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BETWEEN GENERATIONS: Freezing eggs: panacea or Pandora’s box?

- Belle DeMont
- Belle DeMont

It’s not news. The younger the woman, the more likely she’ll get pregnant. This reality runs counter to a 2018 Statistics Canada report showing age is on the rise for first-time pregnancies. In 2003, the largest group of new moms were 24 to 29. In 2016, it was 30 to 34, with the 35-to-39 crowd nipping at their heels. This trend comes hand in hand with a host of issues.

Cue 21st Century solutions. . .

Egg freezing has been around for decades, first used for in vitro and later extended to women with infertility issues stemming from disease or medical treatments, such as chemotherapy. The science evolved and improved, and in 2012, freezing eggs was officially taken off the list as experimental research, and policy changed in response.

The pivot opened up a new market for egg freezing as an option for healthy women. Presto! A new, product-based business was born, a frozen guarantee offering women the luxury of time and choice. Google and Apple jumped on the ‘eggs on ice’ bandwagon, providing coverage for the hefty costs for female employees, helping bring the practice into the mainstream.

It’s now a new normal. Freeze your eggs to make a baby, at any age, via youthful ova of your own genetic material. Almost sounds too good to be true, and maybe it is. To help Karalee and Jill understand the pros and cons, they asked Françoise Baylis, a professor at Dalhousie University and bioethicist, to join the conversation around the ethics of egg freezing.

Karalee:

In my day, pregnancy mostly just happened. One basement couch or car backseat plus two teenagers and, blamo! Sperm, meet egg. For those trying, but unable to have kids the old-fashioned way, options were minimal; the most common fix was sperm donor or adoption, though marriage was pretty much required for either. Fertility options have, thankfully, multiplied exponentially, with a laundry list to assist with baby-making, including egg freezing.

Jill:

It’s comforting to be reaching adulthood when options like egg freezing are possible. It’s certainly a benefit to my generation, though at this time it may only be available to the most privileged among us. Because the procedure is not something I’ve ever considered, I’m left pondering the various motivations. I assume some people want to freeze their eggs because it’s not the right time for them to have a baby, whether a result of career, living situation, or other factors. But I’m sure a few have grown up with the ideology they need to “wait for the right partner.”

Karalee:

The ‘why’ is complicated, but you’ve hit one nail on the head. A 2013 survey by the Society for Reproductive Medicine showed only 19 per cent of women deep-freezing eggs mentioned workplace inflexibility. Meanwhile, a whopping 80 per cent cited lack of partner as the primary motivation. Freezing eggs gave the undecided a fertility future and sense of empowerment, to boot. A recent 2018 study bore the same results. Françoise, what’s going on?

Françoise:

This is a generation living in complicated times. These are smart, successful women who speak their voices, and that’s intimidating to men. Women worry about getting older, not having a partner, and becoming a single parent. I actually think a part of it is the ‘Lean In’ of Sheryl Sandberg, saying that women can have it all, and women then trying to figure out “How will I have it all?” The background noise becomes the operating narrative. Women don’t know what the future might hold, but understand the biology of aging.

Freezing eggs takes the pressures off. Park your fertility, while you figure out who you are and what you want. It’s called ‘social egg freezing,’ and believe it or not, some U.S. companies are selling the idea by throwing awareness parties, for women.

Jill:

The tendency for things to “trend” in millennial culture has me wondering if freezing your eggs is the “it” thing to do, while throwing those parties seems a deliberate marketing strategy that glosses over the seriousness of the medical procedure, the risks and challenges pushed to the wayside for the promise of something more.

Françoise:

We are also living at a time when many women are aggressively using reproductive technologies to have genetically-related children. For some reason, these women believe it is critically important to use their own genetic material. With this approach to family-making, what’s valuable about family is somewhat lost. What matters is the social part, crafting a loving environment and healthy relationships, and that doesn’t require genetics. After all, 50 per cent of marriages will end in divorce and likely, many will end up caring for children who don’t share their genetic material, and yet those stepchildren will be loved. So, does it really matter if, at 40, you use an egg from a healthy 20-year-old, rather than a frozen egg?

