Egg freezing, no longer considered an experimental procedure, is getting more and more attention as a way for women to delay having kids.
In 2014, Apple and Facebook became the first major employers to offer female employees coverage to freeze their eggs without a medical reason.
Even for women who don’t work in Silicon Valley, egg freezing is becoming more financially accessible and mainstream. The startup EggBanxx has been throwing egg freezing parties, events where women can learn about the procedure — and the competitive prices the company offers.
Despite the growing popularity of egg freezing for women who want kids eventually but not right now, doctors don’t actually recommend the procedure for this purpose. The doctors who wrote the American Society for Reproductive Medicine committee opinion on egg freezing only recommend it for women about to undergo chemotherapy or another necessary medical procedure that would damage their ovaries and make them permanently infertile.
The doctors write that data about the “safety, efficacy, cost-effectiveness, and emotional risks” of egg freezing aren’t sufficient to recommend the procedure be done simply to try to delay pregnancy.
What it is
Egg freezing is a medical procedure technically known as oocyte cryopreservation, and it’s more invasive and expensive than casual observers might realise.
To begin the process of harvesting her eggs, a woman has to take hormone injections. Those stimulate her ovaries to turn out more than the one fully mature egg they would normally produce. When her eggs are ready, the woman will be sedated while they are retrieved with a fine suction device, which usually takes about a half hour.
After that, the eggs are frozen and stored until the woman is ready to use them to try and get pregnant through in vitro fertilization. They will be thawed, fertilised with sperm in a lab, and then one or more fertilised embryos will be placed in the woman’s uterus, where one will hopefully implant and grow into a baby.
The whole process is costly. Writing for Nautilus, Abby Rabinowitz calculated one cycle of egg freezing, two years of storage (many women would need longer), and three attempts at IVF (from the New York University Fertility Center) would cost her between $US39,410 and $US46,560.
In a way, egg freezing seems to make sense as a way for a woman to increase her chances of having a baby when she’s older. A woman’s fertility declines with age, mostly because o
lder eggs are more likely
to have abnormalities that will prevent them from developing into healthy babies if fertilised. Using eggs from a younger woman, whether they were donated or a woman froze and saved hers at an earlier age, seems like a straightforward way to get around that effect of ageing.
But it’s not quite so simple. In fact, egg freezing is more like hedging your bets — which isn’t the same thing as taking out an insurance policy, an act egg freezing is sometimes compared to.
What it isn’t
Freezing eggs does not act as a guarantee a woman will be able to have a baby later, fertility preservation expert Dr. Kutluk Oktay stressed in an interview with Business Insider. It’s a more common practice to freeze already fertilised embryos for future IVF cycles, which leaves fewer hurdles to a baby than egg freezing.
“When you freeze eggs you’re really not freezing babies, you’re freezing the possible potential to carry [a baby],” Oktay said.
More research is needed about how effective egg freezing is, but in four careful trials comparing the use of fresh and frozen eggs for IVF, between 4.5% and 12% of thawed eggs resulted in pregnancies.
That sounds pretty low, but the overall pregnancy rates in these trials were similar whether fresh or frozen eggs were used. The women in these studies hadn’t frozen their eggs to delay having kids, though — they had either not become pregnant from a previous cycle of IVF and used frozen eggs instead of embryos to try again, or they were receiving donated eggs. There’s not yet data about what happens for women who freeze their eggs when they’re younger to use later, which means there’s a great deal of uncertainty about how reliably it will lead to pregnancy.
The procedure also has the potential to backfire, Oktay said: If a woman puts off having children during her fertile years because she assumes freezing her eggs left the option open, she might be unable to conceive later if for whatever reason IVF with frozen eggs doesn’t work when she’s older.
Egg freezing, then, is not the ideal solution for all women who want to put off having kids.
“I think that at the current time, egg freezing is an important concept for a small group of women — only a small group of women,” Dr. Norbert Gleicher, founder, medical director, and chief scientist of the Center for Human Reproduction fertility clinic in New York City, told Business Insider.
Both Gleicher and Oktay told Business Insider they think elective egg freezing is being “oversold.”
“You cannot offer every treatment to everybody on demand. There has to be some clinical judgment there first and counseling,” Oktay said.
“I think the healthiest thing for people to do is find time to have children while the [eggs] are healthy,” he added.
Of course, the idea of outsmarting the biological clock — something men don’t have to worry about while many women do — is appealing. But as much as human beings are pushing medical technology forward, we have not yet come up with a completely effective, guaranteed way for women to extend their fertile years.
We may be on our way, but egg freezing in its current form is not a perfect or even particularly reliable fix — and it shouldn’t be sold as such.
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