February 23, 2016 | In the News
Viv Groskop, British writer and stand-up comedian, wrote a recent op-ed in the Guardian calling “social” fertility preservation “weird” and “hideous.” The essay is not only unnecessarily judgmental of women’s choices, but full of inaccuracies that are making our heads spin (and giving health journalism a bad name). Here are 7 corrections we wish we could make to Ms. Groskop’s report.
1. Calling egg freezing a “fertility gamble” is misleading and inaccurate. Sure, this headline is an attention grabber. But typically, when we think of something as a “gamble,” we’re thinking of something reckless and crazy—throwing money away at the slots in Vegas, for example. Egg freezing is actually the opposite of a gamble. It’s uber responsible, an investment of time and money to try to keep more life options open in the future. Think of it like buying insurance (though it’s not insurance, as we explain below). Far from a gamble—this is actually a really smart and, dare we say it, nerdy thing to do.
2. No doctor would make promises about the outcome of a medical treatment. Ms. Groskop writes that egg freezing “seems to make the promise of a guarantee or fallback” while actually “just introducing more Russian roulette into your family planning in the guise of a faulty insurance policy.” Medical treatment—including elective procedures like egg freezing—are never a guarantee, and healthcare teams like ours ensure that women fully understand the potential benefits and side effects of a treatment before proceeding. (Seriously. You should see our consent form.) It’s our goal, and the goal of many other healthcare providers, to improve public understanding of egg freezing by providing accurate and thorough information.
That being said, recent medical evidence points to the fact that, when eggs are frozen in a woman’s 20s or early 30s, using those eggs to try to conceive after 35 is successful about 50% of the time—higher when they froze 15 eggs or more. (See the study.) No, it’s not an insurance policy—but it is an option that can drastically improve a woman’s chances of pregnancy. No guises or “Russian roulettes.”
3. Plenty of women have benefitted from egg freezing, even if Ms. Groskop doesn’t know them. “Have you heard of anyone of your acquaintance, even anecdotally,” Ms. Groskop asks, “who has used this ‘socially’ in the past 15 years and would recommend it to others?” Though a quick Google search might clear this up for her, it seems Ms. Groskop is ignoring the fact that there’s still—unfortunately—a stigma around egg freezing. Perhaps that’s what’s keeping her friends, family, or coworkers from discussing the procedure at the water cooler or over lunch?
In actuality, though it’s only been deemed “non-experimental” for a few years, egg freezing has already been used by scores of women, many with positive results. In our network of providers alone, nearly 2,000 freezing and thawing cycles have resulted in about 700 babies and 450 active pregnancies (as of December 2015). (If you’re counting, that’s about a 50% success rate.) And our providers are only a few of the reproductive endocrinologists offering this procedure worldwide. Suffice it to say that plenty of women—perhaps even some in Ms. Groskop’s immediate circle—are opting for egg freezing. Read more about why egg freezing is so popular now.
4. The “research and the headlines and the funding” offered to social egg freezing procedures aren’t taking away from IVF or medical egg freezing—these procedures go hand-in-hand. “Of course egg-freezing techniques are invaluable,” writes Ms. Groskop, “and the science behind them deserves to be lavishly funded to benefit those with a medical need.” And, later: “Who among us doesn’t know someone who has had IVF (without social egg-freezing), using their own genetic material or donor eggs?... These are the people who deserve the research and the headlines and the funding: the women and men with fertility problems.” Setting for a moment aside the icky notion of determining who “deserves” an available medical treatment, we want to address another illogicality in this statement. The truth is that research on egg freezing benefits in vitro fertilization, and research on in vitro fertilization benefits egg freezing (and, of course, medical egg freezing and social egg freezing are exactly the same procedure).
That’s because egg freezing is, essentially, just the first half of the in vitro fertilization process. In vitro fertilization consists of ovarian stimulation, egg retrieval, fertilization, and embryo transplant; egg freezing uses all of the same techniques, with the addition of freezing and thawing between the retrieval and the fertilization. The medication is the same. The retrieval technique is the same. And egg and embryo cryopreservation—the technical term for freezing—is even used in many medically “necessary” cases of fertility treatments. So if doctors and researchers make discoveries or improvements to either process, those discoveries or improvements will affect all the processes.
