Despite the improving odds of success, some reproductive specialists say egg freezing is not ready for prime time. “The field is still new,” admits Dr. Grifo, who says that many women have frozen their eggs, but few have used them yet.
While a few facilities have a solid track record and carefully monitor patients, some centers have not yet produced a single birth. And some experts fear the industry may be promising more than it can deliver. “Some programs portray egg freezing as mainstream,” says Dr. Winslow. “It’s not.”
There are also concerns about the safety of freezing eggs. A 2008 study from McGill University found that the rate of birth defects from vitrified eggs was 2.5 percent, which is comparable to natural pregnancies and IVF. While reassuring, it’s only a start. “We will know better when there are thousands of babies born and followed through puberty,” Dr. Winslow says.
Experts are conflicted on whether women who don’t have a compelling medical reason to delay childbirth should be offered the option. No one questions a woman freezing her eggs because she faces losing her fertility due to cancer, but what about healthy women who want to have children later in life? Some feel the procedure, at least for now, just gives false hope. Others wonder why you wouldn’t offer women a chance to preserve their fertility if the technology is available.
These are among the reasons ASRM still considers egg freezing experimental and discourages its use among healthy women until more is learned. “I’m hopeful that it will work,” says ASRM past president G. David Adamson, M.D., a clinical professor at Stanford University School of Medicine. “We’re just not quite there.”
n a paper published in February in the Journal of Assisted Reproduction and Genetics, three leading researchers in the field urged the ASRM to remove the experimental label from egg freezing. Writing in Slate magazine in March, Sarah Elizabeth Richards (whose book, Motherhood, Rescheduled: Five Women, Five Quests to Stop the Biological Clock will be published by Simon & Schuster in October) wrote: “Ideally, as doctors churn out clinical results the field can find a middle ground, preserving the relevant elements of the experimental label—such as informed consent—while enjoying the medical and social acceptance of the mainstream.”
Experts agree that healthy women who seek egg freezing to delay childbearing should be carefully counseled about the possible risks and the chances for success. “It’s always optimal to think of starting a family earlier rather than later,” says Dr. Winslow. “But if individuals don’t have a choice—either because they haven’t met Mr. Right or they’ve reached a point where their ovarian reserve is a concern—then egg freezing is a reasonable option.” Adds Dr. Silber, “The message should be, ‘Live the life you want to live. Here’s a hedge against infertility, but it’s not a guarantee.’”
Jean Farmer (not her real name), 38, a finance professional in San Francisco, knows her decision to freeze her eggs in 2009 was a gamble. She had recently broken up with a long-time boyfriend and saw no prospect for marriage or pregnancy soon. “A doctor advised me to bank whatever eggs I might have,” she says.
So far doctors have been able to retrieve only about eight of Farmer’s eggs—16 is considered optimal for someone her age to have a 50-50 shot at a later pregnancy. She is considering undergoing one more cycle before moving on. “I know the odds are against me,” she says. “But this is something I don’t want to regret in the future.”
More Preservation Options
Egg freezing isn’t the only fertility preservation option for women, although it is currently the most successful. Next on the fertility front are techniques that sound like science fiction: ovarian tissue freezing, entire ovary freezing, and ovary and womb transplants.
Stopping the Fertility Clock With New Techniques|
May 28, 2010
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