In One Basket
For years, the media has trumpeted the praises of fertility technology, an industry aimed almost exclusively at women. Among all other procedures, the cryopreservation or freezing of eggs has received a disproportionate amount of media attention. Years ago the headlines were everywhere implying that the female biological clock had finally been conquered. “Motherhood on Your Own Terms”, “Freeze Your Eggs, Free Your Career”, “Extend Your Fertility”, “Leave Conception for Later”. The implication was that women could schedule motherhood as easily as they scheduled a client meeting or business trip. There was no need to worry about age anymore because eggs frozen at 27 would still be viable and healthy, even in a 40-year-old body. The truth is science is nowhere near conquering the fertility cycle of the female body and giving women the option to put off motherhood to middle age (35) and beyond. So little has been achieved in fertility science that it can hardly be called a science at all. For example, it’s been 45 years since the first baby was born via in vitro fertilization (IVF) and yet, there remains a 79% failure rate and that’s for women under 35. If you’re older, it’s even worse. Healthy men remain fertile into their 80’s because they produce millions of new sperm daily. In contrast, women are born with a finite number of eggs, all they will ever produce in their lifetime. The younger a woman is, the more viable her eggs are, and the odds are much greater that she will have a healthy baby through a relatively uncomplicated birth. Because of this and the fact that a woman’s egg count starts to decrease with her first period around age 12, nature has intended that women have their children as early as possible with a fertility window peaking between the ages of 18 and 32. After 35, a woman’s fertility rate drops sharply in what’s informally known as the “fertility cliff”, making conception more difficult and bringing with it new risks and possible complications. So the idea that women can cheat Mother Nature when it comes to fertility and timing is simply not true. Unfortunately, this false idea only makes billions of dollars for the fertility industry and leaves tens of thousands of women heartbroken and struggling with regret.
Harvesting Eggs… and Money
Normally, a woman’s body releases just one egg per month. In order to retrieve a larger number for freezing, a woman must first submit to an extensive series of blood tests, ultrasounds, and other examinations in the days or weeks leading up to the retrieval. During this time, she will be injecting herself with a powerful combination of hormones over a series of days in order to hyper-stimulate the ovaries to release larger numbers of eggs. It should be noted that some of the hormones used in this process are done so “off-label” meaning they have never been studied or intended for such use. Each harvest cycle of eggs costs around $20,000 with most fertility clinics charging a $1,000 per month storage fee. When the time comes to use her eggs, the woman must again inject herself with hormones in order to prepare the uterus to accept the embryo. Once again, a heavy protocol of blood tests, ultrasounds, vaginal probes and more lead up to the implantation. Up to 15% of eggs don’t survive the thawing process. Because the sperm cannot penetrate the cold, hardened outer membrane of the egg, it must be injected directly inside through a process called Intracytoplasmic Sperm Injection (ICSI). If any of the eggs fertilize successfully, they are monitored for five days with the most promising being transferred to the woman’s womb through IVF, which can cost about $12,000, even though the overwhelming majority of attempts (79%) fail ending in spontaneous miscarriage.
Failure & Fraud
In spite of what the media and fertility industry have told women about the benefits and flexibility of postponing motherhood, the process of harvesting large numbers of eggs comes with serious risks, and the percentages of actually achieving a live birth are extremely low. A study published in Fertility and Sterility found a 77% failure rate of frozen eggs resulting in live birth in women aged 30. According to the American Society for Reproductive Medicine (ASRM), the chances of just one frozen egg leading to a live birth in a woman under 38 is 2% to 12%. As if those odds weren’t discouraging enough, the average age of American women freezing their eggs is 37.4.
In an article published in the scientific journal, Nature, it was found that worldwide, fewer than 2,000 people were ever born from frozen eggs, and that only 10 of them had been born to women 38 or older.
