With the rise of social egg-freezing, women are receiving the message that they really can have it all. But is this the case? We asked our Director of Fertility services and current Chair of the Royal College of Nursing Fertility Nurses Forum, Francesca Steyn.
What is egg freezing?
As a woman ages, her fertility declines and her chances of conception decrease. Your eggs are also more susceptible to chromosomal damage as you get older, so you’re at a higher risk of complications, including miscarriage. That’s why having your eggs surgically collected and frozen when you’re younger can be a helpful option. It means you have a higher chance of having a live birth when you are ready, if you choose to have those frozen eggs defrosted and implanted in a treatment cycle. This is known as social egg freezing.
In certain circumstances, egg freezing may be offered as an option if you are having treatment that may affect your fertility. For example, women who have been diagnosed with some types of cancer or who want to preserve their fertility before undergoing gender confirmation surgery may choose to have their eggs frozen. This is known as medical egg freezing.
Who is it for?
Egg freezing is a fertility option suitable for a woman with healthy eggs who is not ready or able to start a family and wants to freeze and store her eggs until later. A report from the Human Fertilisation and Embryology Authority (HFEA) showed in 2016, there were 10,253 eggs frozen in the UK and this number is growing rapidly.
- Considering egg freezing before the age of 37 is the ideal time. Statistics show that a woman under the age of 37 needs around 15-20 mature eggs for a 70-80% chance of pregnancy.
- Egg quality does decline quite rapidly after the age of 35, increasing the risk of chromosomal damage to the egg.
- However, the most common age for a woman to freeze her eggs is 38*. Yet, if a woman freezes her eggs in her late 30s, when her fertility is already in decline, the process may be more invasive and expensive. More cycles may be needed to collect the preferred number of eggs and the birth rate is lower*.
How does it work?
Egg freezing involves going to a fertility clinic to have a cycle of ovarian stimulation and monitoring until the follicles (fluid-filled sacs that contain our eggs) are mature in size. She is then prescribed a trigger injection to release them and the clinic performs an egg collection. The clinic then cryopreserves and stores all mature eggs. The current 10-year legal limit on storage sets a defined period during which treatment must be completed*.
A controversial subject
The problem is, many women are receiving the wrong message. That they can have it all, because this form of fertility treatment buys them loads of extra time. This is a dangerous belief. There isn’t enough information given about the fact that success rates are very low.
A couple of years ago there was a trend for Silicon Valley giants like Apple and Facebook to fund egg freezing for female employees. Giving their young employees support over their fertility choices can be seen as a family-friendly policy. But it could also be suggested that the offering of egg freezing is to prevent female talent disrupting their productivity by starting a family while they’re young.
Arguments for egg freezing
Ignoring the time pressure
With egg freezing women can choose if they want to have children later in life and that flexibility means they don’t have to worry too much about their biological clock. They can focus on their career while young. They can decide later if they want to think about having children. Those eggs won’t be affected by their mother’s age at the time of giving birth. Interestingly, the younger a woman is when she freezes her eggs, the less likely she is to ever use them in treatment*.
Certain type of cancers or other medical conditions faced by women could cause them to become infertile. Freezing their eggs means they are preserved before being affected by their illness or treatment. The option to become a mother is potentially still open to them. They can either carry the child themselves or via a surrogate.
Arguments against egg freezing
Low success rates
Current success rates for live births after egg freezing cycles are at just 18%. This leaves a lot of women disappointed. With such low success rates, it’s hardly a safe choice for women who intend to have a baby in the future.
It costs about £5,000 pounds per egg freezing cycle. Clinically, statistics show you probably need two or three cycles, so you’re looking at £10,000 to £15,000. Depending on the clinic you may have to pay for IVF on top of fertilisation and embryo transfer. There’s also added costs for storing your eggs at the clinic.
As with other fertility treatments such as IVF, there are some risks associated with an egg freezing cycle, including the risk of ovarian hyperstimulation syndrome (an over-response to the stimulation medication). In most cases, OHSS is mild, but in some it can require hospitalisation. Other risks include bleeding or infection after the egg-collection procedure.
For women who want to ensure they have reproductive choices, egg freezing may be an option. For those who are not ready to have a family or not sure they want children in the future, this option gives reassurance. But everyone should do their research and get all the facts before proceeding with an egg freezing cycle.
Peppy support with egg freezing
You can best help your employees considering or going through egg-freezing by empowering them. Provide them with the right information and support at all stages of their fertility journey. Ensure you have a fertility policy in place and complement this with specialist fertility support on Peppy. Peppy Fertility programmes start every Monday and you can choose from four 6-week courses designed to boost a woman’s chances of success on her fertility journey – exclusive to Peppy users. For more details and to sign up go to https://peppyhealth.typeform.com/to/mEe2Eo1S