Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-hvd4g Total loading time: 0 Render date: 2025-01-11T05:37:16.180Z Has data issue: false hasContentIssue false

Chapter 5 - Fertility Preservation for “Social” Reasons

from Section 4 - Rethinking and Redefining “Family Planning” for the Twenty-First Century

Published online by Cambridge University Press:  15 September 2022

By
Timothy Bracewell-Milnes  and
Dimitrios S. Nikolaou
Edited by
Dimitrios S. Nikolaou  and
David B. Seifer
Dimitrios S. Nikolaou
Affiliation:
Chelsea and Westminster Hospital, London
David B. Seifer
Affiliation:
Yale Reproductive Medicine, New Haven, CT
Get access

Summary

Egg freezing was initially introduced as a fertility preservation measure in women without a male partner who were about to undergo gonadotoxic treatments. The use of oocyte cryopreservation for social reasons has been an increasingly popular strategy for women to preserve their fertility potential, a term most referred to as ‘social egg freezing’ (SEF). As well as for career progression or waiting until they are financially more secure, some women may be single, or may decide to egg freeze to relieve pressure on a relationship, until they decide they are ready to have children with their partner. Upon introduction, success rates with SEF were low due to poor oocyte survival rates. With the advent of oocyte vitrification techniques, assisted reproductive technology (ART) procedures using frozen oocytes have shown a similar live birth rate (LBR) to those using fresh oocytes. Due to this growing evidence for the efficacy of egg freezing, both the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) changed their stances and no longer consider oocyte freezing to be an experimental technique.

