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Dr. Sandra Glahn Dr. Sandra Glahn

Egg Freezing = Experimental

An August article for BioEdge explored egg-freezing as an uncertain business. In one estimate fewer than 10 babies have been born from eggs frozen for women aged 38+. So we don’t know the ramifications of freezing and thawing older eggs. Of special concern: women seeking such services are typically over 38. Even members of the American Society for Reproductive Medicine (ASRM) –the US fertility industry’s self-regulating arm—offer such services to older women, despite the fact that the guidelines they drafted state they should reserve egg-freezing for younger women. These guidelines also say clinics should consider egg-freezing experimental and conduct it as research governed by an institutional review board (IRB). Most clinics don’t classify such practices as “experimental” so they don’t reduce fees, submit to review boards, or monitor research. All this leaves patients vulnerable. A related article in Nature News described most people who freeze eggs as aging single women seeking to “buy themselves time.” Yet fewer than ten babies have been born worldwide from eggs frozen for women aged 38+. We know little about the success of freezing and thawing older eggs. According to an industry insider, some chemicals used in the freezing process are toxic to embryos, and no one knows how much the eggs absorb. Also, no one has done systematic follow-up of children born from frozen eggs. Greed seems to be the motivation behind leaving patients at risk. In a competitive industry, clinics hesitate to share knowledge. Clinics must report IVF-related data to the Society for Assisted Reproductive Technology (SART), as sister organization to ASRM. But when it comes to egg freezing, reporting is virtually non-existent. Other countries tend to be more careful than the U. S. The Netherlands, for example, had a parliamentary vote in April that ended non-medical egg-freezing for women up to age 45. So if a woman has cancer and her ovaries at risk, she can freeze. But a woman delaying childbearing cannot. It’s much easier to freeze sperm and embryos. Human eggs are large, aqueous, and permeable. But advances during the past few years have significantly increased success rates, and now as many as 50–90% of eggs can survive slow-freezing and thawing. Still, researchers share concern that “cryoprotectants can be toxic to the egg, and that freezing and thawing might affect the egg's meiotic spindle, although spindles are generally thought to reform several hours after thawing.” What we don’t know is if older, more fragile eggs, have more difficulty recovering. Fewer than 2,000 people worldwide have been born from frozen eggs, with 400 of those in the U. S. But again, most of these were born using eggs from younger women. Italy has the highest number of such babies, as only recently has embryo-freezing been allowed. The cost of stimulating ovaries and freezing eggs can exceed $10,000. Add to that an annual cost of $500 to keep them frozen and $1,000 for the thaw. So the cost per child runs about $20,000. With fresh eggs, a single IVF attempt gives a 38- to 40-year-old woman a 22% chance of a live birth. By age 43 or 44, the rate drops to 5%. Many clinics offering egg freezing have limited experience in thawing the cells. One researcher contacted every U. S. clinic, of which 64% responded. Of the 140 providing egg-service info, 45 had never even thawed a client's frozen eggs. At least 30 clinics had zero live births from thawed eggs, and 11 more had only one. Only 8 clinics had 10+ live births.

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