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Fri October 19, 2012
Shots - Health News

Freezing Eggs To Make Babies Later Moves Toward Mainstream

Originally published on Tue October 23, 2012 12:03 pm

Doctors who specialize in treating infertility are making a big change in their position on a controversial practice. The American Society for Reproductive Medicine (ASRM) has concluded that freezing women's eggs to treat infertility should no longer be considered "experimental."

The group plans to officially announce the change on Monday.

More and more women are using frozen eggs to try to have babies. Some older women use frozen eggs donated by younger women. Some younger women freeze their own eggs while they finish school, focus on their jobs or keep looking for the right guy.

That's why Jennifer Anderson did it last year.

"I really wanted to have the traditional experience of falling in love and getting married, and then having children. But I know every person's life path is different, and it hadn't worked out for me yet to fall in love and get married," says Anderson, 40, a consultant who lives in Arlington, Va.

So Anderson went to the Shady Grove Fertility clinic in Rockville, Md., to freeze some of her eggs.

"I guess I feel like I've stopped the biological clock, to some degree. That this gives me a few more years to find what it is that I'm really looking for," she says.

The practice of freezing eggs has long been controversial. Many experts argue there's too little data on how well it works or how safe it is. So they've mostly recommended it only for women whose fertility is at risk because they are undergoing chemotherapy or have some other medical problem.

But Eric Widra, an infertility doctor at Shady Grove, says that's changed. He chaired the Society for Assisted Reproductive Technology (SART) Practice Committee, which prepared the report. It was the first time the group had reviewed egg-freezing since 2008.

"We no longer think that it should be covered under the experimental label. Sufficient studies have been done to warrant considering this a clinically available technique," Widra says.

The report reviewed nearly 1,000 published studies. Egg freezing and thawing techniques have gotten a lot better, he says.

"The available data for egg freezing indicate that it is safe and effective and has a good probability of success," he says.

So far, babies born from frozen eggs seem to be healthy. And a woman in her 40s or 50s seems to have about the same chances of getting pregnant as a woman in her 20s or 30s if she uses frozen eggs from a donor that young. "We think that is a reasonable expectation going forward," he says.

But the new policy, which is being published in the society's journal Fertility and Sterility, warns clinics against creating "false hope" by aggressively marketing egg freezing to women as a guaranteed way of stopping their biological clocks. There still haven't been enough studies to know for sure how well long-term egg freezing works, according to the assessment.

"Women who are considering doing this for elective reasons should understand that they are really at the leading edge of using this technology," Widra says, "and we're not yet certain that it will provide the promise that we hope it does."

That said, Widra says he thinks it's probably going to work for women seeking to postpone childbearing. "How good an assumption that is, time will tell. But at this point, we think the available data are strong enough to say it's reasonable to do," he says.

But the fertility society's shift is raising a lot of concerns. Some women's health advocates say there's still not enough data to really know how often frozen eggs actually produce healthy babies. The society's assessment was based on pregnancies, not healthy births, noted Amy Allina of the National Women's Health Network.

In addition, the hormone injections needed to get eggs to freeze can, in rare cases, cause potentially life-threatening complications in women.

"We're talking about a procedure that has some known risks and unknown benefits," Allina says.

There's also the worry that the policy shift will fuel the creation of frozen egg banks. Marcy Darnovsky of the Center for Genetics and Society says that could lead to the exploitation of poor, younger women.

"It's pretty evident that there's usually a difference in socio-economic status between the women who are being asked to sell their eggs or rent their wombs, and the women who are using it," she says.

Some argue that society should make it easier for women to have kids when they are younger so they don't have to resort to technological fixes.

"It's an example of using technology to solve social problems," says Adrienne Asch, a bioethicist at Yeshiva University.

As for Anderson, she's just glad she had the option.

"To be honest, it just, it really took a lot of the anxiety away from my personal life, I guess, and my efforts to date and to find the right person," she says.

