Orly Halperin on a choice she never made
When I was a little girl, my mother – Nitzan’s grandmother – liked to tell me romantic stories that ended badly. Her favorites were stories about barren women and other women struggling with fertility. Rachel our Matriarch, the poet Rachel Bluwstein and Grandma Rachel – my father’s mother – merged in my mind into a single tormented woman.
All three had a heroic aura: from “Give me children, or I shall die” (and the biblical Rachel did indeed die), through “Had I a son” (Rachel the poet died too), to Grandma Rachel, who bore 10 children, six of whom died at birth or in infancy.
The message was clear: The whole business of fertility is extremely complicated and dangerous, and a life without children is not one worth living. So I wasn’t really surprised when it took me a decade and eight pregnancies to bring three living children into the world – what gynecologists call “take-home babies.”
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Nitzan Halperin (center), with her mother, Orly Halperin (top right) and her grandmother, Miriam Philosof (left). Credit: Courtesy of the family
Nitzan Halperin (center), with her mother, Orly Halperin (top right) and her grandmother, Miriam Philosof (left). Credit: Courtesy of the familyThe only role left to women
On the other hand, I never really chose to be a mother. It was clear to my husband and me that parenthood is a natural stage of life – like teething, adolescence or growing old – and that despite the difficulties, it would happen in the end, because it couldn’t not.
That may explain why I find it so hard to accept the choice of my eldest daughter, 33-year-old Nitzan, not to make me a grandmother just yet. Part of it is fairly selfish. In an interview I conducted with Carmel Shalev, a legal scholar and bioethicist specializing in reproduction and aging, she told me the obvious: Being a grandmother is the only social and cultural role allotted to Israeli women my age.
I never really chose to be a mother. It was clear to my husband and me that parenthood is a natural stage of life – and that despite the difficulties, it would happen in the end, because it couldn’t not.
As for Nitzan: It’s not that she knows she doesn’t want children, or that she does. She simply hasn’t yet decided whether or not to be a mother. And as long as she hasn’t decided, she won’t know whether everything works – or whether she might be “sick.” Because in Israel, infertility is perceived and culturally constructed as a serious medical condition.
And because infertility is defined by a specific incapacity – one that usually causes no harm to the body and usually has no other clinical manifestation – viewing it as a disease is normative, culturally dependent and contested. While the World Health Organization recognizes infertility as a disease, in England, for instance, most of the public regards it as a “normal variant.” And according to various liberal and feminist approaches, infertility is a social construct.
In Israel, the prevailing social imperative is to have at least two children (according to the Taub Center for Social Policy Studies in Israel, an average of 2.84 per woman in 2023), to fight any fertility problems that arise – and to keep fighting even when the odds are slim to none.
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Cryogenic storage tanks at the in vitro fertilization unit, Sheba Medical Center, Tel Hashomer. Credit: Moti Milrod
Cryogenic storage tanks at the in vitro fertilization unit, Sheba Medical Center, Tel Hashomer. Credit: Moti Milrod
The state is an active partner in realizing the right to parenthood: Fertility technologies are fully funded in Israel through the birth of a second child. According to the 2024 State Comptroller’s special report on IVF, Israel ranks first in the world in IVF cycles per woman of childbearing age, yet relatively low in treatment success rates. This paradoxical gap stems from the fact that Israel, unlike other countries, funds fertility treatments even when the chances of success are very low.
This large number of IVF cycles is enshrined in law, which requires the state to fund the diagnosis and treatment of infertility and IVF for a first and second child – for couples with no children together and for childless single women – with no limit on the number of treatment cycles: up to age 45 using a woman’s own eggs, and up to 54 using donor eggs or her own eggs frozen before age 45.
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No other country in the world matches, or even approaches, this funding policy: In France, the public system funds up to four rounds of IVF; in Denmark and the Netherlands, three; in the U.S., funding is private. Israel’s funding policy has not changed since the 1990s, even as IVF technology has advanced, and even though the success rate for a woman using her own fresh eggs (retrieved just before fertilization) falls sharply after 40 – from around 15 percent at 40 to under 1 percent at 45.
