Should you freeze your egg?

What is egg freezing?

Egg freezing is a process that entails the hormonal stimulation of the ovaries, followed by transvaginal retrieval, and subsequent freezing and storage of a woman’s viable eggs. It is a method of preserving a woman’s fertility so she can attempt to have children at a later date. Medical Egg Freezing (MEF) and Social Egg Freezing (SEF) are two distinct practices with differing societal perceptions. MEF involves the preservation of a woman's eggs for medical reasons, such as prior to undergoing cancer treatment or for other health-related concerns.  SEF, on the other hand,  refers to the elective freezing of eggs for non-medical reasons, often done for lifestyle choices or to delay childbearing for personal or professional reasons. The use of social egg freezing (egg freezing for non-medical reasons) is on the rise in the United States, Europe, and the UK.

Vitrification (flash-freezing) protocols are more popular, as they offer improved pregnancy rates. However, it should be noted that the data used in research are generally derived from oocytes (immature egg cells) obtained from women less than 30 years of age. It is important to consider that clinical pregnancy rates decline with advanced maternal age at the time of freezing.

Why are so many women opting to freeze their eggs?

Social egg freezing is typically offered to women under 38 years of age who wish to preserve the option of having healthy, genetically-related children at a later date. This process, followed by in vitro fertilisation (IVF) and embryo transfer, provides women the opportunity to become genetic parents using their frozen-thawed eggs at an advanced age. The prevalence of social egg freezing has increased in recent years due to a combination of complex and interrelated factors, including personal, professional, financial, and psychological considerations.

Increased media attention, as well as employer and private insurance coverage of social egg freezing, may result in growing pressures on young women to freeze their eggs. However, it is noteworthy that the majority of private medical insurance providers in the UK do not cover infertility treatment, as they perceive fertility treatment as a 'lifestyle choice' rather than a medical necessity.

Media coverage often highlights the potential advantages of egg freezing while overlooking or downplaying the associated risks. With social egg freezing presented as a valuable reproductive option, some women may come to believe that freezing their eggs is the best way (if not the only way) to secure the opportunity of having a healthy, genetically-related child in the future. Viewing social egg freezing as a “back-up plan” that allows young fertile women to take the time to find suitable long-term partners, complete their education, achieve financial stability or advance their career goals without having to worry about their future fertility can significantly influence their decision-making regarding this reproductive choice. The cultural and social pressures for women to become mothers have a huge impact on the decision to use this technique. For centuries motherhood has been considered a fundamental aspect of womanhood. Perhaps the question we should ask is whether in our modern world we still have to accept this stereotype on women’s role in life.

What are the potential benefits and risks of social egg freezing and in vitro fertilisation?

Regarding benefits, for women without a partner or those with moral concerns about the status of a developing embryo, egg freezing may be a preferable alternative to embryo freezing.

Examining risks, the most significant medical risks associated with egg freezing stem from ovarian stimulation, notably ovarian hyperstimulation syndrome. Mild-to-moderate ovarian hyperstimulation syndrome may entail fatigue, nausea, headaches, abdominal pain, breast tenderness, and irritability, but these adverse effects are typically well-controlled. However, 0.1%–2% of patients may experience severe ovarian hyperstimulation syndrome, leading to complications such as blood clots, shortness of breath, abdominal pain, dehydration, and vomiting, necessitating hospital admission. Women inquiring about social egg freezing should be informed about the medical risks associated with ovarian stimulation and egg retrieval. It's essential for young, healthy, fertile women to understand that the data on the effects of ovarian stimulation and egg retrieval are limited and based on experiences in a different patient population (i.e., older women with infertility issues). However, there is no evidence of long-term health impacts after egg freezing. Researchers have extensively tested fertility technologies for decades, and there is no indication of long-term egg freezing side effects for either women or their potential future offspring.

How much does it cost?

In the UK, the average cost of having your eggs collected and frozen is £3,350, with medication adding an extra £500-£1,500. Storage costs are additional and typically range between £125 and £350 per year.

In Canada, the costs and availability of social egg freezing vary between $5,000 and $10,000 per stimulated cycle. These costs may encompass consultations, laboratory fees, medications, the egg retrieval procedure, freezing, and storage. Storage fees are estimated to be between $300 and $500 per year.

Given these high costs, social egg freezing is likely to be an option for only a small group of privileged women, therefore it is misleading to present social egg freezing as a benefit to all women. This poses some moral dilemmas as well as the controversial fact that social egg freezing uses medical technology to respond to a non-medical problem. This distinction sometimes implies a moral judgement, suggesting that medical egg freezing (MEF) is generally more socially acceptable than social egg freezing (SEF).Despite its controversy, SEF has been described as one of the fastest-growing assisted reproductive technologies within Europe, the UK, and other parts of the world. In light of the controversial nature of social egg freezing, GPs have the duty to assist women in accessing accurate and balanced information about their reproductive health. This information should be provided to all women who ask about social egg freezing, regardless of sexual orientation, age, disability, health, relationship or socioeconomic status.

What does the law say in the UK?

The law in the UK now permits you to store eggs, sperm or embryos for use in treatment for any period up to a maximum of 55 years from the date that the eggs, sperm or embryos are first placed in storage. However, crucially for storage to lawfully continue you will need to renew your consent every 10 years.

In summary the landscape of social egg freezing is complex, encompassing a range of considerations from cost implications to moral dilemmas. The rising popularity of this assisted reproductive technology prompts critical conversations about accessibility, ethical boundaries, and societal expectations. As the controversy surrounding social egg freezing persists, healthcare professionals play a crucial role in providing accurate and comprehensive information to empower women in making informed decisions about their reproductive health.

Here you'll discover interesting information from an independent fertility regulator in the UK.

https://www.hfea.gov.uk/treatments/fertility-preservation/egg-freezing/