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Is it true - Should women freeze their eggs (Oocyte cryopreservation)?

Women as young as 30 are being targeted by businesses advertising to freeze their eggs in order to extend their reproductive years. In 2014 in the US, Facebook and Apple announced that they would subsidise their female employees’ elective (aka ‘social’) use of egg freezing to let women pursue their careers for longer.
But what is the success rate versus cost of freezing your eggs and is it a genuine option for women wishing to preserve fertility?

Provide your answers below and we’ll award Fact Finder badges to the best comments.

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This scheme hinges mainly on the idea that as women age their eggs degrade and fertilising an egg that was harvested while young (say 20) carries fewer genetic risks than an egg produced at (say) 40. Another reason for the procedure is to extend the age of fertility past the normal span. We have to keep in mind that new eggs are not created during each cycle, just released from storage. As the eggs age the chance of some genetic damage increases. For example the probability of having Down’s syndrome children increases with the age of the mother. Genetic issues (not necessarily derived from the egg) are a major reason for miscarriages, which are more prevalent than usually thought.

Whether egg harvesting fulfills the aims of having healthier embryos or middle-age fertility is only part of the story. Bear in mind that there will always be a cost in money and (probably) emotion in going through the harvesting and fertilisation procedures and that they are not certain to work.

Aside from that there is the question of whether it is a good idea (regardless of genetic problems) to be bearing children as one ages. It may be unfashionable but once women reach 35-40 the chance of medical complications with the pregnancy itself increase. Even if you have a genetically clean fetus the body is not such a good host. As with the genetic questions this a matter of probability, it is quite possible for a 40+ woman to have no problems and for a 20YO to have plenty. But overall the odds favour the young. As for those contemplating pregnancy after the normal age of menopause, it can be done (women over 60 have given birth) but is it a good idea?

The last point I want to make is that parenting is hard work. Would all the women who recall sleepless nights and seemingly endless days of nappies and vomit at 28 have the energy to do it all at 48? Will you be able to romp in park or at the beach with your children if your back hurts and all you are looking forward to is retirement? Do you think it valuable for grandparents to be around to support young families in very many ways, is this a part of the cycle of life that you look forward to? Leave it too late and you will miss out.

TANSTAAFL

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Andrea - firstly, may I suggest you change the title to “Should women freeze their ova”?

When I saw the title in the listings I thought it was about chicken eggs. The correct term for what you are talking about is ova or if talking about one, it is ovum. And of course, the ‘you’ is imprecise, because obviously it only applies to women.

In general, the longer women leave the fertilisation of their ova (getting pregnant) the less the likelihood of success, and the greater the risk of complications. The quality of the ova deteriorates from about the age of 20 years old, and decline considerable from the mid 30s leading to increased infertility and likelyhood of complications both with the foetus and with the birth. The tendency is for women to leave pregnancy till their late 30s and even into their 40s.

IVF doctors and clinics makes huge promises to these women/people/couples about their success rates, but the true statistics don’t back the promises up. Ova can be frozen and thawed for use. Having younger healthy thawed ova to fertilise even if the woman is older does improve the chances of success.

What maximises the chances of having a healthy baby is getting pregnant earlier when the woman is no later than in her early to mid thirties. Twenties is the best chance.

Those companies are being very mercenary about retaining their female staff at a very high personal cost later to those women.

So yes it is a genuine option, but it reduces the fertility and likelihood of a normal pregnancy compared to having a ‘natural’ pregnancy earlier.

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Thanks for the feedback @meltam - hopefully the changes I’ve made make the topic clearer.

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Even better than my suggestion @ajohnson .

I had refrained from being that medically correct because I though it would be too much. :smile:

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“oocyte cryopreservation” is precisely correct but my buccal lingual implantation prevented me from saying so until you mentioned it.

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If one knows they are about to undertake a medical treatment which could affect fertility (through surgery or medications), then freezing eggs may be worthwhile as the risks associated with freezing may override the risks of having future fertility problems.

There are risks associated with falling pregnant when one is older and these include higher chance of genetic problems (e.g. down syndrome) and miscarriage/still birth. These can be partially overcome through using frozen eggs when one was younger, but can also be screened during the pregnancy to allow parents to make an informed decision in relation to the pregnancy.

Most medical practitioners indicate that risks generally increase anyway after puberty. but substantially increase after the age of 40.

The other complication of waiting for a later pregnancy is conception/fertilisation rates lower. While there may be a higher rate of a fertilised egg with a frozen egg (IVF), the is still age risks associated with the fertilised egg not implanting in the womb.

Irrespective of whether frozen or ‘fresh’ eggs are used for a later pregnancy, the risks of gestational diabetes, placenta previa, breech positioning of the baby, emergency cesarean delivery, postpartum haemorrhage, preterm birth, low birth weight, high birth weight or mother mortality increases. There would be no difference between frozen or fresh as these complications are due to the mothers age and not that of the egg.

There is also the ethical dilemma of what to do with the frozen eggs when they are no longer needed. So they be destroyed. donated or used for research? Each of these do require some thinking as one will have to make a ‘difficult’ decision at some stage int he future.

I personally think that unless one knows of a major event (e.g. surgery or medications) which will significantly affects one fertility, the benefits of freezing eggs at 30 aren’t warranted.

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Freezing of the ova of younger women who may wish to wait some longer time before becoming pregnant or who are suffering cancer or some other illness and thus may be subject to radiation and or drug/chemotherapy are certainly valid choices. Yes it does lower the risk of Downs Syndrome and other generally age related genetic abnormalities, but also missing in this is the age of the sperm that are being used.

If a woman and her male partner are both much older when seeking to become pregnant then the risk also rises due to the age of the male person and thus the genetic quality of their sperm. There has been some research into this and it may increase the risks by around 20% (nothing as yet is a hard and fast figure but the studies suggest at around this figure). So even if frozen ova are used the risk factor because of an older father increases significantly.

It is perhaps where possible for increased chances of genetically healthy children that becoming pregnant earlier in life is better than waiting a long time to use frozen ova.

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Thanks for all your accurate and considered responses. Egg freezing has low success rates, that get lower the older the eggs are. But the way these services are marketed to women can build unrealistic expectations, leaving them thousands of dollars out of pocket with zero return on their investment.

Considering the amount of money required to undertake the treatment ($10,000 per cycle, plus storage costs of around $300 per year) it is highly unethical for women to be targeted in advertsing for these services based on their age and for companies to offer it as a ‘perk’.

Great point @phb! At what point in time do you even decide that you no longer need to store them and the potential that they represent (talk about an emotional decision) and how are they disposed of? Bio-security and ethical dilemmas crop up everywhere in this topic.

I’m awarding fact finder badges to all of you - really nice work! :clap:

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