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The Business of Egg Freezing: From Bluster to Best Practice

15 March 2021
Appeared in BioNews 1087

The Progress Educational Trust (PET)'s most recent online event concentrated on how egg freezing relates to the interests of patients and businesses.

As the name suggests, the event was focused on the increasingly popular technology of freezing eggs for later use. Egg freezing for medical reasons, such as fertility preservation before cancer treatment, has been practised for many years. More recently, so-called 'elective' or 'social' egg freezing, where eggs are frozen in the hopes of preserving fertility to have children later in life, has become increasingly popular due to a combination of social and technical factors.

It was this latter type of elective egg freezing that the event mostly focused on, inviting an impressive panel of experts to introduce the implications of egg freezing for women and for society more broadly, especially in the context of the plethora of new medical and financial services that have sprouted alongside this technology.

Rachel Cutting, director of compliance and information at the Human Fertilisation and Embryology Authority (HFEA) offered context for the later speakers by introducing the state of egg freezing in the UK today. She pointed out that while the number of elective egg freezing cycles carried out per year has indeed been increasing dramatically, very low numbers of women are returning to thaw and use their eggs.

Cutting pointed out that while recent improvements in vitrification (an ultra-rapid cooling method in which egg cells are immersed directly into liquid nitrogen, cooling them quickly) had shown encouraging increases in the survival rate of frozen eggs, it was nonetheless important for clinics to be clear to patients about the lack of guarantees in egg freezing, the true cost of the process and the ten-year storage limit currently in place in the UK.

Dr Zeynep Gurtin, lecturer in women's health at University College London's EGA Institute for Women's Health and research associate at the University of Cambridge's Reproductive Sociology Research Group picked up on the topic of marketing and information.

In her research on the information provided to patients by some of the largest egg freezing providers in the UK, clinic websites appeared to promote the technology as exciting and empowering while avoiding to mention potential risks and low success rates. Pricing was often misleading, making the true cost of treatment hard to gauge. Dr Gurtin concluded that the current standard of information on UK clinic websites was in urgent need of improvement for reasons of both consumer rights and medical ethics.

The tension between medical care and commercial interests was further explored by Dr Lucy van de Wiel, research associate at the University of Cambridge's Reproductive Sociology Research Group and author of Freezing Fertility: Oocyte Cryopreservation and the Gender Politics of Ageing (see BioNews 1086). Dr van de Wiel argued that fertility has become a frontier for financial investment, where clinics were being bought up by large groups while new financial services such as fertility loans and fertility insurance were being developed.

The need to sell those services to increasing numbers of women in order to provide shareholder value to corporate investors is, according to Dr van de Wiel, one of the drivers of fertility treatments changing from being seen as reactive treatments to becoming proactive fertility management.

Eileen Burbidge, the next speaker, is on the board of Fertifa, a UK corporate fertility benefits company that is trying to follow the lead of large US technology companies, such as Google and Facebook, to introduce egg freezing into corporate benefits packages in the UK. She is also the founding partner at its key investor, Passion Capital, making her well positioned to share insights on egg freezing in the workplace.

Burbidge's experience in corporate reproductive benefits was complemented by her own personal experience of IVF. She argued that companies were increasingly realising just how important fertility benefits were for their staff and that there was growing interest in the field as a result. It is important, Burbidge argued, to see compensation for fertility services as part of a broader set of practices aimed at normalising conversations around fertility and reproduction at the workplace. In her view, fertility benefits had the potential of making workplaces more family friendly, rather than less so.

Marcia Inhorn, professor of anthropology and international affairs at Yale University and author of books including Cosmopolitan Conceptions: IVF Sojourns in Global Dubai, finished off with a presentation focused on what the needs and wants are of women who freeze their eggs.

Professor Inhorn argued that the embeddedness of egg freezing services within the IVF industry impacts women who freeze their eggs in multiple negative ways because it places the entire procedure in the context of a couples oriented, 'married space'. Women who often already feel vulnerable undergoing the egg freezing process are being confronted with couples in clinic waiting rooms, given consent forms that require the partner's signature and expected to have the help of a partner with injections and clinic appointments. As egg freezing becomes more popular, Professor Inhorn argued, it is important to separate it from IVF in order to provide safe and effective clinical environments and services for women.

The lively Q&A session addressed the power of egg freezing to be potentially liberating and coercive simultaneously, giving women the freedom to manage their reproduction but perhaps also pressuring them to do so, especially in relation to the workplace. Most of the panel, however, agreed that while there were important issues to consider, women generally welcomed the option of egg freezing and that the decision to delay motherhood is linked to a broader and more complex set of pressures on women's lives beyond their careers.

Several of the questions also focused on the details of egg freezing, such as age considerations, the lack of awareness of storage fees, limits to how eggs can be used and the fact that egg freezing predestines the need for IVF treatment to use those eggs in the future.

The event went on for two hours and it could have easily gone on longer. The fantastic panel and this evolving important topic made for a stimulating and thought provoking evening.

PET is grateful to University College London's EGA Institute for Women's Health, the British Fertility Society, CooperSurgical, the London Egg Bank, the University of Cambridge's Reproductive Sociology Research Group, Combined Academic Publishers and the journal Reproduction and Fertility for supporting this event.

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 1300 signatures to date. Help the petition reach 1500 signatures by reading, signing and sharing it.

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