Left Out In The Cold: Seven Reasons Not To Freeze Your Eggs

Françoise Baylis criticizes including egg freezing as part of employee benefits packages.

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In 2012, the American Society for Reproductive Medicine (ASRM) lifted the experimental designation on human egg freezing. At this time, it was careful to indicate that freezing technology should not to be used for elective purposes, particularly as this might give young women false hope. A 2014 fact sheet prepared by the ASRM confirms that “Even in younger women (i.e., < 38 years old), the chance that one frozen egg will yield a baby in the future is around 2-12%.”

These professional cautions are of no consequence to Facebook or Apple, however. Both of these companies have decided to include egg freezing in their employee benefit package. As an alternative, they could have decided to improve the health benefits offered to all employees. Or, to stay focused on the issue of reproduction, they could have included a full year of family leave in the benefit package. Instead, they chose to pay up to $20,000 for egg freezing. Now call me crazy, but I think this choice just might have to do with their corporate priorities – which include keeping talented workers in their 20s to early 30s in the workplace, not at home caring for babies.

Sadly, from my perspective, some describe this corporate decision in positive terms. They congratulate the companies for “taking the lead”. In this way, they both endorse the decision and encourage others to follow this lead. Already, Virtus Health in Australia has announced that it too will pay for egg freezing for its female employees. According to the Medical Director of Virtus “… if it’s good enough for Apple and Facebook, it’s good enough for us.”

imac

The original bondi blue iMac from Apple.

Here are seven good reasons why Facebook and Apple employees should reject this employee benefit.

First, ovarian stimulation and egg retrieval to collect eggs for freezing are both onerous and risky. The two weeks of daily injections are known to be painful and uncomfortable. There can be cramping, abdominal pain, nausea and vomiting. More serious possible side effects include rapid weight gain and damage to organs close to the ovaries. More serious still is the small risk of severe ovarian hyperstimulation syndrome which can require hospitalization and rarely has resulted in death (see here and here). As well, there is a small chance of infertility (1%) and there are reports suggesting a link between ovarian stimulation and certain cancers. In brief, there are risks associated with egg freezing.

Second, contrary to popular belief, egg freezing does not set back a woman’s biological clock. While it is certainly true that eggs from a younger woman are more likely to generate a healthy embryo and a healthy pregnancy than eggs from an older woman, it very much matters that the body into which the embryos will be transferred is the body of an older woman. From a purely biological perspective, it is in the interest of women to have their children while they are younger.

Third, while we know that egg freezing is of limited efficacy (there is only 2-12% chance that a frozen egg will result in a baby), we don’t yet know with confidence that egg freezing is completely safe for the children born of this technology. Preliminary, short-term safety data appear reassuring. Long-term safety data are not available. And, specific to elective egg freezing, the ASRM reports that: “Data on the safety, efficacy, cost-effectiveness and emotional risks of elective oocyte cryopreservation are insufficient to recommend elective oocyte cryopreservation.”

Fourth, egg freezing is a half-way technology insofar as eggs in storage are of no value to a woman who wants to make a baby unless she uses in vitro fertilization (IVF). This is a costly option and it is not clear that this is part of the employee benefit package. This effectively means that Facebook and Apple are willing to pay up to $20,000 to keep women “unpregnant”. If the women want to become pregnant using their frozen eggs, they have to pay for this. Moreover, if they do become pregnant, paid family leave is quite limited and arguably not supportive of a decision to reproduce.

Fifth, normalizing egg freezing does nothing to correct the fundamental social injustice experienced by women in the workplace who are effectively forced to choose between having a career and raising a family. This is not a choice demanded of young men. The working assumption is that they can be fathers and productive employees.

Sixth, providing women with the option of egg freezing does not meaningfully expand women’s choices because it does nothing to ameliorate the context in which they must make decisions. The social context, which does not assume that women can be mothers and productive employees, significantly (and inappropriately) constrains the options they get to choose between.

Seventh, many of the young women who freeze their eggs are unlikely to use them. They may never find a partner with whom they want to have children and they may not want to be a single mother. Alternatively, they may find a partner with whom they want to have children and they may prefer to conceive their children in the privacy of their bedroom, instead of conceiving their children in a lab. What should/will happen to those unused frozen eggs? Will the women want to sell them on the open market for reproductive or research use? What if the cosmetic industry has an interest in purchasing this reproductive material? We all need to think carefully about the downstream effects of encouraging elective egg freezing.

Facebook and Apple employees should not only reject egg freezing, but should lobby their respective companies to provide them with a benefit package that is truly family-friendly. At minimum, this package should include a year of family leave following the birth of a child or the legal adoption of a child, on-site subsidized day care, flexible work arrangements, and support for re-entry into the workforce.

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Françoise Baylis is a Professor and Canada Research Chair in Bioethics and Philosophy at Dalhousie University, Halifax, Canada. @francoisebaylis

For more on this issue listen to CBC’s The Current with Anna Maria Tremonti and guests, Katherine Rushton, Saadia Muzaffar and Françoise Baylis.

4 comments

  1. Hi! I just replied in full to this post over at my blog. Thank you for the talk at Ryerson, Françoise! https://waysofworldmaking.wordpress.com/2015/03/08/frozen-eggs-for-working-women/

  2. Roxanne Sperry · · Reply

    The author has not provided a credible argument for women not to freeze their eggs. Rather, the author has built a house of cards, based on erroneous assumptions. With little effort this house of cards can and should be dismantled. Of critical importance the author forces me into questioning the ethics of the ethicist, after listening to the CBC’s The Current interview embedded in this blog entry.

