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Saturday, July 24, 2021

Freezing Eggs and Creating Patients: Moral Risks of Commercialized Fertility

E. Reis & S. Reis-Dennis
The Hastings Center Report
Originally published 24 Nov 17


There's no doubt that reproductive technologies can transform lives for the better. Infertile couples and single, lesbian, gay, intersex, and transgender people have the potential to form families in ways that would have been inconceivable years ago. Yet we are concerned about the widespread commercialization of certain egg-freezing programs, the messages they propagate about motherhood, the way they blur the line between care and experimentation, and the manipulative and exaggerated marketing that stretches the truth and inspires false hope in women of various ages. We argue that although reproductive technology, and egg freezing in particular, promise to improve women's care by offering more choices to achieve pregnancy and childbearing, they actually have the potential to be disempowering. First, commercial motives in the fertility industry distort women's medical deliberations, thereby restricting their autonomy; second, having the option to freeze their eggs can change the meaning of women's reproductive choices in a way that is limiting rather than liberating.

Here is an excerpt:

Egg banks are offering presumably fertile women a solution for potential infertility that they may never face. These women might pay annual egg-freezing storage rates but never use their eggs. In fact, even if a woman who froze eggs in her early twenties waited until her late thirties to use them, there can be no guarantee that those eggs would produce a viable pregnancy. James A. Grifo, program director of NYU Langone Health Fertility Center, has speculated, “[T]here have been reports of embryos that have been frozen for over 15 years making babies, and we think the same thing is going to be true of eggs.” But the truth is that the technology is so new that neither he nor we know how frozen eggs will hold up over a long period of time.

Some women in their twenties might want to hedge their bets against future infertility by freezing their eggs as a part of an egg-sharing program; others might hope to learn from a simple home test of hormone levels whether their egg supply (ovarian reserve) is low—a relatively rare condition. However, these tests are not foolproof. The ASRM has cautioned against home tests of ovarian reserve for women in their twenties because it may lead to “false reassurance or unnecessary anxiety and concern.” This kind of medicalization of fertility may not be liberating; instead, it will exert undue pressure on women and encourage them to rely on egg freezing over other reproductive options when it is far from guaranteed that those frozen eggs (particularly if the women have the condition known as premature ovarian aging) will ultimately lead to successful pregnancies and births.