Keywords

Egg-freezingsocial egg-freezingfertility preservationvitrificationslow-freezingearly ovarian ageingfamily planningovarian reserve
Type
Chapter
Information
Optimizing the Management of Fertility in Women over 40 , pp. 56 - 70
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baldwin, K., Conceptualising women’s motivations for social egg freezing and experience of reproductive delay. Sociol Health Illn, 2018. 40(5): p. 859–73.CrossRefGoogle ScholarPubMed
Dunson, D.B., Baird, D.D., and Colombo, B., Increased infertility with age in men and women. Obstet Gynecol, 2004. 103(1): p. 51–6.CrossRefGoogle ScholarPubMed
Nicoletti, C. and Tanturri, M.L., Differences in delaying motherhood across European countries: empirical evidence from the ECHP / Différences entre pays européens dans le retard à la maternité: Analyse des données de l’ECHP. European Journal of Population / Revue Européenne de Démographie, 2008. 24(2): p. 157–83.Google Scholar
Leridon, H., A new estimate of permanent sterility by age: sterility defined as the inability to conceive. Popul Stud (Camb), 2008. 62(1): p. 15–24.CrossRefGoogle ScholarPubMed
Goldman, K.N., Elective oocyte cryopreservation: an ounce of prevention? Fertil Steril, 2018. 109(6): p. 1014–15.CrossRefGoogle ScholarPubMed
Alteri, A., et al., Elective egg freezing without medical indications. Acta Obstet Gynecol Scand, 2019. 98(5): p. 647–52.CrossRefGoogle ScholarPubMed
Crawford, S., et al., Cryopreserved oocyte versus fresh oocyte assisted reproductive technology cycles, United States, 2013. Fertil Steril, 2017. 107(1): p. 110–18.Google Scholar
Waldby, C., ‘Banking time’: egg freezing and the negotiation of future fertility. Cult Health Sex, 2015. 17(4): p. 470–82.Google Scholar
Argyle, C.E., Harper, J.C., and Davies, M.C., Oocyte cryopreservation: where are we now? Hum Reprod Update, 2016. 22(4): p. 440–9.Google Scholar
Cobo, A., et al., Six years’ experience in ovum donation using vitrified oocytes: report of cumulative outcomes, impact of storage time, and development of a predictive model for oocyte survival rate. Fertil Steril, 2015. 104(6): p. 1426–34.e1–8.Google Scholar
Dondorp, W., et al., Oocyte cryopreservation for age-related fertility loss. Hum Reprod, 2012. 27(5): p. 1231–7.Google Scholar
Mature oocyte cryopreservation: a guideline. Fertil Steril, 2013. 99(1): p. 37–43.Google Scholar
RCOG. RCOG suggests caution over social egg freezing. 8 August 2018; Available from: https://www.rcog.org.uk/en/news/rcog-suggests-caution-over-social-egg-freezing/.Google Scholar
Cobo, A., et al., Oocyte vitrification as an efficient option for elective fertility preservation. Fertil Steril, 2016. 105(3): p. 755–764.e8.CrossRefGoogle ScholarPubMed
Cil, A.P., Bang, H., and Oktay, K., Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis. Fertil Steril, 2013. 100(2): p. 492–9.e3.CrossRefGoogle ScholarPubMed
Doyle, J.O., et al., Successful elective and medically indicated oocyte vitrification and warming for autologous in vitro fertilization, with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval. Fertil Steril, 2016. 105(2): p. 459–66.e2.CrossRefGoogle ScholarPubMed
Human Fertilisation and Embryology Authority (HFEA), Fertility Treatment 2014-2016: trends and figures. 2018. Available from: https://www.hfea.gov.uk/media/3188/hfea-fertility-trends-and-figures-2014-2016.pdfGoogle Scholar
Hammarberg, K., et al., Reproductive experiences of women who cryopreserved oocytes for non-medical reasons. Hum Reprod, 2017. 32(3): p. 575–81.Google ScholarPubMed
Stoop, D., Nekkebroeck, J., and Devroey, P., A survey on the intentions and attitudes towards oocyte cryopreservation for non-medical reasons among women of reproductive age. Hum Reprod, 2011. 26(3): p. 655–61.Google Scholar
Cobo, A., et al., Elective and Onco-fertility preservation: factors related to IVF outcomes. Hum Reprod, 2018. 33(12): p. 2222–31.Google Scholar
Greenwood, E.A., et al., To freeze or not to freeze: decision regret and satisfaction following elective oocyte cryopreservation. Fertil Steril, 2018. 109(6): p. 1097–104.e1.Google Scholar
Stoop, D., et al., Does oocyte banking for anticipated gamete exhaustion influence future relational and reproductive choices? A follow-up of bankers and non-bankers. Hum Reprod, 2015. 30(2): p. 338–44.CrossRefGoogle ScholarPubMed
Bracewell-Milnes, T., Norman-Taylor, J., and Nikolaou, D., Social egg freezing should be offered to single women approaching their late thirties: AGAINST: Women should be freezing their eggs earlier. BJOG, 2018. 125(12): p. 1580.Google Scholar
