Don’t leave it too late to invest in your reproductive future
This post recently appeared on Professor Nargund’s Huffington Post page.
Until now women have faced a “Catch 22″ dilemma when planning a family; namely in either pursuing a career during their most creative years only to find they may have left it too late, or choosing to have their babies young and then discovering they have lost out in the career stakes as their male rivals surge ahead.
The advent of the pill in the 1960’s is regarded as a seminal moment in the history of female emancipation. Women were given the choice to postpone having children in order to accommodate their careers. However the pill did not answer the problem of diminishing ovarian reserve of eggs, which occurs with increasing age. When it comes to choosing motherhood, the reality of human biology is that a woman’s reproductive clock ticks much quicker than a man’s. There is a sharp decline in female fertility after the age of 36, while men, in most cases, can go on reproducing until their 60s or 70s. This places acute strain on the career woman, who may often find that in her most vital and empowering career stage, she is staring down the barrel of declining fertility.
I believe we have now reached a second defining moment in the history of female emancipation, namely, egg freezing. It seems so logical: bank your eggs while you are young, and use them at a point in the future when ready to start a family. Until recently this was just a dream for most, as the technique was not sufficiently reliable and a large percentage of frozen eggs were not viable after thawing. However the situation has now changed dramatically due to tremendous advances in methodology through the development of rapid freezing or vitrification. This has given new meaning to the term “family planning”. Two years ago the American Society for Reproductive Medicine, after reviewing nearly 1000 scientific articles, stated:
“oocyte preservation (i.e. egg freezing) is an exciting and improving technology and should no longer be considered experimental. Pregnancy rates and health outcomes of the resulting children are now comparable to those of IVF with fresh eggs”.
In a recent, and highly scientifically rigorous, study from Spain the use of frozen eggs from an egg bank were found equally as effective as fresh eggs in egg donation treatment . This is further evidence that frozen eggs are not biologically different from fresh eggs. Of course it is important to remember that the biological efficiency of fresh and frozen eggs (and hence success rates) declines with increasing age of the woman. So if considering freezing your eggs for future use, you should consider doing so by your early 30’s when egg number and quality have not been affected.
The ideal is of course to have your baby at a young age, but an increasing number of women are not ready to start a family when they are young either because they have not met the ideal partner or have a career to pursue. Therefore with egg freezing advancements women no longer have to lose out in the career stakes in order to start a family. In a recent survey of female medical students from the University of Leeds, 80 % said they would consider up to 3 cycles of egg collection and freezing in order to be free to pursue their career. The only main barrier to widespread uptake is the cost of treatment, which is why I believe that every effort should be made by clinics to reduce costs, and thus make this exciting advancement accessible for as many women as possible. However in pursuing this we must also remain vigilant to the risks of ovarian hyperstimulation syndrome (OHSS), and so it is vital that clinics offering this treatment should consider using modern “OHSS Free ” stimulation protocols, in order to better protect both the woman’s health and the quality of her eggs.
The development of egg vitrification is a ground-breaking development in its ability to empower women and provide them with the freedom to choose when they have their children, and for these reasons I believe it to be a key milestone on the road to gender equality.