Katherine Gobbi was 35 and single when she decided she should freeze her eggs.
- 250 women will take part in a trial of the online tool with plans for it to be up and running by the end of 2020
- The number of women with eggs in storage has doubled in Victoria over the last four years
- A study of 100 Australian women found the average age at which women froze their eggs was 37
“It had never felt right or I needed to until that morning, when I woke up and realised that, absolutely, I wanted that insurance policy,” Ms Gobbi said.
Things moved quickly from there.
The following week, Ms Gobbi, an insurance company CEO, was at her doctor’s office, but there had been years of indecision.
“I am someone who does a lot of research when it comes to big decisions — I found that information was accessible, but not necessarily consistent between different clinics,” Ms Gobbi said.
Now a team of Australian researchers is working on an online tool to help women weigh up their options.
In a world-first, a “decision aid” will provide independent information about egg freezing and offer guidance to women considering egg freezing.
Dr Michele Peate is leading the research at the Royal Women’s Hospital in Melbourne and said it was a very difficult choice for women.
She said finding “reliable information” was a challenge.
“Most women would probably go to Google, type in ‘egg freezing’ and often the first pages that come up are IVF clinic web pages,” she said.
Patients with eggs in storage at clinics in Victoria
- June 30, 2015: 1,085 women
- June 30, 2016: 1,604 women
- June 30, 2017: 1,925 women
- June 30, 2018: 2,411 women
In 2016, 1,790 IVF cycles were for oocyte (egg) freezing, up from 1,213 in 2015
Source: Australian and New Zealand Assisted Reproduction Database and Victorian Assisted Reproductive Treatment Authority
“What we’re trying to do is develop an unbiased, evidence-based resource to guide women through the decision-making process.”
Dr Peate said the website would include a questionnaire in which users were asked to write the “pros and cons of egg freezing based on their own personal values”.
The quiz will cover a range of topics, including the woman’s understanding of success rates, when they would ideally like to become a parent and whether they would have regrets if they didn’t give egg freezing a go.
“The decision aid will then provide feedback along the lines of ‘it looks like egg freezing might be for you, or not,” Dr Peate said.
Later this year, 250 women will take part in a trial of the online tool, with plans for it to be up and running by the end of 2020.
“Obviously we’ll start in Australia first, but it’ll be great to see how the same tool performs around the world,” Dr Peate said.
Growing demand for egg freezing technology
The prevalence of age-related infertility has risen sharply in Australia, with more women leaving motherhood until later in life.
Advances in technology mean women can reliably freeze their eggs, and statistics show it was becoming an increasingly popular choice.
Data collected by the Victorian Assisted Reproductive Treatment Authority (VARTA) showed the number of women with eggs in storage had doubled in Victoria over the last four years.
How many eggs do you need?
Success is highly dependent on the age at which a woman freezes her eggs.
VARTA chief executive officer Louise Johnson said if women waited until their late 30s it was “very, very risky”.
However, that was when most women underwent the procedure.
A study of 100 Australian women found the average age at which women froze their eggs was 37.
Monash University senior research fellow Dr Karin Hammarberg said at that age “there has already been a decline in the quantity and the quality of the eggs”.
The older a woman is, the more eggs she would need to give herself a decent chance of having a baby in the future.
An American study concluded that to have a 75 per cent chance of having one live birth, a 34-year-old woman would have to freeze 10 eggs.
A woman undergoing the procedure at 37 would need 20 and at 42, 61 eggs are required to have the same chance of success.
“Of course the chance of getting that number of eggs [in one cycle] at that age is pretty low … you wouldn’t expect to get that in one stimulated cycle, you might have to come back a few times,” Dr Hammarberg said.
Ms Gobbi’s first cycle produced 10 eggs, but she had been hoping for more.
“It’s a game of numbers — the higher the number of eggs in storage, the more likely it is you can create a baby out of those eggs,” she said.
At 37, and after meeting her now-husband Graeme Anstey, Ms Gobbi froze 40 more eggs.
Last year, they decided the time was right to expand their family and unthaw the eggs to create embryos.
All 50 fertilised, but from there, she said the numbers dwindled.
“Twenty-one embryos matured to day five — we then elected to have genetic testing and ended up with five genetically sound embryos that were successfully frozen,” she said.
Happily, Ms Gobbi and her husband are expecting their first child later this year.
The truth about success rates
There’s “attrition” at every step of the process, Ms Johnson said.
“It may be that not all those eggs thaw successfully and then when eggs combine with sperm to create embryos … not all of those embryos maybe really healthy embryos,” she said.
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“Egg freezing is not an insurance policy.”
But that is how it’s often marketed by IVF clinics.
Dr Hammarberg said while fertility doctors probably did a good job at explaining success rates, the corporate marketing can be misleading.
“If you just look at websites, I have to say I think that it is quite glorified and looking more promising than I think you would say that the evidence suggests,” Dr Hammarberg said.
“It’s more like a lottery than an insurance policy.”
The financial outlay is significant and may not be immediately apparent.
Ms Johnson said each cycle of treatment could cost up to $10,000 and women might need more than one to get “enough eggs to ensure their chances are optimal for being able to use those eggs successfully”.
There was also the added cost of hospital stays, medication and oocyte storage.
Currently, only 10 per cent to 15 per cent of women who froze their eggs ever went on to use them.
Dr Hammarberg said there was a real dilemma.
“If women are younger when they freeze their eggs, they are quite likely to conceive without using those eggs,” Dr Hammarberg said.
“For others who are a bit older, if they don’t find a partner, [most] are not willing to be single parents, so the eggs remain frozen.”
Why are women freezing their eggs?
Contrary to popular perception, most women who froze their eggs do not do it because they have busy careers.
“This is a complete myth but it’s propagated everywhere,” Dr Hammarberg said.
“Studies all around the world show that the main reason women freeze their eggs is that they haven’t found a partner, or they have a partner who’s not quite ready [to be a parent].”