Last year, while working from home as a result of the Covid pandemic, Emily went through the process of freezing her eggs.
It was something the 26-year-old Australian had been interested in for several years, but she made the decision to undergo the procedure when her company introduced it as an employee benefit.
Emily, whose name has been changed for her privacy, was then working at a multinational firm, which partially reimbursed her for two cycles of egg freezing.
“For me it was a very pragmatic decision,” she says – one informed by her own medical background. Emily is now practising clinical medicine, working as a junior doctor with an interest in specialising in obstetrics.
“I understand the realities of what my future career is going to look like,” she says. “It’s not a career that necessarily accommodates having a baby and child-rearing in a timeframe that is most biologically ideal.”
The firm’s contribution clinched her decision. “I think, if my employer hadn’t paid for it, that I probably would have waited and considered it in five years.”
The demand for egg freezing has increased dramatically in the past decade. In Australia and New Zealand, the number of egg freezing cycles carried out annually rose by 860% between 2010 and 2018, according to the latest available national figures. Since the pandemic began, some Australian clinics have reported further surges in demand.
Employer-sponsored egg freezing is also becoming more common. First introduced by Apple and Facebook in 2014, egg freezing is a work perk now offered by nearly one in five major US firms.
In Australia, it’s unclear how many companies offer the procedure to their employees, but new research from Monash University suggests nearly half of women are receptive to the idea.
The study, which surveyed 656 women in Victoria, found that 42% believed it would be appropriate for employers to offer egg freezing as a job benefit, while 27% of respondents were opposed to the idea.
Molly Johnston of Monash University, the study’s lead author, says the women surveyed had differing views of whether employer-sponsored egg freezing would promote or undermine reproductive autonomy.
Of those who were opposed to egg freezing as an employee benefit, many women viewed career and reproductive decisions as mutually exclusive. Some believed egg freezing to be a personal decision whose financial burden was an individual’s own to take on.
Others, Johnston says, “thought that employers actually had a conflict of interest, and that they are motivated to get women to delay having children because it retains them in their workforce”.
“People who were more apprehensive … said that it might be unnecessary and more attention should be focused on providing truly family friendly policies and supporting flexible work arrangements,” she says.
Emily says: “There are all kinds of other changes we need for women to have equality in the workforce … But on a very practical individual level, I want to have kids, and so I made the decision that was right for me.”
Increasing popularity, ‘growing awareness’
Prof Catherine Waldby, a sociologist at the Australian National University who was not involved in the study, says she is “surprised that the number of women who think it’s inappropriate is so high”.
“This particular survey had a very wide age range and it was noticeable that older ages were more likely to say it wasn’t appropriate,” she says.
Waldby believes the number of women freezing their eggs has increased because of a growing awareness in young women about fertility decline.
“You can order an ovarian reserve test on the internet and administer it to yourself,” she says. “They’re actually not very useful – their level of their indicativeness is quite poor in lots of ways, but they’re really popular.”
Dr Genia Rozen, a gynaecologist and fertility specialist at the Royal Women’s Hospital in Melbourne, says the age of patients consulting her for egg freezing has decreased in recent years.
“I’m still seeing women in their late 30s, but I’m also seeing more women in their early 30s who are contemplating this,” she says.
“If we do it too early, say women in their late 20s, we’re going to have better quality eggs but … there’s still a great chance they won’t need to use their frozen eggs.
“For women in their late 30s, there’s more of a chance they will need those eggs – but also, per egg, we’re getting less chance of success. So there’s a balance to be struck, and it’s probably around the age of 35.”
As a result of hormone injections to stimulate egg production, some women experience ovarian hyperstimulation syndrome, with symptoms including abdominal pain and nausea. Severe cases, though uncommon, may require hospitalisation.
Though women are delaying having children – and there are established financial advantages in doing so – career is not the primary consideration for women who cryopreserve their eggs.
“What the studies tell us is the No 1 reason that women don’t have babies earlier and that they freeze their eggs is that they’re not in a relationship,” Rozen says.
This is the case for a Sydney woman in her early 30s, who wishes to remain anonymous. Her company offers egg freezing as a benefit and she is currently considering the procedure. “I actually think it’s less to do with my career and more about being able to reduce the pressure on finding the right guy ASAP,” she says.
A prohibitively expensive procedure
Johnston sees egg freezing as still an inaccessible option for many women. “There are a lot of people who won’t be able to afford to self-fund it,” she says.
Waldby agrees. To collect enough eggs – ideally between 15 and 20 eggs for women 35 and younger – two cycles may be needed. “You’re looking at $20,000,” she says.
Waldby recalls interviewing women who were gifted cycles of egg freezing by their families as birthday presents.
One Melbourne woman, who did not wish to be named, tells Guardian Australia she took money out of her superannuation to fund the procedure. The woman has multiple sclerosis and was eligible for a Medicare rebate – without it, she estimates it would have cost her $12,000.
The woman, who was 35 at the time, only underwent one cycle. The daily hormone injections were unpleasant, and she experienced significant pain after her egg retrieval surgery, which yielded five viable eggs. “It was quite a big toll on me and my body,” she says. “To end up with only that, I was quite disappointed.”
Even so, she is glad she went through the procedure. “It is a massive relief to know that I’ve got eggs frozen and I don’t need to necessarily worry about that right now.”
While the egg freezing process itself is reliable, Johnston says it is not a guarantee. UK statistics suggest a birth success rate of around 18% for women using their own eggs. According to IVF Australia, egg freezing is “unlikely to lead to a pregnancy” in women older than 38. “Because you have frozen eggs does not mean that they will lead to pregnancy or the number of children that you desire,” Johnston says.
The majority of women who freeze their eggs do not end up using them, Rozen says. “I think it’s something really important to be telling women when they’re freezing their eggs: that they’re not necessarily doing this in order to come back and use their eggs.”
“Hopefully, they’re never going to need to,” she says. “That’s the idea: that they’re there just in case.”