Elective Egg Freezing: Should it Be Publicly Funded?

Zoë Walwyn and Katie Hammond evaluate the Ontario Liberal Party’s inclusion of funded elective egg freezing in their platform for the June 2022 election.

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The recent Ontario election on June 2nd led to a second majority government for Doug Ford’s Conservative Party. Although the Liberal Party was unsuccessful, there is an element of their platform, in their “Dignity and Opportunity for All” section, which may have been overlooked by many voters – this was provincial funding for elective egg freezing.

Elective, also known as “social,” egg freezing is the freezing of a person’s eggs for non-medical reasons, such as to delay child-bearing. It differs from medical egg freezing, which is already funded in Ontario for people getting treatment for a medical condition that may cause infertility. The Liberal Party’s promise was to cover one cycle of egg freezing for patients aged 35-40.

Even though the Liberal party did not win, they will likely not be the last provincial party to broach elective egg freezing. While the details of how it would have been offered are sparse, we have some concerns with their proposal.

Photo Credit: Ed Uthman/Wikimedia Commons. Image Description: Ovum in Cumulus Oophorus, Human Ovary.

First, a reason in favour of funding elective egg freezing is that it could allow for more equitable access to the technology. Egg freezing is prohibitively expensive, with a price tag as high as $10,000 per cycle. It is often only available to those with significant financial means, or those who work for companies that cover elective egg freezing as a benefit. While funding egg freezing will help make access more equitable, the associated costs like the yearly storage fees (approximately $300/year) and in vitro fertilization (IVF) to use the eggs (if not eligible for funded IVF), will still make the technology cost-prohibitive for many.

Second, there are health risks, like ovarian hyperstimulation syndrome, associated with egg retrieval, and little longitudinal data on its long-term risks.

Additionally, even though egg freezing is often marketed as “fertility insurance,” there is no guarantee that egg freezing will work and there is insufficient data to accurately estimate individual success rates.

Provincial funding for elective egg freezing might be perceived as confidence by the government in its safety and efficacy which may give people interested in freezing their eggs a false sense of security. This is particularly concerning given the Liberal Party’s suggestion to fund egg freezing for those aged 35-40. Someone who freezes their eggs in their late 30s would be of advanced maternal age when they ultimately use the eggs and they would have a higher likelihood of experiencing health risks. Freezing eggs over the age of 35 is also associated with a lower birth rate.

Third, many people who electively freeze their eggs never return to use their eggs. Studies show that 6% of elective egg freezers return to use their eggs in IVF. Funding elective egg freezing might encourage its use, even though most users might not return for IVF. Should egg freezing be encouraged given that existing data suggests that many people will not use their eggs?

Fourth, funding elective egg freezing is a band-aid solution to social-structural problems, such as the absence of affordable childcare, that lead people to delay childbearing in the first place. The Ontario Child Care Action Plan states that by September 2025 childcare will cost $10 per day in participating childcare centres, and there is a plan to have 86,000 more of these childcare spaces built. This is a great stride towards making childcare accessible. However, there are still concerns about whether there will be sufficient funds to attract and retain staff to operate these facilities.

Although the federal government is providing a large amount of funding for childcare, as evidenced by other provinces like British Columbia and Manitoba, Ontario will likely still have to foot a significant part of the bill. The funding that would go towards an egg freezing program would be better served to fulfill Ontario’s accessible childcare goal.

The proposal for publicly funding egg freezing for Ontarians, as put forward by the Liberal Party, thus presents several challenges and concerns.

If a provincial egg freezing program is implemented by any party, information should be distributed to inform the public about future costs, risks of egg freezing, and success rates. Circulating the risks and benefits will support people to make informed decisions about their bodies, finances, and future. Further, tools are needed to encourage people to think about options for any unused eggs, such as whether to donate, or thaw and discard.

Promoting this technology under the guise of “Dignity and Opportunity for All” is worrisome without addressing these concerns. If achieving dignity and opportunity for all is the goal of the Liberal Party, more needs to be considered before promoting egg freezing to the masses.

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Zoë Walwyn is a second year JD student at the Lincoln Alexander School of Law and is a research assistant on Prof. Hammond’s Canada-wide study on elective egg freezing. @zoewalwyn

Kathleen (Katie) Hammond is an Assistant Professor at the Lincoln Alexander School of Law at Toronto Metropolitan University. @HammKatie