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Event Review: Egg freezing – what's the deal with fertility preservation?

26 October 2020
Appeared in BioNews 1069

Egg freezing has been around for 20 years now, originally as an intervention for women who were about to lose their natural fertility through cancer treatment and/or surgery. Somehow it has passed into collective consciousness as an accessible fertility 'fix' and is even on offer to women in the US as part of an employment package. It is now increasingly of interest to thirty-something women who have needed to defer the option of motherhood for other reasons. Some of the media have shaped this into a narrative of 'career women' being 'too busy' to have children but wealthy enough to access egg freezing as a convenient way to control personal biology. This predictably simplistic stereotype ignores the complex reasons why women choose this option.

Billed as a 'forum for civilized disagreement', this hour-long webinar, Egg freezing – what's the deal with fertility preservation?, offers an opportunity to understand what egg freezing is, how and why it is accessed and what its long-term implications are for the women who use it. In addition, its expert contributors offer much-needed insights into recent research, raising useful questions about the continuing marketisation of egg freezing and its ability to deliver what it promises.

Professor Frances Flinter starts the webinar by introducing findings from a report by the Nuffield Council on Bioethics, aimed at public engagement and highlighting a mismatch between the number of people having eggs frozen to those actually defrosted and used. The process, which is invasive and similar to IVF, tends to result in a one in five chance of a viable pregnancy from healthy defrosted eggs. However, a lack of transparency over the data, as well as the targeting of women through the use of algorithms and so-called 'Prosecco parties' may mean that women's anxieties are exploited into buying expensive and ultimately unnecessary procedures.

Dr Kylie Baldwin, a medical sociologist, describes it as a 'numbers game';  a single cycle and egg retrieval – at around £4000 a time, perhaps with one year's storage included – might, optimistically, result in ten eggs, of which five survive the freezing process, and ever-decreasing odds of fertilisation and viable pregnancy. The more eggs, the greater the odds, but this requires a robust bank account, and for a woman in her late thirties, the chances of producing good quality eggs is already dwindling considerably.

In the UK, the average age for freezing eggs is 38, according to Professor Joyce Harper, professor of reproductive science at University College London, so the opportunity to have several cycles and 'bank' the resulting eggs is curtailed quite considerably compared to a woman in her late twenties. Comparing it to IVF, she thinks it should be considered very much a 'plan B'.

We heard from Helen, who defied medical advice to go through a retrieval cycle prior to embarking on treatment for an aggressive, hormonally-driven cancer. Her account of being pressured into daily scans (at £300 a time) on top of a £4000 fee is a reminder of the way commercial interests can abandon pretence at ethical treatment at a time when a patient is at their most vulnerable. Happily, four years after treatment for cancer, Helen has a young daughter (her one remaining embryo) and clearly feels it was all worth it. One can imagine many untold stories with a different ending.

Ultimately, it takes two to make a baby – Tessa Murray, director of communications at Tortoise Media who ran the webinar, challenged us to consider the role of men, their own dwindling sperm count over the last few decades and the continuing focus on women in the drive to 'correct' fertility problems. It would have been useful to explore that issue from first principles, as egg freezing seems to be uniquely the woman's domain, but this was beyond the scope of the webinar.

Claudia Williams, chairing, added her personal perspectives as a 27 year old woman. One hour is hardly enough to do justice to a contentious topic like egg freezing, but the evident expertise of the panel and the generosity of all participants in sharing perspectives from their own lives made this an absorbing experience. For further discussion, it would be useful to engage further with the issues surrounding women in the workplace and working towards swifter change in society.

The workplace should be supporting women with family-friendly policies. It should be eminently possible to return from maternity leave at the same level of seniority. Egg freezing should not be a 'graduation present' to young women, in the expectation they will devote their early working lives in an exclusive relationship with the workplace. The mere idea of 'Prosecco parties' is enough to send shivers down the spine, and not just because it is a ghastly drink designed for teeth-grinding headaches and rampant heartburn; rather, it reinforces a tiresome stereotype of women as prey to impulse and collective neurosis. Whereas the reality tends to be that deciding to freeze one's eggs is a more introspective, considered and intimate process.

I took from this webinar a strong feeling that this thoughtfulness on the part of the women concerned should be at least matched with transparency by the clinics providing this service, over the reality of expectations of success and the cold hard facts of the financial outlay required, which could leave even a relatively well-heeled professional seriously divested of hard-won financial security.


PET's #ExtendTheLimit petition at www.change.org/extendthelimit calls on the UK Government to extend the ten-year storage limit for eggs frozen for non-medical (social) reasons.

The petition has amassed more than 1200 signatures to date. Help the petition reach 1500 signatures by reading, signing and sharing it.

SOURCES & REFERENCES
Sensemaker live: egg freezing - what’s the deal with fertility preservation?
Sensemaker Live |  2 October 2020
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