‘A lottery ticket, not a guarantee’: fertility experts on the rise of egg freezing

Hannah Devlin

The Guardian

Originally posted 11 NOV 22

Here is an excerpt:

This means that a woman who freezes eggs at the age of 30 boosts her chances of successful IVF at 40 years. But, according to Dr Zeynep Gurtin, a lecturer in women’s health at UCL, this concept has led to a false narrative that if you freeze your eggs “you’ll be fine”. “A lot of people who freeze their eggs don’t get pregnant,” Gurtin said.

First, only a fraction opt to use the eggs down the line – some get pregnant without IVF, others decide not to for a range of reasons. For those who go ahead, HFEA figures show that, as an average across all age groups, just 2% of all thawed eggs ended up as pregnancies and 0.7% resulted in live births in 2018. For each IVF cycle, this gives a 27% chance on average of a birth for those who froze their eggs before the age of 35 and a 13% for those who froze their eggs after this age. The most common age for egg freezing in the UK is 38 years old.

A recent analysis by the Nuffield Council on Bioethics found women often felt frustrated at having received insufficient information on success rates, but also reported feeling relief and a sense of empowerment.

Egg freezing, Gurtin suggested, should be viewed as “having a lottery ticket rather than having an insurance policy”.

“An insurance policy suggests you’ll definitely get a payout,” she said. “You’re just increasing your chances.”

As lottery tickets go, it is an expensive one. The average cost of having eggs collected and frozen is £3,350, with additional £500-£1,500 costs for medication and an ongoing expense of £125-£350 a year for storage. And clinics are not always upfront about the full extent of costs.

“In many cases, you’re going to spend a third more than the advertised price – and you’re spending that money for something that’s not an immediate benefit to you,” said Gurtin. “It’s a big gamble.”

“When people talk about egg freezing revolutionising women’s lives, you have to ask: how many can afford it?” she added.

Travelling abroad, where treatments may be cheaper, is an option but can be logistically problematic. “When it comes to repatriating eggs, sperm and embryos, it is possible, but it’s not always that straightforward,” said Sarris. “You need to follow a process, you don’t just send them with DHL.”

The info is here.

Debate ethics of embryo models from stem cells

Nicolas Rivron, Martin Pera, Janet Rossant, Alfonso Martinez Arias, and others
Nature
Originally posted December 12, 2018

Here are some excerpts:

Four questions

Future progress depends on addressing now the ethical and policy issues that could arise.

Ultimately, individual jurisdictions will need to formulate their own policies and regulations, reflecting their values and priorities. However, we urge funding bodies, along with scientific and medical societies, to start an international discussion as a first step. Bioethicists, scientists, clinicians, legal and regulatory specialists, patient advocates and other citizens could offer at least some consensus on an appropriate trajectory for the field.

Two outputs are needed. First, guidelines for researchers; second, a reliable source of information about the current state of the research, its possible trajectory, its potential medical benefits and the key ethical and policy issues it raises. Both guidelines and information should be disseminated to journalists, ethics committees, regulatory bodies and policymakers.

Four questions in particular need attention.

Should embryo models be treated legally and ethically as human embryos, now or in the future?

Which research applications involving human embryo models are ethically acceptable?

How far should attempts to develop an intact human embryo in a dish be allowed to proceed?

Does a modelled part of a human embryo have an ethical and legal status similar to that of a complete embryo?

The info is here.

Can IVF influence human evolution?

Hans Ivar Hanevik, Dag O. Hessen, Arne Sunde, and Jarle Breivik
Human Reproduction (2016) 31 (7): 1397-1402 first published online April 19, 2016 doi:10.1093/humrep/dew089

Abstract

IVF, a procedure in which pharmacological and technological manipulation is used to promote pregnancy, offers help to infertile couples by circumventing selection at the most fundamental level. Fertility is clearly one of the key fitness-promoting drivers in all forms of sexually reproducing life, and fertilization and pregnancy are fundamental evolutionary processes that involve a range of pre- and post-zygotic screening mechanisms. Here, we discuss the various selection and screening factors involved in fertilization and pregnancy and assess IVF practices in light of these factors. We then focus on the possible consequences of these differences in selection pressures, mainly at the individual but also at the population level, to evaluate whether changes in the reproducing genotype can affect human evolution. The aim of the article is not to argue for or against IVF, but to address aspects of assisted reproduction in an evolutionary context.

The article is here.