To Freeze or Not to Freeze? That is The Millennial Woman’s Question
The first time I heard about a young woman freezing her eggs in order to focus on her career was when celebrity hairstylist Jen Atkin announced it via Instagram.
Is that the most millennial sentence I’ve ever written? Probably.
Atkin revealed to her 1 million (now 2.5 million) followers on December 21st, 2015, that she had “recently had my eggs retrieved and made the decision with my husband to freeze my embryos.”She went on to say that she “hopes that career-driven women can stop feeling the social judgement and pressure to conceive once they reach a certain age.”That “pressure” is all too real for most women, but especially those nearing towards their mid to late thirties like TTC reader Amanda who is 33 and says, “My GP demands I get impregnated any time I pop in for a flu jab.”
Another reader, Nikki, was 36 year’s old when she decided to freeze her eggs. She had just come out of a serious relationship and didn’t know if she wanted children, but knew that she wanted the option if the opportunity arose, “My biggest worry was that it might take some time for me to meet someone again and establish a loving, long-term relationship with them, and that could put my fertility at risk because of my age.” Now 44, Nikki recently attempted to use her frozen eggs but the IVF was unsuccessful, “It didn’t work. And I’m not sure I would have made the decision again knowing what I know now.” So what actually is the correlation between age and fertility? According to Charlotte Walker, who is currently undertaking a PhD in Women’s and Reproductive Health at the University of Oxford (as well as undertaking the role of being related to me), it’s twofold. She explains that women are born with all the eggs they will ever have – the eggs have been in your ovaries since you were a baby in your mother’s stomach (!!). Therefore it makes sense that if you try to get pregnant when you are 40, those eggs are already forty year’s old. Two things happen as we age that make it less likely you will fall pregnant: First, the number of eggs you have left is lower. As you probably learned at school, every month a group of eggs will start to grow however only a single egg is selected to ovulate and the other eggs will undergo atresia (read: die). The number of eggs left in a woman’s ovaries when she wants to start a family is referred to as her “ovarian reserve”. The second factor that can make pregnancy less likely is that the eggs you do have are getting older. You see, biology doesn’t give a damn about feminism. Your biology doesn’t care about your career, or your right to Have! A! Baby! And! Run! A! Company! At! The! Same! Time! Which is why science needs to intervene sometimes.
Before I get ahead of myself, let’s go over what it means to freeze your eggs. Char, over to you!
“Freezing your eggs involves going through an IVF cycle but stopping after they take out your eggs. You have about two weeks of daily injections to get your eggs to the right stage to collect, and to increase the number of eggs that are growing. This might be preceded by a course of drugs to suppress your natural cycle. Then you go into the fertility clinic where they collect the eggs. This is generally done under sedation, it is a quick procedure (15-20 minutes) but it does involve the doctor going in through your vagina and using a needle to collect the eggs from your ovaries so there is some discomfort. The lab will then look at the eggs to see how many are mature enough to freeze. If/when you decide to use those eggs they are first thawed and then either injected with sperm (ICSI) or put in a dish with sperm (IVF). We would estimate that from ten collected eggs there would be approximately six viable embryos. On average, depending on the age of the egg at time of freezing, each of those viable embryos have a 15-30% chance of leading to a live birth. Therefore, the original group of ten eggs should lead to a 60-80% chance (cumulative) of a live birth. This means it might take 3-6 embryo transfers for you to fall pregnant.”
Ok I’m literally learning so much right now.
Age isn’t the only factor influencing millennial women to delay childbirth. According to the Society for Assisted Reproductive Technology, 76,000 women in the United States are expected to freeze their eggs this year, and fertility preservation is now attracting much younger audiences than just those in their mid to late 30s. A piece in the New York Times last week attributed some of this to the promotion of fertility clinics who glamorise the treatment with special discounts and “let’s chill” egg-freezing parties, inviting guests to take in facts and figures along with champagne and canapés. Yes, really. TTC reader Julia was 28 when she first had her AMH levels tested and discovered she had a low egg count. AMH stands for “anti-mullerian hormone”. It’s a hormone released by the eggs in your ovaries and your AMH levels decrease as you get older. Four years since she had that test, Julia is now a successful businesswoman and has made the decision to freeze her eggs so that she can focus on her career for a little longer. She calls it her “insurance policy”. The process for Julia, which she started last week, involves taking a pill twice a day for 7 to 10 days followed by two weeks of injections twice a day until her follicles are large enough for the eggs to be collected. “The medication has made me feel awful but I know it will be worth it.” Siobhan is also only in her twenties, “I’m 28 and have stage four endometriosis. While this doesn’t always affect a patients ability to have IVF, in my case my uterus is severely damaged from an extensive growth I had removed as well as the subsequent scarring from that surgery, both of which can affect the successful implantation of an embryo. Therefore freezing my eggs gives me the option of surrogacy later down the road.”
I’d be interested to know if there’s any correlation between career-related egg-freezing and the rise of big corporations like Apple, Facebook and Google offering to shell out tens of thousands of dollars for their female employees to have the procedure. You have to wonder, when does it stop feeling like a “kind gesture” and start feeling more like a gentle push? Women already feel insurmountable levels of pressure in the office, from the clothes we wear to how we negotiate salaries or raise the issue of pay disparity. Is our reproductive health, or lack thereof, just another one to add to the list?
Which leads me to my final point. Women deserve to be able to make an informed decision. I have spoken with so many women in the last few days who are considering freezing their eggs, and the right to choose their reproductive future is what makes it so appealing. It’s about autonomy.
Charlotte agrees, and said there are a few things to consider: It costs between $8-10,000 for the egg collection and freezing, about $5000 for the drugs taken before this process, and you then pay for every year that your eggs are stored. There is an additional fee for if/when you choose to use the eggs in IVF. She also said that any clinic you talk to should be transparent about their success rates and you shouldn’t be afraid to get clarification on the number of successful IVF cycles they’ve done with frozen eggs and then compare those rates between clinics before choosing. And what if you don’t want kids right now but also don’t want to spend close to $20,000? The good news is that – while time may not be on your biological side – it is still possible to do things the old-fashioned way, as evidenced by Sarah, “My parents were 38 when they had me and 42 when they had my sister. We were both conceived naturally. Having children later in life gave my parents the time to establish their careers, which ultimately allowed them to provide us with some amazing opportunities. My mum spent nearly ten years in her profession as a veternerian before she got married and started a family.”
Sounds like Sarah’s mum was ahead of her time.