Frozen Eggs: What Happens After the Thaw?
My first reaction to the announcement by Facebook and Apple that they will cover the cost of egg freezing for female employees was ‘This is really creepy, Orwellian and a bit Mao-like.’ Is there an undercurrent of ‘Big Brother’, that they are trying to dictate when it is the ‘right’ time for workers to have families? Is this an act of generosity or a self-serving way for an employer to control its workforce?
The ideal time to freeze eggs is when a woman is in her 20-30’s, usually before the age of 37 when her fertility begins to drop fairly dramatically. Every woman’s fertility is going to be slightly different and some may start to have a drop in their ovarian reserve at a much younger age. Before a reproductive embryologist freezes a woman’s eggs, certain tests are performed to assess her current ovarian reserve and to make her aware of the viability of freezing her eggs. This can be a good choice if a woman has yet to meet her life partner and wants to hedge her bets. In this case, having this expensive procedure paid for by her employer is a huge benefit.
But egg freezing is hardly a foolproof way to preserve a woman’s fertility. Women must take into consideration what happens after the thaw? As Dr. Jane Fredrick, of HRC Fertility in Orange County, CA said in her interview this week with Chicagoland Television “It’s not a baby in the freezer it’s the possibility of a baby down the road.” Dr. Fredrick went on to say that with advances in the last 10 years of the use of vitrification (rapid method of freezing eggs), women who choose to freeze their eggs when they are in their 20’s and 30’s have a 40-50% chance of a positive pregnancy. Ideally they should have 20-30 eggs frozen which may require more than one egg retrieval cycle to accomplish. In an NPR interview last week Dr. Richard Paulson, of USC Fertility, in Los Angeles, CA Dr. Paulson stated, “Egg freezing offers a ‘state of suspended animation’” according to Dr. Richard Paulson, “egg freezing doesn’t stop the biological clock it just sort of pauses it.” In this same interview Dr. Valerie Baker of Stanford Fertility in Palo Alto, CA cautioned that “while egg freezing is ‘an exciting new option,’ it shouldn’t be relied on to make family-planning decisions … We wouldn’t want to have people think this is a substitute for making family building decisions in a broader context. It’s not a guarantee that if a woman freezes her eggs she’s eventually going to be able to have a baby with one of those eggs.”
There are a number of factors that appear to be amiss in this plan and raise a number of questions.
- Who is going to pay for the IVF required to fertilize and implant future embryos? Thawing and embryo transfer is around $5,000 each time
- Egg Freezing offers no guarantee of future children. I have worked with a number of women who froze their eggs only to find that the eggs did not survive the thaw or did not produce a positive pregnancy. They have nothing to work with and now need an egg donor. The techniques for egg-freezing have been improved upon since these woman froze their eggs but it is still not a panacea.
- Who will pay for the counseling required for those who have deferred their families if the frozen eggs don’t produce positive pregnancies?
- Will these same institutions pay for fertility treatment?
- Will they pay for egg donor cycles if the frozen eggs don’t produce viable pregnancies?
- Do these institutions truly support equality in the work place if their solution to a woman’s most fertile years is to freeze her eggs so that she can keep on working?
- Why not offer flexible hours, childcare benefits and the ability to work remotely for both parents?
- If a woman chooses to have children rather than freeze her eggs is she then seen as not being serious about her career?
- Can’t one lean-in and follow the Sheryl Sandberg path to success?
Egg freezing is expensive so it's a huge commitment for Apple and Facebook to cover the cost for those who want to do so. But those who choose this path need to do so with their eyes wide open. Just as we have learned the hard way that we can’t put off child-bearing until our 40s without facing negative consequences, regardless of how fit a woman is or how young she looks, our eggs are the age that they are and after a certain age, they are no longer viable. Freezing a woman’s eggs until she has time to have a baby is no guarantee of future parenthood. I counsel women everyday who are broken-hearted, mourning the loss of a biological child that they will never have because they waited too long. I would hate to see the next generation going through the same mourning with the added resentment that they were suffering under the illusion that they had beaten the system by freezing their eggs only to find that the eggs they froze may have only caused them more pain and suffering if they don’t produce positive results.