Women today are waiting longer than ever to start having children. The National Center for Health Statistics at the Centers for Disease Control and Prevention studied accumulated data from the past four decades discovering that in 2012, there were more than nine times as many births to women over the age of 35 than there were in the 1970s. In fact, the first birth rate for women from the ages of 40 to 44 has more than doubled since 1990. But with the postponement of childbearing comes the inevitability of increased rates of lower fertility, leading several women in the direction of oocyte cryopreservation, or egg preservation.
According to Lorraine Kushner, a therapist who specializes in fertility issues, women are furthering their education while obtaining more demanding jobs. In turn, these factors delay partnerships.
“More women are engaging in opportunities for careers, pursuing their education, and in the end put off having babies, and some women don’t even want them,” Kushner said. “The attitude of women has changed and they are becoming more selective about it.”
Unfortunately, the risk of a child being born with a genetic disorder begins to rise after the age of 40. So why is the risk greater? Women are born with a limited supply of eggs. As a woman’s body begins to age, so do her eggs. This can cause problems with chromosomes being misplaced in older eggs, leading ultimately to birthing defects.
Kushner regularly sees patients who need eggs and sperm donors, as well as older women experiencing infertility. She explained that women in their 40s just do not have as many viable eggs anymore.
According to many doctors, 35 marks the magic number in which fertility begins to decrease exponentially. However, Kushner remarked that there are some exceptions to the 35 rule, but agrees that infertility begins to increase as well as other complications. Some of these complications include chromosomal problems, viability in eggs as well as an overall decline of the number of eggs a woman has.
In an attempt to preserve their fertility, women are turning to the egg freezing process in order to embark on their careers as well as to ease their worries about having a child later in life.
“I remember when they first started testing [egg freezing],” Kushner said. “And I remember thinking when this happens, it’s going to change the idea of conception. This tells women maybe you don’t have to worry about the demise of your eggs! It’s great that it’s possible.”
Beginning in 1986, egg preservation was initially offered to cancer patients who had to undergo chemotherapy and radiation: two treatments that can lead to early menopause. When it started, the egg preservation procedure included a slow cooling of the eggs. This process often caused the eggs to develop crystal formations, damaging the eggs. In 2003, scientists discovered a new method called “vitrification” which cools the eggs much faster, so that they become similar to glass, vastly improving the procedure’s success rate.
In 2012, the American Society for Reproductive Medicine opened the floor to those who were interested in freezing their eggs, but also warned people of the inadequate data pertaining to the procedure’s safety, success rates and cost-effectiveness. The procedure’s success depends on how many eggs the doctor can collect.
Leading up to the procedure, women are sedated and given fertility injections at the doctor’s office. As age increases, the amount of eggs harvested decreases. Typically, doctors expect to retrieve anywhere between 13 to 16 eggs per cycle for women 35 and under, as opposed to women between the ages of 37 to 40, who are expected to release 8 to 10 eggs per cycle.
Once the eggs are extracted, they are frozen in a lab and can be defrosted once the patient is ready to have a child. The eggs are then thawed and fertilized with sperm, leaving the doctors to choose which eggs to implant. How many eggs the doctor chooses to implant is contingent upon the age of the patient.
According to Marcelle Cedars, director of the Center of Reproductive Health at the University of California, San Francisco, the estimated live birth rate per egg frozen under the age of 35 is 10 to 12 percent. For those whose ages are closer to 40, the chances of a live birth drop to around six to eight percent.
During the procedure, many eggs are extracted, increasing the overall chances of a victorious birth. Recent studies showed that if a woman freezes and thaws six eggs, her live birth rate is 31 percent at 25 years old, but 13 percent at age 40. Researchers are still trying to figure out what makes an older woman’s eggs particularly fragile during the egg preservation process.
In addition to unreliability, the procedure is not cheap, and insurance companies do not generally cover egg freezing. However, a few companies such as Apple and Facebook recently announced financial support of the procedure for their employees.
For those who don’t have insurance or don’t work for the aforementioned companies, expenses can reach as much as $10,000 for the initial procedure, which includes medication and two years of storage. After the two years is up, it costs $300 a year for storage. Once the patient is ready to have a child, an additional $7,000 must be paid in order to fertilize the egg and transfer the embryo.
“If they can’t afford it, they can’t do it and they’ll have to go back to the ‘old fashioned’ way,” Kushner said. “Egg freezing is so new and I can see why women are excited and reacting to it this way. But they need to be informed about their decisions and the procedures involved.”
In the last five years, the number of women who are freezing their eggs has tripled, a trend that started with the beginning of the new millennium. In 2014, 816 women at 65 different clinics began the process toward egg freezing, which was a rise of 25 percent in just one year. In 2009, only 284 women at 36 different clinics were opting to undergo the procedure.
“It’s already huge and it’s already booming,” Kushner said. “Now with time, the rate of success has increased, especially when freezing embryos. Now some doctors say the chances of one embryo surviving are greater. Since embryos can last a while frozen, it gives women another option rather than just starting all over again.”