Embryologist Ric Ross pulls out vials of human embryos from a liquid Nitrogen storage container at the La Jolla IVF Clinic February 28, 2007 in La Jolla, California. (Photo by Sandy Huffaker/Getty Images)

Is egg freezing the solution to gender inequality?

Why are more and more women are opting to freeze their eggs as a form of fertility insurance policy?

Artillery Row

Liz Beardsell was 35 years old when she thought that a baby might be on the horizon for her and her then-partner. While the relationship didn’t last, and despite not previously having had a notable maternal desire, the idea of becoming a mother was now something she contemplated afresh.

So, when a friend told her of how she had frozen her eggs, Liz was curious. Some months later and Liz decided to use the same clinic her friend had so thoroughly researched and freeze her own.

Over a four-month period, she went through hormone regulation, follicle growing and harvesting, and used three different kinds of injections, injecting herself daily, to do this. Liz also had the requisite scans and blood tests to detect whether had responded as required for harvesting good eggs, which all in all proved a more physically taxing experience than she had anticipated.

“I don’t think I was quite prepared for the impact it has on your body,” says Liz. “You can feel your ovaries. If you don’t drink the right amount of water and milk, for example, you do feel the impact and it’s quite exhausting.”

Nonetheless, Liz, who discusses the experience in her podcast, Diary, she wrote, is “pleased I’ve done it”, even while knowing that when it comes to converting those eggs into an embryo and then a baby, “the odds aren’t great.”

Liz’s story is typical of many thirty-something women who find themselves wondering if motherhood is on the cards for them, marital status aside, and decide that freezing their eggs may just be the insurance policy they’re looking for in the interim.

In fact, egg freezing has been increasingly common in the UK in recent years. Data from the Human Fertilisation and Embryology Authority (HFEA) show that the number of embryo and egg storage cycles increased by 523 per cent between 2013 and 2018 – from 1,500 cycles in 2013 to just under 9,000 in 2018, while there was a 93 per cent rise in frozen embryo transfer cycles between 2013 and 2018 – up from 13,421 to 25,889.

And now fertility clinics across the country such as the London Women’s Clinic are reporting an increase of up to 30 per cent in enquiries about egg-freezing as a result of the pandemic. The positive narrative is that women worried about the Covid-19 ‘dating drought’ are taking charge of their fertility during a time in which it is practically illegal to meet someone new. But at what cost?

Egg freezing increasingly presents itself as a solution to prevailing economic equality

Egg freezing is not cheap. According to the HFEA, a single round of treatment costs around £3500, with additional medication required costing between £500 to £1500 and egg storage costing around £250 per year. And then there’s the cost of having eggs thawed and transferred to the womb, at an average of £2500. Depending on the number of eggs produced, a woman may need to repeat the process two or three times to get enough eggs to freeze, giving her a mere 18 per cent chance of being able to convert an egg into a baby further down the line.

While some experts perceive egg freezing to be akin to the pill in terms of reproductive emancipation, others remain reserved about its effects on both the women that undergo it, and society at large.

Those experts include Professor Adam Balens of Leeds Teaching Hospitals, formerly chair of the British Fertility Society, who has cautioned about relying on egg freezing as a preferred method of having a baby. Professor Balen is keen that women and their partners better understand the time restrictions on their fertility in order that they can make the right choices for them in the appropriate time frame about having their family, and, as such, has launched a video series for younger people called Your Fertility Matters with the Fertility Education Initiative.

While Balen says that egg freezing is a vital procedure for those who are keen to preserve their fertility in the face of something like cancer, he is conscious that “social egg freezing” is “quite invasive” and that “some key things need to be understood” about the process, including the fact that only 4 per cent of babies currently born in the UK do so via IVF: “it’s an option but it shouldn’t be considered a guarantee”.

Balen also notes that:

The technology for freezing eggs has improved significantly but not all eggs once thawed will develop into embryos. A baby isn’t guaranteed by freezing eggs so there’s a debate about how many eggs to have in the freezer. The younger the better for freezing and certainly past age of 37 freezing eggs offers less chance of having a baby and it may even be a consideration to do more than one round of egg freezing.

All of which bumps up the cost as previously mentioned.

