Perth-based gynaecologist and fertility specialist Dr Tamara Hunter has seen a surge in women coming to see her about egg freezing — but she is sending about half of them away.
"I often invite them to come back six months, 12 months, even two years later," she said.
"I don't necessarily think that they need to jump into this. It is a medical procedure [and] it is not without risk.
"Equally, there's no absolute guarantee that they're going to get a live birth out of this.
"Given that we know that less than one in 10 women actually come back to use these eggs, it's a big step financially, physically, mentally and socially to take if you're never actually going to act on it."
The number of women who froze their eggs tripled in the five years to 2020, according to the latest data from the National Perinatal Epidemiology and Statistics Unit (NPESU).
In Victoria alone, 1,513 women froze their eggs during 2021-22 — up 63 per cent from the year before, according to the Victoria Assisted Reproductive Technology Authority (VARTA).
Like IVF, the egg-freezing process starts with a woman injecting herself with hormones over several days to stimulate the ovaries before a surgical procedure to extract multiple eggs.
The more eggs the doctor retrieves, the better her chances of having a baby in the future.
But it does not come cheap and does not guarantee a baby.
Depending on the provider, egg freezing can cost between $5,000 and $10,000 per egg retrieval cycle, and a woman may need multiple cycles to give her the best chance of having a baby in the future.
Then it costs around $500 per year in annual storage fees to keep the eggs on ice.
Celebrities and influencers driving awareness
Jennifer Aniston, among other celebrities, has given egg freezing a plug by saying she wished she had done it when she was younger.
Meanwhile, some IVF clinics are partnering with social media influencers, and targeted ads about the biological clock are popping up in women's social media feeds.
Fertility specialist Dr Lynn Burmeister says all the increased attention has drawn more women to the procedure.
"Over the last three years, we've seen an increase in our egg-freezing business by about 50 per cent," Dr Burmeister said of her Melbourne-based clinic.
"We're finding that more women are choosing to egg freeze and they are choosing to do it as an elective process.
"There are a lot of influencers on Instagram and Facebook and TikTok that are egg freezing and I think there is more awareness about fertility — which is great."
Dr Hunter said while increased awareness about fertility issues and family planning was a very good thing, she worried about any marketing that made the process seem easy or straightforward.
"I think it's a really fine line," she said.
"Given that we know that young women pay a lot of attention to social influencers and social media, I do think there is a place [for this kind of promotion].
"But there need to be caveats around the information that has been given.
"We cannot 100 per cent guarantee you to have a baby, let alone a family, from the eggs that you've frozen."
Monash IVF recently had to defend criticism over the ethics of its partnership with Melbourne social influencer Tully Smyth, who has been documenting the process with videos to her 218,000 followers.
Monash told 7.30 that partnerships with social influencers were about starting conversations about fertility.
"From a very early age, we have been educated on how to avoid getting pregnant, but the reality is that one in six Australian couples will experience challenges conceiving," Monash IVF told 7.30 in a statement.
"Through our partnership with Tully, we hope to educate and empower more Australians and raise awareness of the importance of being proactive about fertility."
In a statement sent to 7.30, Ms Smyth said she was committed to sharing her experience in a "raw, authentic and honest" way, and "share the good and the bad, all the ups and downs".
"The other day after a Monash appointment, I shared a reel where I'm crying in my car, fending off a panic attack because I just felt alone and overwhelmed," she said.
"I don't see how it's any different to partnering with a laser eye clinic for LASIK eye surgery or with a dental clinic to promote Invisalign [teeth straightening] – both of which I have done in the past," she told 7.30.
"This is the most authentic partnership I've ever been a part of.
"It means so much more to me than promoting skin care or teeth whitening."
Conflicting messaging on age
While marketing suggests egg freezing is an option to start considering from the age of 20, the three fertility doctors that 7.30 spoke with all said they would not recommend elective egg freezing to someone in their early 20s.
Dr Hunter warned that as well as being less likely to ever come back for the frozen eggs, women under 30 were also at higher risk of developing ovarian hyperstimulation syndrome (OHSS) — a rare but potentially life-threatening side effect of hormone treatments.
"With hyperstimulation of the ovaries, there is a risk, albeit small, of ovarian hyperstimulation syndrome," Dr Hunter said.
"[Which] can potentially be a life-threatening complication of what is essentially an elective procedure.
"It [egg freezing] is a process that is performed regularly and commonly, but it is still a surgical procedure and is not without risk."
IVF specialist Dr Devora Lieberman is a medical director at City Fertility, which owns the dedicated egg freeze service provider Chill Egg Freeze.
The Chill website states that when it comes to the right age to egg freeze, "sooner is better".
"Whether you are in your early 20s or approaching your 40s, elective egg freezing provides you with options for your future fertility," the website states.
One post on the Chill Instagram page says while "there is no 'perfect' time to freeze … we suggest doing it sooner rather than later".
"The optimal window for freezing your eggs is between 20-40 years of age," the post states, before adding: "We encourage women to talk to one of our fertility specialists to discuss their individual circumstances and if egg freezing is right for them".
Dr Lieberman told 7.30 that while it depended on a woman's personal circumstances, she would generally not suggest elective egg freezing to a woman in her early 20s with no medical issues.
"I think 20 is very young. That woman will have a good 15 or 16 years to partner and to start a family," she said.
In terms of when was the right time to egg freeze, Dr Lieberman said it was a difficult balance to strike.
"If you come to freeze your eggs when you are too old, say 37 or 38, the egg quality will not be as good as it once was and many women may actually be freezing their infertility," she said.
"On the flip side of that, if you freeze your eggs when you are very young, say in your mid-20s for example, you have a lot more time in which to partner and have that family without needing the technology.
"And in addition, you will have that many more years of storage fees to pay."
Dr Lieberman said when it came to having conversations about fertility and family planning, "sooner the better" was the right message to be sending.
She recommended that 20-somethings with concerns about their fertility see a specialist and start thinking about their family planning.
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