Women need more realistic data on eggfreezing success, say experts
Women who opt to freeze their eggs need to be made aware of how realistic their chances of pregnancy are, experts have warned, as more turn to the procedure.
Egg freezing in the UK is funded by the NHS for girls and women for medical reasons, such as undergoing cancer treatments. However, women can elect to freeze their eggs privately for nonmedical reasons. Currently the standard for elected freezing is that eggs can be stored for a maximum of 10 years.
“While women should be supported in their choices, they must be informed about the relatively low success rates, high costs and side effects associated with egg freezing and IVF treatment,” said Adam Balen, professor of reproductive medicine and spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG).
“If a woman does decide to freeze her eggs for social reasons, she should have counselling with a reproductive specialist and choose a clinic that has plenty of experience. The clinic should provide a realistic idea of potential success related to her age. Evidence suggests that the best time to freeze eggs is in a woman’s early twenties and certainly under the age of 37 years old,” Balen added.
The latest figures from the Human Fertilisation and Embryo Authority (HFEA) show that in 2016, 32% of all patients freezing their eggs were under the age of 35, while 62% were under 38. Overall, 27% of patients thawing their eggs for use were over the age of 44. According to the HFEA, the live birth rate per embryo transferred for women who have frozen their eggs is 19%.
“Success rates for egg freezing have improved significantly in recent years so offer an opportunity for women to freeze their eggs for social reasons if they’re not ready to have children yet,” Balen said. “However, it must be stressed that egg freezing does not guarantee a baby in the future.”
In two articles published in BJOG: An International Journal of Obstetrics and Gynaecology, experts expressed arguments for and against the idea that “social egg freezing should be offered to single women approaching their late thirties”.
Among the supportive arguments, experts from Imperial College London and the Centre for Reproductive and Genetic Health noted that improvements in egg freezing technologies mean a far better chance of egg survival now.
“Women should no longer be punished with childlessness for not finding a partner, nor should they feel pressured into a relationship because of their declining ovarian reserve. While it does not guarantee against involuntary childlessness, SEF [social egg freezing] extends the window of opportunity for single women to find a partner and offers them hope where their ‘biological clock’ would otherwise run out of time,” they wrote.
However, the second group of experts, from Imperial College London and Chelsea and Westminster hospital, said that women in their late thirties face higher costs – due to the need for more eggs than at a younger age – and that having a baby later in life was linked to a higher risk of complications in pregnancy.
They pointed out that the proportion of frozen eggs which leads to a live birth among women under 36 is 8.2%, while among those aged 36 to 39 this dips to 3.3%.
Stuart Lavery, consultant gynaecologist and director of IVF at Hammersmith hospital, told the Guardian that permission to store frozen eggs needed to be extended beyond 10 years.
Currently, women are caught between having eggs stored during a period where they still have good fertility but the storage time limit might expire before they want to use the eggs, and waiting until later to store them – when their eggs might be of poorer quality – but the possibility of having a child is extended further.
“The law has to change,” said Lavery, noting that pressure from professionals is building. “It is really important. We don’t say that men are only allowed to store sperm for ten years, and then you have got to destroy it, and it is an absolute nonsense that we should say [that] for women.”
Lavery said the decision of women to freeze their eggs for non-medical reasons, including because they have not yet met a partner with whom they wish to raise a child, should not be termed “social egg freezing”.
“The term social egg freezing I think is too pejorative. I think people really get very judgemental about it,” he said.