Of course, one of the key problems with social egg freezing is that it tends to be older women that do it, down to a combination of selective advertising on the behalf of private clinics and economics – most twenty-somethings simply don’t have the funds to egg-freeze – by which point its efficacy is in decline. As Mara Korotsou – Chief Medical Officer at Apricity and Consultant Obstetrician and Gynecologist explains:

The ideal time for egg freezing is when you’re at the prime of your reproductive life. The optimal fertile time is before the time of 35 but we see lots of women starting to explore the option in their late 30s. It can still be efficient and cost efficient up to the age of 38 but sometimes women do it over 40 as this is where it becomes difficult and you need to have a frank discussion about that working.

But despite this growing number of hope-dashed women investing in a procedure with rapidly diminishing odds of success, the HFEA has no rules or ethical guidelines about not harvesting eggs past a certain point. “They say for women over the age of 40 to advise them that the chance of it working is very slim. But once that’s been understood, they may still proceed.”

Anna* 43, from Hertfordshire, was one of those women:

Throughout my thirties, I’d wanted a baby but it hadn’t happened. So, as I approached my 40th birthday single, I made an appointment for myself at a fertility clinic. The staff I spoke to were adamant if I really wanted a baby, I should go for it. My age was barely mentioned.

With this in mind, Anna paid for and began a course of treatment. Just five eggs were harvested and she later failed to fall pregnant, only coming to terms with the fact she had perhaps been mis-sold her dream of motherhood once she gave up trying.

“I just wish they’d been clearer with me at the beginning. I now believe I should never have had the treatment.”

For every year a woman delays having children, she adds approximately 10% to her lifetime earnings

The economic motivations of those offering egg freezing also sometimes incentivises women in controversial ways. Take the London Egg Bank, which will freeze a woman’s eggs for free provided she donates half of them to other women in need, or the well-recorded cases of corporate businesses offering their employees egg freezing, raising questions about whose convenience it really suits. And then there’s the matter of the ten-year limit on storage, which has been raised as a topic of debate in the House of Lords recently with the Storage Period for Gametes bill, introduced by Baroness Ruth Deech, and supported by PET’s #extendthelimit campaign. Under this limit, if a woman in her late twenties or early thirties is to freeze her eggs, they will be automatically destroyed within a decade, regardless of the money invested in their preservation, or her partner status.

Aside from the controversies around its promotional strategies, egg freezing increasingly presents itself as a solution to a deeper problem of prevailing economic equality between the sexes. As Professor Adam Balen points out, for every year a woman delays having children, she adds approximately 10 per cent on to her lifetime earnings while women that leave the workplace in their twenties to have children “face significant economic disadvantages for their whole career – so society needs to address that”. He recognises that having children at one’s optimal fertile age is still not economically or socially viable for so many women. Perhaps egg freezing is an effective solution to this inequality.

Would egg freezing contribute to a culture in which fewer men are willing to step up to the domestic plate?

While finding economists who will comment on the societal implications of egg freezing is nigh on impossible (several I spoke to for this article said it was simply not within their remit), other critics of the economics believe egg freezing may simply act as a sticking plaster solution to structural inequality. As Suzanne Moore put it in a Guardian column back in April 2017 on the issue, “The structure of the workplace is still not meeting the needs of women, and the culture is not producing men who meet the desires of generations of women who thought they could have it all.”

Which brings us to the age-old question of just what impact egg freezing has on male responsibility. Recent survey data discussed at the 2020 Fertility Conference in Edinburgh found that only 2 – 3 per cent of women freeze their eggs because they want to concentrate on their careers. Instead, the majority are opting to do so because they are failing to find suitable male partners.

In many ways, it seems that egg freezing has soared in popularity not just because it offers women more control over their futures, but because it reduces the responsibilities of men along the way. But in what way might egg freezing contribute to a culture in which fewer men are willing to step up to the domestic plate?

“I don’t know”, says Sophia Money-Coutts, whose podcast Freezing Time explores the topic and her own journey of egg freezing:

I go round in my head about what men think about women and children and babies. Men know so little anyway. On the podcast, I talk about the Lister Clinic’s open evening where the men have no clue what’s going on. There needs to be quite a lot more education in general when it comes to men and fertility. I don’t know if egg freezing gives them a false sense of security.

While doctors like Professor Balen focus on the need for better fertility education, those like Sophia Money Coutts who have chosen to freeze eggs remain confident that the procedure is, for now, worth it: “Egg freezing is far from perfect and not guaranteed but made me feel like I had a bit more control. And any bit of control we can claw up back from the patriarchy is to the good!”

*Name has been changed to preserve anonymity.

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