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Egg Freezing: The Key to Motherhood at Any Age?

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When 42-year-old Sarah Richards met her partner eight months ago, one of the first things the couple eagerly discussed was the prospect of starting a family together.

A little optimistic perhaps, given both Sarah's age and that of her partner, who is nearer to 50 than 40. But Sarah doesn't think so: between the ages of 36 and 38, while in her then-relationship, she underwent eight separate procedures to freeze her eggs, and she now has 70 stashed away. The eggs, she believes, are her key to motherhood, whatever her age.

It was a grueling and expensive process, costing her around £30,000. But Sarah believes it was worth every penny and every painful hormone injection -- and if she had her way, every single or childless woman over the age of 30 would contemplate following her lead. Offering to pay to freeze their daughter's eggs should, she argues, be the birthday present every loving parent gives their 30-something daughter. "If your parents have the resources and can afford it, then absolutely, they should do this for their daughters," she says. "Even though I paid part of the bill, my parents helped me financially by paying several thousand dollars towards it, and it felt good for them, as they were investing in me and in their future grandchildren."

It's not a horrible plan B. I think there's a psychological benefit to doing it even if you don't get the baby at the end of it, because it makes you feel like you have taken charge of your fertility -- and in taking charge of your fertility, you're taking charge of your life. Instead of being sad and desperate I honestly feel it should be seen as something empowering.

Sarah feels so strongly that she has written a book about her experiences: part memoir, part scientific history, it chronicles both her own experiences and that of three other women who froze their eggs in the last decade.

Of course, the fact is that egg freezing remains controversial, not in the least in terms of its efficacy: to date, as few as 20 babies have been born from frozen eggs in Britain, although the figure is believed to be around 1,200 worldwide. That is likely to increase however, given pioneering new procedures: in the past fertilization rates were poor, as many eggs burst when exposed to extreme temperatures, but the introduction five years ago of vitrification -- a process in which the eggs are taken down to -196C in 60 seconds, leaving no time for damaging crystals to form -- has significantly improved the chances of their survival.

Then there is the ethical argument: While egg freezing has been available in the UK for more than a decade, many people feel uncomfortable with the notion of women freezing their eggs for social rather than medical reasons.

And Sarah undeniably falls into the former category, although by accident rather than design. Like many women, she grew up assuming she would become a mother, only to find that life didn't quite work out the way she'd planned. "I was the eldest of four, and the neighborhood babysitter. If you asked my friends at college who would be the first in our peer group to have kids my name would probably be top of the list," she recalls.

But, like many other young women, Sarah also spent most of her twenties drifting in a relationship she was not entirely sure about. "It wasn't a bad relationship, but it wasn't strong enough to survive the stresses of having children," she recalls. "At the same time, it was easy to drift."

But by 32, and with both her friends and her younger brother all suddenly having families, Sarah knew she needed to act.

Suddenly, I looked around and there were a lot of babies out there. It felt like everyone was moving forwards with their life, and I was aware of this creeping sadness starting to lurk around the edges. I was starting to focus on what I didn't have -- a baby -- and it became all I could think about. Sometimes, when I played with my niece, I felt this crushing sadness. It would take my breath away and I knew that although I wasn't unhappy with my boyfriend, if I was serious about becoming a mum I needed to walk away. It was heart-breaking, but the relationship wasn't quite right. I was only 32 and I felt confident I would meet someone else.

And at first, being back on the singles market was not as intimidating as she assumed. "I still had time on my side, and I had a lot of dates, often with guys who were a bit older and who were open about wanting to start a family -- so ideal on paper. But none of them were quite right."

By 35 however -- an age which is often billed as the time when fertility starts to decline -- she was in a stable relationship with a man six years older, yet children were still not on the agenda.

On his dating profile he had ticked 'maybe' to kids and of course at first, I was just trying to enjoy the relationship, although it was always weighing on my mind. When it did come up, his position was 'I don't want them now, but I don't know how I'll feel in a few years'' - but increasingly time was the thing I didn't feel I had, even though I also believed that in time he would be ready.

It was then, she says, that she started to contemplate the idea of freezing her eggs after learning about the idea from a friend.

I loved my boyfriend, and we had a really great relationship, but he still wasn't ready to commit to kids and I guess my age was starting to really hit home. You start to do the maths, to think 'hang on, if I want a couple of kids then we are looking at me being in my late thirties.' So the notion of egg freezing was suddenly very attractive. This way I felt like I was buying myself time. I wanted to be able to take my ovaries off the table, to be able to see what the relationship would be like without this huge clock ticking in the background.

She consulted her doctor who was supportive, but didn't have much in the way of information. "I realized that if I was going to do this I would have to work it out for myself," she recalls.
Within a month she had found a company which offered a free information session, which she attended alone, along with 20 or so other anxious 30-something women.

It was actually terribly poignant. I looked around and there were all these smart Manhattan women with great shoes and designer bags, drinking Chardonnay, yet none of us would catch each other's eyes. There was this embarrassment about being there. At the same time I walked away convinced that egg freezing was the right thing to do.

And so, just before her 37th birthday, Sarah embarked on the first of what would be eight egg freezing procedures, with her boyfriend's full knowledge. "I told him I was covering the seminar as part of a reporting assignment, but that I was now thinking about doing it for myself. And his reaction was 'cool, I think it's great to buy yourself time'. Now looking back I can see that it was buying him time too."

Her parents, meanwhile, were supportive, although her mother was initially nonplussed. "At first her position was 'why not dump this guy and find someone who wants babies now, that I was making things harder for myself. But I was in love with him. And she gave me her backing, emotionally and financially."

