10/2/2014

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Life & Style

Elective egg freezing allows women to stop their biological clocks

Elective egg freezing allows women to stop their biological clocks
A mature egg ready to be frozen, courtesy Pacific Northwest Fertility.
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When Mary Smith was 35 years old she and her husband divorced. She wanted kids, but he did not. Once Smith was single again, her strong desire to start a family put unavoidable pressure on any new relationship.

"It freaks men out when you walk around like a ticking biological clock," Smith said. "Even if I met somebody today, it takes a while to get to know someone. The pressure would be there from day one."

In January, Smith took her fertility into her own hands. She had her eggs frozen to give herself more time to find a partner before having children.

A new option

While egg freezing was once only recommended to women facing medical crises like cancer, the technology is now allowing healthy women to electively preserve their fertility and delay motherhood.

Egg freezing is one method of in-vitro fertilization (IVF). Most commonly, IVF is done by removing eggs from a woman, fertilizing them in a lab with sperm, and then transferring them into the women’s uterus. The process can also be done by fertilizing eggs and then freezing them as embryos for later use. Or, women can freeze eggs without fertilizing them for pregnancy with an undetermined partner later in life.

Doctors have been freezing eggs since 1986. However, up until October the practice was considered experimental by the American Society for Reproductive Medicine.

Before mounting research on the success of egg freezing caused the society to remove that label, many doctors believed women would have better luck getting pregnant if they fertilized their eggs before freezing them. For women without a partner, this meant using donor sperm.

At age 37, Smith still hopes to meet a partner. Fertilizing her eggs with a stranger’s sperm would have prevented her from having her future husband's child one day. So, she traveled from Canada to Seattle to find a clinic that would freeze her eggs without fertilizing them.

"If I'd had to decide on a donor right now I would not have been ready to make that decision," she said.

Smith also could have used traditional IVF and donor sperm to become pregnant immediately, but as a business owner with a demanding career she did not feel comfortable becoming a parent on her own. 

Lab director Amin Khabani opens a freezer containing frozen eggs, courtesy Pacific Northwest Fertility.

"If it wasn't for the fact that I own a company I would get pregnant now," Smith said. "Freezing my eggs buys me a couple more years to find someone."

Dr. Julie Lamb, a physician at Pacific Northwest Fertility in Seattle, said her clinic has led women through enough successful pregnancies using frozen eggs that they recommend it as an elective procedure to women who qualify. Nationally, she estimates 1,000 babies have been born from frozen eggs.

"It's something we feel a lot more comfortable doing now that we have had so many successful pregnancies and deliveries," Lamb said.

The future of egg freezing

Another physician at the clinic, Dr. Lorna Marshall, believes elective egg freezing will become more common in the future, just as birth control measures became mainstream years ago. She said as more women strive for successful, professional careers their process of having a family gets delayed.

"For a professional woman it is going to be a stress reliever," Marshall said.  "A lot of women see this time fly by them, and they may have enough income to consider something like this."

Smith said egg freezing has become a common conversation topic among her colleagues.

"There's a lot of pressure on women that having a career is the only acceptable way to go and that graduating to become a homemaker is a failure," Smith said. "I feel like since I got pushed on the path of having a career this is the logical consequence."

Cost concerns

The cost of egg freezing is prohibitive for many women. The process costs around $15,000 per ovulation cycle and it is not covered by most insurance plans. Women also pay about $500 per year to store their eggs.

Cancer patients get a slightly decreased rate and have more financial aid opportunities to help cover the cost of egg freezing.

Even though Smith could afford the cost of egg freezing, she said buying her more time to become a mother was worth any price.

"In the grand scheme of things, do I want a new bag or clothes, or do I want to start a family?" she said. "Clearly, this is more important."

Age limitations

Both Marshall and Lamb advise that egg freezing is not an ideal fertility option for women over 37. While the doctors will implant the thawed, fertilized eggs in women as old as 50, they say the success of implantation depends on the age at which the eggs were harvested.

Like retirement saving, Marshall said it is best not to wait too long before freezing eggs.

"This is not something for women in their 40s," Marshall said. "By then it’s too late."

No matter when a women freezes her eggs, pregnancy is not guaranteed. Marshall said that for each successfully thawed and fertilized egg there is a 50 percent to 70 percent chance it will lead to a pregnancy.

Smith is well aware of the odds.

"I know I might not get a baby at the end of it," Smith. "But it’s all I can do at this point. It gave me peace of mind."

Taking a risk

There are medical risks to women who become pregnant later in life. Marshall said women are at higher risk of developing diabetes, hypertension or high blood pressure after 45. At Pacific Northwest Fertility, anyone over 40 who wants to become pregnant must consult with a high-risk obstetrician.

The egg-freezing process also has risks. Ovary-stimulating hormones used in all in-vitro fertilization can lead to bloating and blood clots, though Marshall said the risk is small.

"We don't want it to be used frivolously," Marshall said. "Even though it's no longer considered experimental we still don't know all the risks."

In some ways, there are fewer ethical concerns tied to egg freezing than with embryo freezing, Marshall said. If patients don't use their frozen eggs, she said they tend to have fewer concerns discarding them than they might have discarding frozen embryos. 

Still, Marshall said legal issues regarding frozen eggs can be complicated. For example, there is currently no legal precedent determining whether eggs are joint property in a marriage. It is unknown whether one or both partners have control over their use.

Despite these concerns, Marshall said she is happy to offer women any option that gives them greater control over their reproduction.

Ed. Note: We have changed the name of the woman referred to as Mary Smith upon her request.

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