I am sitting in a fertility clinic, looking at a wall covered in baby photos. These are babies born with the help of the consultant I am about to meet. As I wait, I wonder if the pictures provoke pain or hope in women who have sat on this same leather sofa. I can’t know that agony – I don’t think anyone can until they experience it – but I am afraid of it. I am 29, my boyfriend and I are not trying to conceive a child, and we have no fertility problems that we’re aware of. So why am I here?
It all started earlier this year, when my partner and I were enjoying a lazy Sunday evening in our flat. I was hanging up my washing, and as I shook my jeans to get the creases out, he said, “I would like to have a child. But can we wait until we’re 40?” I laughed, but he wasn’t joking.
We’ve always said that starting a family was a long way off, but I didn’t realise he meant that far away. He is blissfully oblivious to both the biological challenges and the political ramifications of his question. I am not. Having worked for five years on a women’s magazine, I know that waiting until we’re 40 to start a family is a pretty risky play. Although new research suggests that children born to older fathers may face higher risks of autism and other disorders, my partner has grown up believing he can have kids whenever he wants. This is very much not the message given out to women. The expert and inexpert alike are lining up to warn us not to leave it too late, from consultant gynaecologist Professor Geeta Nargund, who recently advised that women start trying for a baby at 30, in order to avoid falling victim to the “fertility time bomb” hanging over Britain, to broadcaster Kirstie Allsopp, who wrote that she would tell her daughter (if she had one) to have a child at 27.
According to the NHS, around one-third of couples in which the woman is over 35 have fertility problems. This rises to two-thirds when the woman is over 40. No wonder more and more young women are looking into egg freezing: inquiries at private fertility clinics in the UK surged by more than 400% in the past year, with more than half coming from women under 35. Apple and Facebook now offer to pay for female employees to freeze their eggs as part of their benefits package. It’s starting to feel as if “investigate egg freezing” is just another thing to add to my to-do list.
I wish I had the fertility of a lobster, which gets more fertile with age – or a Brownbanded bamboo shark. These females can store the male’s sperm for up to four years after mating, and self-inseminate when they’re ready. But at 29, I’m not sure even four years is enough. Like my partner, I would love to wait until we’re 40; the thought of us having a child before then feels absurd. When I held my friend’s new baby two months ago, I was overwhelmed with joy at the beauty and miracle of new life – and overwhelmed with relief to hand her back. I love my career, my independence, my social life, my relationship with my boyfriend and our one-bedroom flat (not in that order). It’s just a shame my biology hasn’t caught up with my feminism.
But perhaps now it can. The first pregnancy from a frozen egg was reported in the Lancet in April 1986, a few weeks after I was born, but the slow freezing techniques used then meant there was a risk of ice crystals forming during the freezing process. Then, in 2012, fertility specialists began to use a new flash-freeze technique called vitrification, to preserve the eggs of women under 35. This could be the most revolutionary development in women’s liberation since the pill. Could egg freezing give us the power to have children when we want them rather than when we feel we should?
When I first heard about this process, known as oocyte cryopreservation, it sounded like some sort of sci-fi fantasy answer to all my problems. But success rates are hard to pin down. Every clinic has different results, but as of 2013 – the most recent records available from the Human Fertilisation and Embryology Authority, which regulates this industry – the number of live births in the UK from eggs frozen for the patient’s own use sits between 36 and 46. Not very many.
What’s more, everything I read was about single women who’d reached their late 30s or early 40s and were desperate to give themselves a window of a few more years to start a family – this was their last resort. I couldn’t find much about women like me, in their late 20s, who are in a relationship with the person they wish to start a family with, and considering a pre-emptive strike. The kind of women who might take Apple or Facebook up on their offer.
