The chill­ing truth about freez­ing your eggs

The Myanmar Times - Weekend - - Weekend - BY FRANCESCA SPECTER

The tech­nol­ogy has been pre­sented as a magic bul­let to level the play­ing field be­tween women and men, re­pro­duc­tively speak­ing. How­ever, the suc­cess rates are still low.” Dr Kylie Bald­win Med­i­cal so­ci­ol­o­gist with the Cen­tre for Re­pro­duc­tion Re­search at De Mont­fort Univer­sity

CRYOGENIC egg-stor­age tech­niques have im­proved dra­mat­i­cally in re­cent years. But as one woman says, ‘If this is your Plan B, you’ll need a Plan C’

Egg freez­ing, the process by which eggs are re­moved and cryo­geni­cally stored to pre­vent age-re­lated de­cline, has seen a rise in pop­u­lar­ity , with a three­fold in­crease since 2014, ac­cord­ing to re­search from the Lon­don Women’s Clinic.

Mean­while, re­cent cov­er­age of “so­cial” egg-freez­ing ad­vo­cates, such as Dr Emily Gross­man , seems to of­fer hope to women who want to buy time be­fore meet­ing the right part­ner or to de­lay preg­nancy.

Os­ten­si­bly, egg freez­ing of­fers women this breath­ing space: to pre­serve their chance of hav­ing a baby with­out com­pro­mis­ing on other as­pects of their lives.

Ex­cept the most re­cent fig­ures tell a dif­fer­ent story. A study by the Hu­man Fer­til­i­sa­tion and Em­bry­ol­ogy Au­thor­ity (HFEA) of women who used their frozen eggs in 2014 found that only 14% of im­plan­ta­tion cy­cles were suc­cess­ful.

So how ef­fec­tive is the tech­nol­ogy? And should women re­ally be trust­ing egg freez­ing as a fer­til­ity so­lu­tion, given the lim­ited ev­i­dence in its favour? Dr Kylie Bald­win, a med­i­cal so­ci­ol­o­gist with the Cen­tre for Re­pro­duc­tion Re­search at De Mont­fort Univer­sity, is scep­ti­cal: “The tech­nol­ogy has been pre­sented as a magic bul­let to level the play­ing field be­tween women and men, re­pro­duc­tively speak­ing. How­ever, the suc­cess rates are still low.”

The sci­ence is rel­a­tively straight­for­ward. As Dr Si­mon Fishel, head of re­search and de­vel­op­ment at Care, a UK fer­til­ity clinic, ex­plains, pa­tients are in­jected with drugs to stim­u­late the ovaries for around 10 days. The eggs are then re­moved be­fore be­ing taken away to be frozen and stored in a lab.

The freez­ing process has got more ef­fec­tive in re­cent years: it used to take more than four hours, but now it is done in a mat­ter of min­utes by a tech­nique called vit­ri­fi­ca­tion, which Fishel deems “much more ef­fi­cient”. He be­lieves egg freez­ing is now “as good as IVF ” – al­though that has a suc­cess rate of 26.5%, ac­cord­ing to data from HFEA.

Dr Zeynep Gurtin, a se­nior re­search as­so­ciate at the Lon­don Women’s Clinic, is – like Fishel – op­ti­mistic. “Vit­ri­fi­ca­tion has sig­nif­i­cantly in­creased the sur­vival rates of frozen-thawed eggs, re­sult­ing in much bet­ter rates of fer­til­i­sa­tion.” How­ever, she feels it will be “some time be­fore these po­ten­tial suc­cesses are re­flected in na­tional and clin­i­cal sta­tis­tics”.

And, even if egg freez­ing it­self is im­prov­ing, cur­rent pa­tients may still face is­sues – par­tic­u­larly if they are over the op­ti­mum fer­til­ity age. “It’s all about the egg and the age of the woman from whom the eggs were taken,” says Fishel. Egg freez­ing may pause the age­ing process, but it can’t re­verse it.

Brigitte Adams, 45, who froze her eggs aged 39, learned this the hard way. “When I froze my eggs, it was em­pow­er­ing; I hadn’t met any­one and I wanted to wait for a part­ner to have a child with. When I pro­duced 11 eggs, my doc­tor said, ‘Con­grat­u­la­tions,’” – and that was that. When she sub­se­quently went to de­frost her eggs, only one sur­vived to the point where it could be im­planted – and, al­though she fell preg­nant, she mis­car­ried weeks later. “It had never oc­curred to me that it wouldn’t work. That was it: my last pos­si­bil­ity of hav­ing a bi­o­log­i­cal child.”

Adams feels she wasn’t given enough in­for­ma­tion. She wishes she had been ad­vised to do mul­ti­ple cy­cles – Fishel rec­om­mends at least 20 eggs for the op­ti­mum chance of suc­cess – re­peat­ing the process over two or three cy­cles, es­pe­cially for those beyond their mid-30s. She also re­grets wait­ing: “I wish I had gone into it ear­lier, with more in­for­ma­tion and a bet­ter grasp on re­al­ity.”

The ob­vi­ous an­swer might be to freeze eggs at an ear­lier age. But in the UK, the HFEA places a 10-year limit on stor­age. “I don’t think many women younger than 30 will con­sider freez­ing their eggs un­der the cur­rent reg­u­la­tions,” says Gurtin. And even with­out reg­u­la­tion, the huge cost of egg freez­ing – around £10,000 in the UK – is a con­sid­er­able bar­rier for most. Al­though egg freez­ing can be cov­ered by in­surance on med­i­cal grounds (can­cer for in­stance), for “so­cial” pur­poses it must be done pri­vately.

Adams be­lieves all this re­quires a “clearer con­ver­sa­tion” – one that ac­com­mo­dates the sub­stan­tial pos­si­bil­ity of fail­ure and there­fore al­lows women to man­age risks – for in­stance, with mul­ti­ple cy­cles. “We read a lot about women freez­ing their eggs, but

She also be­lieves that me­dia cov­er­age of com­pany-funded egg freez­ing (for ex­am­ple by US com­pa­nies such as Ap­ple and Face­book ) “glosses over the fact it is still a cut­ting-edge med­i­cal pro­ce­dure and it’s not go­ing to work for every­one”.

Bald­win ar­gues that re­spon­si­bil­ity also rests with clin­ics to re­port data ac­cu­rately. “Many stud­ies that give favourable odds of suc­cess are drawn from highly spe­cialised clin­ics work­ing with eggs much younger than the av­er­age user of egg freez­ing. Clin­ics need to be hon­est about how likely it is that they will be able to repli­cate these re­sults in their own labs.”

Then again, the sim­ple truth echoed by most ex­perts is that there just isn’t enough ev­i­dence on egg freez­ing to know one way or an­other. “As the numbers of women un­der­go­ing egg freez­ing are much smaller than the numbers un­der­go­ing IVF, it will take some time un­til any mean­ing­ful data can be amassed,” says Bald­win. Ul­ti­mately, un­til sci­en­tists es­tab­lish ex­actly how ef­fec­tive egg freez­ing is, the nar­ra­tive should per­haps shift from one of em­pow­er­ment to a more cau­tious ap­proach, tak­ing into ac­count the fal­li­bil­ity of the process and ac­knowl­edg­ing that, in Brigitte’s words: “It might be your plan B, but you will need a plan C as well.”

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