09 March 2015
ByAppeared in BioNews 793
I arrived with some bemusement at this one-hour debate, 'Does egg-freezing enable women to "have it all"', to Beyoncé playing out loudly to an excited lecture theatre.
We first heard from Joyce Harper, professor of human genetics and embryology at UCL. She explained the biology behind why, if a woman wants to delay having children, she might want to consider egg freezing. She explained how the quality of eggs declines with age and the risk of chromosomal abnormalities that can lead to disorders, such as Down's syndrome, increases. After 35 years of age, women's fertility also declines rapidly, making it harder to become pregnant naturally.
Professor Harper clarified that fertility is specifically linked to the age of the egg, however. So, if a woman decides to delay starting a family then freezing her eggs at a younger age could improve her chances of having a biologically related child, if she uses the eggs to become pregnant in the future.
However, she also discussed how the egg freezing process is more difficult to perfect as compared to sperm, the egg is larger and more complex. Although the first birth using a frozen egg was in 1999, it wasn't until 2012 that the American Society for Reproductive Medicine stated that vitirification was no longer experimental and could be used clinically (see BioNews 681).
Professor Harper concluded that she does believe egg freezing allows women 'to have it all'. Given the choice she would have done it as she feels it gives women greater control over their own reproductive choices, making them equal to men and more attractive to employers.
However, she was careful to caution that she would still encourage women to have children naturally at young age, if they can, as there are some disadvantages to egg freezing. These include the need to go through IVF, which is expensive and may not work. She also explained that although using younger eggs increases pregnancy rates, there are some additional risks during pregnancy in older women.
Professor Harper was followed by Dr Nicky Hudson, a reader in medical sociology at DeMontfort University, Leicester. Dr Hudson agreed with Professor Harper on the medical risks of IVF but also raised a common, but not unimportant, argument in assisted conception debates that the long-term health effects of egg retrieval and IVF using frozen eggs are as of yet unclear.
However, in contrast to Professor Harper, Dr Hudson felt that egg freezing is not in fact 'women friendly', and she posed some alternative questions that mainly centered on the social implications of the technique.
As social egg freezing would take place in the private sector, rather than on the NHS, Dr Hudson said this could exacerbate 'stratified reproduction' and mean that only the affluent minority of women can 'have it all'. She also felt that social egg freezing will not in fact empower women, but could lead to them feeling pressurized to freeze their eggs and delay pregnancy.
Dr Hudson used some startling statistics to describe how there is still a large social gender inequality in the workplace. Egg freezing does not address this inequality, she said, but only takes a social problem (that is, whether women are able to 'juggle' a career and a family) and places it on individuals to sort it out for themselves – and in so doing widens the gender inequality.
She argued that companies should better develop policies to support anyone to have a career and family simultaneously, rather than putting an emphasis on egg freezing and placing the responsibility of delaying a family firmly on their employees.
Following these discussions, a number of fertility professionals in the audience spoke up to support the arguments that had been raised already: primarily that there is not enough long-term data on the consequences of egg freezing and that it will only pressurise women to delay pregnancies.
It was most interesting, however, to hear about the more personal experiences of some audience members who, in fact, largely refuted these concerns. Several women stated that they regretted not having children at an earlier age, and agreed with Professor Harper that given the choice, they would have opted to freeze their eggs.
Listening to this debate, I realized that in some ways I am the epitome of someone who should freeze their eggs. Although I am in a long-term relationship, I am still finishing my PhD, and - to the confusion of most people - I'm actually excited about having a job and paying taxes like a 'real' adult before having children. At 27 years old (and with a bit of luck) my eggs should be healthy and at a good age to be frozen to allow me to delay starting a family for just a little while longer.
Yet before this event I had not really thought about whether I should freeze my eggs. Luckily this debate provided me with enough scientific fact, well-articulated social arguments and personal experiences to leave me thinking in more detail about my reproductive choices. As one audience member put it, we only have a choice if we are well informed - and I'm encouraged to say that I am certainly now well informed.