A medical perspective on egg freezing
Mike Crossley, October 17, 2014
Egg freezing has hit the headlines this week with news that Facebook is already paying up to $20,000 for its female staff to have the procedure done, with Apple due to follow suit in January 2015.
It has been described as a key to "levelling the playing field" between men and women: without a ticking biological clock, women have more freedom in making life choices, say advocates.
But does this help women, or are we moving towards a 'brave new world' scenario where babies are produced to suit employers?
Some commentators are taking the line that this is an employee benefit. They are suggesting that companies are offering something individuals cannot afford for themselves.
So are companies genuinely recognising the struggle some women face or are they using it to leverage competitive advantage by luring female employees in a male-dominated industry? Apple said in a statement: 'We want to empower women at Apple to do the best work of their lives as they care for loved ones and raise their families'.
Egg freezing is currently getting a lot of support in the US, where use of the procedure is much more widespread. In the UK, we are just beginning to utilise the technology, and it is predominantly being used in adverse diagnosis situations (such as cancer patients needing chemotherapy) rather than elective fertility preservation.
Records show that up to December 2012, about 18,000 eggs have been stored in the UK for patients' own use. Around 580 embryos have been created from the stored eggs. These embryos were transferred to women in around 160 cycles, which resulted in around 20 live births.
Previously we may have assumed women undertaking this procedure are individuals making choices about their own future. But will they now feel pressurised to take up the offer? What will be the repercussions in terms of management pressure and peer pressure to conform? Will women be discriminated against for not putting the company first?
Businesses with good insurance packages have been paying for IVF for a while, but offering to pay for egg freezing is rather different. IVF means firms are comfortable with women or couples having a baby now – if successful. Egg freezing on the other hand may be perceived as the company coming first. And, of course, none of these procedures are risk-free and certainly don't guarantee a baby.
Dr Beth Kennard, director of the Division of Reproductive Endocrinology and Infertility at the Ohio State University Wexner Medical Center, says egg freezing does not guarantee pregnancy.
“According to a 2012 American Society of Reproductive Medicine report, which looked at studies conducted in Europe on frozen eggs from donors under age 30, pregnancy rates ranged from 36% to 61%. It's not a guarantee that you're going to be able to have children when you come back and thaw them out," she said.
However, natural pregnancy rates are not 100% either; among couples without fertility problems, 60% will become pregnant within three months of trying.
So, should UK companies be looking at egg freezing as an employee benefit? Or could that money (the equivalent of around £12,600) be better used to support women in monitoring their fertility as they age, and helping them to deal with any issues?
Perhaps employees would prefer their employers to invest in childcare and support mechanisms that enable them to work and have a family.
Mike Crossley is COO and clinical services director at Fertile Matters, a Harley Street fertility practice