Glamorizing egg freezing can have devastating consequences

Glamorizing egg freezing can have devastating consequences
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Fertility treatments are sounding more and more like something out of a science fiction movie. Artificial intelligence and embryonic gene editing pose potential solutions to infertility and disease. Scientists are discovering how to turn human stem cells into sperm and eggs. Slices of ovarian tissue and immature eggs can now develop into mature eggs. And, fertility treatments are being used to save species at risk of extinction like the northern white rhino and coral in the Great Barrier Reef. Recent advances in fertility treatments also allow women to freeze their younger eggs to use at an older age.

No longer considered experimental as of late 2013, the widespread availability of egg freezing technology has resulted in an increased focus on women’s eggs and fertility. More and more celebrities like Kourtney Kardashian, Olivia Munn, and Bachelorette star Andi Dorfman are publicly talking about freezing their eggs.

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The American Society for Reproductive Medicine guidelines state that all women who freeze eggs should be “carefully counseled” about realistic chances of success. This counseling should not only be verbal but should also include a written explanation of the realistic probability. Although not stated in the guideline, in order to be most effective, this counseling should not only be verbal but should also include a written explanation of the realistic probability of having one or more children with the frozen eggs. Patients should be required to sign this document and be provided with a copy for their future record

 

Even more employers like Facebook and Google are paying for their female employees to freeze their eggs. And egg freezing parties, where women sip wine, snack on hors d’oeuvres and discuss their future fertility have become more commonplace.

Amidst the glitz and glamor of celebrities and swanky parties, the truth about egg freezing has gotten lost.

As a clinical psychologist in the Division of Reproductive Endocrinology and Infertility at Northwestern University, I counsel many women who are considering egg freezing as well as women who are returning to the clinic to use their frozen eggs.

The majority of women I counsel about egg freezing tell me that they initially thought, as some have suggested, that egg freezing was an “insurance policy” against infertility. They inaccurately believed that freezing their eggs would guarantee they could have one or more babies at any age.

Research on egg freezing shows a very different picture of chance of success with frozen eggs. Even for the youngest group of women (<35 year olds) who freeze their eggs, 10 eggs are needed for a 70 percent chance of having just one baby.

Women who are 40 to 42 years old will need as many as 50 eggs for that same 70 percent chance of having one baby. Yet the average number of eggs retrieved per cycle from the youngest group of women is slightly above 10 and for women in their 40’s is under 10. This means that in order to have a decent chance of having one or more children, most women will need to consider undergoing multiple costly cycles of egg freezing.

Far from an insurance policy, egg freezing offers an improved, albeit somewhat uncertain, chance at conception later in life. It offers the best return on investment for women who freeze their eggs before they turn 38 years old.

To be sure, egg freezing offers women an opportunity to do something to try to preserve their chances of having a genetic child with a future partner. Described as an empowering experience by my single patients, egg freezing offers them not only a chance at future conception but also hope. For my transgender male patients and cancer patients, egg freezing also offers them the chance to have genetic children should other medical treatments make them infertile.

But, failure to talk to women realistically about egg freezing gives them false hope. This false hope may lead to more women pursuing egg freezing who otherwise would have declined treatment. My own research finds that women may change their minds about egg freezing if they know the truth about the chance of success with such treatment.

It can be emotionally devastating for women who return to use their frozen eggs only to discover that their eggs do not result in the birth of a child. Now several years older, it is also less likely that she will be able to conceive with the eggs remaining in her ovaries.

But few women return to use their eggs. Whether because they have not yet found a partner and do not want to pursue single motherhood or were able to conceive on their own, counseling about egg freezing should include the recommendation that family building following egg freezing begin as soon as possible. If the woman is unable to get pregnant on her own and if her frozen eggs also do not result in a pregnancy, if she is young enough, she may have a chance to conceive following the retrieval of more eggs.

Medical and social communities have misled women for far too long about their realistic chances of getting pregnant and about their ability to control their pregnancy chances by doing things such as reducing stress. Any implication that egg freezing guarantees women the ability to have children in the future is disingenuous.

Future scientific advances will improve the success of fertility treatments. But the time is now for honest counseling about egg freezing. Hiding the truth from women about their fertility can have dire consequences.

Angela Lawson PhD is a clinical psychologist and associate clinical professor in the Departments of Obstetrics and Gynecology & Psychiatry at Northwestern University Feinberg School of Medicine and is a Public Voices Fellow.