POLL: Is freezing your eggs worth the investment?

Is social egg freezing a way for women today to stop the biological clock from ticking, or just an expensive procedure that gives them false hope, asks Katy Harrington.   

ON a busy Friday afternoon in London, commuters and tourists are swarming around Old Street Station.

Underground, in the station’s graffitied corridors there are the usual city Tube station amenities — newsagents, coffee shops, a cobbler, and for one week only — a pop-up shop with a difference.

From the outside, Timeless, looks like your typical beauty store — a pretty window display, attractive staff, nicely packaged ice-cream colour boxes and glass bottles stacked on white tables, but it’s all just a front.

The brand is fictional, and inside nothing is for sale.

What is on offer is all the free, impartial information you could need on one of society’s hottest fertility topics — social egg freezing.

Egg freezing (oocyte cryopreservation) is a medical procedure where a number of a woman’s eggs are extracted from the ovaries and frozen for use in the future.

Social egg freezing is the freezing of women’s eggs for lifestyle as opposed to medical reasons — for example, to give you enough time to conquer your career goals, or meet someone you want to start a family with.

As one of the creators of Timeless, Sarah Douglas — a smart, savvy working mother — guides me through the space, she explains why she and her business partner Amanda Gore, directors of a creative consultancy called The Liminal Space, wanted to address this issue now.

Spurred on by the news that big tech companies like Apple and Facebook were offering egg freezing as part of benefits packages to their employees, Douglas says she and her 30-something group of female friends (some with kids, some without) were more and more conscious of the conversation about fertility, having children later in life and balancing it all with work.

But, there were so many confusing statistics, mixed messages from clinics and polarising opinions in the media they didn’t know where to start.

Worried that women were making highly emotive (and expensive) decisions without the right knowledge to hand, they assembled an advisory a board of impartial experts and carried out their own social science research this year *.

What they found out is that women’s attitudes are changing and changing fast.

Chiefly, more young women are open to the idea of freezing their eggs now as an “insurance policy” for later — 84% of women aged 18-24 believe that improving career options was a good reason for women to freeze their eggs, with 59% agreeing women should be encouraged to use egg freezing as a way to give them more reproductive autonomy.

More than eight in 10 women under 40 thought women should freeze their eggs if they wanted to buy more time to find the right partner to have kids with.

Right now, despite the costs involved, 11% of women of all ages — and 20% of women aged 18-24 — would consider paying to have their eggs frozen.

So what about the cost?

Although prices vary depending on the clinic, ReproMed Ireland (with clinics in Dublin, Limerick, and Kilkenny) charge €150 for an initial blood test, and €150 for an assessment scan.

Because of licensing, the clinic must also carry out HIV, Hep B&C blood tests before the procedur at a cost of €150.

One egg freezing cycle costs €3,000 and that includes storing the precious eggs for the first year. After that, keeping the eggs on ice is €300 per year.

If you don’t get pregnant naturally, and, therefore, need the eggs for an embryo transfer and IVF you are talking a further charge of about €1500.

In total, if a 35-year-old woman was to have one round of egg freezing, and later decide to have IVF using her own eggs at age 40, the complete egg freezing package adds up to a cool €6,150.

Money aside, there is the procedure itself to consider too.

Dr David Walsh, medical director at the IVF clinic in Rotunda Hospital says the mechanics are fairly straightforward.

First they check every woman to see how many eggs she has left.

Here, at this early point, about half the women are told they have enough eggs, enough time, and decide not to go any further, says Dr Walsh.

Although at the Rotunda Dr Walsh’s work is still primarily in IVF, he has seen an increase in women coming in for consultations on their egg reserve.

For those who do want to take the next step, they are given stimulation drugs, (the dosage depending on how many eggs they have left).

The next part is a little trickier.

As Dr Walsh points out, while men can just masturbate to produce a sample of sperm, it’s more invasive for women.

“Because her ovaries are inside her, she must have a needle put into her tummy,” he explains.

There are small chances of bleeding and infection but on the topic of safety, Dr Walsh says it is “not no-risk, but low-risk”.

The extraction takes about 25 minutes, and is done under sedation. In total, the process takes about two weeks.

You hope, says Dr Walsh that most women who freeze their eggs will never come back for the next step, they’ll get pregnant naturally and never need to collect.

If that doesn’t pan out, the eggs are thawed, mixed with sperm and left to grow for a few days.

Embryos are then transferred and “you complete the IVF process”, says Dr Walsh.

The million dollar question is does it work?

“There is no guarantee that the eggs that are frozen will ultimately result in a baby, so all it is is a form of insurance… it gives you a chance that you might not otherwise have”.

The issue with measuring success rates is tricky.

This type of fast egg freezing is so new (only in the last few years has it ceased to be labelled ‘experimental’) and clinics in Ireland have only been doing this for the last three to four years, so Dr Walsh says it’s impossible to say how well it works until women have come back in a few years time and had IVF.

One article in The Observer this year estimated that in Britain, that “only two to 12% of thawed eggs lead to a live birth.”

And, TIME, with no published data available, did some of its own digging in the US, where one doctor reported that out of “353 egg-thaw cycles in 2012, only 83 resulted in a live birth.”

The truth is, as Dr Walsh repeats, until women come to the end of the cycle, we just won’t know how many babies will be born from vitrified eggs.

