Costly, invasive and unlikely to work: are fertility clinics being honest about the realities of egg freezing?

For centuries, broody mothers and grandmothers have driven their daughters to the brink of insanity with comments like “when will we finally hear the pitter-patter of tiny feet?” Or worse, being told to be “careful, as you are getting close to your peak fertility.”

The past year of on-off lockdowns has only compounded the anxieties of older, single women who wish to have children. For many, the only opportunities to ‘meet the one’ were either logistically challenging (socially distant strolls) or painfully awkward (dates via Zoom); pandemic-era dating hasn’t given much of an opportunity for blossoming love.

So it comes as no surprise to learn that there has been an upsurge in the number of women choosing to slam on the brakes and freeze their eggs. Pausing the biological clock has become an attractive option for young professional women who feel they regain certainty and control of their fertility when their relationships and careers are so unpredictable.

“Egg-freezing is the single largest growing fertility treatment in the UK with the number of women increasing year on year,” says Dr Zeynep Gurtin, a lecturer at UCL’s Women’s Health Institute. The number of people choosing to freeze their eggs or embryos has increased five-fold since 2013, according to data from the Human Fertilisation and Embryology Authority (HFEA). “In lockdown, this has increased as single people have found it more difficult to meet partners, and it has led to an increase in anxiety about people’s reproduction,” she says. 

The process of freezing eggs takes around two to three weeks to complete. First, drugs are administered to boost egg production which are collected once ready. Then a cryoprotectant (freezing solution) is added to protect the eggs before being frozen by vitrification (fast freezing) and stored in liquid nitrogen tanks. When a woman wants to use her eggs for fertilisation they will be dethawed, and the ones that survive will be injected with their partner or donor’s sperm. The average storage period for these eggs is a maximum of a decade, although some women can store for up to 55 years. 

Yet according to the HFEA, only 19 per cent of IVF treatments using a patient’s own frozen eggs were successful in 2017. This fits with other available data. A study by The Conversation, looked at a ten-year period with 129 women aged 25 to 45 and found that the overall success rate was 21 per cent. This means that only around a fifth of women are likely to conceive from egg-freezing treatments. 

And the process costs a small fortune. According to the HFEA, the average cost of having your eggs collected and frozen in the UK is £3,350. Medication is an added £500 to £1,500, storage costs are £125 to £250 a year, and the process of ‘dethawing’ the eggs and transferring them to the womb costs an average of £2,500.  In other words, women must be prepared to spend between £7,000-8,000 for a process where the odds of success appear to be slim.

But are private fertility clinics presenting trustworthy information about the realities of the treatment ? Or are they profiteering off the back of women’s anxieties?

In November 2020, Dr Gurtin and a colleague, Emily Tiemann, conducted the UK’s first study into the marketing of elective egg freezing (EEF) by fertility clinics. They downloaded materials about EEF from the websites of 15 of the country’s fertility clinics (these clinics had conducted almost 90 per cent of all egg freezing cycles in the decade before the study). Of the 15 analysed, they only rated the quality of information of one clinic website as “good”.

To come to this conclusion, Dr Gurtin and Tiemann conducted a three-step analysis and looked at the content, prices and the accuracy of information on the 15 sites. “From our content analysis, we found that websites were more likely to discuss the potential benefits of EEF and were unlikely to discuss the risks,” says Dr Gurtin. “Our systematic cost analysis found that most clinic websites were not clear about the overall cost, with the average ‘true’ cost exceeding the advertised costs by approximately a third. Lastly, we did a quality analysis looking at the information available on egg freezing and its adherence to the guidelines on the HFEA. We found that the quality of information was very poor and that these websites provided little detail.”

The researchers confess to being “taken aback” by how poorly these clinic websites scored and found it problematic that these private clinics provide so little crucial information. “Egg freezing is supposed to be this ‘cutting-edge’ technology that empowers women, but there is little discussion about the medical risk, the cost, and the potential emotional difficulties,” explains Dr Gurtin. 

She adds: “Like any medical procedure, EEF carries risks and injecting the body with all these hormones can have an adverse effect on certain women. Some women can’t work in the days before/after egg collection; some experience discomfort and some may even need to go back to the hospital. Yet we don’t hear about these effects on the websites.”

Justine (not her real name), a London-based journalist who froze her eggs aged 38, told Dr Gurtin that she felt unprepared for the reality of how it would feel to freeze her eggs. Before her procedure, she was told that she could carry on as usual. Instead, Justine ended up in more physical discomfort after egg collection than she ever expected, telling Dr Gurtin: “After the hours passed, I still felt incredibly weak, bloated and short of breath. I called the clinic, which just said if you continue to feel bad, then go to A&E. It was at that point I felt very alone.”

It turned out that Justice suffered from ovarian hyperstimulation syndrome (OHSS), a rare complication of the IVF and egg freezing processes that causes the production of too many eggs. Justine felt she had not received enough information about this potential risk from her clinic, which had failed to offer adequate follow-up care.  

“Seventy per cent of egg-freezing treatments in the UK are being offered by private clinics which can do so according to their own rules,” says Dr Gurtin. The HFEA is unable to enforce changes as many of the commercial aspects of fertility treatments remain outside its jurisdiction. For immediate change, Dr Gurtin and Emily Tiemann included an urgent recommendation and criteria for clinics so that they can improve their websites, adhere to HFEA guidelines and help patients make an informed decision about whether they should pursue egg freezing. Dr Gurtin also urges women considering egg freezing to look beyond the information on clinic websites and ask for specific and verified data regarding the number of cycles the clinic performs each year, their success rates, and the aftercare offered. 

If demand for egg freezing continues to increase, there is even more of an impetus to make this information as transparent as possible. These private clinics will often be the last hope for a woman wanting to become a mother, which means it is all the more vital that certain websites are upfront about the physical, emotional and financial cost – and low success rate – of such a life-defining procedure.