The flawed promise of the egg freezing ‘insurance policy’

The flawed promise of the egg freezing ‘insurance policy’

A phenomenon we have covered before is the increasing pressure on women to consider freezing their eggs. It is advertised as a new solution to the ‘biological clock’ problem, the panic-inducing thought of women’s peak fertility window only lasting until around age 40. 

IVF Australia’s website promotes egg freezing as “a way of preserving the possibility of fertility for women who are not in a position to become pregnant” by extracting eggs and freezing them until they are wanted, before they are warmed, fertilised, implanted and (fingers crossed) developed into healthy children. 

Companies like Apple, Spotify and Facebook offer to cover the costs of egg freezing for their female employees and ads on Instagram target millennials with ticking clock emojis and chirpy slogans: 

"I got to say, you don’t look a day over 33 *heart eyes*" 

"When you freeze your eggs, you #freezetime" 

Playing on women’s anxieties about fertility and the possibility of not being able to have children, both fertility clinics and companies reluctant to provide maternity leave for their young female employees offer women a ‘generous’ insurance policy instead: freeze your eggs and you don’t have to worry about having kids later in life. (In the meantime, keep working).

The problem is that egg freezing is not, by any definition, an effective insurance policy. 

Firstly, the procedure is incredibly expensive. A study published in the Canadian Medical Association Journal (CMAJ) examining “Social egg freezing: risks, benefits and other considerations” estimates that a single stimulated cycle costs between $5,000–$10,000 CAD, in addition to hundreds of dollars spent on annual storage fees and medication costs. In the UK, the whole process of freezing and thawing on average costs between £7,000–£8,000, according to the Human Fertilisation and Embryology Authority. In Australia, IVF Australia’s website is coy about the costs. Medicare will subsidise the procedure if it is done for medical reasons, for example, for someone freezing their eggs because they are undergoing cancer treatment. For social egg freezing, it can cost a woman up to $10,000.

Not only is it expensive but it is also invasive, requiring women to take rounds of hormonal medication to stimulate egg production, before a transvaginal oocyte retrieval which happens under general anaesthetic. This procedure inserts a needle through the vaginal wall and then into the follicles. Women who have undergone this procedure attest that it is not innocuous.

There are also numerous risks to both mother and child associated with the egg freezing process, as outlined in the CMAJ study. 

To add insult to injury, egg freezing is very unlikely to be successful. IVF Australia’s website lists some success rates at each stage of the egg freezing process, without any linked data or studies to support these statistics. These are more optimistic than the success rates published in the CMAJ study. According to the study, the clinical success rates for pregnancy following egg freezing are about 4.5–12%, with an abysmal live birth rate of only 2–12% for women under 38 years of age. One can only imagine the disappointment of a woman who has waited until her 40s, paid thousands for hormonal treatment, extraction, storage, thawing, fertilisation and implantation processes, only to experience the trauma of unviable pregnancy or miscarriage. 

It is surely unethical to promote egg freezing as a viable insurance policy when it simply does not provide women with the solution it promises. There must be a better way for women who want to have children. We need to talk more about the way a woman’s fertility changes across her lifetime – it is not as simple as using contraception until you’re ready to turn your fertility back on, as Dr Karin Hammarberg stated last week in the Sydney Morning Herald. Instead of offering women expensive, invasive and ineffective procedures so that they can work and study through their 20s and 30s without ‘interruption’ from childbearing, shouldn’t we instead restructure our economy and workplaces to give women the freedom to have children whenever it is best for them to do so? 

As the CMAJ study notes, “the pressure to use egg freezing unduly places reproductive responsibilities on individual women and obscures the influence of social structures that can contribute to delayed childbearing in the first place.” 

Women are forced to sacrifice motherhood in order to study or advance their careers in their 20s and 30s, and afterwards turn to inadequate avenues like egg freezing to try to restore the fertility they sacrificed in those peak years. 

We need solutions that protect and respect rather than manipulate a woman’s fertility across her lifetime. Women wouldn’t need to freeze their eggs if their workplaces had policies that supported young mothers. If housing was more affordable for young couples, fewer would be forced to delay having children. Sex education that currently treats fertility as a disease to avoid at all costs could instead consider it as one of the many unique and important aspects of a woman’s health and life. More men could step up, commit to and co-parent with their female partners, and fathers could share more of the burden of parenting to take the pressure off women’s careers during those childbearing years.

Economic and workplace policies shouldn't penalise women for having kids in their peak fertility window – they should support them to do so. No woman should have to fork out thousands of dollars for a procedure that works 2–12% of the time because her workplace, study, or career won't accommodate her choice to have children when it is easiest on her body and most likely to result in a healthy pregnancy. This legitimate choice shouldn't come at the cost of other aspects of her life. Egg freezing is a band-aid on a problem that can only be solved with a renewed focus on and respect for women.