Now, I find myself quietly freaking out in Harley Street’s London Women’s Clinic, where £350 gets you a blood test and a pelvic scan to check your ovaries are looking good, a consultation, and a counselling appointment. I don’t know why I feel so anxious. But my breathing is shallow and I feel panicky. Perhaps it’s because the issue is so rarely discussed calmly. When I think of fertility, I think in Daily Mail headlines: SELFISH WOMAN! EGG-WASTER! END OF DAYS!
My consultant, Dr Nair, has a soft voice and a kind face. She scans my ovaries – an intimate, internal procedure – and shows me the screen, on which, she assures me, I can see sacks called follicles, 2-8mm in size, which contain my eggs. I have seven to eight on each side, which is good, apparently. She told me she could see no abnormalities, and I felt a worry clear from my mind, despite never knowing it was there in the first place.
Once my knickers are back on, she explains how each month, my body selects one follicle which continues to develop while the others die away, and when the chosen follicle reaches around 18mm, the egg pops out, ready to be fertilised.
But not with egg freezing. Under this treatment, Dr Nair explains, I would inject myself for around 12 days with up to three different fertility drugs, so that my spare follicles would continue to grow – and I would have five scans over that time to monitor their development. At just the right moment, the fully mature extra eggs would then be collected from the follicles with a needle while I am under conscious sedation, in a procedure that lasts about 20 minutes. And an hour later, I could go home, knowing my eggs are safe in the freezer, for a maximum of 10 years. A good harvest is considered to be around 10 to 12 eggs per cycle.
She says it’s a shame my partner was unable to make the appointment – in fact, I hadn’t thought to ask him, which suddenly strikes me as very odd – and asks if we would consider embryo freezing, which has a higher success rate, as embryos are more robust and survive thawing better than eggs. Embryo freezing is a routine part of IVF – in fact, studies show that it may be safer for mothers and babies if frozen rather than fresh embryos are used.
Instinctively I know I can’t do that, but it takes me a while to work out why; it’s something to do with the fact that freezing my eggs, which already exist inside me, feels very different from creating an embryo and freezing that, ready to thaw if and when we’re ready. There are also the ethical implications – as demonstrated by two recent cases. Modern Family actor Sofía Vergara is currently embroiled in a custody battle over embryos made from her eggs and the sperm of her now ex-partner, businessman Nick Loeb. She would like them to remain frozen; he would like to thaw them and start a family using a surrogate, and is now suing for custody. In a similar case in California, a judge is to decide whether a woman can thaw frozen embryos while her ex-husband wants to have them destroyed.
I learn three very important facts during that consultation, which turn my assumptions upside-down. First, I thought that egg freezing and thawing was very rare and experimental – I was wrong. Since the law was changed in 2011 to allow women to be offered £750 in expenses for egg donation, frozen eggs are now thawed every day. Second, I believed the procedure would cost tens of thousands of pounds – in fact, it would set me back £4,300, including two years of storage, and £250 per year for storage thereafter. This is a lot of money, but nowhere near as much as I thought – and the London Women’s Clinic offers egg freezing free to women who also donate to an egg bank. Third, I assumed it would be extremely unlikely to work – but this was based on what I’d read about older women freezing their eggs, when the odds are much lower. With eggs frozen aged 29, I have at best a 45% chance of a clinical pregnancy per cycle. For comparison – with fresh eggs, it’s 55% per cycle.
But I also learned that this is not the solution to all my problems. It is not a way for me to delay motherhood, or to future-proof my ovaries. I cannot plan my future around frozen eggs, and decide to delay starting a family until my 40s, because there are no guarantees. The uncomfortable reality is that sometimes it works, sometimes it doesn’t, and the earlier you freeze your eggs the better. I have the savings to pay for it – but does that mean I should?
After my consultation, I walk out into the bright sunshine feeling light-headed. I am drained, I don’t know what I should do, and I wish I hadn’t asked the question in the first place. I meet my parents for a walk in nearby Regent’s Park, where we stroll to the pond, and watch a coot swim along followed by her three little chicks. Why am I overcomplicating this? The next step is the clinic’s counselling session, in two weeks. I have a lot of thinking to do.
