Egg freezing is all the rave this past year or so. I’ve read about egg freezing in Self Magazine, on news sites like CNN, and elsewhere. While egg freezing is an exciting new way to possibly preserve fertility in women with cancer, that’s not what’s made the headlines.
It’s women choosing to freeze their eggs when they are in their 20s, so that later in life, when they want to have kids, they won’t need to be as concerned about age related infertility. That’s the idea, anyway.
The thing is, I have a serious problem with the marketing of egg freezing procedures to young women, for the sole purpose of extending their motherhood years. And I have good company -- The American Society of Reproductive Medicine also objects to the marketing of egg freezing to patients looking to avoid age related infertility.
For cancer patients, egg freezing offers hope. It makes sense to take a risk on this new procedure, since without it, the possibility of having kids after treatment may be completely gone. But I feel it’s unethical for the fertility clinics to offer egg freezing for fertility age-extending reasons.
Why? Because egg freezing is a brand new procedure. There has been perhaps a few hundred pregnancies from frozen eggs, and all of these pregnancies were short-term freezes. Hours or days, at most months – never years, certainly not decades. No one knows how successful these egg freezings will be, especially over the long term.
But at least egg freezing has been tried out a few hundred times. I was completely surprised to see an essay in the UK’s Telegraph written by Dr. Sherman Silber promoting ovary freezing to young women looking to extend their fertile years. He writes, “I see no reason why this technique to prolong reproductive life should not be routine for all women who want it.”
I see a big reason: because no one has gotten pregnant and given birth after having a frozen ovary thawed and placed back. There have been a handful of cases where pregnancy was achieved after a slice of ovarian tissue was replaced, but again – only a handful, and usually pregnancy was achieved using IVF.
Just this past week, a woman gave birth to the first pregnancy which resulted from an ovary transplant. The ovary transplant was between twins, with the still fertile sister donating one of her working ovaries to her infertile twin.
But this was a quick transplant and didn’t involve long-term freezing. I don’t think one successful ovary transplant is enough.
In the essay, he also writes, “The cancer patients who we have frozen ovaries for say they feel really lucky they had cancer, which is an odd thing to say. But they say 'I'm getting older and am not in a relationship and all my friends are worried about their biological clock. But I'm not worried because I've got a young ovary frozen'.”
It’s a nice thought. But how many of those cancer patients have had their ovaries thawed, placed back, and gotten pregnant?
In my opinion, the right thing to do is offer ovary freezing to those who really need it: female cancer patients who risk losing their fertility from chemo and radiation. Then, once a sizable number of studies have been done on these frozen ovarian transplants, and a sizable number of successful pregnancies and births have taken place, it may be time to market ovary freezing to those looking to preserve fertility just because they want to extend their fertile years.
But to offer it now? When the technology is so new, and no one can say whether it will work as well as hoped? When no one can say what the long term effects might be of having an ovary removed, just because? (I suspect we have two ovaries for a reason.) To go through a serious surgery, all based on a handful of cases? And with not even one natural pregnancy resulting from a transplanted, long-term frozen ovary?
Sorry, Dr. Silber. I think you’re wrong.
You can read about egg freezing and vitrification, including the research and how it works, here:
What do you think? Should ovary freezing be offered to whomever wants it? Or should we wait until more research is done? Please leave a comment below. I’d love to hear your thoughts on this important and controversial topic.
Rachel,
You’ve hit the nail on the head. This is not a fertility improvement process, this is a money making proposition. Unproven, expensive, set up to take women’s money with no proof it will ever work. No doubt it comes with a slew of paperwork making sure nobody can come back to sue the doctor when it doesn’t. Oh, plus the admonition that there must have been something wrong with the woman or her eggs/ovaries — never the process itself.
I’ve said many times that there are more snake oil salesmen online than there ever were roaming the countryside pre-Internet.
This is a perfect example of how we need to follow the money when it comes to healthcare!
Trisha Torrey
About.com Guide to Patient Empowerment
http://patients.about.com
Hi, Rachel. I was surprised to actually find an instance of ovarian tissue freezing on an episode of the Discovery Health Channel’s “Medical Incredible” the other day. The tissue samples were frozen, the woman in question went through cancer treatment, and afterwards the tissue samples were implanted under the skin of her stomach. Apparently this was enough to reactivate her monthly menstrual cycle and re-start her inactive ovary – she did get pregnant and have a child. Other than that particular instance, I haven’t heard of this working…just thought I’d share!
Trisha,
Thank you for the comment! Yes, I also sniff money making motives. That makes me all the more upset about it!
Myrrh,
Yes, I have heard of this case (it’s what I was referring to when I mentioned slices of ovaries being transplanted). But as you said, it was on an amazing miracles kind of show. This isn’t common place enough to say, “Hey everyone, come freeze your ovaries.”
I agree. It would be one thing if it had been proven to actually work and there were successful cases, but absent that it definitely sounds like a money making scheme and not something that should be widely available to people who do not have special circumstances (cancer patients should definitely have this option though).
Krissi,
I agree 100% that cancer patients should have this option. It may over the years turn out to be an amazing technology.
I think that patients deserve to plan their reproductive lives they way they choose. If that means freezing one ovary just in case, I’m okay with it – if it works.
I like to put the “Yuck Test” to these sorts of medical ethics issues – if it feels “yucky”, it probably is. (This is a real ethics concept that I read about in a journal!) Taking the entire ovary feels dramatic and I can’t imagine how successful it would be. Eggs are one thing to freeze (and you lose many eggs in the process), ovaries are much different. I’m torn, and wouldn’t have chosen it for myself, but I do think that patients have the right to choose it if they understand how experimental it is.
There’s a better article (better than the UK Telegraph article) in the Washington Post.
Apparently this guy Sherman made a presentation on this topic this week at the American Society for Reproductive Medicine annual meeting in San Francisco. The Washington Post article tells more about it.
Hi all,
I just wanted to let everyone here know that the company I work for has a trained professional staff division devoted to women and childcare, and they all agree that freezing eggs is not the safest, or proven processes. This is just one more opinion to add, but I hope it gives some of you more assurance.
-Dillon (greenhome.com)
It is no longer true that no-one has gotten pregnant naturally after having part of their ovaries frozen then reattached.
A Bristish woman reportedly has not only done it using IVF but then later conceived naturally