Unknowns and uncertainties raise ethical concerns for UK egg freezing


Research by a De Montfort University Leicester (DMU) academic has informed a new call for fertility clinics to provide better data to women.

Dr Kylie Baldwin of DMU’s Fertility Research Centre has spent years researching fertility issues, particularly egg freezing. She is advocating for a change in the law so women who freeze their eggs for non-medical reasons do not have to destroy them after 10 years.

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Today the Nuffield Council on Bioethics published a new briefing note partly informed by Dr Baldwin’s research – which highlights a need for data on egg freezing success rates to be presented more clearly, accessibly, and transparently. At present, research suggests that women find these data difficult to navigate.

Dr Baldwin said: “As egg freezing becomes more popular, clinics and those advertising the technology have a responsibility to provide transparent, age-related success rates which details the probable chance of a live birth with frozen eggs in the future. This information should be drawn from in-house clinic data or if not available, then the best comparable data.

“Providers of egg freezing should be discouraged from advertising success rates taken from highly specialised clinics which often use eggs from much younger women than the average user of the technology in the UK or should be transparent about the extent to which they expect to be able to replicate such success rates in their own clinics.

“Women should be made aware at the outset that they may need to undergo multiple rounds of egg freezing in order to store enough eggs for future use; particularly women who may be undergoing the procedure at an older age.”

Dr Baldwin said the 10-year storage time limit on eggs frozen for social reasons requires urgent revision to enable women to use their own genetic material to attempt to conceive at a time that is right for themselves and their family.

She added: “The current time limit is not only inequitable but non-sensical and could prevent women from freezing eggs at a biologically optimal age due to the fear that their eggs may need to be used or destroyed before they are ready or need to use them.”

Frances Flinter, Nuffield Council member and Emeritus Professor of Clinical Genetics at Guy’s and St Thomas’ NHS Foundation Trust, said: “It’s vital for women thinking about freezing their eggs to be able to make informed choices.

“To do this, they need easy access to data on their chances of success across various stages of the process – from freezing and thawing eggs, to having a live birth. But they also need clinics to be frank about the process, and about what is known and unknown about egg freezing. This is especially important given egg freezing’s increasing popularity.”
 
One area where clear information and research are likely to be important in the future is where egg freezing is offered as part of an employment benefits package. Although this isn’t common in the UK at present, it is beginning to be offered by some companies.
 
For some women, being offered egg freezing as an employment benefit could feel empowering and give a sense of being in more control over their reproductive future. For others, the offer might make them feel pressured to delay motherhood. If more employers consider providing this benefit, research needs to focus on women’s needs and their experiences of using such schemes.

The Nuffield Council also highlights that offering egg freezing as part of a benefits package is not the only option for employers to support employees’ reproductive choices. Improvements to family-friendly work environments, childcare subsidies, and family leave also have a key role to play.
           
The briefing also notes:

•    Concerns over the way that social egg freezing is presented in the media and marketed to women
 
•    Research also suggests that women can feel pressure to freeze to avoid blaming themselves later. It is important that marketing strategies consider such research so that women’s anxieties are not exploited. 
 
•    There appear to be few arguments against increasing the storage limit for social egg freezing from its current limit of ten years. Changes to this limit are currently being considered by the Government.
 


Posted on Wednesday 30 September 2020

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