The Truth About Egg Freezing In Your 20s

Artwork by Anna Jay.
We're born with between one and two million of the things. Each passing year, the quality and quantity of our precious reserve declines until we hit the menopause and they effectively run out. I'm talking, of course, about our oocytes, the little eggs produced in our ovaries. But one procedure, oocyte cryopreservation, more commonly known as 'egg freezing', allows women to subvert this process and gain some control over their so-called "biological clock". It's been hailed by many over the last few years as a silver bullet offering young women the chance to “have it all”: build a successful career while putting their chance of having a baby literally on ice, until a time that suits them. In 2014, when the news broke that Facebook in the U.S. would start covering the cost of its employees freezings their eggs, the debate around the issue exploded. Citygroup and JP Morgan Chase in the U.S. were already offering it to their employees, but Facebook's connection with the "Lean In" narrative (that women should grab all the career opportunities they can), propagated by Sheryl Sandberg, the company's Chief Operating Officer, really got people riled up. Apple also began offering egg freezing to its staff shortly after. Opponents argued that it forces women to work through the most fertile years, when what women who want kids really need is well-paid parental leave and subsidised childcare. While those in favour said it will be "the great equaliser" for women at work, and could be "our generation’s Pill — a way to circumvent a biological glass ceiling that, even as we make social and professional progress, does not budge."
This publicity led to an increase in the number of women inquiring about the procedure in the U.S., Time magazine reported, and it's quickly gaining popularity among professional women. Just 500 women froze their eggs in the U.S. in 2009, while nearly 5,000 did in 2013, according to data from the Society for Assisted Reproductive Technology (SART), Time reported. And fertility marketer EggBanxx estimates that 76,000 women will be doing it by 2018. In the UK, the marketing of egg freezing hasn't been anywhere near as aggressive as it has been in the U.S. so far, and the industry remains embryonic. UK companies don't offer to cover the costs for their staff like they do in the U.S. yet, either. Facebook and Google don't currently cover the cost of egg freezing for their UK staff, and while Richard Branson said last year he wanted to introduce it for Virgin employees, it's not offered to UK employees yet either. However, there are signs that interest in the procedure is growing in the UK. A cocktail of social and economic factors has meant that British women are increasingly delaying motherhood, and the number of young British women freezing their eggs has risen rapidly in recent years, according to the Human Fertilisation and Embryology Authority (HFEA). In 2014, 816 British women froze their eggs – 25% more than the previous year, and more than 28 times the number who did in 2001, when just 29 women underwent the procedure. The most commonly cited reason being that they had no male partner. Inquiries into the procedure at private clinics also apparently rose by 400% in Britain between 2014 and 2015, with more than half of these coming from under 35s.

Egg freezing parties
, offering women the chance to talk about the procedure informally and potentially receive a discount, are already all the rage in the U.S. and fertility experts in the UK have said they could soon become a reality in cities like London, with a high population of professional women. There was even an egg-freezing popup shop earlier this year in Old Street, London, designed to stimulate debate about social freezing (as opposed to eggs frozen for medical reasons), and get more young women talking about their fertility. (Hence the use of "Tumblr pink" in the creators' marketing material, presumably.) "I think younger and younger women will freeze [their eggs] as egg freezing goes more mainstream, success stories of pregnancy are published, and prices decline," Brigitte Adams, the founder of Eggsurance, a blog and discussion forum about egg freezing, told Refinery29. "When I froze in 2011, the majority of egg freezers were like me, at desperation point, in their late 30s. Demographics have since shifted a few years younger since then, and I believe this trend will continue." According to some experts, freezing your eggs earlier – in your 20s – increases women's chance of becoming pregnant using them later on. So if you're in your 20s or early 30s and thinking about freezing your eggs, is it worth it? And what does the seemingly miraculous technique actually involve?