Pressing pause on the biological clock
Because egg quality declines rapidly with age, some within the Israeli medical establishment have in recent years tried to set a lower age ceiling for ending treatment with fresh eggs. The attempt has failed, in the face of stubborn public and political opposition. At the same time, they are pushing to raise awareness of egg freezing at younger ages, which would preserve their quality, and to expand subsidies for fertility preservation on social grounds – which would encourage women in their thirties to freeze their eggs.
Israel ranks first in the world in IVF cycles per woman of childbearing age and fertility technologies are fully funded through the birth of a second child.
The idea is that the chances of successful fertility treatment for a 42-year-old woman using eggs she froze at 32 are far higher than they would be had she not frozen her eggs.
And what about the cost? In Israel, a young woman will pay around 3,500 shekels (about $950) per treatment cycle; women are entitled to up to three cycles subsidized through the public healthcare services’ supplementary insurance (without a subsidy, each cycle costs between 7,500 and 17,000 shekels, roughly $2,000 to $4,600).
For that young Israeli woman’s American counterpart, egg freezing costs $14,364 per cycle (according to the Freeze website). What’s more, most U.S. insurance plans don’t cover elective egg freezing, and only about 22 percent of large employers (500 or more employees) offered coverage in 2025 – so most women pay out of pocket.
And really, what’s so bad about “elective fertility preservation” or “social fertility preservation”? You devote two weeks to hormone injections, a short day-hospital stay and a retrieval under sedation, and in return you press pause on the biological clock. Why not?
Orly Halperin is a Ph.D. candidate in the Science, Technology and Society program at Bar-Ilan University, where she studies the history of in vitro fertilization in Israel.
Nitzan Halperin on choosing not to choose
U.S. Congresswoman Alexandria Ocasio-Cortez holds up her phone, leans toward the camera and smiles. She tells her viewers that she began her political career at 28, and that the years since have left her thinking about a woman’s place in society and politics. She reflects that a private person makes her mistakes in private, but an elected official makes them in public.
Well into the monologue, she tells her viewers that she has recently decided to begin the process of fertility preservation, or “egg freezing.” She connects the decision to financial considerations, to gaps in women’s knowledge of their own bodies, to the state of American society. She says she chose to freeze her eggs to feel more in control of her life, and that she feels empowered making the choice, which she calls a privileged position – one made possible, she notes, by changes in technology that have also made the process more financially accessible.
In the videos that follow, she sits beside her dog on the couch, films the injection and narrates the act. Ocasio-Cortez is 36, single, works a demanding job and turns to her audience – her female viewers – asking them, “don’t be weird about this.”
From Ocasio-Cortez’s words, egg freezing comes across as normal, natural, even responsible and feminist.
Ocasio-Cortez isn’t alone: In Israel and elsewhere, egg freezing is “part of the conversation.” Women talk about it not in whispers while waiting to see the doctor, but at the office, at the bar, at social gatherings. On my 30th birthday, three years ago, my grandmother asked me why I didn’t buy myself egg freezing as a birthday present.
“Elective egg freezing” or “social fertility preservation” are the terms reserved for egg freezing performed for non-medical reasons – terms that invite us to focus on two key words: “social” and “elective.” To call the process “social” is to describe the act by the context in which the choice is made, rather than the act itself. After all, the preservation itself is hardly social; there’s no gathering where you and your girlfriends throw an egg party together.
The second word, “elective,” emphasizes that egg freezing is a choice – an act that springs from desire rather than necessity.
The picture that emerges is of an ideal world in which the average thirty-something woman who, for one reason or another, doesn’t yet want to get pregnant can walk into a gynecology clinic and walk out with a fertility iceberg, which she can put in the freezer for five, 10 or 15 years, until the time comes when she wants to embark on the promised pregnancy.
Reality, the position paper of the Israel Society of Obstetrics and Gynecology tells us, is different: “Achieving pregnancy and birth with frozen eggs is not guaranteed. The method does not guarantee future fertility,” its recommendations state, adding that “efforts should be made to raise patients’ awareness of the inverse relationship between a woman’s age and her fertility.”