For Lydia Cowell, 31, who lives in Sheffield, the decision was straightforward. After finding her career in marketing unsatisfying, she started retraining to be a doctor at 27, and that was the trigger. “When I was growing up,” she says, “I always saw 30 as this big milestone, and thought by then I would be married with kids and sorted in my career. But in reality, I was 27, single, and had just left my job to go back to study. Life wasn’t turning out the way I had imagined. I still felt like a teenager, and not as grown up as I’d thought I would.”
Cowell, who is now in a serious relationship, realised that she wouldn’t want to start a family until at least two years after finishing medical school.
“I knew if I tried to do them at the same time, I’d end up doing a rubbish job of both. I wanted to focus on my career, and then have a family, and egg freezing seemed the ideal way to do that.”
She knew she wanted to conceive via IVF, because she has an inherited neurological condition that can cause muscles to weaken and waste. “It can be really variable, but it’s affected me enough to know I wouldn’t want my child to have it, so I would want to screen any embryos,” she explains. At 29, she froze 13 eggs, and she hopes to be pregnant at 35.
She found the experience transformative. “It puts you on a more level playing field with men. As women, we’ve got this clock ticking over our heads that men don’t have, and it’s a clock that we’re not aware of until we’re in our 30s. You just don’t think about it – you’re so obsessed with contraception, you never think about conception. Freezing my eggs massively took the pressure off, as I had one less thing to worry about. You can’t control when you meet someone, you can’t control when your fertility starts to decline; this felt like a positive step towards taking back control,” she says.
But, I suggest, you also can’t control whether your frozen eggs will give you a child. Hasn’t this just given her the illusion of control over something that remains as out of her hands as it ever was? “Even if it doesn’t work, at least I’ve given it a shot,” she says. “If there is some chance, I would rather do something than nothing. You’re not going to regret having had a go. If you end up trying for a baby and you can’t conceive – and you’d thought about freezing at 29 but decided you’d rather spend the money on a holiday – you’d never forgive yourself.”
Still, she does have doubts. “As part of my medical degree, I recently had some lectures on fertility, and I asked the doctor what he thought about egg freezing. He told me not to waste my money, that it’s unreliable, and that the evidence doesn’t exist to say that it works.”
I would love to get that lecturer in a room with Robyn Ross, 45, from California. One of the first things she says to me is, “I have a child because of egg freezing, and that’s everything to me. I don’t think there is any greater joy in life than becoming a parent; my daughter is my other half, my heart and soul. I love to spread the word about egg freezing as much as possible, because every woman should know her options.”
Ross froze her eggs in 2007, when she was 36 and single. She later married, and her daughter Camden was the second baby born in America to a mother who froze her eggs electively. “The procedure was so new, I had no numbers to go by. I was taking a risk. But I’m a very positive person, and for me, there was never a question that it wouldn’t work,” she says. She spent $30,000 in total to have Camden.
Ross has only positive things to say about freezing: “This technology is revolutionary. It’s given women an empowering tool that was not available before. So many women are having babies older now. At my daughter’s preschool I’m not the only 45-year-old mum. There are plenty of us, and one or two who are older.”
Ross’s story is compelling, and I find myself leaning towards the freezer. It’s not like taking out an insurance policy, as I’ve heard it described – I would never take out an insurance policy that was more than 50% likely not to pay out. But I would pay to increase my chances of having a child if I ever found myself in a situation where I was struggling to conceive. That seems like a logical choice to me. The problem with the logic is the more rounds you have, the more likely you are to be successful – and that means you could go on for ever.
I spoke to Sarah Elizabeth Richards, author of Motherhood, Rescheduled: The New Frontier Of Egg Freezing And The Women Who Tried It. She sounds almost bashful when she tells me that she has 70 eggs on ice, and is thinking about trying to use them in the next year (she is now 44). She has simply followed the statistics: the more eggs you freeze, the higher the odds are that at least one will survive the thaw, fertilise, implant, and lead to a healthy and successful pregnancy.
