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It's time to remove the ten-year limit on social egg freezing

26 October 2020
By Dr John B Appleby
Lecturer in Medical Ethics, Lancaster University
Appeared in BioNews 1069

According to UK law (the Human Fertilisation and Embryology Act 1990, as amended 2008; henceforth 'the Act'), human eggs can only be frozen for a maximum of ten years for social reasons. However, if a woman has medical reasons (eg, being at risk of premature infertility), then they can extend the freezing of their eggs for as long as 55 years. While there are good reasons to challenge the basis of the regulatory dichotomy between 'medical' and 'social' reasons for egg freezing, I'm going to leave this aside for another discussion and ask instead if this ten-year social egg freezing limit should be maintained by regulators. This is a particularly timely question because it is something the UK government is currently reviewing.

A recent Briefing Note on 'Egg Freezing in the UK', by the Nuffield Council on Bioethics, has highlighted the ethical complexities surrounding egg freezing. The Briefing Note emphasised the importance of reviewing the time limit on frozen eggs, especially considering there is an increasing interest and use of egg freezing in the UK. The Council accurately points out that '[t]here appear to be few arguments against increasing this limit.' In this article, I aim to provide three reasons why it is time to remove the ten-year limit on social egg freezing. These reasons are drawn from my own research; however, they also reinforce and expand upon the points made in the Briefing Note itself.

Why is there a ten-year limit?

The ten-year limit on social egg freezing was a recommendation from the Committee of Inquiry into Human Fertilisation and Embryology, also known as the Warnock Committee. According to the recent 2020 consultation document published by the UK Department of Health and Social Care on 'gamete (egg, sperm and embryo) storage limits', in 1984 the Warnock Committee recommended the ten-year limit in response to the following concerns: a) 'it would be unreasonable and impractical to expect those responsible for storage to maintain all eggs and sperm stored indefinitely'; b) 'the risk of the use of frozen embryos was unknown'; and c) 'the legal and ethical complications that might arise over disposal of the embryos where the couple died, divorced or otherwise separated'.

No explanation is given about why the precise time span of ten years was chosen as a limit. Nevertheless, the ten-year limit made its way into the Human Fertilisation and Embryology Bill (that was subsequently passed) and we still have it today as part of the Act. While this restrictive ten-year limit may have helped to allay some concerns about egg freezing at the time it was introduced, it has nevertheless created a new set of problems.

Why we should remove the ten-year limit

I want to highlight three important arguments for removing the current limit, although there are many more.

First, egg freezing is expensive and physically demanding. However, there is nothing morally significant or medically special about the timespan of 'ten years' when it comes to freezing eggs. Perhaps this point is best highlighted by the fact that if a woman has appropriate medical reasons, the government will allow her to freeze her eggs for up to an additional 45 years. It is unethical to maintain this arbitrary time limit that creates a harmful asymmetry between the treatment of women who freeze their eggs for social reasons versus medical reasons.

This arbitrary ten-year limit also demonstrates a serious disregard for individuals' reproductive projects and everything that has been invested in them. The ten-year limit amounts to a major restriction on the reproductive liberty of individuals and the burden should rest on regulators to provide compelling reasons for retaining this limit, if they wish to do so (as part of the UK government's current review of the law). So far, no compelling reasons have been provided for retaining this specific restriction. Removing the ten-year limit on egg freezing is an important part of the reproductive medicine industry (including both clinics and regulators) treating women with dignity and respect.

Second, the ten-year limit is a blunt legal tool that papers over the many decisions clinics and patients have to make when deciding the fate of frozen eggs. As mentioned above, one of the reasons for the ten-year limit is that it creates an administratively convenient cut-off point in time to help clinics avoid having to negotiate tricky situations involving the disposal of eggs (eg, if a client dies or simply falls out of touch with the clinic). The fear is that without a ten-year limit on freezing the clinic could be stuck with the frozen eggs indefinitely.

I do not want to diminish the seriousness that such problems may create for clinics. I also recognise that some individuals with frozen eggs may also prefer having the ten-year limit because it takes the decision out of their hands if they no longer want to use the eggs but can't bring themselves to request their destruction. However, the UK needs better legal provisions to more specifically and appropriately address the practical concerns of clinics. Clinics also need to be providing appropriate counselling and support to their customers so that they feel informed and empowered to make decisions about the fate of their frozen eggs. This would be preferable to leaving some customers to rely on a provision in the law that takes this decision out of their hands after ten years.

Third, it is entirely possible that a woman may freeze her eggs and then remain uncertain about whether she wishes to use them to have children. In some instances, women may be approaching the ten-year mark but may wish to keep their eggs frozen so that they can continue thinking about donating them to help others have children or donating them to research. Donating eggs is a big decision, and one that might change over time. For example, someone who freezes their eggs at 23 years old may change their views considerably after ten or 15 years.

It is possible that if given more time (beyond ten years) more people might donate their frozen eggs later. However, the ten-year limit extinguishes this possibility. The fact of the matter is that in the absence of any compelling reasons otherwise, women with frozen eggs should be free to make decisions about how and when to use their eggs. It is unethical to maintain an arbitrary and unforgiving ten-year limit that restricts the time that individuals have to exercise such important aspects of their reproductive liberty.

These are only a few of the reasons why the UK government should abandon the ten-year limit for social egg freezing. It is crucial that the UK government recognises this need, for change and follows through by amending the Act.

PET's #ExtendTheLimit petition at 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.

Bioethics Briefing Note: Egg freezing in the UK
Nuffield Council on Bioethics |  30 September 2020
Consultation document: gamete (egg, sperm) and embryo storage limits
Department of Health & Social Care |  11 February 2020
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