Egg freezing is becoming an increasingly popular option for women who want to take control of their fertility, providing a possibility for delaying pregnancy. Although the process is becoming more accessible and affordable through clinics specializing exclusively in egg retrieval and freezing, as well as some companies offering it as part of their benefits package, there is still a lack of clear, uniform guidelines about the procedure.
And according to new research, there is one component largely missing from the egg-freezing process: comprehensive counseling. In an article published recently in the Journal of Women's Health, the authors argue that with egg freezing on the rise — especially in elective uses in situations where women are looking to extend their fertility — extensive counseling should be part of the process, regardless of a person's age or reason for freezing. But that doesn't always happen.
Specifically, the authors are concerned about scenarios in which young, healthy women who opt to freeze their eggs for later use may not be aware of the potential risks associated with pregnancy in older mothers. As they discuss in the article, when individuals or couple seeking other forms of assisted reproductive technologies like in vitro fertilization or artificial insemination, any counseling they receive as part of the process involves the immediate risks and benefits of the procedure, as well as any potential complications. The aim of ARTs is typically to produce a pregnancy as soon as possible, so the counseling they receive is applicable right away.
But in situations in which a woman freezes her eggs, she may not actually use them and become pregnant until years later. At that point, her fertility situation — including the chances of a successful pregnancy, as well as possible maternal and fetal health issues — may have changed from the time she went through egg retrieval and freezing. As a result, the authors of the study recommend more thorough counseling for women at the point when they freeze their eggs.
Also of note, up until 2013, the American Society for Reproductive Medicine considered egg freezing for nonmedical reasons (meaning in situations in which a person's fertility is not compromised because of aggressive cancer treatments, for instance, which may reduce their fertility) an experimental procedure. While that is no longer the case, the ASRM still currently does not recommend elective egg freezing for the sole purpose of working around reproductive aging — which they refer to as "social freezing" — because of a lack of data in the area.
But as the authors mention, despite the lack of official recommendation, because egg freezing has become so mainstream — including with corporations like Apple and Facebook offering it as a medical benefit — it is important to address the elective egg-freezing process and make it as safe as possible, starting with increased counseling for patients.
According to the authors of the study, the rise in social freezing occurred alongside a sevenfold increase in the number of women undergoing egg freezing in the United States between 2009 and 2013. And although egg freezing works best with patients 35 years old or younger, most wait until their mid to late 30s to get the procedure. But just because someone is young doesn't mean they're necessarily in the optimal health condition for egg retrieval, which is also something that should be discussed with doctors.
As a result, the researchers suggest multidisciplinary counseling involving an OB-GYN, reproductive endocrinologist and a mental health professional to provide the woman with the most complete picture possible regarding not only the immediate procedure, but also what a potential pregnancy might look like down the road.
"When a woman of any age chooses to undergo egg retrieval and cryopreservation, she should have access to the knowledge and counseling available to be able to make a truly informed decision," Dr. Susan G. Kornstein, editor-in-chief of the Journal of Women's Health, says in a statement. As the authors point out, she adds, the scope of that information should not differ depending on the woman's age at the time of the egg freezing, the reason for the procedure or her plans for future pregnancy.
Ultimately, anyone who decides to use ARTs, including egg freezing, should be fully informed before medical action is taken in order to ensure the best health outcomes for everyone involved.
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