Egg freezing won't insure women against infertility or help break the glass ceiling

Modern women are increasingly delaying having children. In Australia, the median age of mothers has increased from 25.4 years in 1971 to 30.8 in 2013. The most recent data from 2012 showed the average age of women receiving assisted reproductive treatment was 35.8.

Prohibitive workplace practices and unsympathetic employers are often cited as some of the reasons for the delay, as is the financial burden of taking time off work to raise children. To combat this, women are turning to science.

A recent study from Israel suggests that women who know they can easily access IVF if they need to are more inclined to delay motherhood to focus on developing their careers. The authors of this study, who were economists without expertise in assisted reproduction, said “this is especially relevant as companies consider funding for employees to freeze their eggs as well as other fertility-extending measures".

According to these economists, “by giving people a form of insurance against later life infertility, women who wanted to pursue a career were able to do so".

Indeed, the practice of offering egg-freezing perks to employees is increasingly common. Facebook and Apple are in on the act, as are some of our local IVF clinics.

However, women should be cautious before they take up these sorts of offers from their employers. IVF and egg freezing will not will insure women against infertility as the authors of the study suggest, nor will this technology help break down the glass ceiling. Indeed, it is possible your boss may just try to freeze your wages along with your reproductive potential.

Until only recently, egg freezing was considered experimental, and there is only limited data about its safety and efficacy. The latest results show that success rates with frozen eggs are about 10% lower than with fresh. (It should be noted there remain inconsistencies in information about thaw survival rates and fertility outcomes, and previous studies have shown that the results are comparable to fresh.)

However, even with fresh eggs, you have only around a 26% chance of a live birth per fresh cycle. The chance of success will depend on the age of the woman at the time of egg collection, among other factors. So if it is true that frozen egg cycles are 10% less successful than fresh cycles, you would be looking at around a 15% chance of having a live birth per frozen egg cycle.

And therein lies the problem, as once you’re 45 you can’t just do another egg-collection cycle. If you freeze your eggs at 30, and then wait until your mid-forties to thaw them out, you’ll be left with however many were collected in the first instance. So while egg freezing may be better than doing nothing, you would hardly call it insurance.

Doctors usually aim to collect around 10 eggs per cycle. However, the end result will depend on the individual, and not all eggs will necessarily be suitable to freeze. Depending on how many eggs were collected, you would really want to do more than one cycle to give you the best chance of success later in life. And that’s just to have one baby. If you want a larger family, you’ll need many more cycles.

Each egg-collection cycle costs around A$10,000 or more, and there is no Medicare rebate for social egg freezing. I certainly don’t know too many Australian employers who would be willing to fund all of that.

Even if they were, the above estimates were made using self-reported clinic data from the Australian & New Zealand Assisted Reproduction Database (ANZARD) report. However, it’s unclear whether or not this data can be trusted.

Recently, doctors at the Monash IVF Group of clinics raised concerns about patient care and the way the company reports its IVF success rates. According to a recent news report, the doctors claim the company is overstating its treatment success rates and hiring inexperienced medics. And when doctors don’t trust the treatment and success rates provided by their own clinic, you know something is “fundamentally wrong”.

It should be noted that Monash IVF denied media reports that its staff had concerns about patient care. The company also stated it complies with industry reporting practices. Regardless, this latest incident will only serve to amplify pre-existing fears about IVF industry practices in general.

Notwithstanding concerns about the unclear success rates of egg freezing and the issue of IVF success rate reporting, the problem of pregnancy and parental discrimination in the workplace still exists. According to Job Watch Employment Rights Legal Centre, the number of calls from women who reported they were discriminated against at work because they were pregnant has doubled in the past ten years.

The Victorian Equal Opportunity and Human Rights Commission even produces a booklet warning working women of the “risks” they face while pregnant; and these risks do not include those incurred from eating raw fish or soft cheeses.

So when egg freezing is billed as some sort of insurance policy to protect against the perils of advanced maternal age and is marketed as the key to women breaking through the glass ceiling, and there is also a legitimate concern about the way IVF clinics market and disclose their results to patients, one can’t help but wonder if some of the major beneficiaries of the egg-freezing campaign will be IVF clinics, their shareholders and the workplace boss.

Marketing egg freezing as a way to extend women’s reproductive lives is simply false and it does not address the underlying social reasons for why women freeze their eggs in the first place. Egg freezing might break the bank, but it’s not going to break down the glass ceiling.

It is encouraging that employers and economists are finally recognising some of the barriers women face in employment. However, like so many people and policies in the workplace, IVF and egg freezing simply do not work as effectively as we’d like them to. It’s not a solution to workplace discrimination, it’s not an insurance policy against ageing, and it’s not helpful or fair to pretend that it’s either. And women deserve better.

Loretta Houlahan is Sessional Lecturer, Master of Clinical Embryology, Department of Obstetrics and Gynaecology at Monash University

This article was originally published on The Conversation. Read the original article.