The cost

The first thing to think about, and hurdle to overcome, is the price. Egg freezing is expensive and as such is highly exclusive: it's an option only available to a small minority of women. Namely, those already in stable and, mostly likely, professional careers or with family money behind them. For most younger women, with lower salaries and student loans to pay off, it's not an option, or at least not something to consider lightly. Egg freezing isn’t universally available to healthy women on the NHS, only those facing reduced fertility for medical reasons, such as cancer and premature menopause. While there have been calls to make it available for free to all women in their 20s and early 30s, most women turn to private clinics. One cycle of egg freezing can cost between £3500 to £4500 in total, but costs can vary between clinics, and most women go through more than one cycle to increase their chances of "harvesting" their desired number of eggs. You can be charged extra for blood tests, drugs and sedation. Then there's the annual storage fee, which can be up to £400, so the earlier you freeze your eggs, the more you’ll end up paying in storage costs. If you freeze them at 25 and don’t use them until you’re 40, you could pay around £6,000 for storage alone.
"It's worth researching which services are actually required and speaking to different clinics as often unnecessary tests are tacked on to the price," says Professor Geeta Nargund, Medical Director of CREATE Fertility, who is an expert in the field. "Always question if high doses of drugs are prescribed, as they cost more and may not be necessary." Alice Mann*, 39, froze her eggs nearly three years ago after splitting up with her long-term partner. She has spent nearly £14,000 so far on three cycles, which resulted in 14 frozen eggs, plus £300 per year to keep them on ice. She breaks down the cost in a post on her blog, Egged On, where she chronicled her experience. Mann is glad she froze her eggs when she did, rather than in her 20s, but she told Refinery29: "Although in some ways, I wish I'd done it when I was younger as I know that younger eggs are healthier, I have to be realistic. "My fertility wasn't forefront of my mind when I was in my 20s and, crucially, I didn't have the money," Mann added. There's also a chance she wouldn't have been able to chose flash freezing, a newer and more effective freezing technique, when she was in her 20s. "Fundamentally, I did it when I was mentally and financially ready to – and fortuitously at a time when the technology had improved." For most women in their 20s, then, freezing their eggs isn't really an option, especially in the current economic climate: eye-watering rent and property prices, precarious employment, government austerity and the ongoing financial crisis, mean young women don’t exactly have much spare cash lying around. "Egg freezing is an expensive process and should not be taken lightly," said Nargund. "In the future there may be opportunities to discuss partial-public funding, once we have established a robust national database." However, for those who can afford the procedure, it could mean they end up spending less on fertility treatment in later life.

The physical impact

The sunny farmyard metaphors frequently used to describe the process – eggs are "harvested" before being "fertilised" – belie the physical toll the process can have on a woman's body. In basic terms, it involves drugs and daily self-administered hormone injections over a number of weeks, with regular internal ultrasound scans to check how your ovaries are responding to the drugs. An ovulation trigger injection is then administered to "mature" the eggs before you go under anaesthetic to have them removed via a needle inserted into the ovary. Many women don't experience negative effects from the potent cocktail of hormones. Mann says she had a "dull period-like pain" and felt "a bit spaced out" after the retrieval process. "To be honest I really didn’t feel too bad," she added, "I had a personal training session the following day, which I’m not sure is recommended." However, not every woman is so lucky – their bodies don't respond well to the drugs and the pain is greater than they expected. In the worse cases, women may also suffer from ovarian hyperstimulation syndrome (OHSS), during which too many eggs develop in the ovaries and they become large and painful. In a powerful article for The Guardian last year, journalist Eleanor Morgan wrote about her experience of egg-freezing in her 20s because of infertility, and the toll it took on her body. She spent ten days throwing up and developed painful OHSS. She said she wishes she'd known how, "You might feel pain for the next week so deep it feels like your spine is growling. You might walk around like you’re trying to hold an aubergine inside your arse."

The emotional toll

For many women, deciding to freeze your eggs is emotionally challenging and even traumatic. Tracey Sainsbury is an accredited fertility counsellor working with the London Women's Clinic, the Bridge Centre, London Egg Bank and London Sperm Bank. She described egg freezing as "an emotional rollercoaster", with a high in the immediate aftermath once the eggs have been frozen and lows at other times. "Though consciously we know women are more than baby-makers, our unconscious can feel very primal," she told Refinery29, and we conflate our worth as women with our ability to have children. "If treatment is unsuccessful, a momentary feeling of worthlessness, useless, barren can impact on our self confidence, our self esteem and general sense of wellbeing." Counselling is compulsory before you begin the process and you receive copious amounts of clinical information, however not everyone finds discussion of the mental health risks satisfactory. In her article, Morgan described the experience as lonely: "People don’t want to ask you about too much in case they think it should be private, when actually, you’re dying for someone to come round.” For Mann, the biggest impact was emotional – something she wrote about on her blog at the time. “I know other women have different experiences but for me, it was emotionally hard, rather than physically," she told Refinery29. "Making the decision to freeze my eggs was hard. The fact that I was having to do it made me feel as if I'd failed in some way, as if there was something wrong with me that I hadn't been able to find someone who wanted to father my children, as if it was a shameful secret." However, the process got easier the more cycles she did and the way she feels about it has become more positive over the years. "I spent a lot of the first cycle crying, but by the third cycle when I was taking higher doses of drugs, I was much more on top of things emotionally." Now she's proud of her decision, which, she says, bought her hope at a time in her life she really needed it.

