Edmonton Journal

Don’t encourage egg banking, MDs told

But supporter questions whether doctors should impose their views

- SHARON KIRKEY National Post

Doctors are being warned not to encourage young women to freeze their eggs as a way to avoid “future regret,” says a just-published article in the Canadian Medical Associatio­n Journal that argues it risks perpetuati­ng expectatio­ns that being a mother is central to being a woman.

“Social egg freezing uses medical technology to respond to a non-medical problem — natural aging,” the authors of the CMAJ analysis write in a paper published Monday, which was intended to help family doctors advise women contemplat­ing egg banking.

Growing numbers of Canadian women are seeking “social egg freezing,” a once highly experiment­al procedure that allows women to put their eggs in deep-freeze until they are ready to try to have a baby, the authors write.

This raises important “societal implicatio­ns,” the authors of the CMAJ analysis write, and reinforces social norms “that construe motherhood as a central aspect of womanhood.”

“Pressures for women to freeze their eggs occur within a broader social context that strongly pushes women to become mothers,” they said.

“Physicians should be careful not to place additional pressure on women by portraying egg freezing as something that they should choose to avoid future regret.”

Instead, young women who want to build a family should be encouraged to do so naturally, said co-author Dr. Arthur Leader. “(T)hey should do this younger, rather than when they’re older.”

More funded child-care programs and other support to help women continue working while raising a family would be a better option than egg freezing, added the co-founder of the Ottawa Fertility Centre, which offers social egg freezing.

“We’re not opposed to it. People just have to be well-counselled so that when they go into it they understand what it is that they’re undertakin­g.”

It’s not an insurance policy, he said.

“It’s not a guarantee that the eggs that are frozen are going to result in a family.”

The Canadian Fertility and Andrology Society says egg freezing allows women to “preserve their fertility in the face of anticipate­d decline.”

“Our feeling was that there have been enough reported studies to show that this works routinely — it falls out of the realm of experiment,” said the society’s vice-president, Dr. Heather Shapiro, a member of the Mount Sinai Fertility Centre in Toronto.

Shapiro questioned why the article was labelled an “analysis” and not an opinion piece. “I’m not sure what the relationsh­ip is between trying to change societal norms and responding to a patient’s medical query,” she said.

She said the issue parallels recent debates over whether doctors have a moral and ethical duty to separate their personal views from the care of their patients.

“If you think that egg freezing is a cash-grab, if you think that egg freezing is morally wrong because it encourages women not to have babies,” she said, “does it follow that you have the right to say, ‘I’m going to discourage that in my patient?’ ”

In October, Facebook and Apple said they would provide up to $20,000 in benefits to cover “non-medical” egg freezing. With egg freezing, a woman has to inject herself daily with fertility drugs to stimulate her ovaries to produce multiple eggs. The eggs are then retrieved, using an ultrasound-guided needle. Eggs, the largest cell in the human body, are exquisitel­y sensitive to the normal freeze-thaw process.

A newer, Canadian-developed technique, called vitrificat­ion, uses ultra-fast cooling. This allows no time for cell-destroying ice crystals to form, cooling the eggs into a glass-like, solid state. Egg freezing costs $5,000 to $10,000 a cycle. Storage fees are another $300 to $500 a year. None of the provinces covers egg freezing for non-medical reasons. According to data from the U.S., the pregnancy rate per vitrified egg is five to 12 per cent. However, those rates are generally in eggs taken from women under 30 years of age. Most clinics offer egg freezing for women up to age 35.

However, older women who become pregnant have higher risks of gestationa­l diabetes, high blood pressure and low birth weight babies.

Shapiro said the level of risk is manageable. “We know there is an increased risk ... but compared to other medical complicati­ons of being pregnant, being old is not even in the running,” she said. “We’ve had patients who have had liver transplant­s who get pregnant. We’ve had patients on dialysis get pregnant.

“What I say to my patients is, ‘If you’re 42 and pregnant, you don’t even get into the door of the high-risk pregnancy clinic. You don’t qualify.’ ”

The numbers of women seeking egg freezing are small, but increasing, fertility experts say. The Ottawa Fertility Clinic sees one or two women a month, instead of one or two a year. But there are no reliable figures on what is happening in clinics across the country.

Shapiro of the Canadian Fertility and Andrology Society said the organizati­on “would be the first to line up for improved maternity benefits, all those kinds of things that would improve fertility rates, absolutely.

“But I don’t think it’s a zero-sum game. You don’t have to trade off one, to get the other. And if the patient is there (in a family doctor’s office), now is not the time to say, ‘You’re hurting our society and our culture by doing this.’ ”

“We’re not opposed to it. People just have to be well-counselled.” DR. A RTHUR LEADER, CO- AUTHOR OF A MEDICAL JOURNAL ARTICLE

 ?? SANG TAN/ THE ASSOCIATED PRESS ?? “Social egg freezing,” a once highly experiment­al procedure, allows women to put their eggs in deep-freeze until they are ready to try to have a baby.
SANG TAN/ THE ASSOCIATED PRESS “Social egg freezing,” a once highly experiment­al procedure, allows women to put their eggs in deep-freeze until they are ready to try to have a baby.

Newspapers in English

Newspapers from Canada