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Women Can Freeze Their Eggs For The Future, But At A Cost

A doctor uses a microscrope to view a human egg during in vitro fertilization (IVF), which is used to fertilize eggs that have been frozen. (ScienceSource)

Until recently, freezing a woman's eggs was reserved mainly for young women facing infertility as a result of cancer treatments like chemotherapy.

But recent advances in technology have made freezing eggs easier and more successful, and likely have a lot to do with the recent decisions by Facebook and Apple to offer female employees a health benefit worth up to $20,000 to freeze their eggs.

The benefit is intended for women who don't need to freeze eggs for medical reasons, but rather as a choice. This would likely appeal to women who want to focus on their careers instead of child rearing, as well as women who just haven't yet met "Mr. Right."

Doctors have had the technology since the mid-1980s. But, according to Dr. Richard Paulson, director of the fertility program at the University of Southern California, it just didn't work very well. "Everybody figured there was something wrong with the eggs after freezing them; you just couldn't get them to fertilize," he says. Then, about 10 years ago, someone came up with the smart idea to use technology typically used to help weak sperm fertilize an egg.

"I think it would be fair to say the 'ah-ha' moment came when someone figured out that you could bypass the hardened egg shell," he says.

When eggs are frozen, their "shells" harden. Researchers bypassed the hardened shells by injecting sperm through the shell and directly into the egg. Then, within a few years, a rapid new freezing method enabled eggs to be quickly frozen with their quality preserved, putting the eggs into a "state of suspended animation," says Paulson.

Even so, age remains a major caution. Since eggs degenerate with age, the younger a woman is when she freezes her eggs, the better. For example, if a 30-year-old freezes her eggs and then uses them at age 38 or 40, she will be getting pregnant with the eggs of a 30-year-old with lower risk of miscarriage and genetic defects, including Down syndrome.

Egg freezing doesn't stop the biological clock, says Paulson. It just sort of "pauses it," he says, giving women the option to delay childbearing until they're ready.

While egg freezing is "an exciting new option," it shouldn't be relied on to make family-planning decisions, says Dr. Valerie Baker, a fertility specialist at Stanford University Medical Center. "We wouldn't want to have people think this is a substitute for making family building decisions in a broader context. It's not a guarantee that if a woman freezes her eggs she's eventually going to be able to have a baby with one of those eggs."

Baker says it's more reliable for women to try to get pregnant at a younger age, if possible, rather than banking eggs and hoping to get pregnant later in life. Even so, in vitro fertilization, or IVF, either with fresh or frozen eggs certainly boosts a woman's chance of getting pregnant at any age.

But egg freezing is costly, both emotionally and financially. Many women will have to undergo the procedure more than once. It cost about $10,000 to harvest eggs from the ovaries, after a woman has taken medications for several weeks to stimulate egg production. Then the eggs need to be frozen and stored, at a cost of about $500 a year. Each time eggs are thawed, fertilized and transferred to the uterus with IVF it costs about $5,000.

Baker adds another caution: Not all women have the same biological clock. "Some women are running out of eggs when they're in their late 20s/early 30s, whereas other women may have reasonably good fertility into their mid- to late 30s," she says. Reproductive specialists can help women figure out which category they are in, which is an important factor to consider when thinking about freezing eggs.

Most insurance companies don't cover the cost of egg freezing, not even for medical reasons when a young woman's fertility is jeopardized by cancer. So the decision by Facebook and Apple to foot the bill is a significant benefit for women who want to freeze their eggs.

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Transcript

MELISSA BLOCK, HOST:

I'm Melissa Block. Facebook and Apple created quite a buzz this week, but it wasn't because of a new smart phone or new privacy disclosure. It was over a new employee benefit. They are covering the cost of egg freezing.

AUDIE CORNISH, HOST:

Facebook already offers this and Apple will begin its coverage in January. They're thought to be the first big companies to cover the procedure for elective use. In a moment, the implications or not in the workplace.

BLOCK: But first, the science. Until recently, freezing a woman's eggs was reserved mainly for those facing infertility as a result of cancer treatments like chemotherapy.

NPR's Patti Neighmond reports that advances in technology have made freezing eggs easier and more successful.

PATTI NEIGHMOND, BYLINE: Doctors had the technology to freeze human eggs over a decade ago, but it just didn't work very well.

RICHARD PAULSON: Everybody figured there was something wrong with them. After the freezing, you couldn't get them to fertilize.

NEIGHMOND: Dr. Richard Paulson directs the fertility program at the University of Southern California. He says in the last few years the likelihood of producing a healthy baby from frozen eggs has dramatically increased.

PAULSON: I think it'd be fair to say that the aha moment came when someone figured out that you could bypass the hardened egg shell - this is what happens during egg freezing, is that the egg shell actually freezes - and then you can bypass that by simply injecting the sperm into the egg.

NEIGHMOND: Then researchers figured out how to freeze eggs so rapidly that quality was maintained on the spot.

PAULSON: Liquid nitrogen is -196 degrees Celsius and at that temperature, there's no biological activity. So it's really kind of a state of suspended animation.

NEIGHMOND: But a major caution - age still matters. The younger a woman is when she freezes her eggs, the better.

PAULSON: If a 30-year-old freezes her eggs and then comes back and uses them at the age of 38 or 40, she will still be getting pregnant with the eggs of a 30-year-old, which then have the concomitant lower risk of miscarriage, lower risk of down syndrome, et cetera.

NEIGHMOND: Egg freezing doesn't stop the biological clock, says Paulson. It just sort of pauses it, giving women the option to delay childbearing until they're ready. At Stanford University Medical Center, fertility specialist Valerie Baker says that while egg freezing is an exciting new option, it shouldn't be relied on to make family planning decisions.

VALERIE BAKER: We wouldn't want to have people think that this is a substitute for making family building decisions in a broader context. So meaning that it's not a guarantee that if a woman freezes her eggs that she is eventually going to be able to have a healthy baby from one of those eggs.

NEIGHMOND: It's more reliable, Baker says, for women to try to get pregnant at a younger age rather than bank eggs and hope to get pregnant later. Even so in vitro fertilization - IVF - either with fresh or frozen eggs boosts a woman's chance of getting pregnant at any age. But it's costly, both emotionally and financially. Many women will have to undergo the procedure - harvesting, freezing, thawing and fertilizing eggs - more than once. It costs about $10,000 to harvest eggs from ovaries and if the first effort fails then it can cost about $5,000 each time new eggs are thawed, fertilized and transferred to the uterus. And it costs about $500 a year to keep the eggs frozen.

But Baker says there's another caution.

BAKER: Not all women have the same biological clock. So some women are running out of eggs when they're in their late twenties and early thirties, whereas other women may still have reasonably good fertility into their mid-to-late thirties.

NEIGHMOND: So if possible it's still a better bet, she says, to get pregnant the old-fashioned way. Most insurance companies don't cover the cost of egg freezing, not even for medical reasons when a young woman's fertility is jeopardized by cancer. So the decision by some high-tech private companies to foot the bill is a significant development.

Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.

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