Irresponsibility versus responsibility, looking away versus awareness
So this is a medical procedure, not magic. No one is forcing you and no one is promising you anything. So why does it feel as though someone, somewhere, is?
In the gap between the social stance that encourages women to freeze their eggs and the more guarded professional one, a polarized perception takes shape – irresponsibility versus responsibility, looking away versus awareness. Fertility preservation preserves not only your potential to have biological children, but also your place in society as a woman who thinks ahead, shows she’s serious and wards off the pathological label that comes with her current childlessness.
The narrow field of choice lets you move between being a mother, now; being ready for motherhood, equipped with eggs just in case; or being a half-girl, half-woman who refuses the role everyone can see she’s supposed to take on, dismissed for her refusal to participate in these fertility games.
What’s more, refusing to have a child or freeze one’s eggs “erases” the other women in the family of that woman who is me, depriving them of their perceived and culturally constructed roles: It denies my mother the chance to become a grandmother, and my grandmother the chance to become a great-grandmother.
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A woman injects hormones to stimulate egg production ahead of fertility treatment. Egg freezing comes across as normal, natural, even responsible and feminist. Credit: Nipshutter/Shutterstock
A woman injects hormones to stimulate egg production ahead of fertility treatment. Egg freezing comes across as normal, natural, even responsible and feminist. Credit: Nipshutter/Shutterstock
My theoretical egg freezing would produce an imagined baby who would save them from the threat I represent, and would win me the coveted prize of a few years of psychological and social peace regarding my position on producing offspring.
I keep coming back to the words Ocasio-Cortez chose at the start of her video, about the “mistakes” you make in private and in public. When you refrain from having a child, you risk making a mistake in the private and public spheres, going back generations. I betray my own future, but I also deny the previous generations of women in my family their social role.
‘So what,’ my mother says, ‘you have a child for yourself, not for society.’ But who is this self so eager to reproduce?
In this way – to return to my mother’s words – a self-reinforcing system takes shape. The technology exists, and the decision to use it is almost taken for granted. Encouraged by the new reproductive technologies, young women decide to postpone having children until later in life.
Those same women move through a world seemingly free of children and free of worries – until they reach the age at which they’re more likely to need treatments of one kind or another – until it turns out what a shame it is that you didn’t freeze your eggs, that you didn’t get pregnant back when you could. Do you hear the clock ticking in the background of this story? What a shame, such a shame for you. Freeze. Preserve. What sane woman wouldn’t choose it?
The transient self that is here and now
In a 2016 article, cultural and political geographer Merav Amir traces the emergence of the “biological clock” in the 1970s and ’80s, alongside the invention of the contraceptive pill and new reproductive technologies. Amir argues that the concept of the biological clock was meant to frame the course of women’s lives according to a predetermined timetable; this ticking clock reinforces the traditional family structure and the balance of power between the genders.
Isn’t fertility preservation simply one more digit on that ticking clock? Isn’t it a means of providing a sense of security that in practice only underscores the exhausting, grinding voice pressing you to get pregnant, and as quickly as possible? In her article “Mining Women,” the scholar Omi Leissner describes the public and medical treatment of women’s fertility as a resource, and reproductive discourse as one conducted over women’s heads. “The question worth examining, then, is not what women want, but which of their requests are granted,” she writes. “So what,” my mother says, “you have a child for yourself, not for society.” But who is this self so eager to reproduce?
In refusing fertility preservation, there is no heroism – no courage in the face of adversity – to match that of Rachel the poet, Rachel our Matriarch and Grandma Rachel. There is nothing rational about deciding to forgo freezing, and no prize awaits you if you decide to – or not to – “have the child.”
And yet, in the end, there is a palpable sense of heroism in feeling that within the refusal of this invasive invitation lies the choice of yourself: not a future, theoretical version of you, not the version your mothers expect, but the transient self that is here and now, that wants to linger a while longer in the present, and that has the right not to choose.
Nitzan Halperin is a culture researcher and community organizer. She lives in the Tel Aviv area with her partner of 10 years, her cat – and no children.