The odds of 'success'

Egg freezing is still a relatively new procedure and the American Society for Reproductive Medicine (ASRM) only removed the "experimental" label in 2012. Even then, the ASRM didn’t endorse the freezing of eggs for social reasons – such as to delay motherhood – because it said women shouldn't put all their eggs in one basket (if you'll pardon the pun), and have unrealistic expectations of its effectiveness. “Marketing this technology for the purpose of deferring childbearing may give women false hope,” its report said. Not many women have frozen their eggs and even fewer babies have been born as a result of egg freezing, so there is little available data on the procedure's effectiveness. But the science and data that does exist, doesn't strongly support the assertion that you'll definitely have a baby from it. According to the Human Fertilisation and Embryology Authority (HFEA), up to December 2012, "around 18,000 eggs had been stored in the UK for patients' own use. Around 580 embryos from stored eggs have been created. These embryos were transferred to women in around 160 cycles, which resulted in around 20 live births.” Fertility experts have also suggested that the younger a woman is when she freezes her eggs, the greater the likelihood of success, i.e. that a live birth will result from the process. So does this mean women in their 20s should consider egg freezing regardless of their circumstances? Not at all, says Nargund. "I do not recommend women in their early twenties consider egg freezing unless there are clear medical reasons. From the late twenties to early thirties I would recommend women check their ovarian reserve through a fertility MOT, to get reassurance that they still have time to fall pregnant naturally."

So, who is the ideal candidate?

The ideal age would be between the late twenties and early thirties, says Nargund, ideally before the age of 35, if they're sure they want to go down the egg-freezing route. "Those who should particularly consider egg freezing include women who have a family history of early menopause, or a medical history which suggests she may be at risk of early menopause," says Nargund. "As a start she should have her ovarian reserve checked, and then if the prognosis is not good, spend time considering egg freezing and whether it is right for her." Young women who want to have children eventually but face premature infertility because of illnesses, such as cancer, may also want to seriously consider it. One such women is Michelle Gonzalez, 26, a marketing manager from Melbourne, Australia. After being diagnosed with ovarian cancer two years ago at 24 years old, she decided to freeze her eggs. Luckily the Australian public health system paid for most of it, otherwise she says she wouldn't have been able to consider it at such a young age. She is also planning to freeze her embryos with her boyfriend of five years. For her, the process hasn't been anywhere near as emotionally or physically challenging as what she's already been through with cancer, and she's pleased she went through with it despite not knowing for certain whether she will necessarily want children in future. "Emotionally it wasn’t too bad, because I'm not very 'mumsy'– I'm not a girl who has always wanted kids – for me it was more a logical tactical plan of 'what if?',” she says. “Freezing my eggs has impacted my confidence in a good way. I'm taking charge in my fertility and it's given me back a feeling of power." For the majority of women in their 20s then, it seems, egg freezing isn't necessary and definitely not something to be relied on. Sally Cheshire, the chair of HFEA, warned against this earlier this year: “New freezing techniques appear to have improved the chance of future success, but it’s still too early to know that for certain, so it’s important that women don’t see freezing as a guarantee of future pregnancy.” If you’ve got enough money, however, and are prepared for the potential physical and emotional risks, it could be worth doing. Mann says she is conflicted over whether she'd recommend egg freezing to women in their 20s hoping to become mothers. "At the moment, egg freezing doesn't offer any guarantees of anything at all," she said. "For me, I needed to feel that I'd done everything I could to improve my chances of becoming a mother, and I was lucky enough to be able to afford – financially – to do that. But how practical is that when you're in your 20s? “I would hate for a woman in her 20s to freeze her eggs and think that meant she didn't have to worry about trying to get pregnant until she was 40. But if, for whatever reason, you've got the money, and you go into it with your eyes open about the risks and the benefits, there's a bit of me that feels 'why not?'” Fertility is an emotionally-charged personal issue and a topic of thorny debate. As with most things when it comes to women's bodies, the decision to freeze your eggs (or not) should be yours and yours alone.

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