When asked about the effectiveness of frozen egg implantation, ASRM practice committee chair, Samantha Pfeifer stated, “That has not been evaluated in any randomized controlled studies.” The fact that the effectiveness of using frozen eggs for conception has never been subjected to a legitimate research study should come as no surprise. Fertility clinics that make millions off of 30-something women do their best to keep the massive failure rates a closely guarded secret. Even so, when researchers contacted every fertility clinic in the U.S. about their success rates, the responses although limited were very telling. In all, 64% of the clinics contacted responded. Of those 140 clinics, 45 had never even thawed their client’s eggs. Just over 30 achieved no live births from their thawed eggs, while 11 achieved just one live birth. Only 8 clinics said they achieved 10 or more live births. In the UK, which tracks fertility outcomes through its Human Fertilisation and Embryology Authority (HFEA), only 20 people were ever born from frozen eggs. The idea that eggs harvested at a younger age are more viable and hold better odds for pregnancy is misleading. Frozen eggs continue to experience age-related problems like chromosomal breakage and genetic replication errors over time albeit at a slower pace. One study found eggs frozen at age 25 had a failure rate of nearly 70%, those frozen by 30 had a 74% failure rate, those frozen by 35 failed 81% of the time, and eggs frozen at 40 failed 85% of the time…and that was after three cycles of IVF and regardless of the freezing method. Dr. James A. Grifo, specialist at NYU Langone Health, and one of the pioneers of egg freezing called the idea of women being able to control their fertility promoted by the media and fertility industry “destructive”. “It’s total fiction. It’s incorrect,” Grifo said. “Your whole life it’s beaten into your head that you’re in control…There has to be more dialogue about what women can be responsible for and what they are not responsible for.”
Risks Without Reward
According to the Center for Genetics and Society (CGS), there also remains concern about the long-term risks associated with using powerful hormone cocktails that contain hormones that were never medically approved for such purposes. Concerns have been raised about infertility, cancer, and the effects on any children born from frozen eggs because the chemicals used in the freezing process are known to be toxic. Unfortunately, long-term health studies on women using frozen eggs for conception have never been done. At the same time, women using frozen eggs must undergo IVF which has been linked to an increase in stillbirths, cesarean sections, preterm deliveries, multiple gestations, and higher rates of fetal anomalies.
Aside from the physical risks, women using frozen eggs find themselves on an emotional rollercoaster. With every failure or miscarriage comes a tidal wave of feelings like sadness, anger, and especially regret that can be overwhelming.
A study that interviewed 500 women ages 27-44 two years after using frozen eggs found that 50% experienced moderate to severe regret. Interestingly, the average age of the women was 36 with 80% holding a graduate degree and 70% earning over $100,000. Researchers stated that using frozen eggs was, “…emotionally more complex than people might have assumed initially” and expressed shock that a significant percentage of the women “grossly overestimated” their probability of having a child, with some believing the success rate was near 100%.
Experts Refuse to Endorse
Much of the confusion and marketing around freezing eggs came after the ASRM removed the “experimental” label from the procedure. Almost immediately, fertility clinics began marketing the idea of controlling fertility and postponing motherhood to women. What they neglected to tell women was that the ASRM only approved of freezing eggs for younger women with cancer as a way to protect the eggs from the effects of chemotherapy and to provide the patients with a very small chance of having a child later. Approving elective egg freezing for healthy women or even implying that it was effective for such use was never part of their intention. In 2012, ASRM committee chair, Samantha Pfeifer stated, “While a careful review of the literature indicates egg freezing is a valid technique for young women for whom it is medically indicated, we cannot at this time endorse its widespread elective use to delay childbearing. This technology may not be appropriate for the older woman who desires to postpone reproduction.” She went on to say, “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.” In 2013, the ASRM was joined by the Society for Assisted Reproductive Technology (SART) in publicly stating that freezing eggs should never be recommended to healthy women. The official statement said, “…there are not yet sufficient data to recommend oocyte cryopreservation for the sole purpose of circumventing reproductive aging in healthy women because there are no data to support the safety, efficacy, ethics, emotional risks, and cost-effectiveness of oocyte cryopreservation for this indication” After the article was published, the American College of Obstetricians and Gynecologists (ACOG) publicly declared they also would not endorse egg freezing for healthy women as an effective way to delay motherhood.
Refocusing on Family
The best chance any woman has at conceiving and having healthy babies is to have them as early as possible. That reality might not sit well with some feminists, but nature isn’t concerned with being politically correct. Of course, money can be an obstacle to starting a family, as is finding a good partner in the age of internet “hook up” culture. Even so, young people must find creative ways to overcome these challenges if they wish to have families because nature doesn’t change, and time moves on. We must help young people rearrange their priorities and once again place more importance on family and relationships. At the same time, young women must realize that motherhood is the most important and rewarding job they will ever have. That doesn’t mean young women shouldn’t pursue careers, it simply means that work will always be there…but their fertility won’t, and it’s very dangerous to put all their hopes for motherhood in one basket.For more health insights from Dr. Sadeghi, please visit beingclarity.com to sign up for the monthly newsletter or check out his annual health and well-being journal, MegaZEN here. For daily messages of encouragement and humor, follow him on Instagram at @drhabibsadeghi.