Ideally, around the age of 30, a woman who gets 10-15 eggs frozen twice (that’s 24-25 eggs ‘vitrified’, or fast frozen, in total) will have “a very good chance of succeeding”.

He concludes: “If it was my daughters I would seriously look at advising them to have one or two egg freezing procedures in around the 30 mark. I can’t see a real downside besides the cost.”

Professor Emily Jackson of London School of Economics, is keenly interested in the field of medical law and ethics, particularly reproductive issues.

For her, social egg freezing is “a new and fascinating question” that brings new dilemmas with it.

As she sees it, there are some amazing benefits.

For one, being able to now freeze just eggs (as oppose to embryos) opens a new world of possibilities for women, particularly women with cancer.

“For women who have a cancer diagnosis, they can freeze their eggs, if they freeze embryos and subsequently spilt up with their partner that can cause difficulties.”

One of Jackson’s concerns, is women may be lulled into a false sense of security by choosing egg freezing.

“This is the first half of an IVF cycle, and IVF doesn’t always work, there isn’t any guarantee that you will have a baby.

"It means your chances of IVF working at the age of 40 is greater but it doesn’t guarantee it.”

Women, she says, need to be informed.

“They need to know it’s still a good idea to have kids younger, this isn’t the panacea.”

Jackson raises another issue that has the potential to get contentious — disposal.

In the UK, she cites the statutory storage limit of 10 years.

So let’s say you freeze your eggs at 25, at 35 years of age those eggs would have to be destroyed. (Jackson says if a woman was to become prematurely infertile, there can be an extension).

In Ireland, the rules are different, explains Caitriona McPartlin, general manager of ReproMed Ireland.

Currently there is no such legislation in Ireland, although there is legislation “at consultation stage at the moment”, which “may come into effect over the next couple of years.”

Generally, she says, IVF units, including ReproMed, “will not dispose of eggs unless otherwise instructed by the female in question.”

Still, once you get into the fine print, you begin to see that there is more than writing a €3000 cheque to think about.

HELEN’S STORY

Helen Johnson is a 35-year-old self-employed former barrister. At 33, she started thinking about having her eggs frozen and at 34 she did it.

She knew two women in their late 30s whose IVF attempts had been “derailed” because of the viability of their eggs so decided to buy herself a little peace of mind.

The reaction from those she has told has been mixed. Some friends seemed surprised.

“A few said ‘but can’t you get pregnant ’til you’re 40?’. Maybe, says Johnson, but it wasn’t a risk she was willing to take.

“There is a biological reality, just because one person has a baby at 40…”

There was social stigma to overcome too. The assumption that freezing your eggs was “for sad, depressed women that are frightened” was something she encountered.

“It was bit shaming, when people paint you in that light, it’s so disrespectful.”

Men, however, have taken the news rather calmly.

“Every time I tell a man I’ve had my eggs frozen they’re like ‘oh cool’. They just think that sounds like a good idea.

“Women were the problem for me,” she continues.

“They thought I was giving up, that I was saying I was never going to meet a man and do it naturally. Men never saw it as an act of desperation, they saw it as practical.”

Either way, she says it hasn’t affected her attitude to dating or her career.

She hasn’t stopped thinking about her fertility, or forgotten about it and she’s certainly not regretting the cost.

“I’ll be glad even if I don’t use them, even if five minutes later I’m pregnant, I won’t regret spending that money at the time.”

For Johnson, the emotional side was the most daunting.

“You have to face up to your vulnerability, the fact that you don’t have complete control. Then you have to acknowledge that ‘I really do want to have children.’

"However, as a women in your 30s you are told men won’t want to date you if you are desperate to have a baby and employers will think you are going to bugger off on maternity leave.”

What Johnson and women like her in her 30s know, is that women are more than wives and mothers.

However, the change of social attitudes towards women’s roles at home and work has been glacial and until things change at home and in work with better government policies and funding, more fathers participating more in childcare (a March 2016 survey from the International Overseas Development Institution found Irish women carry 93% of the workload with children), and more support for working women from employers, the conflict in women’s lives will remain.

Complex, far-reaching and challenging as the idea of freezing eggs is, Johnson boils it down the crux of the issue for women who want a career and children, financial freedom and a family — “It’s really hard to admit that there is something you really want, but might not get.”

See more at www.time-less.org

*ICM conducted a poll on behalf of The Liminal Space in November 2015. There were 2013 respondents, (903 men / 1110 women), across England, Scotland and Wales.

Attitudes to egg freezing

Of more than 1,000 women surveyed 71% under 40 agreed that egg freezing would be justifiable to improve opportunities for career progression before they have children

* 16% of people polled agree that it should be a corporate benefit.

This rose to 37% among the youngest cohort of women (18-24yrs)

* Even if it cost over €10,000, 20% of women aged 18-24 would currently consider, or would have considered, paying to have their eggs frozen

* 59% of women aged 18-24 versus 22% aged 55-64 agreed: ‘It is right to encourage women to freeze their eggs as it gives them more control over their lives’

* 82% of women under 40 agreed that it was justifiable for women to freeze their eggs in order to give them more time to find the right relationship in which to pursue parenthood

* 45% of men under 40 would support a decision for a woman they were in a relationship with to freeze her eggs – relieving the time pressure on both sexes.