By Professor Emily Jackson, LSE
All of the evidence to date suggests that women are, in practice, most likely to freeze their eggs in their late thirties, when egg freezing is least likely to work. If we are concerned only with clinical success rates, the best time to freeze one’s eggs is in one’s twenties. There are, however, other considerations that militate towards later freezing.
First, the younger the woman is at the time of freezing, the more likely it is that she will conceive naturally, and egg freezing will have been an uncomfortable waste of time and money. Secondly, in the absence of premature infertility, the statutory time limit for the storage of frozen eggs is currently ten years.
Women choosing to freeze their eggs therefore have to balance a complex set of odds. Do it too early, and your eggs are likely to be unused or legally unusable. Do it too late, and it will be more expensive, and more invasive (because more cycles are needed), and it is also less likely to work. There may then be an extremely narrow window in women’s early thirties in which the odds of the frozen eggs both being used and working well are (relatively) favourable.
There are potentially huge profits to be made from selling an invasive medical treatment to retrieve eggs from women who are unlikely to ever actually use their frozen eggs. It is therefore critically important that women have all of the information they need in order to give fully informed consent. It is also important that clinics do not oversell this technology as the ‘ultimate family planning technology’, capable of ‘stopping the biological clock’, ‘cheating biology’ and ‘preserving a woman’s fertility indefinitely’. Egg freezing does not preserve a woman’s fertility, which will continue to decline. Instead, while it might increase the chance of successful IVF treatment in one’s forties, IVF fails more frequently than it succeeds.
It is therefore crucially important that women understand that there are no guarantees that egg freezing will enable them to have a baby later in life. There is a danger that women with frozen eggs may be lulled into a false sense of security, and further delay childbearing as a result, making their future childlessness more, rather than less likely. As well as the immediate health risks and discomfort of ovarian stimulation and egg retrieval, women also need clear and frank information about some of the difficult decisions they will face in the future.
Egg freezing is commonly compared to taking out insurance: you may never need it, but it gives you peace of mind to know that it is there. But few of us would take out an insurance policy costing at least £4000 when the chance of it paying out were as slim as the chance of success with frozen eggs and IVF. Egg freezing is an insurance policy which will provide peace of mind only with a hefty injection of hope and optimism.
Emily Jackson is Professor of Law at The London School of Economics and Political Science, and has been an advisor to the Timeless project. Emily is a Member of the British Medical Association Medical Ethics Committee, and until 2012 was Deputy Chair of the Human Fertility and Embryology Authority.