When the American Society for Reproductive Medicine (ASRM) announced last week that it was removing its “experimental” label from egg freezing, the resulting media coverage highlighted certain issues while others were left notably missing. Many articles focused on women who want to delay childbearing for social reasons – until they find the right man or get that promotion for example (1,2,3) – with some lauding egg freezing as an unproblematic path to freedom and autonomy. A number of articles neglected entirely the fact that ASRM is recommending that the procedure only be used by women at risk of losing their fertility due to medical treatments such as chemotherapy. And while some accounts mentioned the scant evidence about safety for children born from frozen eggs, few discussed the risks for women who undergo ovarian stimulation and multiple egg extraction.
Also under-reported was the prospect that egg freezing will trigger what one observer called a “paradigm shift” in the fertility industry: a proliferation of frozen egg banks, larger online databases of egg providers, and an intensification of “catalog shopping” for their eye color, height, ethnicity, and other traits.
While a few companies have been offering frozen eggs for non-medical purposes for years, advertising has recently kicked into high gear. My Egg Bank, which offers only frozen eggs, started shipping this past June. Its website raves that “patients can now achieve the same clinical success rates as traditional egg donation programs… AT HALF THE COST.” It boasts that it “only use[s] the highest quality donors” who have been pre-tested for 21 genetic conditions, and that it provides “care conveniently planned around your busy schedule.” Anyone can search through its database of donors and traits, though only current patients can view the women’s pictures (in order to protect their anonymity).
At the website of The World Egg Bank, by contrast, simply providing an email address and the name of a hospital is enough to grant you full access to donor profiles, which are oddly reminiscent of Myspace profiles. Each woman has a page with multiple photos of herself, and descriptions of her looks, ethnicity, educational level, talents, and activities.
The World Egg Bank provides both fresh and frozen eggs, but makes its preference crystal clear. The page titled “Are You Better with Fresh or with Frozen?” outlines many problems with fresh eggs, mentioning the hormone supplements the donor has to take for egg retrieval, increased costs, the trouble of coordinating the donor’s and recipient’s menstrual cycles, the travel that is necessary, and the fact that you’ll just have to “trust her commitment to following medical protocol.” The frozen egg section mentions not a single potential downfall except that the company’s selection of frozen eggs is not yet as big as it would like (there seem to be only 13 frozen egg donors currently, in contrast with hundreds of fresh egg donors). It doesn’t mention anything about the risks of egg extraction, which seems to suggest that it’s somehow safer if the eggs are frozen – even though the procedure is exactly the same.
From the point of view of recipients, brokers and clinics, the use of frozen eggs certainly does remove certain obstacles. Medical director of the South Florida Institute for Reproductive Medicine Juergen Eisermann told a reporter that acquiring fresh eggs is “never fun,” and that with frozen eggs, “you have no idea how much administrative time it saves us. It’s incredible. We want to convince more of our patients to do frozen.” He went on to complain about being at the mercy of an egg donor’s whims, and shared a story of one who wanted to jaunt off for a boat race when her estrogen levels were ideal for egg extraction.
But there are serious reasons for concern about the prospect of frozen egg banks. In a blog post at Egg Donation Inc., David Randall points out that
it is impossible to overstate how easy it is for a “fly by night” online frozen egg agency to send genetic material that bears no relation to the donor claimed by the agency as there is simply no guarantee that an agency who traffics in frozen eggs over the internet can guarantee that eggs are in fact from the individual who the agency claims they are from.
He also notes that “buying eggs, embryos, or other genetic material over the internet could be considered illegal in some jurisdictions in the United States, Canada, and Europe.” In the assisted reproduction industry, he says, “You very much get what you pay for.”
The spread of large frozen egg banks could change the experience, and potentially the quality, of egg donation. It could lead to another change as well: the outsourcing of egg donation to other countries. Egg banks like to advertise the diversity of their donors. With the need for local eggs gone, it is easy to imagine clinics trying to increase their profits by looking to Eastern Europe or South East Asia for example, where they could find women with desirable traits who would be willing to give their eggs for less. If commercial dynamics encourage egg retrieval, like surrogacy, to become a cross-border arrangement, the risks of exploitation could dramatically increase.