With Apple and Facebook’s recent announcement that they are now covering egg freezing for their female employees, egg freezing (otherwise known as oocyte cryopreservation) has received a lot of press lately. Irrespective of the debate about whether or not this was a prudent decision for these companies to make, one undeniable outcome of the new policy is that egg freezing is taking the spotlight in public discourse. More young women than ever before are taking an understandable interest in this emerging technology.
Oocyte preservation is a fairly novel reproductive technology. The first human birth from frozen sperm was reported in 1953, and it took over three more decades to develop the technology required to safely preserve female egg cells. Oocytes are large cells filled with water, and the formation of ice crystals during traditional freezing methods caused serious damage to the cell. A technique known as the “slow-freeze” technique led to the first human birth from a preserved oocyte in 1986. Since then, oocyte cryopreservation methods have continued to improve and data have demonstrated reassuring safety, spurring the removal of its “experimental status” label in 2013.
The vast majority of studies have examined oocyte cryopreservation’s relevance to women whose fertility may be in jeopardy, such as women in military service or women with cancer, as chemotherapy usually leaves very few, if any, viable egg cells after treatment. Egg freezing for these women may be the only chance to have biological children.
But egg freezing has also captured the interest of a statistically even larger group of women: women looking to defer childbearing. Delayed childbearing is becoming increasingly appealing as more and more women pursue higher education and careers during their most fertile years. The average age of motherhood is steadily increasing in the United States and many couples find themselves facing stressful fertility problems when they try to conceive in their mid- and late-30s. Egg freezing’s appeal is, in theory, the opportunity to slow down a ticking biological clock. But egg freezing – at least with the technologies available right now – has some significant drawbacks. For anyone considering this procedure, there are risks that must be weighed carefully.
Recent studies show that elective oocyte cryopreservation is least reliable among women who may show the most interest in the procedure: women over the age of 35. Although data are limited, studies have found that the older a woman is when she has her eggs frozen, the lower her delivery rate is when she is eventually ready to become pregnant, particularly in women over 40 years of age.
The dearth of data on the precise relationship of age to clinical pregnancy rate makes it difficult even for experts to estimate the viability and cost-effectiveness of the procedure for delayed childbearing. Considering with the hefty monetary and emotional investment this procedure requires, it’s especially important to weigh the pros and cons and understand the possibility that egg freezing may not result in a live birth.
If you’re interested in this procedure, experts recommend thoroughly interrogating the specific clinic offering this service. Important questions to ask your provider include:
1) What are the side effects and potential risks associated with the medication and process of oocyte retrieval?
2) Which freezing method does the clinic use to preserve oocytes? (Vitrification, a new fast-freeze technique, has yielded higher thaw-survival rates than the slow-freeze method.)
3) What are the clinic’s rates of both oocyte survival and clinical pregnancies – in other words, what is a reasonable estimate of your chance of a live birth from one cycle of egg freezing?
4) What is the cost of the egg retrieval procedure, annual storage fee, and sperm injection?
5) What is the likelihood that you will actually need to use the frozen oocytes (considering the large majority of women marry by age 35 and have a relatively low incidence of childlessness)?
No clinic is able to guarantee a live birth from cryopreservation, but gathering all the data you can about the procedure will help you make the most informed decision. Ultimately only you can decide the emotional investment and risk you’re willing to take and whether this procedure is a good decision for your particular circumstances.