Researchers are advising physicians to warn patients of the risks associated with social egg freezing. In an article titled “Social egg freezing: risk, benefits and other considerations” published in the June 16 edition of the Canadian Medical Association Journal, the authors review guidelines and weigh the benefits and dangers of the practice.
Social egg freezing involves preserving a woman’s oocytes (unfertilized eggs) for “nonmedical” reasons. “Medical” reasons for cryopreservation of oocytes include loss of fertility due to diseases such as cancer or cancer treatment.
In 2012, the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) stopped classifying oocyte cryopreservation as experimental. The 2013 joint guidelines by the two organizations, however, warned physicians that “(m)arketing this technology for the purpose of deferring childbearing may give women false hope and encourage women to delay childbearing.” There is also not enough data about the risks of the practice towards this population. The guidelines, however, do give the green light for cancer patients, patients who plan on getting their ovaries removed to decrease cancer risk, couples who are unable to harvest suitable sperm at the moment for IVF, and IVF patients who do not want to freeze embryos. The 2014 position statement of the Canadian Fertility and Andrology Society finds no issue with social egg freezing.
The most effective way to freeze eggs is vitrification, also known as fast-freezing. Even then, the fertilization rate of the thawed oocytes is 71-79 per cent, while the implantation rate is 17 to 41 per cent and the pregnancy rate is only 4.5 to 12 per cent. These statistics only apply to women who freeze their eggs when they are less than 30 years old.
The oft-cited benefits of cryopreservation that the authors list in the article include being a genetic parent at a later age and the possibility of being a mother without a partner. There is also a decreased chance that the resulting embryo will have an abnormal number of chromosomes and the practice may be morally preferable to freezing an embryo.
The medical risks include developing ovarian hyperstimulation syndrome, a consequence of priming the ovaries with large amounts of hormone so that ovulation can occur and the eggs can be collected for freezing. The syndrome typically manifests as nausea, fatigue, abdominal pain, irritability, headaches, and breast tenderness, but there is a small risk of more severe manifestations such as blood clots, severe vomiting, dehydration, and death. Patients may also have a greater chance of getting breast or uterine cancer. There would be additional risks to the health of the mother and child associated with the process of IVF and giving birth at an advanced age.
The researchers also look at the issue from a social perspective, stating there is an increased pressure on women to freeze eggs due to media attention and the decision of employers like Apple and Facebook to cover a portion of the costs of cryopreservation. There is unequal access to the procedure (each cycle costs $5,000 to $10,000 and storage fees are $300 to $500 per year) and the practice implies that genetically related children are more valuable. In addition, social egg freezing is sold as a way for women to have both a career and a family, with the pressures to freeze eggs “(reinforcing) the social norms and expectations that construe motherhood as a central aspect of womanhood.”
