I am Art Caplan at the Division of Medical Ethics at the New York University (NYU) Langone Medical Center. Facebook and Apple recently announced a new perk for female workers. They will pay to freeze their eggs, a benefit that has sparked an appropriate ethical controversy.
There is no doubt that some women at these companies will think it is a great benefit, and they are glad to have it. But I am afraid that things aren't so simple.
Part of the reason that those companies offer egg freezing is that they don't want women distracted from their careers by having children. One way to manage both career and motherhood is to freeze your eggs. But freezing eggs is not simple, nor is the choice to do so. What if the company says to you, "We offered you the benefit, so why aren't you freezing your eggs? Don't tell me you are going to become pregnant. Don't tell me that you want to have a child right now. That is what we have the egg freezing option for."
I am not saying that anyone from the human resources department of any of these companies is going to be that blunt and say, "This is why we have the benefit. It wasn't out of kindness. It wasn't because we care about the childrearing patterns of our employees. We want them working, and we are tired of hearing people say that they want to balance home life with a career."
Egg freezing is not simple. It carries risks for the mother. She must take drugs to "superovulate," and those drugs carry risks, although these risks are not horrendous. Women assume those risks when they undergo ordinary in vitro fertilization. These risks may or may not be clear to women who hear "egg freezing" and think it is like making a deposit at the bank. It is not that simple.
Egg freezing is also relatively new. It has only been around for a few years as an approved therapy. We don't know the long-term health risks to children born this way because we haven't followed many children who have been born from frozen eggs. Freezing sperm has been around for a long time, but egg freezing as an approved therapy is only a few years old.
Women who contemplate freezing their eggs electively because of career considerations should do so before they reach the age of 35 years. Freezing older eggs can contribute to problems becoming pregnant. Even if you freeze your eggs at a younger age, the chance of a pregnancy with in vitro fertilization (which you must do to use the frozen eggs) is probably no higher than 30%. We are talking about a technology that can help, but there is no guarantee that it will provide you with children. Having them younger, through the good, old-fashioned, birds-and-bees way, is a better opportunity to create a family.
Furthermore, trying to have a child when you are younger also will reveal whether you have fertility problems; 8%-9% of women have problems with their eggs at any age. Freezing bad eggs doesn't make them any better. You may find out too late that the eggs you had weren't going to work, and you may have missed an opportunity.
There is also the issue about freezing your eggs and having a child later in life. The good news is that you will have more resources. You might even have more time for the child. The bad news is that you are probably going to have less energy to parent, and if you have a child late, you may have less time to be with that child, so there are a lot of tradeoffs.
Egg freezing sounds like an interesting benefit, one that insurance companies and third-party payers are not likely to be offering. It is seen as an elective procedure. It is not something to do because you became infertile owing to chemotherapy or radiation. It is not related to any medical need. It is a social choice. When high-tech companies offer this opportunity to their female employees, what looks like a nice perk may be motivated by something other than beneficence towards the workforce. If you are on the other end of the offer, you have a lot to think about as to whether egg freezing is the best way to build a family.
I am Art Caplan at the NYU Langone Medical Center. Thanks for watching.
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Cite this: Companies Pay for Women to Freeze Their Eggs? This Is Not Good - Medscape - Dec 03, 2014.