Freezing Eggs: A fertility insurance policy?
Recently Facebook and Apple made national news when they announced that they will pay for female employees to freeze their eggs for non-medical reasons. Supporters laud this policy as a means of promoting reproductive “choice” for young women – the ability to pause their fertility until they are ready to become parents.
Recommending that professional women consider freezing their eggs to delay childbearing is not new. In April 2013, feminist anthropologist Marcia Inhorn advised ambitious career women, particularly academics, to see egg freezing as a “fertility insurance policy.” Yet Inhorn’s peers, Lynn Morgan and Janelle Taylor, criticized this idea in an op-ed commentary, arguing that Inhorn glossed over both the health risks and the larger social issues underlying such recommendations.
It was only as recently as 2012 that the American Society for Reproductive Medicine (ASRM) stated that egg freezing would no longer be considered an “experimental” technology. Although ASRM recommends egg freezing for women receiving cancer treatments or those with particular genetic conditions, they explicitly state that there is “not yet sufficient data to recommend oocyte cryopreservation for the sole purpose of circumventing reproductive aging in healthy women.” The Society cites concerns with safety, ethics, efficacy, as well as emotional risks. Egg retrieval procedures include two weeks of daily hormone injections, which can be painful and uncomfortable. Some women experience more serious side effects such as rapid weight gain, damage to organs close to the ovaries, or ovarian hyperstimulation syndrome (OHSS). In OHSS, swollen ovaries can lead to abdominal bloating, severe bloating, decreased urination, and shortness of breath. In addition to the side effects of harvesting the eggs, there are women with extensive experiences with IVF who also point out that freezing eggs does not guarantee a healthy baby in the future. At this time, IVF procedures are very expensive, and the percentage of IVF cycles which result in live births is around 22%. This fertility “insurance” policy perhaps insures that you will have younger eggs, but it does not guarantee successful fertilization and implantations of embryos, sustainable pregnancies, live births, or a healthy baby.
Due to its rising popularity, egg freezing is becoming a lucrative industry for those in assisted reproductive technology (ART) – ironically, the same field that recommends against the use of egg freezing to delay childbearing for non-medical reasons. In a timely Slate article predating the Facebook and Google announcement, Robin Marantz Henig discussed attending an “egg freezing party.” Billed as an evening of “Fun, Fertility, and Freezing,” Henig described the event as using alarmist tactics to scare women to sign up: “The company is selling you something: hope, anxiety reduction, a break from the idea that you are hurtling toward a physical breakdown. And science suggests that it might be selling you a bill of goods.”
While reproductive “choices” include supporting women (and men) to make choices based on their individual lives, promoting egg freezing as a means of controlling future fertility ignores many of the problematic social structures that force us to make such choices. Such policies do not necessarily position women to better balance family with career; instead they just postpone this complicated balancing act. Many women and men delay reproductive experiences because of a lack of employer support for maternity/paternity coverage, family leave, and subsidized child care. They are often incentivized to delay childbearing in order to position themselves better economically and in their careers. Although paying for egg freezing may provide a means for some women to achieve their reproductive goals on their own schedule, it seems that as a society we would be better off advocating for social changes that support all reproductive experiences.
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