A few years back I endorsed an unfairly-neglected tech to extend life: cryonics. Yesterday, Amara Graps reminded me of a related unfairly-neglected fertility-promoting tech: egg freezing. Slate in March:
In 2004, the fertility field’s professional organization, the American Society for Reproductive Medicine (ASRM), declared egg freezing “experimental.” … In an unprecedented paper calling for the removal of the experimental label, three of the world’s most prominent researchers in egg freezing claim the technology has vastly improved and is safe: Frozen-egg babies, so far, have no more health problems than the rest of the population. Doctors who support the experimental classification argue that more research is needed and say they’re still uneasy offering the technology to vulnerable women who might unwisely be counting on their frozen eggs years after extraction. … Egg freezing … has been unfairly singled out. By comparison, the adoption processes of other breakthroughs in fertility medicine, such as freezing embryos, injecting sperm into eggs to help men with low sperm count, or screening embryos for abnormalities, have been more informal. … The ASRM did not assign them the term ‘experimental.’ “
In fact, egg freezing received such an outsized institutional smackdown that the ASRM pointedly said it “should not be marketed or offered as a means to defer reproductive aging.” Why the special treatment? Many members … feared women would use egg freezing as “baby insurance” by paying $8,000 to $13,000 per cycle to stash away some good eggs in case their fertility is gone by the time they’re ready to become mothers. …
Many IVF programs are achieving the same success rates using frozen eggs as they normally would with fresh eggs. … Other practitioners have less stellar results. Many have no data at all because they’ve never thawed the eggs they’ve frozen. Although 54 percent of American clinics now offer the procedure, only 1,500 babies have been created from frozen eggs in the world. … With more competition, professional standards would rise and the price might even go down.
Seems docs discourage freezing eggs because they fear people might find, horrors, that it works and adds value. Gee we wouldn’t want people using something that might save the world from a falling fertility collapse! Sigh. Yes, let’s encourage this, and get usage up and costs down.
Let’s not forget at a big cause of falling fertility is women thinking they can wait longer than they can to have kids. Here’s Bryan citing a 2001 survey:
In the survey, “high-achieving women” are basically those in the top 10% of the distribution of female income. … Survey highlights:
- 33% of high-achievers … are childless at age 40.
- “Looking back to their early twenties… only 14 percent said they definitely had not wanted children. … More than a quarter … in the 41-55-year-old age bracket said they would still like to have children”
- Only 1% … had a first child after 39.
- 89% of young high-achieving women believe they can get pregnant into their 40s. In reality, only 3-5% of women in their early 40s are able to have a live birth using in vitro fertilization.
For more quotes, here is Nature in 2007:
Freezing a woman’s eggs for use later in fertility treatments doesn’t seem to greatly increase birth defects or abnormalities, new data suggest. … The field remains caught between researchers, most of whom say that the practice should still be considered experimental, and the public, which is itching to embrace the technology to extend a woman’s fertile years. .. most researchers think that the procedure is not appropriate for women who wish to delay fertility for social, career or other non-health-related reasons. … “there remain very few studies in which the safety and efficacy of this practice can be judged.” …
An ASRM [American Society for Reproductive Medicine] committee … recommended that egg freezing continue to be considered experimental, and not be marketed or promoted to healthy young women. … Egg freezing, which has been in place for at least two decades, has not been used widely; doctors estimate that between 300 and 600 children have been born from formerly frozen eggs. …
Safety remains one of the main concerns. …
[Researchers] presented an analysis of more than 37 publications on children born from cryopreserved eggs. Of 555 live births … he turned up just 3 other major abnormalities. … Five abnormalities in 550 births is a less than 1% abnormality rate — comparable to that for a natural pregnancy. The study didn’t address efficacy, though. “We don’t know the denominator — we don’t know how many [pregnancies] were terminated.” … A small study in which 28 slow-frozen eggs, and 35 vitrified ones, were thawed then fertilized. Further analysis of the results indicates that for every 21 oocytes frozen via vitrification, one pregnancy could be expected. The numbers were slightly worse for slow-rate freezing: 45 frozen eggs per pregnancy.
Here is Amara in 2009:
An unborn human baby girl has already produced all of the … unmature egg cells, that she will produce in her lifetime. … About 400, will mature into eggs to be viable for reproduction in her entire lifetime. … A dormant egg cannot perform the usual cellular repair processes, however, so damage increases as a woman ages. … Egg freezing is a viable technology since 2002, however the societal progress for acceptance is extremely slow. Even though the egg extraction portion of egg freezing has been in practice in IVF for decades, egg freezing is considered by the American Society for Reproductive Medicine, as late as late-2007, to still be an experimental procedure, despite the fact that vitrification, the process in which water is drawn out and anti-freeze chemicals added, is improving success rates to the same level as normal IVF treatment. Many doctors will freeze eggs for cancer patients, but will not offer the option to young, fertile women. Their perspective is that it is unethical to normalize a woman’s waiting to bear children. … Costs for a young woman undergoing such a procedure is also prohibitive (USD ~10 000) at that early point in her career life.
However, out of the three reproductive technologies listed here, egg freezing technology provides the most courageous and comprehensive assistance to women and has the potential to change society the most. … With this technology, the woman has twenty more years of buffer time in which she can build her career to something supportive for herself plus her family. … Single women who find themselves mateless during their usual prime years, will now have time to build a better life to support themselves and their children. …
Extend Fertility (http://www.extendfertility.com) recruits women interested in egg freezing and connects them to a network of cooperating egg freezing clinics. … As of late 2006, 2000 women had inquired, and of those, 200 had frozen their eggs.
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