The content of this website is intended for healthcare professionals only

Egg freezing for social reasons is not without risk, warns Royal College

It’s expensive, there’s no guarantee of success, and it has side effects

Caroline White

Wednesday, 08 August 2018

Egg freezing for social reasons is not without risk: it’s expensive, there’s no guarantee of success, and it has side effects, the Royal College of Obstetricians and Gynaecologists has warned.

The procedure can help women who face infertility for medical reasons, such as chemotherapy for certain cancers, but it may not always be the best option for those who freeze their eggs for other reasons, it says.

Since 2010, 471 babies have been born from frozen eggs in the UK, according to figures from the Human Fertilisation and Embryology Authority.

The warning comes after a debate in BJOG: An International Journal of Obstetrics and Gynaecology, on the pros and cons of social egg freezing and IVF treatment for women in their late thirties when fertility typically starts to tail off.

Dr Jara Ben Nagi from the Centre for Reproductive and Genetic Health and colleagues argue* that it can extend the window of opportunity for single women to find the right partner and offer them hope when their fertility may be in decline.

They point to a study which showed that of 1382 women who opted for social egg freezing, 120 (8.7%) used their eggs after an average length of 2.2 years. 45 of the 95 women who were single at the time of the freezing had a partner when they returned, which proves the benefit of egg freezing for single women, they say.

They also point to evidence which shows the survival rate of the frozen egg using the vitrification method – a new freezing technique with a higher success rate – was 85%, with pregnancy rates of 27%. This is similar to a 23% success rate for IVF in women aged 35-37.

“Women should no longer be punished with childlessness for not finding a partner, nor should they feel pressured into a relationship because of their declining ovarian reserve”, they argue.

They recommend “extensive fertility and preconception counselling, including risk of age-related complications during pregnancy and birth, as well as future unsuccessful treatment. Good clinical practice of IVF is needed to ensure best outcomes and reduce any complications for women and their babies.”

But Dr Timothy Bracewell-Milnes from Imperial College London and co-authors from Chelsea and Westminster Hospital London warn** that most women are freezing their eggs as a “last ditch effort” to preserve their fertility, instead of making a planned and informed choice in their early to mid-thirties.

Research has shown young people are not aware of the natural limits of female fertility and significantly overestimate the success rates of assisted reproductive technologies, they argue.

And they highlight that of the 1173 egg freezing cycles that took place in 2016, only around a third (32%) of women freezing their eggs were aged 35 or younger. This is despite the fact that the highest predictive factor for successful egg freezing is an age below 36.

Because of lower success rates with increasing age, women in their late thirties would need approximately 30 eggs to have a good chance of getting pregnant, they say.

These women would, therefore, require on average three cycles of ovarian stimulation to produce enough eggs, at a cost of around £15,000, overall. This excludes an annual storage fee of £200-400 and the cost of future fertility treatment to use the frozen eggs.

“Egg freezing should be available to single women in their late thirties who accept the high costs and low successes, but these women and their partners must be provided with accurate and balanced information on the safety and likelihood of success,” they insist.

And they conclude: “[F]uture focus should be on providing accurate information from an early age to enable women and their partners to plan their families and present to fertility clinics at a younger age and therefore improve the chances of having a healthy pregnancy and birth.”

Adam Balen, professor of reproductive medicine and spokesperson for the Royal College of Obstetricians and Gynaecologists, said: "Success rates for egg freezing have improved significantly in recent years so offer an opportunity for women to freeze their eggs for social reasons if they’re not ready to have children yet. However, it must be stressed that egg freezing does not guarantee a baby in the future. Women should also be aware that in the UK the storage limit for eggs frozen for social reasons is currently limited to 10 years.”

He added: “While women should be supported in their choices, they must be informed about the relatively low success rates, high costs and side effects associated with egg freezing and IVF treatment.”

Women who opt for egg freezing for social reasons, should have counselling with a reproductive specialist and choose a clinic that has plenty of experience, he said. The clinic should provide a realistic idea of potential success related to age. Evidence suggests that the best time to freeze eggs is in a woman’s early twenties.

“It is extremely important to provide accurate and balanced information about fertility and how it changes with increasing age. Relationships and sex education, particularly for young people, must include information to enable women and their partners to make informed decisions about when to start a family to ensure the healthiest outcomes,” he said.

*Jones BP, Serhal P, Ben‐Nagi J. Social egg freezing should be offered to single women approaching their late thirties: FOR: Women should not suffer involuntary childlessness because they have not yet found a partner. Royal College of Obstetricians and Gynaecologists, 2 August 2018, doi:10.1111/1471-0528.15291.
**Bracewell‐Milnes T, Norman‐Taylor J, Nikolaou D. Social egg freezing should be offered to single women approaching their late thirties: AGAINST: Women should be freezing their eggs earlier. Royal College of Obstetricians and Gynaecologists, 2 August 2018, doi:10.1111/1471-0528.15295.

Registered in England and Wales. Reg No. 2530185. c/o Wilmington plc, 5th Floor, 10 Whitechapel High Street, London E1 8QS. Reg No. 30158470