Social egg freezing: the prospect of reproductive ‘immortality’ or a dangerous delusion?

Abstract 

Until recently there was little to offer young women with cancer facing chemotherapy, radiotherapy or surgery and the probability of premature menopause and sterility. The first ‘frozen egg’ baby was born in 1986, but success rates were so low that egg freezing was neglected. Three technological developments in assisted reproduction treatment (intracytoplasmic sperm injection, dehydro-cryoprotectants and vitrification) have transformed this picture and now young women with frozen eggs have the same probability of a live birth per embryo transfer as women undergoing conventional IVF. For many women it is not cancer but the passage of time that denies them a chance of motherhood. Social, educational and financial pressures often lead them to delay starting a family until their late thirties, by which time the chance of success is compromised by low fecundity rates and an increased risk of miscarriage if they become pregnant. Donor eggs are not an option for many because of supply constraints and ethical concerns. Freezing a woman’s eggs at age 30 literally ‘freezes in time’ her fertility potential and gives her the chance of a healthy pregnancy at a time of her choosing. The role of oocyte cryopreservation in the context of social egg freezing is discussed.

Until recently there was little we could offer young women with cancer facing the chemotherapy, radiotherapy or surgery that could save their lives and the certainty of premature menopause and sterility. The first frozen-egg baby was born in 1986, but the success rate (100 eggs to produce one baby) was so low that egg freezing was neglected for years. Three technological developments in assisted reproduction treatment (intracytoplasmic sperm injection, dehydro-cryoprotectants and vitrification) have transformed this picture and now young women who have cryopreserved eggs can be offered the same chance of a live birth per embryo transfer as women undergoing conventional IVF treatment. For many women today it is not cancer but the simple passage of time that robs them of their chance of motherhood. Social, educational, emotional and financial pressures often lead them to delay trying to start a family until their late thirties, by which time the chance of success is very low. Women at age 40 face a 40% chance of miscarriage if they can get pregnant at all and by the age of 45, the risk of miscarriage is 75%. Donor eggs are not an option for many because of supply constraints and ethical and cultural concerns. Freezing a woman’s eggs at age 30 literally ‘freezes in time’ her fertility potential and gives her the chance of a healthy pregnancy at a time of her choosing. This paper discusses the role of oocyte cryopreservation in the context of social egg freezing.

Keywords: cryopreservation, delayed child-bearing, fertility extension, oocyte, oocyte vitrification, social egg freezing