And if it doesn’t work – well, Richards says the women she interviewed for her book didn’t regret their choice, even if their frozen eggs didn’t give them a baby. “I’ve talked to women whose frozen eggs didn’t work out, and I’ve heard really interesting perspectives,” she says. “They feel they did everything they could. They took care of themselves. One woman told me the act of going down the egg-freezing path made her more open to using other reproductive technologies, like donor eggs.
“It makes you feel more in control of your life, and that sense of empowerment has an impact that lasts for years. For me, the biggest regret is how much time I wasted feeling so anxious. I spent so much energy freaking out in my early 30s. This cultural baby panic is not helpful to women,” she says, “and I bought into it in a big way.”
These women found that freezing their eggs made them feel less guilty. But talking to them makes me fear I’ll feel guilty if I don’t do all I can. In previous generations, childlessness was seen as fate or the will of God; now it feels like if it happens to me, it will be my fault. Poor planning, a failure to invest – why didn’t I just take out the insurance? The pressure to make a decision weighs heavy on my chest, and I feel quite isolated. When discussing it with my partner, I realise why I hadn’t thought to invite him along to that consultation: it’s because the warnings about fertility in our society are directed solely at women, not at the men who love them. I’d been conditioned to feel like this was my problem, not our problem.
But maybe that’s changing. In the Journal Of Medical Ethics, in June, bioethicist Kevin Smith wrote that young men who might choose to have children later in life should consider freezing their sperm, to avoid those children having genetic disorders.
Then there are the social implications: what impact will this have on society if it becomes more widespread? Will women feel pressurised to start a family later in life even if they don’t want to? The fact that the treatment is now offered by Facebook and Apple must certainly be met with caution. Though Lydia Cowell chose to freeze her eggs, she’s concerned that companies are offering the procedure as a perk. For a start, the focus is on helping women who want to delay motherhood, rather than on making life easier for working mothers. Also, she says, “There’s a great danger that women are going to walk in thinking, ‘I don’t need to worry.’ But this doesn’t mean you can have a baby whenever you want; it’s just going to increase your chances should your fertility decline and you want to have kids.”
All the women I’ve interviewed say they found the experience empowering, but I don’t feel empowered. I feel confused. And that is why I am so grateful for the counselling session that followed my consultation. Fertility counsellor Tracey Sainsbury points out how stressed I am when I talk about eggs, but how relaxed I am when I talk about my partner. She highlights how often I use the word “should”, and that there is no single “right” decision. I ask about the other women she sees. She says they are “mostly in their late 30s and older”, but she recently gave a talk in a school and fielded questions from dozens of 14-year-old girls asking if they could freeze their eggs at 18. Perhaps one day this will become the norm, the cost absorbed into a young woman’s life, like driving lessons or tuition fees. Maybe then, the decision not to freeze eggs will become as controversial as the decision to freeze them is today.
But not yet. Sainsbury reminds me of a fact mentioned in my original consultation: for an unspecified reason, women who don’t have a health-related reason for freezing their eggs are only allowed to keep them for a maximum of 10 years. After that, if there is no medical cause for premature infertility, it’s thaw or throw away. Sainsbury plans to campaign to get this changed, but for the moment, the law stands firm. In 10 years’ time I will be 39 – the same age my mother was when she conceived me naturally.
I feel a huge surge of relief. I decide to wait for a few years. Maybe by then my partner and I will feel it’s the right time to start a family, but if we are still unsure, I will know it’s time to freeze my eggs.
Having made a choice – albeit one that simply delays my future decision – feels glorious. And next time I look into it, I’ll do it with my partner by my side – it will be a decision we make together.
We may have our own chicks swimming after us one day; but for now, I’m very happy it’s just us two coots, paddling along together.
