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December 6th, 2014 at 8:46 am

Egg freezing growing in popularity, but the choice leaves no guarantees

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Among urban women in their 30s, freezing is trending.

Tiffany Angelo gave herself a few months to grieve after the abrupt end of her marriage. Then she moved on. Not to the next romance, but to something she could plan for: the children she deeply desired and would still have. With or without her ex.

 

 

“I was married,” she says. “I thought I was on the way to having a child.”

It didn’t turn out that way, so the Bethesda-based anesthesiologist gathered up the kind of money that would usually buy a new compact car and submitted to blood tests and hormone injections that she flinchingly gave herself.

Last year, at 39, Angelo became a freezer, joining the growing ranks of women putting their eggs on ice as a way of girding for life’s great unknowns.

Now, her dreams rest in a row of nitrogen tanks at Shady Grove Fertility, a clinic in a beige office park in Rockville. In the future, perhaps with a partner, she’ll be able to return for them and proceed with her childbearing plans. Even if she waits a decade, her eggs, doctors say, remain just as they were when she froze them — whatever Angelo’s age, they will still be a vibrant 39.

Among urban women in their 30s, freezing is trending. Suddenly, many women “now have a friend of a friend who has frozen,” says Sarah Elizabeth Richards, a journalist who has had eggs frozen twice and written about it in the book “Motherhood, Rescheduled.”

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Only two years ago, the American Society for Reproductive Medicine lifted the “experimental” label long attached to egg freezing, giving women a way to extend their reproductive potential, perhaps long past the natural expiration date. Since then, “more clinics are offering it,” Richards says. Large corporations are catching on, too, tossing in egg freezing as a perk to enlist female talent: Last month, Facebook and Apple became the first to announce that they would each offer $20,000 for the reproductive treatments.

In California’s Silicon Valley and in Manhattan (the town that can’t seem to get over “Sex and the City”), empowered ladies have begun picking up informational packets along with cocktails at “egg-freezing parties.” Even Kim Kardashian has reportedly frozen and, naturally, had the whole thing filmed for reality-TV posterity.

In Washington, it can cost a woman $12,500 to $18,000 to put away enough eggs to bolster her chances of having a baby one day. And yet, as the women who freeze know, the investment carries the real possibility of delivering no return at all.

The women who are freezing here defy the stereotype of the start-up worker or body-conscious singleton hoping to squeeze a few extra years out of her career or her 26-inch waistline before a baby. They’re not rescheduling pregnancy the way you would an appointment for highlights. The choices they’re making are far more nuanced.

For women who still hope to meet cute and fall in love before pregnancy, egg freezing has one little-discussed selling point: It gives them time not just for careers but also to meet the right partner, a tricky business as more and more people postpone marriage or other committed relationships.

“If you ask women who have frozen their eggs why they did it, I thought the two things — probably neck-and-neck with each other — would be that they haven’t found the right partner, and career reasons,” says Joseph Doyle, a reproductive endocrinologist at Shady Grove. “But almost all of them, when you ask them, [the reason] is that they haven’t found the right partner.”

To freeze or not?

On a sunny Saturday morning in November, dozens of smartly dressed women in fitted blazers and layered scarves file into a Penn Quarter design center for Shady Grove Fertility’s first egg-freezing “conference.” Several women have come alone. A few arrive with partners. One has brought her mother, others are with friends. Money is on everyone’s mind, but among the diverse crowd, which includes District natives, women from the Deep South, and others from as far away as Thailand, there are dozens of personal motives for being there.

Shady Grove — and the industry as a whole — largely discourages women in their 20s, who are still likely to meet someone and have children naturally, from freezing. Most women arrive at the Shady Grove offices a full decade later, although, Doyle adds, younger women are increasingly choosing to freeze.

At 28, Ann Morgan may be one of them. It’s not concern about conceiving a baby, but about having a second and a third, that has brought her and her husband to the conference. Morgan wants to go to graduate school, but that choice means that they’ll need to plan how to space out their children. Back home in Thailand, she had never heard of egg freezing; if she and her husband choose to freeze, she says with a laugh, she’ll have to find a way to explain it to her parents.

A 34-year-old woman who asks to be identified only as Jea says that a friend who is struggling to conceive cornered her and urged her to consider egg freezing. “Knowing what we’re going through now,” she says her friend told her, “I would have done it when I was your age.”

