Egg Freezing: Taking a Closer Look at the Experimental Label


Should young women who aren’t ready to have children have their eggs extracted and frozen as an “insurance policy” for future motherhood? Several recent media features seem to be promoting egg freezing, with little or no mention of the risks involved for women who undergo egg retrieval procedures or for the children that might be born as a result.

A January 23 article in Newsweek / The Daily Beast leads with Diane Sawyer encouraging young women who work for her to freeze their eggs and is illustrated with glamorous photos of celebrities who have themselves used egg freezing, egg donors, or surrogates. The article is unabashedly enthusiastic about egg freezing, but makes no mention at all of the significant down sides.

CNN special report, titled Baby Quest, features an inside look at the vitrification process behind freezing eggs. The report encourages women who are concerned with their fertility to consider taking the leap by stimulating the growth of as many eggs as possible in their twenties and thirties, and freezing them “in time.”

And last week the Huffington Post published a first-person account of a 34-year-old woman freezing her eggs to safeguard her future fertility. She encourages more women to start talking about egg freezing, but within the article itself there is no discussion of the relevant risk factors women might consider before opting in.

While the American Society for Reproductive Medicine (ASRM) clearly states that all egg freezing should be considered experimental, this recent media coverage has sent a different but also clear message: egg freezing can prevent infertility – and you need it as an “insurance policy.”

Diane Sawyer has even endorsed a particular egg freezing go-to clinic: New York University’s Langone Medical Center Fertility Clinic. Sawyer froze her own eggs there, and urges colleagues and staff to similarly attain “reproductive autonomy” from her personal fertility specialist, Dr. Nicole Noyes.

Noyes and her Langone partner, Dr. James Grifo, were also featured in the recent CNN segment, which is light on information and heavy on infomercial. Their comments neglected any of the risks associated with egg retrieval or freezing.  Perhaps this is unsurprising in light of Noyes’ comment in Nature last August that the experimental label should be eliminated. “The change in perception,” she says, “will make freezing more widely available and advance the field.”

One has to wonder whether the incentive to “advance the field” might be tied to egg freezing’s $15,000 price tag, and to the new business opportunities opened by a procedure that can be marketed to large numbers of young women rather than only to people with medically known fertility problems.

There are good reasons that egg freezing has been deemed experimental. ASRM’s focus was on the unpredictability of successful pregnancies initiated with embryos made from thawed eggs, and on the lack of research about the effects of the procedure on children born from frozen eggs. As ASRM Practice Committee Chair Samantha Pfeifer pointed out, “Some of the chemicals used in the freezing process are toxic to embryos, and no one knows how much the eggs absorb. Moreover, there has been no systematic follow-up of children born from frozen eggs.”

In addition, it’s important to consider the short-term and long-term risks of egg extraction, which are known to be significant but are also under-studied and under-reported. If the recent spate of media treatments is any indication, many women who consider egg extraction – whether for immediate fertility treatment, possible future fertility treatment, or to sell their eggs – will remain unaware of these risks.

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  • atleebreland

    The best estimates are that somewhere around 1500 children have been born worldwide following oocyte cryopreservation — compared to millions of IVF babies. More than half the US clinics which offer oocyte cryopreservation have never had a live birth at all. Just eight clinics in the US have managed to produce 10 or more live births. (http://www.nature.com/news/2011/110823/full/476382a.html)

    Nicole Noyes’ own clinic has done just 46 cycles total, according to their website, with 21 live births. Meanwhile, they do over 1000 standard IVF cycles per year. 

    Cryopreservation is a good option for some very carefully selected patients, but the idea that it’s a gateway to “reproductive autonomy” is just ludicrous. 

     

  • maggie-in-va

    Yes, it sounds neutral and wonky, but look it up on Wikipedia and related terms like “bioconservative” and “neoLuddite” appear at the bottom.  These people are the left-wing’s answer to Kubrick’s general ranting about sapping and impurifying our precious bodily fluids.  And they are able to exploit the general public’s ignorance about assisted reproductive technology to get support.

    Makker says, “there has been no systematic follow-up of children born from frozen eggs.”  The first child from a frozen oocyte cycle was born in only 2005.  The technology has only been available outside research studies for several years.  This would seem to amplify her point about egg vitrification’s experimental status, but what most people who aren’t involved in fertility medicine or who haven’t had fertility treatment won’t understand is that the place that most genetic defects will be revealed is when the embryos fail to grow in culture or once placed in the recipient’s uterus, i.e., the embryo will fail to implant or the woman will miscarry.

    Ms. Makker throws in ominous allusions to the dangers of egg retrieval, which are real enough, but the great majority of women — and every woman who undergoes IVF with her own eggs does — will suffer no long-term health problems.  The high price tag of oocyte vitrification makes it a non-starter for most young women, and unfortunately most of the women who are inquiring about it are already too old.  I suspect that fertility clinics will begin to offer vitrification at a discount to qualified women who donate a portion of the eggs retrieved for donor egg IVF.  But fertility clinics are researching and developing their techniques, women are getting pregnant through frozen egg cycles, and unless other technologies offer more hope for preserving fertility in the future, egg vitrification will probably become commonplace.