Specialists say fertility techniques that have enabled women with cancer to store eggs should be more widely accessible
Sarah Boseley, health editor
All women should have the chance to freeze their eggs or ovarian tissue in their 20s or early 30s to avoid having fertility problems if they want to conceive later in life, experts say. More and more women are delaying having a family, perhaps because they have not found the right partner or because of their career. A woman’s fertility declines steeply from around the age of 35, which means that many women in their late 30s and early 40s are attempting IVF, often without success.
Experts writing in a new fertility series in the Lancet medical journal say that techniques that have enabled women with cancer to store eggs and ovarian tissue prior to chemotherapy should now be made widely available to healthy women, to save them from possible distress – and reduce the costs of IVF.
Egg-freezing is already being used by some healthy women as insurance against later fertility problems, says Professor Dominic Stoop, director of the Centre for Reproductive Medicine at UZ Brussels. “So far nearly 2,000 babies have been born from frozen eggs, without an increase in the incidence of any birth defects,” he said.
In the UK, however, only 20 babies have yet been born from frozen eggs, according to the Human Fertilisation and Embryology Authority (HFEA). Egg storage has only been available for a few years and was originally offered just to cancer patients. However, there is no rule preventing any woman from having her eggs stored.
Dr Simon Fishel at CARE in Nottingham, which has a chain of fertility clinics, says that relatively few women have chosen to have their eggs frozen except in Ireland. “In our clinic in Dublin, we see a significant number of women for egg freezing. The Irish seem to have got the message. It’s in the consciousness. If the numbers across England were in the same proportion we’d be expecting to see thousands a year, but there are only a few dozen a month,” he said.
“A lot of the young professional women probably don’t realise it is there. The majority probably think it is still going to cost me and I probably won’t need it.” Like an insurance policy, some people will decide to go for it and others will go without, he said.
The cost of egg collection, freezing, storage for three years and thawing at CARE is £3,050. The clinics use a technique called vitrification, which is far more successful when it comes to thawing eggs than earlier technologies, as the HFEA acknowledges.
Prior to December 2012, around 18,000 eggs had been stored in the UK for patients’ own use, the HFEA said. Around 580 embryos have been created from frozen eggs and there have been 20 live births. But interpreting those figures is not straightforward. Some of the women will have been cancer patients and it is not known how old the women were when they stored their eggs. Different clinics will have different results and may be using different freezing and thawing methods.
Stoop and his colleagues say that freezing ovarian tissue is also promising and has the advantage that, when it is replaced, it produces eggs and the woman can become pregnant in the normal way, rather than having to undergo IVF, as she would if using frozen eggs.
Fishel, however, says the freezing and use of ovarian tissue is still effectively at the research stage. Although the Lancet authors say 37 babies have been born after ovarian tissue freezing, Fishel points out that few people yet have the skills to carry out such procedures.
The Lancet authors say egg-freezing has a clear future and that women should be told that this option is available. In the long term, egg and ovarian tissue freezing might also help with the problems many countries face of an aging society, they add. “Couples continue to postpone a family until later in life for various economic, educational and social reasons,” says the paper, an expert analysis of research in the field.
“This trend towards postponement of the first pregnancy has an effect on both family size and the risk of permanent biological childlessness. Consequently, the total fertility rate of most developed countries has dropped below the replacement level, usually deemed to be 2.1 children per woman,” they write.