As the Medical Director of CREATE Fertility and long-term campaigner for gender equality and women's reproductive choices, I listened with earnest when Caroline Dinenage, former Health Minister, made the long overdue announcement last week that the Government will be reconsidering the current ten-year storage limit on eggs, sperm and embryos frozen for non-medical purposes. I am delighted the Government has acknowledged the hard work of the Progress Educational Trust (PET)'s #ExtendTheLimit campaign and has launched a public consultation.
Modern egg freezing is conducted with the use of vitrification (flash-freezing), which is a significant development that I have long felt to be the second wave of female equality, following the advent of the pill in the 1960s. Whilst egg freezing does not guarantee a baby in the future, it provides women with realistic options to manage the decline in female fertility after the age of 35, which has forced many to make tough decisions around when to start a family.
Egg freezing was originally used for women looking to preserve their fertility prior to cancer treatment, which would leave their fertility at risk. However, it is now also used by those who may need to delay having children for a range of other reasons, including not having met the right partner, pursuing a career, not being financially ready, or needing to focus on caring for a relative.
The term I prefer to use is 'AGE (Anticipated Gamete Exhaustion) banking' rather than 'social freezing', which I believe diminishes the process from a medical need to a mere wish. Egg freezing is a proactive and preventative action that women can take to preserve younger and healthier eggs until the time is right for them to become parents.
However, the full potential of this 'game-changing' medical innovation has been held back by the arbitrary ten-year storage limit for eggs frozen for 'non-medical' reasons. It was set before the introduction of vitrification, when the effects of long-term storage of frozen eggs and embryos were unknown. But with current knowledge about the safety and efficacy of vitrification, this limit is now outdated, and it is vital that it is extended if the full benefits of egg freezing are to be realised. The unintended consequence of the current limit is an unnecessary time pressure discouraging women from freezing in their late twenties to early thirties, when eggs are of highest quality.
Personally, I am not keen on an unrestricted extension, but suggest a further extension of ten years, with a possibility of further extension to be considered on a case by case basis. Extending the limit by ten years would provide women with flexibility when it comes to deciding when to freeze their eggs, enabling them to do so earlier, if they are able, when eggs are of highest quality. However, these extensions should be decided on an individual basis, taking age, fertility health and clinician's recommendations into account. This would avoid the unintended consequences of women having children in their sixties or seventies, when it may have a negative impact on both their health and the long-term welfare of the child.
Some, who are against egg freezing and the extension of this limit, have quoted the Human Fertilisation and Embryology Authority (HFEA) data that questions the success of frozen eggs. However, the HFEA does not include information on the method used to freeze eggs and therefore the national data may include eggs frozen using the old slow-cooling method, which is far less successful than the modern vitrification method. In addition, the data doesn't specify the age of the woman at egg freezing, which significantly impacts the chance of a successful pregnancy later.
Large data published in scientific journals since 2010 suggests that with the use of the modern vitrification technique, live birth rates using fresh or frozen-thawed eggs are comparable in women of similar age per oocyte and per cycle of treatment (1,2,3,4,5). Until reliable and large data are available in the UK, we need to look beyond our shores as we have a duty to provide women with clear, up-to-date and accurate data so that they can make fully informed decisions about the age at which they should freeze their eggs.
This Government consultation will have positive effects for women, men and couples in planning for their future families. Following the cabinet reshuffle last week, I hope that Matt Hancock will pursue this matter without delay.
Egg freezing has been transformed over recent years and is a truly life-changing medical development that empowers women with the ability to choose when the time is right for them to have children, without sacrificing a career or rushing a relationship. By discouraging women from freezing their eggs at a younger age when they are at their most healthy and fertile, the full emancipatory potential of egg freezing is limited by the ten-year storage limit. It is time for the law to change to realise this potential, and to catch up with today's technology and societal needs.