Jill:

As Françoise said, family is about love and care, not genes. With nearly 50,000 Canadian children in the foster-care system, I see no shortage of little hearts waiting for a family to welcome them.

I’m not very educated about the limitations of female fertility. I’ve read the chances of getting pregnant with frozen eggs is low and worry the women who invest so much of themselves into this might be disappointed and heartbroken. I assume there's a cost associated, so I also worry that even if you went through with it, when the time came it might not work and may have been a wasted effort. I support a woman’s choice to do anything she likes, but I do hope women are fully informed. They deserve the full story.

Karalee:

I’ll never forget a friend’s face when telling me the last of her frozen eggs had disintegrated during the thaw procedure. Devastated, she decided after umpteen cycles of hormones and the associated ill effects, to call it a wrap. Her issue was fertility, rather than waiting for the right time, but her experience is common.

And what about the physical risks associated, the chemical cocktail of fertility drugs in mind, not to mention the emotional costs. Françoise, can you weigh in?

Françoise:

What’s often downplayed is the process. Women’s ovaries are stimulated over a period of time through a series of hormone injections, and retrieval also carries risk. All have side effects, and frankly, there’s little research to help women better understand what they’re trading off, in terms of their own health.

Around the low live births, when frozen eggs don’t end up a baby, there’s a huge emotional cost along with a sense of loss and mourning of a particular life no longer available. We’ve never done well around a woman’s response to a miscarriage, and we’re certainly no better at understanding the psychological cost of losing a future that freezing eggs in some way purports to guarantee. And surprisingly, the number of women who actually use a previously frozen egg is shockingly low.

Karalee:

Yes, a recent article in HeyReproTech cited studies that say only about five per cent of women actually used their eggs for IVF, the top reasons being they didn’t want to be a single parent or elected to have a child the natural way. With 95 per cent of the eggs going unused, I’m wondering, what happens to them?

Françoise:

Ah, that’s a new conundrum. We now have massive, private bio-banks, filled with safety deposit boxes of human ova. Usually, such banks are intentionally created for research or to help, such as blood banks. In Canada, when someone doesn’t want their eggs, they can donate them or pay for storage in perpetuity. At this time in Canada, however, it is illegal to purchase eggs, and that’s an important point.

Jill:

That’s comforting to hear, and it’s good to have a better understanding of all the issues. In the future, perhaps with more widespread education about egg freezing, both risks and rewards, Canadian women will be fully aware of their fertility options.

Karalee:

Agreed Jill. Though I’m long past the giving birth stage, I do have three adult sons who might be in the baby-making business with partners sometime soon (fingers crossed).

A millennial from Cape Breton, Jill Ellsworth writes because ink lasts longer than her memory. Half Gen X and half Baby Boomer, Karalee Clerk launched three millennials and is rediscovering and writing about how life works, in the now.

The skinny on egg freezing

By Karalee Clerk 

- Belle DeMont
- Belle DeMont

Society has changed significantly, as have women’s opportunities for work and their choices around when to start a family. As statistics show, they’re delaying childbirth, and many women do so assuming fertility will be waiting in some distant future. Unfortunately, that’s not how it works.

Dr. Mike Ripley is a Reproductive Endocrinologist with the Atlantic Assisted Reproductive Therapy (AART), a non-profit clinic operating through the Department of Obstetrics and Gynecology, and an Assistant Professor at Dalhousie. He believes it’s important to get a message out to women, particularly those in their 20s to 30s.

“Fertility declines with age, and multiple studies show women are ill-informed on this reality. We know the ability to achieve a pregnancy starts to decline around age 25 or so. This has been true forever and biology doesn’t change overnight in step with societal trends,” he explains.

