“I guess I’ll just freeze my eggs.” Perhaps you’ve heard your partner, friend or daughter say this, or have said it yourself, throwing your hands up in real or mock despair over the biological clock. It has become a more common refrain as the science that allows some women to “preserve” their fertility becomes more sophisticated. Although such phrases might sound flippant, egg freezing is an insurance policy that didn’t exist for previous generations, and its existence has transformed the way that we see fertility.
Last month, the Human Fertilisation and Embryology Authority reported a “dramatic rise” in the number of UK women freezing their eggs, with some experts suggesting it was prompted by the pandemic and the anxiety it caused women who felt they were being robbed of their “fertile window”.
For women who can afford it, egg freezing is touted as a solution to fertility panic (it is not normally available on the NHS unless you are having medical treatment that could affect your fertility). It’s increasingly seen as an option for women facing what has become known as social, or circumstantial, infertility: those whose housing, career, or relationship circumstances make it difficult to have a child.
Women are offered the chance to “take control” of their fertility and “empower” themselves by “locking in” their good quality eggs before they start to decline too much with age. Some clinics have been criticised for giving patients false hope of a successful pregnancy, or a false sense of security, when chances of success, especially for women over 35, can be low.
Most of the fertility clinic websites that I have come across seem to be more transparent. “We are very honest with our patients and would-be patients about their chances of success,” Dr César Díaz-García, medical director of IVI London, a fertility clinic in central London, tells me. He says he is upfront about the reality of how physically and mentally taxing the procedure can be and the fact that costs have the potential to mount. One cycle of egg freezing alone costs £3,295 at his clinic, without any additional tests or treatments – a figure that is in line with other private clinics. “If you freeze eggs in your late 30s or early 40s, you may produce fewer eggs and they may be lower in quality. This means you may need to go through multiple egg-freezing cycles to accumulate an adequate number of eggs,” guidance on the IVI website reads.
According to Díaz-García, women under 35 have a 16% chance of having a baby when five eggs are frozen – with 15 eggs, this increases to 77% and with 25 eggs to 95%. For those over 35, there is a 6% chance with five eggs, increasing to 50% with 20 eggs. “It’s important to realise that egg freezing doesn’t always result in a baby,” IVI guidance reads, advising women to “manage their expectations”.
It’s easy to see how your heart might sink reading those odds. Egg freezing is by no means a panacea. At the same time, in the words of Emily, who froze her eggs last year aged 35, it can make you feel “extremely liberated”. She took the decision after a fertility test revealed low anti-Müllerian hormone (AMH) levels, an indication of a low egg reserve, and she discovered that her mother went through the menopause in her mid-40s.
“I was lucky to have the funds, so I went for it and did two rounds,” she says. She was able to retrieve 21 eggs – “a very good insurance policy, if the eggs are good, which I won’t know until I use them,” she says. “I broke up with my boyfriend earlier this year and fertility didn’t weigh into the decision. I absolutely know it would have done if I didn’t have eggs in the freezer. I do feel like I’ve bought myself a more relaxed mid- to late-30s. I’ve done everything I can, the rest is up to fate.”
All the women I spoke to about egg freezing had mixed feelings about it, Emily – who suffers from chronic illness and found the treatment exhausting – included. Amy, who is 27 and going through her second cycle of egg freezing, tells me that she’ll need three rounds of treatment at a cost of more than £20,000 – she was told she was not eligible for NHS treatment despite being diagnosed with premature ovarian insufficiency, which means the ovaries stop producing normal levels of oestrogen and may not release eggs. “I wouldn’t have chosen to do it otherwise,” she says. “I think people assume it’s quite a simple process to go through, whereas it does take a mental toll.” She can’t face a third cycle yet, describing the side effects as feeling like “very intense PMS”, so will take a break.
Like Amy, who is hoping for three eggs to be collected in her second round, Harriet has had mixed results with egg freezing, which she found quite hard and invasive. “I’m very happy I tried it, and I’m proud of myself for going through it. But it was not a fun experience even without the fact that it wasn’t successful,” she says. “I think egg freezing can work really well for some people, and it can act like a great insurance. I was always told that I had a low ovarian reserve and so I wasn’t going to get tons of eggs, but I think the clinic kept swinging between reality and hope, and I felt as if I could be one of those ‘lucky’ ones who defied the odds. It turns out I wasn’t.”
She wishes she had gone with a different clinic, but says everyone made her feel like her fertility was a ticking timebomb, and she felt under pressure when she chose where to have treatment. And that’s the crux of the issue, I think: that fertility panic can make a calm, considered decision feel far more challenging, even when you have the facts in front of you. Informed consent is one thing, but making a truly pressure-free choice is a whole different matter. There are no guarantees, but what you’re paying for, if you are privileged enough to have the funds, is a smidge more hope than you might have otherwise. Anyone who has been through fertility panic knows that hope can feel so very precious.
What’s working
My son isn’t the keenest on feeding himself, so I was thrilled to find a solution in the form of Doddl cutlery for toddlers, which is so much easier for him to grasp and which has dramatically sped up mealtimes. He still likes to throw it on the floor, but at least more food is going in his mouth.
What’s not
My work-life balance; perhaps it never will be again. I’m finding that my current setup of three days of stay-at-home mothering, two days of nursery, is making me feel a bit Betty Draper. My boy’s at a gorgeous age, but I don’t think I’m a natural stay-at-home mother, and I feel a bit better having admitted it.
Rhiannon Lucy Cosslett is a Guardian columnist
