitable partner to have a baby.”
Before the pandemic, Brianna Schumacher, MD, a reproductive endocrinologist at Shady Grove Fertility outside of Philadelphia, typically saw one single woman per month seeking donor insemination or IVF. Now, she sees one or two each week.
“I think women had time [during the pandemic] to get over the psychological/emotional hump of ‘Can I do this on my own?’” she says. She points to other factors, too: more scheduling flexibility, more access to care through telemedicine and – especially as people turned to online connection during periods of quarantine and social distancing – a surge of virtual community for single mothers. A TikTok hashtag, #singlemombychoice, has drawn nearly 40 million views.
Jacqueline Gutmann, MD, a reproductive endocrinologist with Reproductive Medicine Associates, which has offices in California, Florida, New Jersey, and Pennsylvania, noted an uptick in egg-freezing and a trend toward younger women – those in their late 20s through mid-30s – seeking to lengthen their timeline for parenthood by preserving their eggs now.
Pre-pandemic, she might have seen one or two women a month who were interested in egg-freezing; now, she sometimes sees three per day. Ninety-five percent of those requests are from single women, she says.
A 2021 study in Fertility and Sterility confirmed that trend. Although the study did not differentiate between single and partnered/married women, it showed a 39% increase nationwide in retrieval volume for egg-freezing between June 2020 and February 2021.
Telehealth has given patients more access and privacy, and employer-sponsored insurance plans cover at least some fertility treatment, making assisted reproduction more manageable for patients in recent years, Gutmann says.
Still, because using donor sperm can cost several thousand dollars per month, and an IVF cycle, including medication, can range from $15,000 to $30,000, those options are out of the question for many single women.
“Women who were economically devastated by the pandemic, who lost their jobs, or who are in service industries: I’m sure they made different decisions,” says Gutmann.
Fertility specialists and scholars note that the pandemic spurred a cascade of changes in how Americans live, work, and think: Some young adults moved back with their parents or sought shared-living situations as antidotes to isolation; many quit jobs, changed jobs, or opted to work remotely even when offices reopened.
“I think all of us had a reckoning: The pandemic could kill us. What do we really want from our lives?” says Hertz, the Wellesley professor. For women who might have preferred to follow the nursery rhyme’s sequence, she says – “first comes love, then comes marriage, then comes baby in the baby carriage” – the pandemic prompted a realization: “I don’t need to be that traditional person any longer, or I’m never going to have a kid.”