Egg freezing has been hailed as a game changer for women, an “insurance policy” to revitalise waning fertility, a breakthrough as revolutionary as the birth control pill. The reality is it doesn't come with a 100% guarantee. Make sure you understand all the risks associated with it...
Over the past several decades the average age of a woman’s first birth has increased to an all-time high of 28.4 years. By 2006, 1 in 12 women were having their first birth at age 25 years o older, compared with only 1 in 100 in 1970. He cause of the delay in attempted childbearing in Western societies is thought to be multifactorial, stemming from both social and economic factors. In Australia, the age of first marriage has increased since 1950; in 2009 the mean age of first marriage was 26 years for women. Now there are ramifications of this with the delay in attempted child-bearing incurring the cost of an increase in age-related infertility.
Unfortunately standard fertility treatments can only partially overcome the fertility decline associated with ageing. However, egg freezing or in technical terms oocyte cryopreservation (OC) can be used as a method of fertility preservation for single women who are not ready to conceive. OC “freezes-in-time” egg quality, protecting the higher pregnancy rates that are seen in IVF treatment with the use of “younger” eggs. Egg freezing has been shown to achieve live birth rates consistent with those of fresh oocytes in egg donation cycles suggesting that the technique is a viable option. After the American Society of Reproductive Medicine state that “oocyte cryopreservation to improve prospects of future child bearing should be available for non-medical reasons,” two of the world’s largest technology firms, Apple and Facebook announced that they will provide a $20,000 employee benefit to fund OC. Off the back of this lead from the US, an increasingly number of corporates in Australia are looking into funding egg freezing in order to keep their female employees in the workforce for longer.
In the United States in 2009 only about 500 women froze their eggs. In 2013, almost 5,000 did and it is estimated that 76,000 women will be freezing their eggs by 2018. Australia is experiencing a similar upward trend in the number of women freezing their eggs for social reasons.
While egg freezing may offer a viable option for single women wanting to protect against the age-related decline in fertility, egg freezing doesn't come with a 100% guarantee and women must exercise caution when placing all their hopes of bearing a child later on in life upon their frozen eggs. We've compiled a list of relevant questions for women to consider and discuss with their specialists:
- What is the live birth rates following egg freezing for someone of my age considering other relevant circumstances?
- What is the “best” age for eggs to be frozen?
- Should I consider multiple cycles?
- How many eggs should I aim to collect?
- Are there any other fertility issues that can be identified that may influence the success of using my frozen eggs later on?
- Should I be undergoing a further fertility assessment to identify any potential fertility issues?
- What is my financial cost of banking eggs that may never be used?
- Am I prepared for the possibility that egg freezing might fail?
A recent article in the The Guardian (Hope or Hype? The Chilling Truth About Egg Freezing, 6th November, 2017) followed a women, Brigitte, that had frozen her eggs at 39. At 45 when she decided she was ready to have a child, only one of the eleven that were collected was viable. She fell pregnant off that one egg, but subsequently miscarried.
"It had never occurred to me that it wouldn't work. That was it: my last possibility of having a biological child," she said.
Unfortunately, how humans produce eggs that can make babies is going to get in the way of the desired outcome for many women. In their early 20s, women will likely release an egg that is good enough to make a baby every couple of months, and if hormones are given to produce extra eggs in a month, often there will be more than one egg that can make a baby. By 35 however, women may well only be making an egg that can make a baby every 3-6 months, and her chances of having a second egg that can also do this in one month is around 1 in 20. And in their early 40s, eggs making a baby is only produced around once a year.
So this means, collecting eggs for maximising the chances of having a baby from them, may entail collecting eggs on a number of different occasions. In the end its the number of best eggs a cycle that are collected, rather than the number of eggs in one cycle. How many eggs from how many cycles is obviously going to depend on the individual person and their age at collection.
And this is where the trade off comes. The earlier the eggs are collected, the better the chance of these eggs making a baby. But conversely, younger women are more likely to not need the “egg insurance” as most will form relationships and conceive spontaneously. As women get into their 30s and remain single, there is a lower chance of conceiving, but also a lower chance of forming a relationship, meaning that frozen eggs are more likely to be utilised.
Even young women have a high percentage of eggs with chromosomal abnormalities which is why most don’t get pregnant every month. This means women won’t know if their eggs are genetically healthy until they’re thawed and fertilised and grow into a baby, which means they could be freezing, and pinning their hopes on eggs that in the end don’t have the ability to make a baby.
At Demeter Fertility, our experience suggests that it is not egg numbers that determine the chance to generate a single pregnancy, but the number of best eggs from an egg collection cycle. The number of eggs expected to be required to produce a pregnancy is reported to be higher in other units, with some suggesting 30 or more eggs, often resulting in hyperstimulation syndrome, and more eggs that are abnormal. Your Demeter Fertility specialist will discuss how many egg collections they recommend you freeze depending on your individual circumstances.
Egg freezing can be performed at Demeter Fertility from as little as $2000 out of pocket. Individual circumstances may vary, and you must discuss your case with our specialist before fees can be confirmed.
Egg freezing can be of great benefit to specific women and has the highest chance of success when performed at an earlier age. For social egg freezing, the ages 35 - 37 years show the largest benefit over no action.
Demeter Fertility is a Sydney-based fertility and IVF clinic with locations in Hurstville and Liverpool. To find out more about egg freezing phone Demeter Fertility on 1300 899 850.