Fertility decline, freezing eggs: myths and realities

Fertility decline, freezing eggs: myths and realities

In last week’s New York Times, just before the holiday weekend, there was an article about a 22-year-old single woman who decided to freeze her eggs. In that article it said that fertility was declining by age 20. This is extremely inaccurate and unfair. According the American College of Obstetricians and Gynecologists, fertility remains relatively constant until about age 30 then begins to decline and there is a sharper falling off after age 35 and especially after age 40. I have dealt with this issue of the “biological clock” with my patients for more than 25 years.

The ability to freeze eggs rather than embryos is now an option if one has not identified a partner with whom one wants to have their children. When first introduced into this country (it was developed in Italy) NYU was one the pioneers in the United States. I was, however, somewhat in an awkward position serving on the Gynecologic Practice Committee of the American College of Obstetrician and Gynecologists when, initially, this was meant to be offered on an experimental basis to patients who had cancer and were about to undergo chemotherapy. There was an opinion by the American College of Obstetricians and Gynecologists as well as the American Society of Reproductive Medicine that this should be done on an experimental basis without charge. In those early days, NYU was offering this as a clinical service and charging patients and, as all of you are probably aware, it is not covered by insurance.

Those times have changed, however. This is no longer experimental. It has been around long enough to have proven that it is virtually as successful as frozen embryos can be. I have begun to discuss with my single patients who are not engaged or married and/or have no intention of being pregnant in the next several years to consider consultation with fertility experts and to consider freezing eggs. I do so not because I am so concerned that they will not be able to have a baby. I have seen so many women in my career who have had successful pregnancies at 37, 38, even 39. But so many of them have come back at 42 or 43 and say, “you never told me how great this was,” and now they are trying to have a second baby and that does not come so easily.

It is very interesting that virtually no one have ever come to me worrying about their fertility and said, “can I have two babies.” Thus, when I speak to patients now at 32, 33, 34 about the possibility of freezing eggs, it is often with the idea that that may be for the second child, obviously depending on their individual circumstances. I do feel, however, that 22, as talked about in the New York Times article, is much too young to be subjecting one’s self to the treatment involved in terms of medication, procedures, and cost to freeze eggs simply because of a fear of declining fertility.

If this is not something that applies to you, perhaps you can pass this along to some friend or family member.