After several years of campaigning (see BioNews 946) to #ExtendTheLimit on the storage period of egg cells frozen for social reasons, I like many welcomed the recent government announcement to change the maximum storage time from ten years to a maximum of 55 years. This brings the limit inline with what was already offered to women who froze their eggs for medical reasons. The change feels 'just', given, as my own research published in the Journal of Psychosomatic Obstetrics and Gynecology has shown, the line between freezing for medical reasons or 'social' reasons is much more blurred and unclear than many people appreciate.
This proposed change, which has yet to be writ in law, came about in part following a public consultation last year and perhaps reflects an understanding of the challenges faced by women and men when it comes to planning and having children. However, almost immediately after this upcoming change in the law was announced, moral panics over 'macabre, nightmare scenarios' of 75 year old women attempting motherhood for the first time emerged in the Daily Mail and many questions were asked about where the decision to extend the time limit to 55 years came from, and why a more sensible time limit of 20 years was not applied?
The act which governs the storage time limits of human genetic material (eggs, sperm and embryos) is the original Human Fertilisation Embryology Authority Act of 1990, while this act has been subject to revisions it has long allowed eggs, sperm and embryos frozen for medical reasons to be stored for over ten years with extensions up to 55 years. This change simply brings about parity between egg freezing for medical, and so-called social reasons. The ten-year time limit originally in place was mostly arbitrary and was decided upon before we were confident that frozen genetic material would not age or degenerate in storage. Now there is no scientific reason to not have a much longer storage period than ten years.
Concerns have nonetheless been raised about the prospect of women freezing their eggs in their 20s and 30s and thawing them to use in their 50s, 60s and beyond. However, as I pointed out in an opinion piece in the Independent, such a moral panic about a sudden rise in much older mothers is a nonsense. This is because while there is no legal maximum age for IVF treatment in the UK, very few fertility clinics will treat a woman over 50 anyway. Indeed, the maximum time limit of 55 years storage isn't intended to help the typical user of social egg freezing but is to enable intrafamilial egg donation.
I have a two year old toddler, if she became ill with a condition that threatened her fertility, or if she had to have treatment that would harm her reproductive potential or if she was born without typically functioning fertility (such as in the case of Turners syndrome) then I could freeze some of my eggs for her to potentially use to conceive with in the future. In this circumstance the 55-year time limit would give her ample time to decide whether she wanted to use them to conceive; the benefits being that these eggs would enable our family to retain some genetic lineage and family likeness as well as a stable known-donor connection, which the Relative Strangers research project showed was important to families who used donor egg, sperm and embryos. Thus a 55-year time limit on the storage of eggs frozen for social reason seems to be just a simple artefact of the decision to extend the current law to include social egg freezing rather than creating a whole new law.
From my research with female users of social egg freezing it has become abundantly clear to me that users of this technology do not wish to store their eggs anywhere near as long as 55 years, but simply wish to have greater flexibility over when they might use their eggs to conceive in the same way that women who freeze their eggs before cancer treatment currently do. The women in my research often told me how they did not want to be 'old-old' mums, no doubt fearing the sort of social backlash and stigma that has been played out in some tabloid newspapers these past few days. Instead, they sought to be able to use their eggs to conceive a much-wanted child, with a partner or person of their choosing usually no later than their mid-40s. The problem with the law as it stands is if a woman freezes her eggs at the age of 32, they will need to be used or destroyed by the time she was 42 where in reality she might just need an extra few years to become ready to have a child. The revision of the egg freezing time limit to allow successive ten-year extensions will remove this artificial and needless time pressure and may help women and men build their families at a time when they are ready to do so.
This change in the law will also enable women to freeze their eggs at more 'biologically optimal' time such as in a woman's 20s or early 30s without them facing being destroyed before they may come to need them. The benefits of freezing at a younger age include a higher quality egg yield, as well as the fact that fewer cycles of stimulation and retrieval would likely be needed to store a sufficient number of eggs for future use. Indeed, as Dr Gillian Lockwood has already noted in the Telegraph, this change in the law may make it 'more likely' that a cycle of egg freezing could become the ultimate graduation or 21st birthday gift for families who can afford the cost. However, this suggestion makes me feel uneasy and reflects the fact that this law change will see the potential user pool of this technology expand rapidly to include any (assumedly) fertile woman. It is therefore important to ensure that younger women who are now 'eligible' for this procedure are not aggressively marketed egg freezing as while egg freezing in ones early 20s might be the most optimal time biologically, it is unlikely to be the best time 'socially', as a woman in her 20s has a significant amount of time to find a partner and pursue motherhood naturally should she wish. Egg freezing is painful, expensive, time consuming, not without risk, has no guarantee of success and is dependent on a technology (IVF) which fails a great deal of the time. It would therefore be worrisome to me to see widespread use of egg freezing in a woman's 20s or young women feeling under pressure to use this technology to avoid future regrets (and thus blame) over unwanted childlessness in the future (a motivation which my research published in the Journal of Psychosomatic Obstetrics and Gynecology had already identified in female egg freezers in their 30s).
This over medicalisation of young women's bodies and the intensification of the responsibility to ensure childbearing is not what myself and others campaigned for in this change of the law. As such it is perhaps our responsibility and those who provide the technology to ensure this legal change is 'for better, not for worse' (as outlined ten years ago by Mertes and Pennings in Reproductive Biomedicine Online) and benefits women who need just a few more years to either become ready to use their eggs to conceive or become at peace with their childfree lives. So, to those who worry about a boom in geriatric mothers in their 50s and 60s, I say such an eventuality is highly unlikely and instead argue that we need to pay greater attention to the needs of younger women being exposed to this technology for the first time.
The future of egg freezing, in light of the UK Government's newly announced change of policy, will be discussed on Tuesday 28 September at the Progress Educational Trust's free-to-attend online event '#ExtendTheLimit: What Now For Egg Freezing?'.
All are welcome. To attend/participate via the web, please register here.