5. Age is a key factor in declining fertility. Ms. Groskop writes that, among couples with fertility problems that require in vitro fertilization, those problems “often don’t have anything to do with age.” “Often” is a noncommittal word, but we want to make one thing clear: ovarian disorder is the number one factor in declining fertility, including difficulty conceiving and miscarriages. And the top causes of ovarian disorder? Polycystic ovary syndrome (or PCOS) and—you guessed it—age-related diminished ovarian reserve. SART, or Society for Assisted Reproductive Technology, deems age “the most important factor” for success in fertility treatments. So while, yes, many younger women and couples suffer from infertility, the fact remains that about half of the women undergoing in vitro fertilization are over the age of 35.
Age is the only common, but untreatable cause of infertility. Even with IVF, a doctor can’t rewind the clock on your eggs. That’s why IVF cycles in women over 40 using fresh (never frozen) have low success rates (think under 20%), even at the best IVF clinics—unless the patient is using donor eggs (fresh or frozen) from a younger woman. See more.
6. An increase in social egg freezing can actually decrease the need for traditional in vitro fertilization. Ms. Groskop expresses sympathy for those who require in vitro fertilization to get pregnant, saying that IVF is “not something you sign up to willingly… It’s a last resort.” If Ms. Groskop is so highly concerned about those couples suffering from infertility and undergoing IVF, she should be applauding the increase in social egg freezing. As we’ve established, egg freezing drastically improves the chances of getting pregnant after 35, and age is one of the most important factors in infertility. It makes sense, then, that research has demonstrated that using eggs frozen when a woman was young to conceive later decreases the chance that she’ll need in vitro fertilization, and reduces the number of cycles—and the cost—involved in achieving a successful pregnancy. Egg freezing increases the success rate of older women attempting pregnancy—who are the primary people using IVF—and therefore can decrease the need to turn to the “last resort” of traditional IVF or egg donation.
One way to think of egg freezing is as preventative care. By freezing her eggs when she’s young, a woman is actually able to be her own egg donor later in life, significantly increasing her likelihood of pregnancy and allowing her to give birth to her own biological children.
7. Changing social attitudes toward working parents isn’t exactly the easy fix Ms. Groskop suggests it is. In the final paragraph, she writes, “The one thing that we could fix easily without money or false promises gets comprehensively ignored: namely, social attitudes towards working parents. Because you don’t need to worry that much about your fertility if you can have a family when you’re ready (and when you’ve met the right person) and when it doesn’t disrupt your working life.”
We absolutely agree with Ms. Groskop here: women (and men) who want to have families when they’re young should have the support to do so. However, she’s blatantly ignoring the fact that women choose to delay childbearing for a whole host of reasons, not just career-driven ones. A recent article written by a woman who’s actually undergone the procedure demonstrates that not having a partner is a strong reason motivating some women to choose egg freezing; in fact, a recent study demonstrated that 88% of women choosing to their freeze their eggs were delaying childbirth because of the lack of a suitable partner. Apart from single motherhood (which many women choose also) or jumping into parenthood with a fling, egg freezing is the best option to address this reason for delaying childbirth.
Other reasons for egg freezing? Emotional readiness, the desire to study or travel before settling down with babies, medical or financial reasons that prevent a woman from being fully prepared for a baby in her 20s. Changing attitudes toward working parents can’t possibly address all of these obstacles. And—even if it could—centuries-long global fights for civil rights have demonstrated that social attitudes may actually be the most difficult thing of all to change.
So there you have it, a few of the facts to help clear up any of Ms. Groskop’s misconceptions. If we were writing an op-ed about egg freezing? It’d go something like this: give women the facts, and let them decide what to do with their bodies—and their futures.
What do you think about Ms. Groskop’s op-ed? Tell us on Twitter!