Lemoine, M.E. and Ravitsky, V., Sleepwalking into infertility: the need for a public health approach toward advanced maternal age. Am J Bioeth, 2015. 15(11): p. 37–48.Google Scholar
Ter Keurst, A., Boivin, J., and Gameiro, S., Women’s intentions to use fertility preservation to prevent age-related fertility decline. Reprod Biomed Online, 2016. 32(1): p. 121–31.CrossRefGoogle ScholarPubMed
Goldman, R.H., et al., Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients. Hum Reprod, 2017. 32(4): p. 853–9.Google Scholar
Mesen, T.B., et al., Optimal timing for elective egg freezing. Fertil Steril, 2015. 103(6): p. 1551–6.e1–4.Google Scholar
van Loendersloot, L.L., et al., Expanding reproductive lifespan: a cost-effectiveness study on oocyte freezing. Hum Reprod, 2011. 26(11): p. 3054–60.CrossRefGoogle Scholar
Devine, K., et al., Baby budgeting: oocyte cryopreservation in women delaying reproduction can reduce cost per live birth. Fertil Steril, 2015. 103(6): p. 1446–53.e1–2.CrossRefGoogle ScholarPubMed
Hirshfeld-Cytron, J., Grobman, W.A., and Milad, M.P., Fertility preservation for social indications: a cost-based decision analysis. Fertil Steril, 2012. 97(3): p. 665–70.CrossRefGoogle ScholarPubMed
Malchau, S.S., et al., The long-term prognosis for live birth in couples initiating fertility treatments. Hum Reprod, 2017. 32(7): p. 1439–49.CrossRefGoogle ScholarPubMed
Hodes-Wertz, B., et al., What do reproductive-age women who undergo oocyte cryopreservation think about the process as a means to preserve fertility? Fertil Steril, 2013. 100(5): p. 1343–9.CrossRefGoogle ScholarPubMed
Baldwin, K., et al., Oocyte cryopreservation for social reasons: demographic profile and disposal intentions of UK users. Reprod Biomed Online 2015. 31(2): p. 239–45.Google Scholar
Gürtin, Z.B., et al., For whom the egg thaws: insights from an analysis of 10 years of frozen egg thaw data from two UK clinics, 2008-2017. J Assist Reprod Genet, 2019. 36(6): p. 1069–80.Google Scholar
Gurtin, Z.B., Ahuja, K.K., and Golombok, S., Emotional and relational aspects of egg-sharing: egg-share donors’ and recipients’ feelings about each other, each others’ treatment outcome and any resulting children. Hum Reprod, 2012. 27(6): p. 1690–701.Google Scholar
Inhorn, M.C., et al., Ten pathways to elective egg freezing: a binational analysis. J Assist Reprod Genet, 2018. 35(11): p. 2003–11.Google Scholar
Pritchard, N., et al., Characteristics and circumstances of women in Australia who cryopreserved their oocytes for non-medical indications. J Reprod Infant Psychol, 2017. 35(2): p. 108–18.CrossRefGoogle ScholarPubMed
Jones, B.P., et al., Perceptions, outcomes, and regret following social egg freezing in the UK; a cross-sectional survey. Acta Obstet Gynecol Scand, 2020. 99(3): p. 324–32.CrossRefGoogle ScholarPubMed
Baldwin, K., et al., Running out of time: exploring women’s motivations for social egg freezing. J Psychosom Obstet Gynaecol, 2019. 40(2): p. 166–73.Google Scholar
Kennedy, S. and Ruggles, S., Breaking up is hard to count: the rise of divorce in the United States, 1980-2010. Demography, 2014. 51(2): p. 587–98.Google Scholar
Woodtli, N., et al., Attitude towards ovarian tissue and oocyte cryopreservation for non-medical reasons: a cross-sectional study. Arch Gynecol Obstet, 2018. 298(1): p. 191–8.Google Scholar
Tozzo, P., et al., Understanding social oocyte freezing in Italy: a scoping survey on university female students’ awareness and attitudes. Life Sci Soc Policy, 2019. 15(1): p. 3.CrossRefGoogle ScholarPubMed
Daniluk, J.C. and Koert, E., Fertility awareness online: the efficacy of a fertility education website in increasing knowledge and changing fertility beliefs. Hum Reprod, 2015. 30(2): p. 353–63.Google Scholar
Carroll, K. and Kroløkke, C., Freezing for love: enacting ‘responsible’ reproductive citizenship through egg freezing. Cult Health Sex, 2018. 20(9): p. 992–1005.Google Scholar
Tan, S.Q., et al., Social oocyte freezing: a survey among Singaporean female medical students. J Obstet Gynaecol Res, 2014. 40(5): p. 1345–52.Google Scholar
Daniluk, J.C. and Koert, E., Childless women’s beliefs and knowledge about oocyte freezing for social and medical reasons. Hum Reprod, 2016. 31(10): p. 2313–20.Google Scholar
Milman, L.W., et al., Assessing reproductive choices of women and the likelihood of oocyte cryopreservation in the era of elective oocyte freezing. Fertil Steril, 2017. 107(5): p. 1214–22.e3.Google Scholar