    When I first read this I did not feel like I needed to respond for lack of interest in the subject matter. I believe in a woman’s autonomy and if she is well informed and wants to freeze her eggs, I say let it be done. She owes no one an explanation. However, the more I thought about it the more I felt compelled to respond for three reasons. First, the author completely ignores cancer in the work place. Second, as an ethicist the author is putting out misinformation into the public domain. Third, I may be wrong, but it sure sounded to me like the author is encouraging women to game the system to get time away from work (listen to what she stated the last 2 minutes of her interview with CBC’s The Current).

    Women of childbearing age are getting cancer, and where do many of these women reside? Many of these women are in the workplace when they are diagnosed with cancer. They are bravely confronting their diagnosis and finding hope in planning for the future. Part of the plan for their future may be pregnancy, and having a family post-recovery. Depending on what type of treatment they have to go through, they may elect to have fertility sparing procedures, which can include freezing their eggs. For this reason alone I say BRAVA Facebook and Apple, thank you for including this benefit as part of their healthcare insurance.

    In the United States a woman’s employment is protected by law for three months under the Family Medical Leave Act (FMLA), if she becomes pregnant and wants maternity leave. When she returns to work she is also protected by law to have appropriate accommodations and time to express her milk if she so chooses. The law provides for what is guaranteed as the minimum, however, most corporations go well beyond the minimum with paid leave extending beyond what the law requires. Additionally, accommodating a new mother’s re-entry into the workforce is very common. New mothers can arrange for a part time and or flexible work schedule. Corporate America is not taking the one size fits all approach to maternity leave that the author suggests (one year leave). Corporate America is being more innovative and creative and giving new mothers options. They are working with women to find the right approach for the individual, to give a woman what she wants. As an example, last week in my work place here in Halifax NS we had a woman return from her maternity leave early. She said she did not want to be at home running a day care. She wanted to come back to work and interact with her peers. One could argue that women want to be in the workplace and the author wants to force women to stay at home caring for babies.

    To further discount the author’s argument that Facebook and Apple want to discourage women from starting families in their 20 and 30’s by paying for egg freezing, I ask why are they supporting these same women to start a family by offering adoption benefits?

    From a business perspective the author is not thinking like a savvy CEO. Stop, and think about it, Facebook and Apple invest a substantial amount of the corporation’s resources in their younger employees, bringing them up through the ranks. An employee in their 30’s or early 40’s most likely has gained critically important experience and taken on expanded responsibilities. If I were the CEO of Facebook or Apple, I would prefer having a younger less experienced employee take time out and temporarily step away from their career to start her family. It is also a fact that from a human resources (HR) perspective, there is an expectation that employees will go out on medical or maternity leave. All of this is taken into consideration for the purposes of building a progressive business model. Perhaps the author has no real life experience or was never involved in running a corporation.

    In the first sentence of the second paragraph the author refers to the efficacy and risks of freezing eggs when she states “These professional cautions are of no consequence to Facebook or Apple. To my understanding this benefit is being offered through the employee health insurance. If this is true the insurance company has vetted the procedure. Does the author really want Facebook and Apple to start vetting medical procedures for their employees? It would be very difficult for me to believe that Facebook and Apple are not invested in the well being of their employees. Human resources are any company’s most valuable asset to acquire and maintain. I will say it again, perhaps the author has no real life experience or was never involved in running a corporation.

    Why are women freezing their eggs? Here is what I have taken directly from the EggBanxx web site “a 2011 Canadian study found that less than one-third of women reported career goals as the reason they waited to have children. Instead, the most popular reason that influenced childbearing for these women was being in a secure relationship—an option chosen by 97 % of the respondents. Other popular reasons were feeling in control of one’s life (82 %) and feeling prepared to be a parent (77 %)”. I must say I have not read the study and do not know how the percentages quoted were determined. It does bring into question, why do women really want this, is it really about their career?

    Finally, I was disappointed with the CBC’s The Current interview not only because of the inaccurate statements made by the interviewees regarding US labor law and culture in the US, but also because the interview deteriorates into a complaint session for the author. Apparently, she had her first child in the US and complained about getting zero time off. Well, all I can say is the devil lives in the details. I would be very interested to know exactly what were the circumstances under which she was working in the US.

    Finally, she really lost me when she said in the CBC’s The Current interview “If I were a younger woman, I might have another kid just to get another year off now in Canada” Really Françoise?

  3. Cynthia Martin · · Reply

    Amen re sheer nuttiness of this “benefit.” It truly puts the cart before the horse, so to speak. How trendy and precious it is, the thought of having children rather than the reality…

  4. Like Francoise Baylis, I too question the logic behind offering egg freezing. Does such a program not send the wrong message? Should we not be making it easier for families to reproduce naturally. Certainly, I am sure we should not be encouraging childbearing in later years. It sends the wrong message.

    I also agree that egg freezing adds additional innecessary risk to the woman. Even though ovarian stimulation and egg retrievals are considered safe, they are not without risk.

    I challenge Baylis on her use of stats and portrayal of success rates using frozen eggs. She gives the impression that a woman only has a 2-12 percent chance. This may be the chance per egg retrieved, but it is not the chance per attempt. Baylis, with her intellectual fortitude should be more forthright with facts. I am not sure her argument about the ethics of egg freezing is that sound either, after all the body naturally disposes of eggs on mass every month.

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