Fertility Factor

Expanded Perspectives on Building a Family

Egg Freezing: A Modern Fertility Conundrum

Biological Clock Boon or Bust?

A recent article in Bloomberg Businessweek entitled, Freeze Your Eggs, Free Your Career, suggested that women now had the opportunity to stop the clock indefinitely so they could pursue a career now and have children whenever. Women are freezing their eggs (oocytes) by ever increasing numbers, some as they begin to hear their biological clock ticking, others receiving this as a gift from parents for their college graduation. But, how much of a guarantee does this really offer to women?

I am all for women having control over their reproductive destiny, choosing both if and when to be pregnant. However, just as the baby boomer generation was encouraged to postpone pregnancy and pursue careers, being promised they could have it all which turned out to be false for some, there seems to be a message in egg freezing that women can freeze their reproductively aging eggs, postpone family building, and still have it all whenever they choose. And this just may not be true.

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Granted, the earlier you freeze your eggs, the better (absolutely before age 37 and younger is better). The process of vitrification (fast freezing) has significantly improved the chance of a successful thawing of these eggs without destruction due to the formation of ice crystals (oocytes are made up primarily of water). But, there is still no guarantee that when a woman returns to thaw her frozen eggs, if, in fact, she does as most women thus far have not returned to use their eggs, any of them will actually fertilize, result in the creation of an embryo, implant, or lead to the birth of a live baby.

Before you break the bank, be sure you understand the following:

• Neither egg freezing nor in vitro fertilization can turn back the clock. If you wait until you are 40 to freeze your eggs, they will still be your 40-year-old, and possibly too old, eggs. So, don’t wait since 35, or even better, 30-year-old eggs give you a better chance of a successful pregnancy if you return later to use them.

We do not have stratified success rates available by age of freezing, at present, as there have not been adequate numbers of women freezing eggs nor returning to use them. And, success is highly dependent on the quality and skills of the lab freezing the eggs. So heed the word “chance” in the last sentence. Egg freezing gives you a possibility, not a guarantee, of a take-home baby, an important fact to understand so women avoid making life decisions based on having what they erroneously assume are guaranteed future babies on ice.

 

• You may need to undergo more than one cycle of IVF for egg retrieval to have sufficient numbers of eggs harvested for a reasonable chance of success. Twenty may be a good number to aim for and this usually takes more than one cycle of IVF, even in young women.

 

• This process is expensive, requiring exposure to ovarian stimulation drugs, a surgical procedure for egg retrieval, and costing approximately $12,000 per cycle plus additional annual storage fees for freezing the eggs, none of which is covered by insurance. This also creates inequities of access because of these costs.

  

Let’s bring men into this conversation, as well, to increase their awareness of women’s decreasing fertility rates and increasing chromosomal and genetic problems for both women and men as they age (as recent research has suggested that men over 40 have an increased likelihood of producing children with disorders such as schizophrenia and autism). Women don’t postpone starting families solely because of career issues. They also postpone starting families because they haven’t found the person with whom they want to create a family. Wake up men, we need to be in this together.

 

In addition, we cannot stop pushing for changes in the work place so that women (and men) are able to balance both career and family-building rather than expecting women to put themselves through the rigors and expense of ovarian stimulation and egg retrieval to try to conserve their fertility. We need to eliminate pregnancy discrimination and offer paid family and medical leave, flexible hours, fair pay, and affordable health care and child care, so women and men feel free to both establish a career and start their families during their peak fertile years if they so choose.

 

If you do not envision being ready to start a family in the near future, this is an option you may want to consider if you are still young enough. But, having children is not the only road to a rich and fulfilling life and we all have the choice not to have children, as well.

 

For further information, see Social Egg Freezing: What’s a Young Woman to Do? The Pros and Cons of Social Egg Freezing at:

 

http://www.theafa.org/article/whats-a-young-woman-to-do-the-pros-...

 

 

Joann Paley Galst, Ph.D. is a cognitive-behavioral psychologist in New York specializing in mind-body medicine and reproductive health issues.

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