THE TROUBLE WITH FREEZING YOUR EGGS
More people put child birth on hold at a high cost and low success rate
When Sally White was 35, she split up with her partner of a decade. A year later, she decided to freeze her eggs so she could, in her own words, put her “biological clock on pause.” At the time, Sally says freezing her eggs — a procedure that costs up to $8,400 a cycle, plus $500 a year for storage — lifted a weight from her shoulders.
“I felt the panic was off,” she explains. “I’d always wanted children, but when you’re dating someone, you can’t ask them if they want a family straight away and I didn’t want to just grab the nearest available man — I wanted to have children with someone I loved, and who’d be around for us.”
Which is exactly what happened in 2011, when Sally met her husband, Rob. The couple started trying for a baby and, after nothing happened, they decided to try IVF using Sally’s frozen eggs. Two viable embryos (from the nine eggs frozen) were implanted and, at the age of 40, she became pregnant. However, at the 12-week scan the midwife was unable to detect a fetal heartbeat and Sally miscarried.
Devastated, Sally’s anger turned toward the egg-freezing clinic, who she feels misled her about the chances of having a baby — especially if you have your eggs frozen in your mid-30s, which most patients do. The latest figures from the Human Fertilisation and Embryo Authority (HFEA) show that, of the 1,173 egg-freezing cycles that took place in 2016, 68 per cent of women were over 35.
“You’re given daily injections to put you through the menopause for 10 days, so doctors can control your cycle more easily, then given further drugs to stimulate egg production,” says Sally. “I’m a tough cookie, but the whole thing wasn’t easy. Yet the doctors at the clinic never mentioned that the success rates were so poor.”
Sally’s story comes as the Royal College of Obstetricians and Gynaecologists (RCOG) this week warned that, despite the hype and hefty price tag, egg freezing “does not guarantee a baby.”
RCOG professor Adam Balen said: “Success rates for egg freezing have improved significantly in recent years, so it offers an opportunity for women to freeze their eggs for social reasons, if they’re not ready to have children yet. While women should be supported in their choices, they must be informed about the relatively low success rates, high costs and side-effects.” He added that women should be freezing their eggs in their 20s, when the quality is better, and “certainly” before the age of 37.
Egg freezing has also hit the headlines in recent years thanks to some A-listers. Actress Sarah Jessica Parker, 53, reportedly used eggs that she had frozen to have her twin girls, Marion and Tabitha, who were born via a surrogate in 2009. And, last December, 26-yearold singer Rita Ora announced that she was freezing her eggs, saying: “Why not put them away and then you never have to worry about it again?”
Defrosting them, however, may not prove so simple. Experts from Imperial College London and Chelsea & Westminster Hospital, writing in the RCOG’s journal, pointed out that the most recent study shows in women under 36, just 8.2 per cent of frozen eggs thawed and used led to a live birth — with that figure dropping to 3.3 per cent in women aged 36 to 39.
“Egg freezing was initially introduced for women who were about to undergo potentially sterilizing treatments, such as radiotherapy or chemotherapy,” says Dr. Gillian Lockwood, medical director at IVI Midland, formerly Midland Fertility Services, where the U.K.’s first frozen egg baby was born in 2002. “However, later it became clear that advanced age was almost as bad for fertility as chemotherapy. Hence the increase in the term ‘social freezing.’ I find that term belittling, because it’s clear that most women, far from being Alphas who delay motherhood to advance their careers, freeze their eggs because they want to bring up their own genetic baby with a partner.
“Whether by necessity or because we have a generation of young men who are increasingly less keen to commit, the fact is lots of women find themselves in their 30s wanting to be mothers, but unable to find somebody to parent with,” she adds. “That’s what’s driving the increase in egg freezing; they’re buying themselves a bit of biological time.”
However, Dr. Lockwood says that while scientific evidence shows that freezing your eggs in your 20s is better than freezing them in your late 30s, the 10-year storage limit places women in a catch-22.
“The U.K. law currently states that women who are freezing their eggs for ‘social freezing ’ can only do it for 10 years. So if you freeze your eggs at 25, you have to discard them at 35.”
In other words, exactly when you might need them. So if Rita Ora has not found a partner by the time she is 36, for instance, she will find that her frozen eggs will be left to perish.
Prof. Geeta Nargund, a senior NHS adviser and medical director of Create Fertility, is calling for the British government to increase the 10-year storage limit, so that women who freeze eggs in their 20s have longer to find a suitable partner. “The 10-year limit needs to be increased,” she says, “otherwise it defeats the point. Why pay out thousands on egg freezing in your mid- to late-30s that is unlikely to work? That’s one key point.”
Prof. Nargund says the headlines around low success rates don’t tell the true story — in reality, it’s the age at which most women end up freezing their eggs that drives the figures down. “If anything, eggfreezing technology is becoming more advanced and the success rates are increasing,” she says, “but because it’s older women freezing their eggs, this skews the data. Success rates for women who freeze under 30 are actually very good, and younger eggs have higher birthrates.”
But clinics don’t necessarily inform older women that they are likely to experience lower success rates, which go hand in hand with higher costs.
Egg freezing shouldn’t just be available to those with good jobs or deep pockets. It needs to be available to all women, if they want it.
As the experts from Imperial College London and Chelsea & Westminster Hospital point out: “Because of lower success rates per egg, women in their late 30s would need approximately 30 eggs to have a good chance of achieving pregnancy. They would therefore require on average three cycles of stimulation, at a cost of approximately $25,000. This does not include the annual storage fee of $335-$670 or the cost of the fertility treatment she would need in the future to use her frozen eggs.”
So what’s the solution? Few 20-somethings can afford to freeze eggs they may never get to use. Four years ago, Apple and Facebook offered to pay female employees up to $20,000 to cover the cost of freezing eggs. But they were quickly criticized for piling pressure on women to prioritize their careers over having a family.
Radically, perhaps, Prof. Nargund believes the NHS should step in. “Egg freezing shouldn’t just be available to those with good jobs or deep pockets. It needs to be available to all women, if they want it. The NHS provides contraception, abortion and fertility treatment. So why not offer egg freezing to younger women?” she says.
“I’m a big champion of natural fertility, but in reality a lot of women can’t find partners to have children with, but also can’t afford egg freezing in their 20s. So they have it in their mid-30s, when it doesn’t work as well. That’s the true problem with egg freezing.”
Luckily, Sally got her happy ending after all. At 41, she had IVF with her own — non-frozen — eggs and now has three-year-old “miracle” twins. “Egg freezing was presented to me as a solution but, as I discovered, it’s no guarantee,” she says.