Egg freezing: Can you really put motherhood on ice?
Brigitte Adams, from the UK, was 38 and single when she froze her eggs, fearing her chances of motherhood were running out. It was not an easy option. Six years ago, the process was very unusual and, at a cost of around $19,300, expensive.
The Los Angeles-based marketing director went through one cycle and harvested 11 eggs. She chose not to have them fertilised with donor sperm and frozen as embryos because she still hoped to find a potential partner. "I didn't want to be a single mum," she says.
But by June last year, Adams, now 44, who runs eggsurance.com, an online community offering information to women considering egg freezing, had come to accept it was time to act alone.
"No one talks about part-two of egg freezing," she says. "We need to start."
Her experience will be aired in the UK in The Great Egg Freeze, a BBC Radio 4 documentary presented by Fi Glover, who considered going down the egg-freezing route herself almost a decade ago when she was single, in her early thirties, and living in the US.
"In the end, it all seemed just a bit too uncertain," she said this week, so she "went on loads of dates instead". Now 47, Glover is mother to two children, aged 11 and eight, and is questioning the trend for US tech companies such as Apple and Facebook to offer egg freezing as a job perk to young female employees.
Does the process really promise the chance to dictate when you start a family, in an age when women are keen to pursue the same career timelines as men - and both sexes wait longer to settle down?
Or is it slickly sold "fertility insurance", that encourages women to defer conception and work through their natural child-bearing years with no real guarantee of later success?
Either way, the option is becoming more normal than you might think. Although we are yet to see the sort of egg-freezing parties thrown in LA and New York - where women sip champagne as they learn about storing their oocytes via the latest vitrification process - UK clinics have already given talks to female employees at investment banks.
Adams says: "There is so much positivity about egg freezing, and I am pro the idea, but there is not a lot of realism. Egg freezing is highly marketed - and not all doctors are being transparent with the data."
She would know. In the past eight months Adams has watched as only nine of her preserved eggs thawed out successfully. Of those, fertilisation took place in only six, and of those just one developed and survived to a sixth day after fertilisation, when it could be used.
Nine days after the embryo transfer, last month, she was "thrilled" to have a positive pregnancy test. But within 48 hours, her hormone levels began to drop. "I was told on [the] Saturday that I was pregnant. I was told on [the] Tuesday the embryo had died. I have no more eggs to try. I have no more eggs to retrieve. I have no energy to try again. I am mourning the loss of a baby and the loss of ever having a biological child," she wrote in an emotional post on her blog.
"It was the cruellest thing," she says, today. "I wish the test had never been positive. I had been so sure this one fighter had made it from the 11 frozen eggs and was going to work."
Is her experience going to be typical? It's hard to know.
According to the most recent data from the Human Fertilisation and Embryology Authority (HFEA), the UK fertility watchdog, up to December 2012 around 18,000 eggs had been stored in the for patients' own use. About 580 embryos from stored eggs have been created. These embryos were transferred to women in around 160 cycles, which have resulted in just 20 live births.
"This is such a new technology," says consultant gynaecologist Tim Child, Medical Director of Oxford Fertility, "the vast majority of eggs which have been frozen haven't been thawed and used yet. So we can't judge the outcome. But we have to accept that the technology exists. And so, why not offer it to women?
However, he warns: "It must be done in a responsible manner."
"I strongly feel there can be a tendency for clinics without much experience yet, to look at the world's best reported data and assume they will achieve the same outcomes in their clinic. This is not true. Clinics must tell would-be patients what the success rate for egg freezing is in their individual clinics."
Ideally, there would be an independent register for women to check, but while the HFEA keeps data for IVF results per clinic, the same information is not yet available for egg freezing.
What is certainly true is that more thought needs to go into its wider implications. Last year, a fictional beauty brand, Timeless, opened a pop-up shop in Old Street, east London, featuring a range of provocative products, including luxury perfume lines called Eau So Pressured and Promotion or Procreation.
It was the brainchild of The Liminal Space creative consultancy whose director, Amanda Gore, who is also a member of the Reproductive Sociology Research Group at the University of Cambridge, explains that it was designed to create debate around egg freezing.
"We wondered, could this be as revolutionary to woman's life choices as the pill - or another reinforcement of the message that fertility is a woman's issue? And shouldn't we be looking at redesigning systems, not the people in them?"
Gore worries that anxious women may find themselves vulnerable to some tough sells. "You see adverts on the underground from some clinics offering to do it for free if you share your eggs for donor purposes. They don't tell you that only the top three per cent of donors are ever good enough to qualify for this, but it gets women through the door.
"They also don't tell you about the full cost. One round of egg freezing will cost $5,267 to $10,530, though several clinics offer 'three cycle packages' for $14,045 to $17,600. Then you have to factor-in the annual storage costs for up to the maximum 10 years that eggs are currently allowed to be stored in the UK. And to use your frozen eggs means having IVF, which will be elective and therefore not available on the NHS. That could be another $17,600."
Egg-freezing, she emphasises, is a journey into the unknown: "It is not as simple as an insurance policy. And there is an emotional cost to count, too. You are investing in something you probably hope you will never need to use."
Londoner Alice Mann would have agreed with that sentiment when, aged 36 and single, she froze her eggs three years ago. "At the time," she says, "it felt like an admission of failure." She is currently in the process of thawing them out, and blogs about it at Eggedonblog.com.
Having done her research, Mann warns: "I was always aware that there were no guarantees whatsoever. And it is still such a new technology - albeit one that is improving all the time. People think they can get the same results from using frozen eggs as frozen embryos, but the truth is, we just don't know."
Mann froze 14 eggs, and recently thawed seven. Only one created a viable embryo when fertilised and she is waiting to discover if it will result in a pregnancy.
"You need to go in with your eyes wide open," she says. "It gave me an opportunity to take a positive step at a time when I couldn't have felt more negative. For me, it was a form of liberation. But I would hate any woman to feel pressured - by her company or anyone else - to defer attempting to conceive, just because egg freezing was being offered."
Brigitte Adams would agree. She still hopes to be a mother and is now looking into donor eggs.
"It's hard to think I waited years thinking I had something that could work - literally on ice," she says. "I thought I had checked-off that worry. But now I am starting again at 44."
- The Telegraph, London