Social Egg-Freezing: Empowering but not an Insurance Policy

It is 30 years since the first successful frozen egg pregnancy was conceived. For many years, egg freezing was considered to be a low-chance option for fertility preservation, needing 100 eggs to get one live birth.

For young women with cancer who were facing the near-inevitable sterility of chemotherapy or radiotherapy, the prospect of freezing their eggs, with even a low chance of genetic motherhood in the future was acceptable. The human egg, the largest cell in the body, is a tiny fluid-filled bubble and, during freezing, icecrystals form that can damage the delicate structures inside. The introduction of egg “anti-freeze”, vitrification (flash-freezing) and sperm micro-injection (ICSI) improved success rates.

Donor eggs are seen as the obvious solution for many women with age-related sub-fertility, but many would still prefer their own genetic child. Fertility clinics now have frozen egg banks where young, vitrified, eggs are available to match any racial or physical characteristic required by the recipients. Pregnancy rates from these frozen donor eggs, obtained from young women, are the same as those from fresh egg-donation cycles (50-70% per cycle).

This success has led to increased takeup of “social” egg-freezing because women want the opportunity to become a mother in a supportive, long-term relationship.

The decision by Facebook and Apple to offer social egg-freezing to female employees has reignited the debate about whether egg-freezing represents the ultimate type of family planning for today’s professional woman, or whether the prospect of having frozen assets really does offer the opportunity to safely defer and delay motherhood until the right time or the perfect partner arrives.

Unfortunately, the majority of women choosing to freeze their eggs have already left it too late to have a realistic chance of achieving a live birth from a single cycle of egg freezing. Just as with fresh eggs, successful pregnancies are more likely to be obtained using frozen young eggs.

The circumstances in which women choose to freeze eggs often reflect their social situation, in which they have either not found a partner who wishes to parent with them, or a long-term relationship that they assumed was heading towards parenthood has failed. It is unfair and unfortunate that at 38 (the modal age at which UK women seek egg freezing), she has two years to realistically achieve a healthy pregnancy whereas her similarly-aged partner has two decades.

Women seeking social egg-freezing are significantly committed to the conventional ideal family structure and regard single parenthood via the use of donor sperm as a poor last resort. By freezing their eggs they may believe they have bought a little biological time and the costs and small risks associated with the procedure may well be worth taking for that sense of empowerment.

However, at the present level of efficacy of oocyte freezing, it is vital that women, especially if they are over 35, are made aware that their frozen eggs do not represent an insurance policy against childlessness.

Source: Gillian Lockwood is medical director of the Midlands Fertility Centre

http://www.theguardian.com/society/2015/oct/24/social-egg-freezing-empowering-but-not-an-insurance-policy-against-childlessness