The fertility society plans to continue to collect data about the safety and effectiveness of egg freezing. In the meantime, Widra says the association hopes the new policy will encourage more insurance policies to pay for egg freezing.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

DAVID GREENE, HOST:

This is MORNING EDITION, from NPR News. I'm David Greene.

RENEE MONTAGNE, HOST:

And I'm Renee Montagne. Good morning.

There's a dramatic change happening in the treatment of infertility. The American Society for Reproductive Medicine has given its stamp of approval to the freezing of women's eggs, saying the practice should no longer be considered experimental. The group will make a formal announcement on Monday.

NPR's Rob Stein has this report.

ROB STEIN, BYLINE: More and more women are using frozen eggs to try to have babies. Older women may want to use frozen eggs donated by younger women. Younger women may want to freeze their own eggs while they finish school, focus on their jobs or keep looking for the right partner.

That's why Jennifer Anderson did it last year.

JENNIFER ANDERSON: I really wanted to have the traditional experience of falling in love and getting married and then having children. But I know every person's life path is different, and it hadn't worked out for me yet to fall in love and get married.

STEIN: So Anderson went to a fertility clinic to freeze some of her eggs.

ANDERSON: I guess I feel like I've stopped the biological clock to some degree, that this gives me a few more years to find what it is that I'm really looking for.

STEIN: This practice has long been controversial. Many experts argue there's too little data on how well it works or how safe it is. So they've mostly recommended it only for women who are undergoing chemotherapy or have some other medical problem.

But Eric Widra says that's changed. He led the expert committee that reviewed egg freezing for the American Society for Reproductive Medicine.

ERIC WIDRA: We no longer think that it should be covered under the experimental label. Sufficient studies have been done to warrant considering this a clinically available technique.

STEIN: Widra says egg freezing and thawing techniques have gotten a lot better.

WIDRA: The available data for egg freezing indicate that it is safe and effective and has a good probability of success.

STEIN: So far, babies born from frozen eggs seem to be healthy, and a woman in her 40s or 50s seems to have about the same chances of getting pregnant as a woman in her 20s or 30s if she uses frozen eggs from a donor that young.

WIDRA: We think that that is a reasonable expectation going forward.

STEIN: But the new policy warns clinics against aggressively marketing egg freezing to women as a guaranteed way to stop their biological clocks. There still haven't been enough studies to know for sure how well long-term egg freezing works.

WIDRA: Women who are considering doing this for elective reasons should understand that they are really at the leading edge of using this technology, and we're not yet certain that it will provide the promise that we hope it does.

STEIN: That said, Widra thinks it's probably going to work for those women, too.

WIDRA: How good an assumption that is, time will tell. But at this point, we think that the available data are strong enough to say it's reasonable to do.

STEIN: But the fertility society's decision to drop the experimental label for egg freezing is raising a lot of concerns. Some women's health advocates say no one really knows how often frozen eggs actually produce healthy babies.

And Amy Allina of the National Women's Health Network says the hormone injections needed to get eggs to freeze can cause complications.

AMY ALLINA: We're talking about a procedure that has some known risks and unknown benefits.

STEIN: And people like Marcy Darnovsky of the Center for Genetics and Society worry it could lead to more exploitation of poor younger women to create more frozen egg banks.

MARCY DARNOVSKY: It's pretty evident that there's usually a difference in socioeconomic status between women who are being, you know, asked to sell their eggs and people who are using it.

STEIN: Some argue society should make it easier for women to have kids when they are younger instead of resorting to technological fixes.

Adrienne Asch is a bioethicist at Yeshiva University.

ADRIENNE ASCH: It's an example of using technology to solve social problems.

STEIN: But for Jennifer Anderson, the woman who froze her eggs last year, just having this option has been a big relief.

ANDERSON: To be honest, it really took a lot of anxiety away from my personal life, I guess, and my efforts to date and to find the right person.

STEIN: The fertility society plans to continue to collect data about the safety and effectiveness of egg freezing. In the meantime, the society hopes the new policy will encourage more insurance companies to pay for egg freezing.

Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.