Introduction from Jody Day, Founder at Gateway Women: I have been increasingly concerned for some time now that egg-freezing is being promoted by the media as the new way to buy peace-of-mind insurance for those women struggling with social infertility, whilst its low success rates and patchy live birth data was not being explored. I am therefore delighted to exclusively publish Miriam Zoll’s new analysis of how this procedure is being taken up and promoted by the ART (Assisted Reproductive Technology) industry in the US…
The most comprehensive study to date [i] evaluating the effectiveness of egg freezing revealed that, despite a new flash freezing technique, high failure rates continue to be associated with egg freezing procedures across all age groups.
The May 2013 data meta-analysis study published in Fertility and Sterility [ii] found that using a technique known as ‘vitrification’ did reveal some improvements for women younger than 30 but that there were certainly no guarantees. Tracking outcomes of 2265 thaws in 1805 patients the study found:
- For women aged 30, the failure rate of an embryo deriving from slow freeze method of egg freezing to transfer was 91% (8.9% success); with vitrification (flash freezing) the failure rate was 77% (13.2% success).
- Women aged 40: 96% failure rate with the slow freeze method (4.3% chance of success) and a 91% failure rate with V (8.6% success)
- There were some live births recorded with the slow freeze method at age 42 and some with vitrification at age 44, but these were very small percentages.
- Miscarriage rates in women between the ages of 30 and 40 who used the slow freeze technique were 35-41 percent. The use of vitrification in this age group reduced miscarriage to 19 – 22 percent.
Researchers concluded: “Our analysis revealed age 36 years as the cut point to provide the best discrimination between successes vs. failures, hence optimal results may be expected in patients who are younger than this age threshold (younger than age 36 is best).”
In October 2012, the American Society for Reproductive Medicine (ASRM)––the lobby and voluntary regulatory arm of roughly 500 infertility clinics in the U.S.––lifted the “experimental” label from this still young science. [iii]
Its Practice Committee said it was not yet ready to endorse widespread use of egg freezing for elective treatments and, while randomized controlled studies were rare, the committee said it did find ‘sufficient’ evidence to “demonstrate acceptable success rates in young, highly selected populations.”
Citing a lack of data on safety, efficacy, cost-effectiveness, and potential emotional risks, their report states, “Marketing this technology for the purpose of deferring childbearing may give women false hope and encourage women to delay childbearing. Patients who wish to pursue this technology should be carefully counseled.”
As would be expected, once their decision became public, their warnings about women’s age and infant health was obscured and eventually obliterated by the dust kicked up by a stampede of panicked but hopeful thirty and forty-something women running to the nearest fertility clinic to have their eggs harvested for future use––for anywhere between $10,000 and $15,000 or more. [iv]
One must wonder why the ASRM felt so compelled to provide a stamp of approval for a procedure still lacking in reliable safety and efficacy data. As legal scholars Debora Spar and Naomi Cahn have written in their books, The Baby Business and Test Tube Babies, respectively, in the context of an unregulated industry in the United States, it is virtually impossible to separate the medical and market forces at play when new techniques and procedures are advertised to potential clients. The blurred boundaries between fertility clinics wanting to provide patients with safe, evidence-based procedures while also needing to generate business to meet their bottom lines puts that much more pressure on consumers to know what they are signing up for.
Author: Miriam Zoll, February 2014
www.miriamzoll.net
Miriam Zoll is an independent journalist and the author of the new book:
Cracked Open: Liberty, Fertility and the Pursuit of High-Tech Babies (Interlink-2013).
About Miriam Zoll
Footnotes:
[i] “Age-specific Probability of Live Birth with Oocyte Cryopreservation: An Individual Patient Data Meta-Analysis,” Aylin Pelin Cil, M.D., Heejung Bang, Ph.D., and Kutluk Oktay, M.D., F.A.C.O.G., May 2013, http://www.asrm.org/
[ii] Ibid
[iii] http://www.asrm.org/Fertility_Experts_Issue_New_Report_on_Egg_Freezing_ASRM_Lifts_Experimental_Label_from_Technique/; http://blog.oncofertility.northwestern.edu/2012/10/asrm-egg-freezing-no-longer-experimental-technique/; http://www.nursingconsult.com/nursing/news/full-text?news_article_id=239680&value=ASRM:%20Egg%20Freezing%20No%20Longer%20%91Experimental%92
I was lead to believe that if I had 20 eggs frozen that I could be fairly sure of having a baby. I did 3 rounds and froze 33 eggs, just to be sure. That was when I was 37. I am now 42 and recently thawed out the eggs for fertilization only to find that I didn’t even have a chance.
With regard to Miriam Zoll, while her concerns with regard to IVF promises and egg freezing are noteworthy and important – what concerns me is the blame game on one hand alongside the idea that as strong intelligent women we are getting hoodwinked. As strong intelligent women self-reflection and personality responsibility on behalf of our choices is a requisite. The point is life isn’t fair and surely the real point of feminism and choice is that we are able to take responsibility for our choices – even the ones, that in hindsight, were not the ones we would have chosen.
Hi, this is Miriam Zoll. The point of my post is that many clinics are not sharing the high failure rate data with their prospective clients, and that women who might enter into an egg freezing contract with a clinic may be doing so without being fully informed of the high failure rates, or the health risks involved.
That’s a great post, thank you so much! I get so annoyed when I hear about the egg freezing thing: First, I am a mathematician and I knew the numbers so I could help but noticing how low the odds were. Then, I have 4 failed IVFs in my mid-thirties, so how is freezing eggs along the way improving anything? Because let’s face it, who has that kind of money in their twenties? Certainly not someone smart enough to make the computation…
What bugs me even more is that this egg freezing scam is yet another way of saying that if you end up childless, well then it’s your fault, “you should have been smarter and frozen your eggs!”.
Hi Lara – your point that it’s yet another way to make it all about making ‘the right choices’ and therefore our fault is spot on. I hadn’t played it forward to that conclusion, but I can see you’re totally right. Jeez. When will the ‘blame’ end!
Thank you for sharing this, Jody and Miriam. This is shocking information. It is true that lots of people think they can freeze their eggs and retrieve at virtually any time for a guaranteed baby. Wow. Another proof that if you’re going to have babies, you need to do it while you’re young.
Hi Sue – thanks for your comment – these options weren’t around when we were young – but I’m sure I would have bought the hype because that would have been so much easier than the truth… which is that life may be long but fertility is short! Jody x
Thank you Jody, & Gateway Women, for continuing to give space and focus to the issues and truths of fertility treatments and results. I hope women reading now will have more understanding of the real ‘success’ rates and more independent support around them as they make decisions regarding treatment than was available to my generation as we transferred our life savings to clinics based on fantasy and obfuscating deceit, if not actual lies. Thank you also for creating such an amazing community in which we can unpick our paths and heal some of the painful wounds of childlessness – I look forward to supporting you for many, many years to come, as you seek to bring understanding and empathetic support to more and more women who need to heal and ‘move beyond’, to live the life they have, with joy x
Hi Emma – thanks for commenting. I was a babe in the woods too when it came to believing the hype… I hope that the next generation coming up behind us have a chance to make their reproductive decisions with more data and less daydreams…