The debate about social egg freezing

The difference between social egg freezing and medical egg freezing

In principle, there are two categories of egg freezing: Medical egg freezing and social egg freezing. Medical egg freezing was to a certain extent the original form of egg freezing. The medical field that had a need for a method such as egg freezing was oncology. Women of reproductive age who develop cancer and therefore have to undergo treatment such as radiotherapy or chemotherapy have an increased risk of their egg reserves being reduced or even destroyed as a result of the treatment. If a woman has her eggs frozen before undergoing cancer treatment, she can use them later and still give birth to children who are genetically related to her. This method of freezing sperm already existed for male cancer patients. Egg freezing was soon extended to women with all kinds of fertility problems. These included, for example, severe cases of endometriosis, malignant ovarian tumours, etc.

However, the real "boom" in egg freezing only began when the first "healthy" women started to register for clinical studies on egg freezing. In 2012, both the American Society for Reproductive Medicine (ASMR) and the European Society of Human Reproduction and Embryology (ESHRE) officially approved egg freezing for medical and non-medical purposes.

Because that female fertility is unfortunately limitedis not a new scientific finding. A woman is born with the "final" quantity of eggs. Over time, both the number and the quality of the remaining eggs continue to decline. The decline in the number of eggs begins in the early 30s and from 37 the rate of decline in the number of eggs increases rapidly. Using social egg freezing, women can therefore "preserve" their fertility and theoretically have children well into their 40s and even after the menopause. Women can therefore easily extend their fertile window, come closer to the longer-lasting fertility of men and take control of their life and family planning more easily and without time pressure. Right?

The chances of success with social egg freezing

Unfortunately, it's not quite as nice and easy in practice as it sounds in theory. Because egg freezing is no guarantee for later baby happiness! As egg freezing is a relatively new technology, there are not yet many comprehensive studies on this topic and the information available, especially on the actual probability of pregnancy with the frozen eggs, is not particularly clear. For example, one Styrian fertility clinic on its website refers to an unspecified study which states that 60- 85% of women who use their frozen eggs for fertilisation become successfully pregnant.

Larger-scale studies from the USA, however, speak a different language. The scientific publication "Fifteen years of autologous oocyte thaw outcomes from a large university-based fertility centre" from the New York University Langone Fertility Center, which analysed the data from the New York Fertility Institute over the last 15 years, came to the sobering conclusion that the chances of a successful pregnancy were only 39% on average. This was mainly due to the older age of the women who had their eggs frozen. The average age was around 38 years. If the women were under the age of 38 at the time of egg freezing, the chances were 51%. The quantity of eggs frozen also played a significant role. For example, women under the age of 38 who had 20 or more than 20 eggs frozen had a 70% chance of pregnancy.

The study by Marcia C. Inhorn also shows that it is not always so easy to have children despite egg freezing. For her book "Motherhood on Ice", she accompanied more than 150 women on their social egg-freezing journey and looked in particular at the socio-cultural reasons that led women to make this decision.

Of the more than 150 women during Inhorn's research period, 10 ultimately decided to use their frozen eggs for artificial fertilisation. Unfortunately, 8 of these women lost all of their frozen eggs in the process, meaning that no successful fertilisation took place. Only 2 of the women gave birth to healthy frozen egg babies. To summarise, egg freezing is no guarantee of a baby. Dr Cedars, President of the American Society for Reproductive Medicine, puts it this way: "The pregnancy rate is not as high as many women think. I always tell my patients: Just because you've frozen your eggs doesn't mean you have a 'baby' in the freezer. You only have a chance of getting pregnant".

The reasons for social egg freezing: self-realisation vs. "the mating gap"

As we mentioned at the beginning of this article, there is a lot of criticism of social egg freezing, claiming that it causes women to postpone having children indefinitely in order to focus on their careers. Marcia C. Inhorn also started her comprehensive egg freezing study with this assumption, only to be proven wrong.

In her numerous interviews with women who underwent social egg freezing treatment, it quickly became clear that most of them took this step because they simply did not have the right partner and were afraid that they would no longer be able to fulfil their desire to have children, as they would simply run out of time. Inhorn refers to this phenomenon as the "mating gap". According to her, well-educated, successful and well-off women in particular find it difficult to find a partner at "eye level" who also has a similar level of academic education, etc. In their opinion, the popularity of social egg freezing is therefore due to "dating problems" rather than "self-fulfilment reasons".