Kiera Peacock hadn't decided that she wanted kids when she made the decision to freeze her eggs.
Friends of the 34-year-old law firm partner were experiencing fertility issues while trying to fall pregnant.
"The older I started getting, the more I thought about egg freezing," she says.
At the beginning of 2022, Ms Peacock had the financial means to go through with it, so she asked herself: "In five years time, if I was going through fertility problems, would I regret freezing my eggs?"
The answer was no.
"But I felt a bit conflicted at times because I was freezing my eggs – which, in a sense, is a luxury – in the same clinic where there are people who are trying for years to get pregnant," she says.
Keira is not alone.
More women in Australia are freezing their eggs now than ever before.
More women are freezing their eggs
Sarah Hunt, a Fertility Specialist at Monash IVF, says that women have a lot more understanding of the impact of age on female fertility.
"I see a lot of women around the age of 35," she says.
"Something's happening when you're 35 – it's not that something drastically changes when the clock ticks over, but that process of loss of eggs starts to happen at a rate that's a little faster than it has been up until that point."
There's also increasing awareness of egg freezing as a possibility.
"If we go back 20 to 30 years ago, it wasn't an option to freeze eggs because the technology didn't exist for them to be frozen and thawed effectively," Dr Hunt explains.
More recently, celebrities like Jennifer Aniston and Rebel Wilson have boosted the profile of egg freezing, targeted egg freezing ads flood the social media feeds of female 30-somethings – and news is also spreading by word of mouth.
"Lots of women that I see come because they know somebody who has either gone through fertility treatment, or frozen eggs themselves," Dr Hunt says.
Monash IVF are pioneers in egg freezing – in 1999, they achieved the world's first birth from a frozen egg.
Since 2015, the organisation has seen an 162 per cent increase in egg freezing, with an "unprecedented" level of enquiries last year, a Monash IVF spokesperson told the ABC.
Other major egg freezing providers have noted an uptick in egg freezing in recent years.
Chill Egg Freeze reported a 234 per cent increase in the number of egg freezing procedures between 2019-20 and 2021-22, and Genea Horizon has seen an increase of 400 per cent in egg freezing procedures since their clinics opened in 2017.
'I was considering my options after a break-up'
Chantel Pountney knew she wanted kids – but not yet.
So, the 36-year-old started looking into freezing her eggs.
"I was considering my options after a break-up," Ms Pountney says.
"When you don't have a partner and you're getting older, you need to consider these things."
There were other factors that led to Ms Pountney's decision to freeze her eggs – she has endometriosis and was told "it won't be the easiest to fall pregnant".
Also, the insurance professional still had a few more career goals to achieve.
She also felt some pressure to have kids, "people were putting that on me a bit," Ms Pountney says.
But she doesn't want to have a child alone.
"I don't want to go through a pregnancy without a partner," she says.
"If I don't [have a partner], I'm not meant to have children – it's not what I want."
Like Ms Pountney, research shows that the most common reason women choose to freeze their eggs is a "lack of a partner", or "the difficulty experienced by well-educated, professional women in finding a partner willing to commit to parenthood".
But there are many other factors to consider.
Egg freezing is a huge and complex decision
Karin Hammarberg is a senior research fellow in the School of Public Health and Preventive Medicine at Monash University, a leading expert in fertility, and a registered nurse with 20 years' experience as clinical coordinator of IVF programs.
"Across literature, there are consistent characteristics," Dr Hammarberg says of the women who are freezing their eggs.
"They are well educated, professional jobs, earning good incomes – and single."
It's a huge decision, Dr Hammarberg says.
There's the financial investment that women must consider – it costs up to $10,000 for one egg freezing cycle in Australia, plus an ongoing maintenance fee to keep their eggs frozen.
Also, egg freezing is an intense medical process, which involves injecting yourself twice a day for up to 14 days as well as an egg retrieval surgery.
And the egg freezing process is often emotionally and psychologically taxing.
"For a woman who is 37, yearning for a baby but doesn't have a life situation that allows her to have one, freezing of eggs is something to grasp for," Dr Hammarberg says.
Unfortunately, it's not as simple as that.
"We're looking at probabilities here," Dr Hammarberg explains.
"If you're 37, you have your hormone stimulation, you pay $10,000, and you get four eggs – the chance of that ever leading to that precious outcome is very small."
"So the only option is to do it again and again and again."
Research shows that at 35 years of age or less, a woman needs to freeze at least 14 eggs to have an 80 per cent chance of having a baby from her frozen eggs.
This increases to 33 eggs for a 39-year-old woman.
"If you're 37, you probably need to freeze 20 eggs to have an 80 per cent chance – and there's never a 100 per cent chance," Dr Hammarberg says.
