The promise of egg freezing is 'very real.' So are the pitfalls, say experts

Najma Kahiye isn't ready to have a child yet, but she's worried that if she waits too long, she'll lose her fertility. 

The 32-year-old Toronto-based policy professional is about to start the process of freezing her eggs. For her, egg freezing provides "peace of mind" as she navigates her career and searches for the right partner. 

"Why wouldn't I consider freezing my eggs if that gave me definitely more time but also … the opportunity to not put so much stress on myself at the present moment to start a family?" she told The Sunday Edition.

Egg freezing involves harvesting eggs from the ovaries and freezing them unfertilized for later use. It was initially introduced to help cancer patients who were concerned that their treatment may affect their chances of pregnancy. Doctors now sometimes also recommend it to transgender people before a medical transition.

But a growing number of women across North America are turning to so-called "social egg freezing" — in which women freeze their eggs for non-medical reasons — because they worry they might lose their fertility before they're ready to start a family. Many of them opt for the procedure because they haven't found the right partner yet or want to delay having a child for financial or career-related reasons.

Does egg freezing feel like a Band-Aid? Absolutely. But for many of us who are living today, it's going to be a pretty helpful part of all of one's choices.​- Fertility specialist, Dr. Tom Hannam

"There are circumstances outside of millennials' control where we are deciding — and sometimes not deciding — that we have to start a family later," Kahiye said, pointing to the challenges of crushing student debt, precarious work, and the cost of housing.

No longer 'experimental'

Between 2013 and 2018, more than 1,500 Canadians froze their eggs for non-medical reasons, according to figures submitted by fertility clinics to the Canadian Assisted Reproductive Technologies Register.

Across Canada, there were only 94 egg freezing cycles in 2013. But that number grew by more than 500 per cent to 504 in 2018.

Dr. Tom Hannam, who runs the Hannam Fertility Centre, told The Sunday Edition that the number of women undergoing egg freezing cycles at his downtown Toronto clinic has quadrupled over the last three years. 

"We'll see about 30 women a week who are making decisions around whether or not egg freezing is right for them," he said.

The uptick came after reproductive experts dropped the "experimental" label associated with egg freezing — first in the United States in 2012, and then in Canada in 2014 — after improvements in its safety and efficacy.

In Canada, non-medical egg freezing has been growing so fast that it prompted the Society of Obstetricians and Gynaecologists to release a new set of guidelines for physicians last year. 

Natalie Grunberg-Ferreira, who lives in Victoria, B.C., is part of the growing trend. She froze her eggs at age 37, thawed them at 40 and had them fertilized with donor sperm. 

"I decided that it was time for me to let go of my dream of having a family with a man and start a new dream of creating my own family," she said. 

But just as she was about to embark on single motherhood, Grunberg-Ferreira, now 42, fell in love. She married when her baby was just three months old.

"I achieved my dreams of having a family and I did it in a very modern way. And it's felt empowering and so joyful," she said.

No guarantee of success

Despite its rise in popularity, egg freezing is not a silver bullet, says Angel Petropanagos, a quality improvement ethicist at William Osler Health System in Brampton, Ont.

"Egg freezing often gets framed as an insurance policy, and I think that's a risky characterization."

Comprehensive data related to pregnancies using frozen eggs is limited, but she notes that an analysis of two U.K. fertility clinics over 10 years found "about one in five women who used their frozen eggs ended up becoming pregnant and delivering a baby with those eggs."

Age, reproductive status and the number of frozen eggs are all factors, she said.

In Canada, there's virtually no regulation for egg freezing, including the way fertility clinics market their services. 

"I think the potential for marketing to step in and to compromise the message here is huge," Dr. Hannam said. "The promise of egg freezing is very real, as is the peril. And when I say peril, I mean the opportunity, unfortunately, for clinics to over-promise and under-deliver."

"Behind the scenes, the clinic can run a laboratory that might not be optimized for success rates and might be optimized for profit."

Petropanagos added that egg freezing is inaccessible to most women because of its costs. 

"The average we have in Canada now is around $10,000 for one [retrieval] cycle, and many women might require multiple cycles to be able to retrieve enough eggs."

There are also annual storage fees and, possibly, in vitro fertilization down the road. 

A 'Band-Aid' solution

Toronto-based writer Sarah Sahagian debated for about a year whether she should freeze her eggs. 

"I considered freezing my eggs when I was 30 and freaking out about my biological clock. I had broken off an engagement … And I knew I wanted to have a family."

Ultimately, Sahagian decided against it.

"My friends who did it, it took a lot out of them ... It took a lot of financial resources," she said. "I think it was worth it for them, but I just wasn't interested in putting my body through that."

Sahagian said she decided to invest in optimism instead. Now 33, she is married and expecting a child. 

She also wants to see more critical discussions about the economic pressures that prompt women like her to consider freezing their eggs. 

"Investing in our social safety net ... might actually be better than using this technology and having women take the financial and emotional onus of extending their fertility," she said.

A number of tech companies now offer coverage for egg freezing, a trend that started with Facebook and Apple in 2014. In November, Goldman Sachs also announced stipends to cover the cost of retrieving eggs.

In 2014, a Time magazine story described company-paid egg freezing as "our generation's Pill," arguing it would be "the great equalizer" in male-dominated fields. 

But Petropanagos is skeptical. 

"It was framed as this wonderful thing that was going to give women freedom," she said. But "it put the pressure on individual women when really the things that we need to be considering are broader systemic social issues."

"[The] compromises of society and biology have not been resolved," Dr. Hannam added. "In that space, does egg freezing feel like a Band-Aid? Absolutely. But for many of us who are living today, it's going to be a pretty helpful part of all of one's choices."

Click 'listen' above to hear Donya Ziaee's full documentary, The Big Freeze.