Lallemant, C., et al., Medical and social egg freezing: internet-based survey of knowledge and attitudes among women in Denmark and the UK. Acta Obstet Gynecol Scand, 2016. 95(12): p. 1402–10.CrossRefGoogle ScholarPubMed
Hurley, E.G., et al., Postponing childbearing and fertility preservation in young professional women. South Med J, 2018. 111(4): p. 187–91.CrossRefGoogle ScholarPubMed
Baylis, F., Left out in the cold: arguments against non-medical oocyte cryopreservation. J Obstet Gynaecol Can, 2015. 37(1): p. 64–7.CrossRefGoogle ScholarPubMed
Bowen-Simpkins, P., Wang, J.J., and Ahuja, K.K., The UK´s anomalous 10-year limit on oocyte storage: time to change the law. Reprod Biomed Online, 2018. 37(4): p. 387–9.CrossRefGoogle ScholarPubMed
Goold, I. and Savulescu, J., In favour of freezing eggs for non-medical reasons. Bioethics, 2009. 23(1): p. 47–58.Google Scholar
Schattman, G.L., A healthy dose of reality for the egg-freezing party. Fertil Steril, 2016. 105(2): p. 307.Google Scholar
Gelbaya, T.A., Short and long-term risks to women who conceive through in vitro fertilization. Hum Fertil (Camb), 2010. 13(1): p. 19–27.CrossRefGoogle Scholar
Human Fertilisation and Embryology Authority (HFEA). Fertility treatment 2017: trends and figures. 2017; Available from: https://www.hfea.gov.uk/media/3189/fertility-treatment-2017-trends-and-figures.pdfGoogle Scholar
te Velde, E.R. and Pearson, P.L, The variability of female reproductive ageing. Hum Reprod Update, 2002. 8(2): p. 141–54.CrossRefGoogle ScholarPubMed
Nikolaou, D. and Templeton, A., Early ovarian ageing: a hypothesis. Detection and clinical relevance. Hum Reprod, 2003. 18(6): p. 1137–9.Google Scholar
Nikolaou, D. and Templeton, A., Early ovarian ageing. Eur J Obstet Gynecol Reprod Biol, 2004. 113(2): p. 126–33.Google Scholar
Nikolaou, D., How old are your eggs? Curr Opin Obstet Gynecol, 2008. 20(6): p. 540–4.CrossRefGoogle ScholarPubMed
Mustafa, K.B., et al., Live birth rates are satisfactory following multiple IVF treatment cycles in poor prognosis patients. Reprod Biol, 2017. 17(1): p. 34–41.Google Scholar
Papathanasiou, A., et al., Trends in ‘poor responder’ research: lessons learned from RCTs in assisted conception. Hum Reprod Update, 2016. 22(3): p. 306–19.Google Scholar
Noventa, M., et al., Testosterone therapy for women with poor ovarian response undergoing IVF: a meta-analysis of randomized controlled trials. J Assist Reprod Genet, 2019. 36(4): p. 673–83.Google Scholar
Zhang, M., et al., Dehydroepiandrosterone treatment in women with poor ovarian response undergoing IVF or ICSI: a systematic review and meta-analysis. J Assist Reprod Genet, 2016. 33(8): p. 981–91.CrossRefGoogle ScholarPubMed
Haahr, T., Esteves, S.C., and Humaidan, P., Individualized controlled ovarian stimulation in expected poor-responders: an update. Reprod Biol Endocrinol, 2018. 16(1): p. 20.Google Scholar
O’Brien, Y., et al., What women want? A scoping survey on women’s knowledge, attitudes and behaviours towards ovarian reserve testing and egg freezing. Eur J Obstet Gynecol Reprod Biol, 2017. 217: p. 71–6.Google Scholar
Azhar, E., et al., Knowledge of ovarian reserve and reproductive choices. J Assist Reprod Genet, 2015. 32(3): p. 409–15.Google Scholar
Hvidman, H.W., et al., Individual fertility assessment and pro-fertility counselling; should this be offered to women and men of reproductive age? Hum Reprod, 2015. 30(1): p. 9–15.CrossRefGoogle ScholarPubMed
Tremellen, K. and Savulescu, J., Ovarian reserve screening: a scientific and ethical analysis. Hum Reprod, 2014. 29(12): p. 2606–14.CrossRefGoogle ScholarPubMed
Tal, R. and Seifer, D.B., Ovarian reserve testing: a user’s guide. Am J Obstet Gynecol, 2017. 217(2): p. 129–40.Google Scholar
Practice Committee of American Society for Reproductive Medicine.Ovarian tissue cryopreservation: a committee opinion. Fertil Steril, 2014. 101(5): p. 1237–43.Google Scholar
Diaz-Garcia, C., et al., Oocyte vitrification versus ovarian cortex transplantation in fertility preservation for adult women undergoing gonadotoxic treatments: a prospective cohort study. Fertil Steril, 2018. 109(3): p. 478–85.e2.Google Scholar
Meirow, D., et al., Transplantations of frozen-thawed ovarian tissue demonstrate high reproductive performance and the need to revise restrictive criteria. Fertil Steril, 2016. 106(2): p. 467–74.Google Scholar
Donnez, J., et al., Ovarian cortex transplantation: time to move on from experimental studies to open clinical application. Fertil Steril, 2015. 104(5): p. 1097–8.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×