Egg Freezing as an Employee Benefit? Gynecologists Have Mixed Views

Mary Beth Nierengarten

Disclosures

November 24, 2014

In This Article

Counseling Women

Dr Toledo tells his patients that egg freezing is a sort of savings account that can be drawn at a later time, if needed. "I tell my patients that when you are ready to settle down and have a family, you don't automatically have to use these [frozen] eggs," he said. "This takes the pressure off women going forward and gives them more confidence when pursuing a career."

Dr Hirshfeld-Cytron said that some women in their late 30s are not sure if they need to freeze their eggs when they see her, but after they go ahead with the egg preservation, it quells some anxiety.

But both Dr Toledo and Dr Hirshfeld-Cytron emphasized the need to freeze eggs in relatively young women. Dr Hirshfeld-Cytron, for example, noted that studies showing similar pregnancy rates when IVF was done using fresh or frozen oocytes involved women younger than 35 years old. "It is not that egg freezing should not be offered to older women; it's just that in older women it may take a couple of cycles to be a realistic back-up plan," she said.

Dr Toledo also noted the increased risks that older women have during pregnancy, such as gestational diabetes and high blood pressure. "If a woman is in her mid to late 40s, there are risks involved in being pregnant beyond simply the age of the eggs," Dr Toledo said.

According to Dr Toledo, many centers that do egg freezing offer the service for women up to ages 39 or 42 years. At his clinic, the cut-off age is 42 years. He also said that his clinic requires any woman aged 45 years or older to go through a full medical workup before pregnancy.

But chronological age is only one factor, he said. Ovarian age or the degree of ovarian reserve a woman has is also important. He cited the example of a 31-year-old patient with a history of endometriosis who, after testing, had the ovarian reserve of a 40-year-old woman.

Dr Toledo said that the ideal time to begin talking to a woman about egg freezing is when she is around age 35 years and not close to starting a family. He also recommends that physicians make the case for egg freezing in women who are younger than 35 years who have lower ovarian reserve, as indicated by an anti-Müllerian hormone level less than 1.5 mg/mL.

Likewise, Dr Hirshfeld-Cytron said that she measures ovarian reserve in every patient considering egg freezing.

"For some women who find out they have decreased ovarian reserve, they will change their mind from egg freezing to pursing fertility treatment to getting pregnant now," she said, "so the conversation becomes about awareness."

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