For the 37-year-old woman who retrieved four eggs in her first cycle, she would hypothetically need to go through the process four more times to have 20 eggs, which would add up to $50,000.
"You might get that baby, you might not – [egg freezing] is a potential, it's not a guarantee," Dr Hammarberg explains.
"If you want kids and can't have them – it's a traumatic experience to want to have children and not being able to."
'I didn't feel ready to have kids yet'
Gretel Wilson and her partner, Sam Clarke, want to have kids some day – but they're focused on their start-up right now.
"Being one of five kids and with both parents having big careers, I was always encouraged to try and have both [baby and career]," the 31-year-old says.
She started looking into egg freezing around the same time they received funding to launch the business.
"I wasn't in a position to have kids in the short term," Ms Wilson says.
But she says she was feeling pressure around entering her 30s.
"Whether it's friends or family, there's a crescendo when you reach a certain point and you realise lots of people are focusing on starting a family and finding someone to settle down with," she explains.
The option to freeze her eggs gave her comfort.
"It takes so much pressure off when you hit that milestone," she says – that milestone being the age when women become aware of their declining fertility.
"You know you might want a family, but you're not on the timeline projected for you."
Tiarna Ernst is an IVF and fertility specialist at City Fertility, the parent company of Chill Egg Freeze.
"None of my patients have regretted going through [egg freezing], but some have thought 'what if I had done it earlier?'" Dr Ernst says.
The important thing is assessing each patient thoroughly and creating realistic expectations.
"I have lots of conversations every week with patients about the pros and cons of egg freezing," she says.
"We also have a thorough debrief after the process, about their response to medications and what can be changed next time to optimise the results of the number of eggs."
Dr Hunt from Monash IVF stresses to patients that egg freezing is a good option, but it's not a guarantee.
"It's tricky because there's so much invested in the collection physically, emotionally, financially – there's a lot of pressure," she says.
"If having a baby is really important and a priority, the only certainty – and the only true test of that fertility – is to actually trying to conceive.
"And there's no perfect time for that to happen, generally, so in that situation I would encourage that couple to move that time frame forward."
Are there medical reasons for egg freezing?
Dr Hammarberg says a doctor may recommend egg freezing for some women due to medical reasons.
Some scenarios include endometriosis (especially if it's extensive and involves the ovaries), a family history of early menopause, ovarian cancer, and if an ovary has been removed.
Egg freezing can also be recommended for women facing gonadotoxic treatment for cancer or autoimmune disease, and women with a genetic predisposition for ovarian insufficiency (also known as Turner Syndrome).
Ms Pountney, who has endometriosis, was told by her doctors that her egg freezing cycle may not yield a high number of eggs.
"When they told me how many follicles there would be, I told myself if I could get half of that I would consider the process a success," she says.
A follicle is where an immature egg develops – Ms Pountney had seven follicles and produced seven eggs, but only three were mature.
"It was still disappointing, but I already told myself it would be a success," she says – she had basically achieved her target of half with three out of seven viable eggs.
"I've got everything ready to go again, but mentally I'm not there," she says.
"Because the results weren't as great as what my doctor had hoped, he wants to increase the dosage of injections – and I don't feel ready for that, if I don't get a good result again."
A low AMH level is another reason why women may consider egg freezing, but this test result is often misunderstood – and AMH levels are not a reliable measure of fertility potential.
"People have the test to get an idea of their fertility and how long they have to have children," Dr Hammarberg says.
"The problem is, the test can't actually tell you that.
"A young woman with low AMH has the same chance of pregnancy as a young woman with high AMH.
"It can't predict the chance of pregnancy … it's not helpful to tell someone about their future fertility."
However, AMH levels can predict how ovaries will respond to stimulation, which occurs during the egg freezing process.
Dr Ernst says there's a broad spectrum of what can be considered a "normal" AMH level.
"We're still learning a lot about what it means to have a lower AMH," she says.
"But it can help with providing an expectation of the number of eggs we can collect from an egg freezing cycle."
Egg freezing is 'no silver bullet' – but it's an option
Dr Hammarberg says egg freezing is often seen as an insurance policy – but it's more like a lottery.
"People think: if something bad happens, it'll pay out," she explains.
"Egg freezing is not a guarantee though."
It's a numbers game that involves weighing cost, age, time and many other factors – "and it's no silver bullet."
"With the complete set of information, women can make the best decision for themselves."
Ms Peacock wishes she had known a little more about the prospects of having a baby from frozen eggs.
"I wouldn't change doing it though," she says.
People said she would feel relieved after the process, like a "weight is lifted", but she didn't.
"Nothing's a guarantee – certainly not unless you go through multiple rounds," she says.
"If the time comes, I've done what I could've done to have eggs that can be used."
