Singer Sophie B. Hawkins gave birth in early July to a daughter at the age of 50.
Using an embryo frozen 20 years prior, she took advantage of the technology so her son could have a sibling.
“Being 50 is actually an amazing age to have a second child because I am more wise, calm, humorous, appreciative, simple, and clear,” Hawkins told US Magazine.
While freezing embryos remains the most popular form of preserving a woman’s ability to have children, freezing unfertilized eggs — known medically as oocyte cryopreservation — is now available in half of assisted reproduction clinics in the United States.
Its popularity has been boosted since Kim Kardashian’s endorsement of egg freezing was featured on the TV show “Keeping Up with the Kardashians” in 2012 and a leading agency on fertility gave it a dimmed green light the following year.
Dr. Alan B. Copperman, medical director of Reproductive Medicine Associates of New York, has been routinely freezing women’s eggs since 2007. He said the technology “has improved to meet the hype.”
“Family planning used to mean preventing unwanted pregnancies. In 2015, that means an opportunity to have the family you’ve always wanted,” he said. “But the goal is not to see how many 50-year-old mothers we can have.”
From ‘Experimental’ to a Trend
Two years ago, the procedure was labeled “experimental,” but when the American Society for Reproductive Medicine (ASRM) changed the designation in 2013, it was intended to help cancer patients who wanted to have children.
Since then, cryofreezing young, healthy, and unfertilized eggs has been marketed toward women in their 20s, 30s, and even 40s who want to have a career first and then have children in their 50s.
While the technology appears to be an attractive strategy for that purpose, there is limited data on the success of long-term egg freezing. And what’s available isn’t necessarily encouraging.
“Marketing this technology for the purpose of deferring childbearing may give women false hope and encourage women to delay childbearing. In particular, there is concern regarding the success rates in women in the late reproductive years who may be the most interested in this application,” the ASRM noted in approving the procedure.
Nonetheless, nearly two-thirds of women who freeze their eggs cite deferring childbearing for a later age while less than 20 percent use it for medical reasons such as cancer treatments.
Dr. Jane Frederick, a specialist in reproductive endocrinology and infertility and medical director of HRC Fertility in Orange County, California, said now single women who haven’t met their ideal mate can preserve healthy eggs in their 20s or 30s to use later in life.
“I think it’s a good thing for women to have more control over [their] fertility,” she said. “I would definitely consider it as a back-up plan for women.”
A $21 Billion Industry by 2020
Egg freezing has turned into a lucrative business, but critics inside the field say its artificial birth techniques remain a largely unregulated field.
The in vitro fertilization market was estimated to be $9 billion in 2012, but with the increased availability of egg freezing and other technologies, that’s expected to increase to $21 billion by 2020.
The insurance industry still considers egg freezing as experimental and elective, so the expenses fall on the patient.
The procedures involved to harvest a woman’s eggs cost between $7,000 to $10,000 per menstrual cycle. Experts recommend multiple cycles to ensure enough eggs are gathered. Most experts recommend preserving 30 eggs, just to be sure.
One freezing cycle can take between four to six weeks as women go through various hormone injections and birth control pills to alter ovulation and stimulate the ovaries and ripen multiple eggs. Then, a woman is sedated and the eggs are retrieved with a needle through the vagina.
After eggs are frozen, storage fees cost another $500 to $1,000 a year. The thawing of the egg, fertilization, and embryo transfer when pregnancy is desired typically costs $10,000 to $20,000.
All told, freezing eggs and translating that into a pregnancy can cost a woman upward of $50,000, depending on the time from freeze to fruition.
“It’s still out of reach for many women. If it would be offered as an insurance benefit, more women could use it,” Frederick said.
Marketing Motherhood Toward a New Generation
Fertility specialists are capitalizing on the trends in technology by predominantly targeting young professional women.
As fertility drops with age, these companies say the ideal candidate for egg freezing is a woman in her late 20s or early to mid-30s. The average age of participants is just over 34. Many fertility clinics set a cutoff age of 38.
A study published in the journal Fertility and Sterility found that women who froze their eggs at age 30 had a 13 percent chance of successful implant while women who froze at 40 had an 8 percent chance.
Across the country, fertility experts hold seminars where reproductive specialists tout the benefits of the procedure, while wining and dining women of a productive and fertile age. These seminars use empowering slogans, including “Take Control of Your Fertility.”
The simple fact is pregnancies can still hurt career-minded women. One United Kingdom survey found a third of managers say they would rather hire a man because of the fear of the guaranteed 39-week mandatory paid leave for new mothers.
While pregnancy discrimination cases have reached the U.S. Supreme Court, some employers are embracing this available technology that give women a choice in their fertile years.
Tech giants such as Google, Apple, and Facebook — whose average employee age ranges from 26 to 33 — are getting ahead of the curve by offering up to $20,000 to female employees to cover egg freezing costs.
“The secondary benefit is that it allows women to focus on their careers and for employers it shows their competitors they’re focused on women and their health,” Copperman said.
Besides career choices, many women are freezing their eggs following a break-up or divorce, hoping to preserve good eggs while searching for a new partner. Others, like Hawkins, are using the procedure for having additional children.
Egg freezing is also a new option for women who oppose freezing embryos for religious or moral obligations, as an embryo is considered a live person by some religions.
Another plus of freezing eggs versus embryos is that the woman is the sole owner of her eggs, while the latter may be contested in a divorce custody battle.
A San Francisco Superior Court judge is expected to rule soon on the case of Dr. Mimi Lee and her now ex-husband, Stephen Findley. The case hinges on a prenuptial agreement and who has the rights to the five frozen embryos created from her eggs and his sperm.
Evolving Science Comes with No Guarantees
The first live birth from a frozen embryo occurred in 1984. The first from a frozen egg occurred 2 years later.
The process involved a slow freezing technique to prevent ice buildup in the cells. Now, vitrification, or fast-freezing, has shown improvements to an otherwise low rate of egg survival, fertilization, and pregnancies.
In its decision to lift the “experimental” label off egg freezing, researchers at the ASRM examined available data and found frozen eggs showed “no increase in chromosomal abnormalities, birth defects, and developmental deficits” compared to conventional pregnancies.
But they also noted there is a lack of data on the many nuanced parts of the procedure. The full picture won’t be known until the scores of women freezing eggs today retrieve those eggs years later.
Frederick says these advances have improved a mother’s chances of giving birth after using a frozen egg, but her chances aren’t at 100 percent.
And the longer a woman waits, the less likelihood she has that a frozen egg will result in a successful pregnancy.
The best research to date shows freezing, thawing, and fertilizing an egg fails 77 percent of the time in women aged 30 and 91 percent of the time in women aged 40. Still, women were able to have children as late as 44 years old.
“I tell my patients it’s a possibility, not a guarantee,” Frederick said.
And while it appears eggs can handle the cryofreezing, there’s limited information at how long an egg can keep its chill.
That’s why Copperman says it’s important to be realistic and practical with patients. Egg freezing, he says, can increase a woman’s chances of becoming pregnant at a later date, but it doesn’t secure their chances of having a baby whenever they’d like.
“There’s no guarantee eggs that have been frozen will be healthy,” he said.