Why do so few women go back for their eggs?

Frozen

Egg freezing is becoming ever more popular. But very few women go back to claim them. Why?

I first wrote about egg freezing back in 2011 in a piece in Nature. Not long after, I did a segment on it for CBC radio's Quirks and Quarks. (The item, called "Cheating the Clock", starts around the 28 minute mark and is about 19 minutes long). At that time, egg freezing was still considered "experimental" and there had only been a small number of children born to women over age 35 — and only one or two born to women over 40.

One of the people I interviewed for the radio piece was John Jain, a leader in egg freezing at the Santa Monica Fertility Clinic in California. He told me he was surprised at how few women were coming back to use their eggs — only two of the more than two hundred women who'd banked eggs with his clinic had come back for them. "I think life situations are slow to change," he said. Women might still be looking for the right partner, he speculated, or they hadn't quite come round to the idea of single parenthood.

Egg freezing has become much more popular in the years since then, and many more women are choosing to do it. But when I checked back with Jain this week, he told me the numbers are still low. He estimates that these days only about 5 per cent of women are coming back for their eggs. The other 95 per cent are simply paying to store them.  

Other studies suggest something similar. A 2016 study by Ana Cobo, at the IVI clinic in Valencia, Spain, reported that 137 of 1468 women — 9.3 per cent — came back for their eggs. (Forty of them went on to have babies). A 2017 study by Karin Hammarberg, at Monash University in Melbourne, Australia, followed up with 193 women who had frozen their eggs for non-medical reasons at Melbourne IVF, a private fertility clinic. Of the 96 women who responded, only six — 6.3 per cent — had returned to use their eggs. (Three had babies from them.)

Imagine going through the process of egg stimulation and retrieval, sometimes more than once, and paying upwards of $10,000 per cycle, and then not reaping the benefit. What's going on? 

There is some intel on this. The Hammarberg study asked all women who hadn't claimed their frozen eggs to say why not. The top reason was not wanting to be a single parent, followed by wanting to keep trying naturally, not wanting to use a sperm donor, and feeling too old. But the researchers found that at least some women hadn't come back because they hadn't needed to. Eighteen of them had conceived without the frozen eggs — 12 naturally and 6 with fresh eggs and IVF.

A 2018 paper by Kylie Baldwin and Lorraine Culley, both at De Montfort University in the UK, also sheds light on why women may not return. The researchers did extensive interviews with 31 women who had frozen their eggs. Reasons for freezing their eggs included not having a suitable partner, not wanting to be tempted into an unwise relationship (dubbed "panic partnering"), and not wanting to parent alone. 

Interestingly, the researchers also found that for some of the women, egg freezing was an 'end in itself' — evidence that they had done everything they could to keep the genetic motherhood option open. It meant that future babies were possible, but, more importantly, if that didn't happen, they could look back without regret.

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