Fertility on ice? Banking eggs buys hope

By Melissa Roth

updated 9:35 a.m. ET July 30, 2008

Three weeks before my 37th birthday, a good friend called me in tears. After two years of trying to get pregnant, she'd learned her ovaries had shut down. At 38, she had to accept that it was too late for her and her husband to have a child with her own eggs. Not even advanced fertility treatments would help.

I was sad for my friend, but I was also scared for myself. One year shy of 38, I didn't have a partner in sight. I was also broke and starting a new career, so I wasn't exactly a candidate for single motherhood. But what were the odds I was going to meet someone and have a child while my ovaries were still viable?

When you're single in your 30s, the question of kids — if, when, how many — comes up early in any serious romantic connection. I had a pat response: With the right person at the right time, I'd love to have a child or two. But it wasn't something I'd go to extremes for.

As a writer living in New York City, I was surrounded by single people, and I'd heard plenty of stories about thirtysomething women in the throes of baby panic who made rash decisions, marrying the wrong guy or getting knocked up by an unwitting fellow who then quickly ran for the hills. I'd catch myself looking around tiny Manhattan apartments and wondering, Where do you even put a baby in this city?

But when a choice may no longer be yours to make, your imagined fate can appear in stark relief. In the wake of my friend's news, I started to remember all the times I'd pictured my own kids, the places I'd show them and the stories I would tell them — how the most trying moments of my life would become more meaningful when I had kids to put it all into perspective. Men take it for granted that they will always be able to have children. Would they date someone whose window had already closed?

With my thoughts sending me into a tailspin, I went online. I'd heard about egg freezing in the late 1990s while researching future fertility treatments for an article I was writing, so I was excited to discover a local clinic was now offering the procedure. Had the future already arrived? I booked a consultation with the clinic to investigate.

Egg freezing still considered experimental
Doctors have been freezing sperm for about 50 years, but egg freezing is still considered experimental by some and reserved mostly for young cancer patients facing fertility-threatening chemotherapy. In the past six years, however, some clinics have started marketing the procedure to women concerned about running out of time to have kids — albeit with controversy. The American Society for Reproductive Medicine, an organization of reproductive specialists in Birmingham, Alabama, asserts that the procedure “should not be offered as a means to defer reproductive aging,” claiming that the current data is too limited to consider egg freezing an established treatment. “It's hard to justify having a $15,000 to $20,000 procedure when there's a very small chance it will work,” explains David Adamson, M.D., president of ASRM.

Yet although the number of births from frozen eggs per clinic remains low, some of the top centers are offering very good odds for success. For instance, at New York University's Fertility Center in New York City, which launched its egg-freezing program in 2005, center director Jamie Grifo, M.D., estimates that women ages 35 to 37 have a 46 percent chance of having a baby after a cycle of egg freezing with thaw, fertilization and transfer, and those ages 38 to 40 could expect a 36 percent chance of success. That may sound low, until you consider that the odds of getting pregnant the old-fashioned way, during peak fertility years, are only 10 to 12 percent per ovulation cycle.

Interactive Learn more about the techniques used to help infertile couples conceive a child.

“Very few fertility clinics have invested their energy and money in successfully developing the technique of egg freezing, so the ASRM is worried about backlash from unhappy patients who freeze their eggs and aren't successful,” says Dr. Grifo, who is also a past president of the Society for Assisted Reproductive Technology, an ASRM affiliate. He agrees with the ASRM that prospective patients must be thoroughly informed about the procedure, including the clinic's experience with actual pregnancies, as well as about alternative options.

I learned in my research that the technique used to harvest a woman's eggs for freezing is the same one used during in vitro fertilization: A woman injects herself with hormones to stimulate egg production. Then a doctor uses a needle to extract each egg. Supercharging the ovaries with hormones did not sound risk-free to me. But the American Cancer Society in Atlanta has reported no increased risk for breast or ovarian cancer from a single cycle of injections. One documented risk, occurring in about 0.5 percent of IVF cases, is hyperstimulation syndrome, in which the ovaries become dangerously enlarged, in rare cases requiring their removal.

Egg harvesting may be fairly routine, but the freezing process is not. Unlike sperm, a mature egg cell is large, and unlike embryos, egg cells contain a lot of water. This means ice crystals can form and cause damage, preventing the egg from eventually being fertilized or from dividing properly once fertilization takes place.

Still, thanks to recent improvements to the procedure, including use of a quick-freeze technique known as vitrification, top docs are optimistic about its efficacy and safety. At least 550 babies have been born from frozen eggs, and recent research, presented at the annual ASRM conference, tracked 517 of these children and found that the rate of genetic abnormalities was the same as in children conceived naturally.

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