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Should we be changing laws regarding egg freezing?

By Margaret Hartness

Egg freezing in the UK is becoming more popular – should we begin considering changes in the laws we have regarding it?

According to the Nuffield Council on Bioethics, current laws dictating that frozen eggs must be used within 10 years should be scrapped. This is in response to the government reviewing the law. Nuffield argues this would give more time and options to those with declining fertility – but even those advocating for the law to be overturned acknowledge the possible social costs.

Egg freezing is a way of preserving a woman’s fertility by collecting eggs at a young age and storing them until needed. This involves collecting around 15 eggs through IVF, freezing them quickly (vitrification) and storing them in tanks of liquid nitrogen. The eggs are then thawed when required, with those that survive the process being injected with sperm.

Theoretically, this offers more options for women to have children exactly when they want; when it’s most convenient for their career, when they have the right social setting, or just when it feels right. Unlike contraceptives, which are birth preventatives, this is actual birth control. Everything’s easy in theory though; reality is harder. 

For instance, the Human Fertilisation and Embryology Authority (HFEA) found that in 2017, only around a fifth of IVF treatments using a patient’s own frozen egg results in the birth of a child. And whilst it allows you to have children at the age that suits you, age still matters. While the most common age to freeze is currently 38, success is more likely for women under 35, particularly if the eggs are harvested from a woman in her 20s, and you will have a hefty bill to collect.

The average cost of egg collection and freezing is £3,350, plus £500 – £1,500 for medication, and an additional £125 – £350 annual fee for egg storage.  

The NHS funds freezing eggs for medical reasons – for instance, in advance of chemotherapy, or for diseases that affect fertility – and those afflicted with such conditions can have their eggs stored for 55 years. But for those who wish to freeze their eggs for personal or social reasons, there’s no funding available. Going abroad may be an option for some women but this “could be logistically problematic at the point of thawing”, to quote Nuffield.

Those in favour of changing the law want to bring us closer to that theoretical situation; where not having found the right partner, or being at an incompatible place in your career won’t stop you from having children at some point further down the line. Despite the recent increase in freezing eggs – Nuffield notes a “240% increase from 569 cycles in 2013 to 1,933 in 2018” – the subject remains controversial. 

The first major issue regards the ethics of older motherhood; older than is naturally possible. While women having children in their 40s is now no longer unheard of, someone having a child in their mid-fifties would start collecting their pension before their son or daughter finished primary school, and would be well into their 70s when they start university.

And whilst life expectancy and quality has gradually increased, insurmountably there are biological limits. Menopause typically begins in someone’s 50s, winding down fertility and the ability to carry a fetus. A woman who birthed a child at this age and raised it would be growing into an old lady, and while there is no shame in being an older mother, you don’t need a doctor to say that women of this age won’t have the same energy as a mother in her 20s, 30s, or even 40s. Women who have children at 35 or over are classified as “geriatric mothers”. Age also starts to impact health in serious ways, and the risk is far higher of a child becoming a caregiver or an orphan.

And yet, those who support the law argue it’s unfair to judge so broadly, and that the underlying arguments are flawed anyway. Some women will have health issues – or a higher risk of health issues – earlier in life than is normal, but this doesn’t mean they should be blocked from having children. On the other hand, there are older people with remarkable energy and health; and it’s a growing number due to the advances in medical science. It has given us the phenomenon of the “young olds”; people with at least another healthy twenty years after retirement. Beyond this, “with age comes wisdom” is more than just a phrase, and an older mother would have the advantage of life experience and greater financial stability.

Regarding finances, a principle argument for egg freezing is that it offers women advantages in their personal and professional lives that the natural cycles of childbirth couldn’t afford them. 

Your 20s and 30s are the most crucial period for career growth and consolidating earned positions and yet this inconveniently coincides with the peak and decline of female fertility. Shouldn’t you be able to delay until you have more stability? The current law says no.  Caroline Dinenage, a minister in the Department of Health, says that the 10-year limit can force women to either destroy their eggs “or feel pressured to have a child before they are ready”. 

Oxford University philosophers Imogen Goold and Julian Savelescu have articulated the ethical case for social egg freezing, arguing that it would act as an “egg insurance” against possible future infertility, would provide women with the prolonged fertility that men naturally have, and thus provide women with the equal opportunity to have children when they have the right circumstances: financially, personally, socially, and psychologically. 

From their perspective, it’s the next step for an equal workplace.

But others say it’s exactly the opposite. Say you work in a high paying position in a company like Google or Apple, whose healthcare policies do cover such egg freezing, and you are thinking you might want to start a family; would you? It’s in a company’s best interest for women to work as much as men, without the interruption of childbirth. Younger women may feel pressured to delay their family life to show commitment to their career or feel penalised for doing so. This was one of the areas of concern that Nuffield noted.

From a feminist position, it seems wrong that the emphasis is upon making women more productive and not changing the workplace to be more accounting for motherhood. Christine Rosen, of the New America Foundation and senior editor at The New Atlantis, argued that such company practice would harm gender equality and “undermine arguments for greater workplace accommodation and flexibility for women with children”. A rebuttal may be that the same could be said about more traditional birth control, but freezing one’s eggs is a far greater commitment than getting a free condom. And returning to the first issue raised, there’s no guarantee that these frozen eggs will result in a pregnancy. As the science improves, this may change, but as it stands, to call it an “insurance choice” is potentially selling false hope to women at a heavy financial and emotional price. Nuffield suggests “gamble” or “lottery” may be more accurate terms, and they support it.

Even in the abstract, these questions are difficult, and regardless of whether the government rescinds the limit, these issues will persist for some time to come.

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