And there’s an outlier: Al Curtis of Alexandria, who came with his girlfriend. She is older than he is, he says, glancing at her warmly. “When I was 22 and in college, there was no way I could envision myself sitting here right now. But life hasn’t gone at all how I envisioned it,” he said. “You adapt as life adapts, and this is one of the things, thankfully, life has adapted to. We’re blessed to have this opportunity. ”

Birthrate fuzziness

Egg freezing may be a blessing, but it’s by no means a panacea.

The doctors at Shady Grove like to pull out a chart during consultations. At the top, it shows 10 frozen eggs, about half the number doctors usually recommend extracting from a woman younger than 37. (For older women, the suggested number shoots to as many as 30.) At each stage, from thawing to implantation, viability evaporates. At the bottom of the chart, after the eggs have been fertilized, just two excellent candidates — now embryos — remain.

The odds of implantation for each of those, Doyle will explain to patients, is 50-50.

Until recently, the most common choice for many women and couples seeking to have children but unable or unwilling to conceive naturally was IVF, a method of fertilizing and implanting embryos that has resulted in countless bouncing baby boys and girls. Egg freezing was largely reserved for young egg donors and women about to embark on aggressive cancer treatments. Like IVF, freezing begins with the harvesting of a woman’s eggs but stops short of fertilization; only when women are ready to conceive are their eggs thawed, fertilized and implanted (to the tune of $6,800). The birthrate among women electively freezing their eggs is still fuzzy.

“You can go ahead and freeze some eggs, and the woman feels great, because, ‘Oh, I’ve got some eggs in the bank,’ ” says Mitchell Rosen, a reproductive endocrinologist and director of the Fertility Preservation Center at the University of California at San Francisco. “But it’s not about feeling great at that time, it’s about when she comes back and uses them, does it work?”

There’s really no data on that, doctors say, in part because this generation of freezers has yet to claim its eggs.

In the meantime, the risks associated with freezing are reportedly few, and data from Italy (where the procedure has been around longer because of the Catholic Church’s opposition to freezing embryos) supports the idea that freezers can go home with babies, Rosen says. The benefit, the possibility of having a baby at 40, 50 or even later — “A 50-year-old can be a very, very healthy individual. Who are we to decide that they can’t have children?” Rosen says — could be huge.

Rosen says that initially, he was uncomfortable doing elective egg freezing. “I felt guilty, almost, because I didn’t want to give this false sense of hope,” he says. His biggest fear is that freezing will encourage women to stop trying on their own, even though the odds remain in favor of the woman who attempts to conceive naturally beginning at 35. The one who returns to thaw her eggs at 45 will have at most only one or two chances at pregnancy.

Questions and concerns

As egg freezing’s popularity grows, it raises some sore points for women, not least the question of the expense that, for now, separates those who won’t have to give up on their dreams of motherhood from those who will.

There are understandable fears, too, that companies such as Apple and Facebook will offer an egg-freezing benefit as a kind of Trojan horse, a maneuver that will leave women no option other than to delay childbearing or be left behind at work.

And then there are women for whom egg freezing isn’t the answer, says Melanie Notkin, the New York-based author of the memoir “Otherhood.” Some of the dozens of women Notkin interviewed for her book were aware of the technology, but “didn’t want to do it,” she says. “To them it felt like throwing in the towel. If they didn’t do it the way they’d envisioned it — finding a guy, falling in love, getting married — they felt like they were giving up on that dream.” (The doctors see this, too; often, they say, patients come to them at a later age, just before their fertility drops dramatically.)

“They don’t want to freeze their eggs, and it’s not because they don’t want to be mothers,” Notkin says. “It’s not how they want to be mothers.”

And then there are the men. Notkin wonders whether freezing won’t offer them one more reason to think that they can go on dating like Leonardo DiCaprio. “Now that these single guys know that women have the opportunity to freeze their eggs, they may perceive it as an opportunity to delay fatherhood,” she says.

That wasn’t the case for Angelo, who says that the men in her life greeted her news with sensitivity. “I was actually dating a guy when I was going through” the hormone injections and procedure, she says. “I was like, I’m just going to have to tell this person.” Rather than being judgmental, she says, he was impressed.

As a doctor, Angelo knows that her investment offers no guaranteed return. But she would recommend freezing in a heartbeat to a younger woman on the fence not only about freezing but about having children.

“Imagine a world where the clock doesn’t tick for women,” Angelo says. “You could technically have children at any age. It’s such a wonderful gift to women, to take the pressure off them.”

Photo credit: CBCNews

Via Washington Post

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