His concern is real. A combination of factors have led to many misperceptions. Fertility and aging aren’t a part most of health education programs. Telling teens the dangers of pregnancy and contraception, along with ‘don’t wait too long to conceive, is a controversial mixed messaged for adolescents. Generally, there’s also a tendency to not think about fertility until a woman decides she’s ready for a child. Now add in media. We live in a culture where celebrities touting pregnancies into their late 40s and early 50s are plastered everywhere, without the backstory. Likely, most used IVF and possibly donor eggs, but when that information isn’t shared, the widespread assumption becomes—if they can get pregnant, so can I.

Sorry. Biology doesn’t wait.

While the AART clinic does freeze eggs, the percentage of patients using the procedure is low, the service offered on case-by-case basis when fertility issues are involved. They expect in the next few years, however, to see a rise in ‘social’ freezing, helped along with recent marketing efforts.

“Egg freezing parties in the US,” he mentions, “can be a bit problematic. You’re talking to people in a social setting, where the norm is a clinic. On the other hand disseminating the information is important, though I don’t agree with the method.

Social egg freezing is often referred to as Elective Fertility Preservation, a term implying that fertility is frozen in time. That’s incorrect. Success rates go down as women age, while the rate for live births from frozen eggs is more complicated than doling out percentages. Two factor impact success, the age of the person when they freeze their eggs and how many eggs were frozen. Dr. Ripley believes a more accurate term is ‘Infertility Risk Reduction.

“The term better explains the procedure. It’s really about reducing the chance of infertility as a woman ages. Currently, 1 – 2 % of all pregnancies are the result of In Vitro Fertilization (IVF), both IVF and egg freezing seen as a saving graces that will overcome age. Life circumstances change often and quickly, though, and women freezing eggs in their 20s risk paying a lot of money for something they may never use. Fertility treatment, such as IVF and egg freezing, retain roughly the same success rates until the mid-30s, so you can freeze eggs a little down the road, with the same results. That’s something to think about since it’s not covered by provincial health care and the cost can be significant.”

The majority of patients at his clinic ideally would prefer offspring genetically related to one or both, though some will consider using donor materials. The right answers are individual, tied up in values and beliefs systems.

“At AART, we do a lot of consultations, and we have partners we refer patients too as well, a reproductive psychologist and patient support groups. We don’t run a bio bank and we’re not a fertility match maker,” says Dr. Ripley. “Anecdotally, the number of patients who actually go ahead and freeze their eggs is fairly low. What everyone really wants most is to discuss and understand the pros and cons, so they can make the right decision.”

All about eggs

How many eggs do I have?

Females are born with one to two million eggs, and of those, about 11,000, give or take, die every month until puberty. About 300,000 remain, of which about 500 are then ovulated monthly. At menopause, the remainder die out. Short story … you are not going to run out of eggs.

How much does it cost to freeze your eggs?

For a single, full cycle, the cost is approximately $7,100 to $10,000, while storage is about $300 per year. If you decide to go through in vitro fertilization, you’re looking at an additional $6,000 for one cycle.


“When you support women everyone rises together”

In honour of International Women’s Day and the 2019 theme of #BalanceforBetter our entire edition has been crafted by women, about women and for women in Atlantic Canada.

From gender parity in politics, egg freezing, self-care and body love and the pervasive pay gap transgender women grapple with, this edition aims at igniting the bra-burner within you.

In the meantime, we’re also making a commitment to diversity and gender equality in this publication. Whether it’s through the writers we hire, the people we interview or artists we collaborate with, diversity and equality remains an integral part of the stories we tell and who gets to tell them.

As Gloria Steinem, world-renowned feminist, journalist and activist once explained, “The story of women's struggle for equality belongs to no single feminist nor to any one organization but to the collective efforts of all who care about human rights.”

If you have a suggestion as to how we can #BalanceforBetter, we’d love to hear from you. Visit us on Instagram @NowAtlantic or send us an email at now@saltwire.com.

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