The process itself is not, she acknowledges, to be taken lightly, with consultations, scans, blood tests, hormones and drugs to be self-administered daily via hypodermic needles, not to mention the 15-minute procedure, undertaken via a light anesthetic, to harvest the eggs. "Overall it takes a month, but then it's done and you can get on with your life. The drugs make you feel cranky and sluggish, and as with IVF there is a risk of ovarian hyper-stimulation, which affects around one percent of patients and at its most extreme causes one's ovaries to burst. It wasn't fun, but it wasn't horrific either." In the UK, it costs between £3-4,000 per cycle, and is only provided on the NHS for cancer patients who face losing their fertility.

Sarah's first foray into egg freezing produced six viable eggs -- a decent haul but not, she felt, enough to give her peace of mind. And so, six months later, she underwent the procedure again, this time harvesting 16 more. "That was really encouraging. But I knew that in an ideal world I'd like two kids, so to ensure the best chance of that, I needed more eggs on ice as an insurance policy." After further research, she decided to try a different clinic, this one in Canada as opposed to New York, where she now lives. "It was better technology, and cheaper too," Sarah recalls. "By going to Canada, I could get three rounds for the price of one round. So I effectively went to Montreal for an egg-freezing holiday." She returned twice more before her 38th birthday -- 39 being the age at which many doctors no longer consider eggs worth saving. By then, she was $50,000 dollars -- or £30,000 -- worse off, but had amassed 70 eggs. "I felt I had given myself the best chance of becoming a mother," she recalls.

But not with her then-boyfriend. "As the months went by we both realized his 'maybe' was more likely to be 'no'," she recalls.

He wasn't a bad person, in fact in every other sense he was a wonderful father -- he just realized he didn't want to be a dad. We both went to therapy, and he spent hours talking to male friends who had children, but in the end he just didn't want to become a father. There was a lot of heartache, but I realized that we couldn't make it work.

And so, at nearly 39, Sarah found herself back on the singles market -- although this time with the knowledge that she had an insurance policy.

Freezing my eggs wasn't a guarantee of motherhood -- but if I hadn't done it I would have been 37, and back on the market knowing my fertility clock was winding down every day. Now I didn't have that. I was sad that my relationship hadn't worked out, but I wasn't scared about the future.

What she felt instead was a degree of curiosity about how life had panned out for other women who had undergone the same procedure -- hence the idea for her book.

I was curious as to how other women would live their life if they had, effectively, stopped their biological clock. I wanted to find that first wave of freezers from five or so years ago -- 10 years as it is now -- and see what happened. I didn't know how my life was going to turn out so I wanted to see how their lives had. Of course along with the curiosity was fear, too, that maybe the future wasn't as rosy as I'd hoped.

She found three women, all now in their forties, who had all frozen their eggs prior to the introduction of the vitrification process. One had had a baby from her frozen eggs, one had gone on to have a baby using donor eggs and one was childless. All three were in happy relationships and none, Sarah says, had any regrets.

Even though it hadn't worked out the way they had hoped for two of them, they all reported that taking charge of their fertility had made them feel they had taken control of their life. It had made them clear-sighted. In the case of the woman who used donor eggs she said that going down the egg freezing route had opened her eyes to the potential of science -- so she had ended up with her baby, just in a slightly different way from what she'd expected. I came away from speaking to all of them thinking that the worst thing that can happen is that it doesn't work -- but it was still worthwhile as in the interim years they had been able to move their lives forward without this fertility shadow looming over it.

For all that though, the fact remains that many people remain uncomfortable with the notion of women selecting motherhood on their own terms, conjuring as it does images of a 60-something gleefully thawing eggs they froze three decades earlier.

Richards however, believes his argument is largely a red herring.

I do understand people's anxieties, but I don't think most women are looking to do anything extreme -- most are looking to have their families by their mid-forties at the latest and they just want to give themselves a decent chance of doing that if life doesn't quite work out the way they planned. Until recently, our ovaries were on their own timeline. That was something you couldn't do anything about -- until now. So why wouldn't you?

Nor, however, is it a total panacea for the panicking 30-something singleton -- or even the thinking-ahead 20-something for that matter. It's expensive, the long-term effects have not yet been proven and the statistics show it's far from foolproof. But Richards believes that women should be allowed to come to their own conclusions and take their own risks.

I'd like to see egg freezing on every young woman's radar, as something they talk to their doctor about. Sometimes that will actually mean they focus their mind and realize they want to have their baby now, whatever circumstances they're in. Either way it's important for every young woman to think about their future fertility.

In her own case, she says, freezing her eggs allowed her to date more discriminately. "It made me more motivated, but also less desperate -- you're looking for someone to make you happy, not make you pregnant." While she did not state she had frozen her eggs on her dating profile or raise the subject immediately on early dates, the fact she was writing a book about it made it an easy discussion point. "Not one of the men I dated seemed freaked out. Instead they all seemed pretty cool with it." Even once she got into her forties without apparently meeting Mr. Right, Sarah says she felt pretty relaxed. "I knew I wasn't going to use donor sperm -- the reason I froze my eggs is because I wanted a family, with the right man, not just a baby -- otherwise I would have just gone ahead and had a baby years ago."

Indeed only now, after three years of Mr. Almosts-But-Not-Quites, is Sarah is in a relationship of seven months standing with a man she met online and who she believes may, finally, be Mr Right. And, of course, potentially the father of her children. "He's got two kids already but he wants more, and it is just so wonderful that it's just assumed it's taken care of," she says. "I told him on our first date that I'd frozen my eggs and he said he thought I was very smart. I think doing it show you're taking care of yourself, which is an attractive quality."

Motherhood, Rescheduled: The New Frontier of Egg Freezing and the Women Who Tried It (Simon & Schuster, May 7, 2013)