The women drifted around the cloth-draped, candlelit tables, cradling glasses of wine and nibbling on cheese cubes. Some, in suits and heels, had arrived directly from work; others, in stylish workout gear, had already been to the gym.
Their chatter muffled sounds of the trendy Rittenhouse Square restaurant downstairs.
Then the PowerPoint image flashed up.
"This is an egg," reproductive endocrinologist Maureen Kelly told the dozen women, now listening intently. The screen showed a human oocyte, the star of this unlikely happy hour on egg freezing for women who want children, but not right now.
Sprouting up all over the country, such events have been praised for offering important information and criticized as marketing schemes targeting a vulnerable demographic, women all too aware of their ticking biological clocks. One company, Eggbanxx, is taking it national by hosting egg-freezing parties in cities including New York, San Francisco, Miami, and Chicago.
Chatting about a major medical procedure over wine and hors d'oeuvres, however, troubles some.
"This makes [egg freezing] a social issue, rather than a serious and thoughtful medical issue that should be approached in a deliberative way," said Susan Crockin, a law professor at Georgetown University specializing in ethical and legal issues surrounding assisted reproductive technologies.
"I think it also reinforces the view that whatever other people are saying about it around you is going to be very influential."
Advocates say the gatherings are just pleasant, low-key ways to explain options to women who are curious but not yet ready to find a specialist and make an appointment.
The late-July event was hosted by Society Hill Reproductive Medicine, a Philadelphia clinic specializing in fertility issues, in collaboration with the Wellnest, a wellness center.
"Tonight is all about just making sure you get the lay of the land," said Kelly, who directs the medical clinic, while her daughter runs the wellness center that shares the office space. "This is not to put pressure on anybody."
Liz Fredette, 35, a professional from Philadelphia, was positive about the evening. "It's much less serious. It allows you to cruise the options and not commit. It's much nicer than sitting in a doctor's office hearing about this," she said.
Her candor was unusual; most of the women there declined to be interviewed by a reporter.
Still, the doctor fielded plenty of questions:
Can you screen the eggs for genetic abnormalities? Does age of sperm matter for fertilization? If I move to a different state, can my eggs come with me?
What's the oldest patient you've worked with?
Once a technology reserved for women facing cancer treatment that could render them infertile, egg freezing has been expanding to healthy women. Most women must foot the bill if they're freezing eggs merely to time their pregnancies more conveniently. But with tech giants Facebook and Apple recently announcing they will pay for egg freezing for their workers, it could gain cachet as an important employee benefit.
The practice clearly is growing. In 2009, 568 women froze their eggs; that figure had grown more than eightfold by 2013, according to the Society for Assisted Reproduction Technologies, which notes that it tracks data only from its member clinics.
Kelly said the technology appeals to all kinds of women. In her clinic she has seen women certain they want babies and women who need more time to decide. Women in stable relationships with solid careers, and women who were still in school.
"Some have suggested [egg freezing] is, or should be, the new college graduation present," Crockin said.
It has long been known that fertility declines with age, though the exact reason was unclear until recently.
"It was because of the egg," Kelly said. "You're not running out of eggs. Eggs become less fertile with age and many, if not all of them, become genetically infertile."
Around the age of 26 - when many young professionals feel they don't have the time and money to raise children - fertility experts note a very subtle decline in egg quality, which increases in a woman's mid-30s. Especially now that technology is improving, advocates say, egg freezing lets women match their biology with their personal reality.
"The rest of culture hasn't caught up with allowing women to have children at the age that's most ideal for them if they want to have a career also," Kelly said.
The average age of first-time mothers in the U.S. has risen steadily since the 1970s, according to the Centers for Disease Control and Prevention.
Kevin Doody, vice president of the Society for Assisted Reproductive Technologies, pointed out that egg freezing is now so successful it has not been considered experimental since 2012.
Because eggs are mostly water, freezing them used to produce damaging ice crystals. Vitrification, a flash-freezing process that has been around for decades in the world of cryobiology, has recently become highly popular for egg freezing. It results in an almost 90 percent chance that the egg will be undamaged by freezing and thawing. And experts agree that about 75 percent or more of those eggs that survive the freeze/thaw process using vitrification will fertilize.
But that's not all there is to the story when it comes to conception and births.
"The limitation [of frozen eggs] compared to fresh eggs is how many will develop into late-stage embryos," said Kutluk Oktay, professor and director of the division of reproductive medicine and infertility in the department of obstetrics and gynecology at New York Medical College. "Some people put out the impression that frozen eggs are as good as fresh eggs. That's still not the case."
Kelly disagrees, but Oktay says frozen eggs have just 50 to 70 percent of the success rate of fresh eggs.
One reason: Eggs don't survive freezing as well as embryos do, Oktay said. Of course, the trouble with embryos is that they require sperm, and many women choosing to freeze their eggs for later use want to keep that selection process open.
Frozen eggs must be thawed, fertilized, and surgically implanted in the uterus using in-vitro fertilization. Among women under 35 who implant only one embryo, Doody estimates half will become pregnant from a single cycle of IVF. This rate could increase if more eggs are implanted - though that could produce multiple births - or if a second cycle of IVF is used with the leftover eggs - incurring more expense.
Kelly, recalling a 27-year-old medical resident visiting her clinic, agreed that the invasive treatments and risks a woman must go through to freeze her eggs deserve careful consideration.
So do costs. Insurance may cover the prescreening to measure ovarian reserve, but those without medical need for egg freezing are likely responsible for the rest. The process from testing to freezing can cost $5,000 to $10,000, Kelly said, plus the $500 to $750 annual storage fee for the harvested eggs.
That is a hefty price for many younger women. Kelly said she had seen patients' parents pick up the tab, and her clinic has a financing program available.
One of Kelly's patients, JoAnna Marmon, who froze her eggs two years ago, said that her insurance did cover a portion of it but that she paid out of pocket for most.
"The chances of my insurance covering any of it were about as good as the chances of me meeting the father of my children in Dr. Kelly's waiting room," joked another patient, Emily Seroska, who shared her experience with the women at the Rittenhouse Square event.
"This was the fastest 10-plus thousand dollars I've ever spent."
There are six steps to freezing human eggs - and that's all before a woman decides she's ready to have a baby. Then come thawing, fertilization, and implantation of embryos. But to get the process started, plan on paying $5,000 to $10,000, plus the $500 to $750 annual fee for storage. Unless you have a medical issue requiring egg freezing to preserve fertility, expect to pay most of it yourself.
1. Assessment of ovarian reserve: A combination of lab work on hormone levels and ultrasound is used to determine how many eggs are still left in the ovaries. (This step is typically covered by insurance.)
2. Stimulation and monitoring: A combination of hormones is self-injected for about 10 days to mature a group of eggs simultaneously, instead of just one during a normal menstrual cycle. Lab work, office visits, and ultrasounds are used to monitor response to medications. Most of this process is usually covered by insurance, except for the hormone medication.
3. Egg retrieval: While the woman is sedated, a doctor uses a transvaginal ultrasound probe, to extract mature eggs from the ovarian follicles. From here on out, insurance typically doesn't cover the procedure except for medical necessity, such as preserving fertility before cancer treatment.
4. Oocyte culture: Eggs are cultured in a petri dish at an embryology lab.
5. Cryopreservation: Here's the actual deep freeze, as eggs are vitrified in a cryoprotectant solution.
6. Storage: Eggs are stored at minus-196 degrees Celsius for as long as needed.