Social egg freezing — or egg freezing to delay childbearing rather than for medical reasons such as for infertility or a cancer diagnosis — has become an increasingly popular choice for women in recent years. But the positive narratives about the option being empowering represent only one side of the story.
On Friday, one of the first studies exploring the patient perspective in elective egg freezing was published in the international journal Fertility and Sterility. The findings provide a more nuanced view, reflecting a complicated mix of positive and negative feelings.
“Working with more and more patients going through egg freezing, we had the sense that this was emotionally more complex than people might have assumed initially,” said study co-author Heather Huddleston, an associate professor of obstetrics, gynecology and reproductive sciences at the University of California at San Francisco.
The study involved 503 women who underwent elective egg freezing between 2012 and 2016. Their mean age at the time of their procedure was 36.5, and they spoke with researchers an average of two years later. Sixty-three percent were white, 78 percent had a graduate or professional degree, and 68 percent reported an income greater than $100,000.
For the most part, the women indicated they felt good about the experience.
Some 89 percent said they were glad they froze their eggs even if they never used them, 88 percent said the procedure made them feel as if they had more options for their life, and 80 percent said they felt they had adequate information when choosing to freeze and store their eggs.
But there were a number of worrisome findings.
A significant percentage of women grossly overestimated the probability of having a child, with some believing they had a 100 percent likelihood of having a child with their banked eggs. In a commentary accompanying the study, fertility specialist Kara Goldman of New York University Langone Medical Center called this finding alarming and “obviously unrealistic.”
“To the extent that this expectation of success may alter a patient's procreative plans, this misconception could lead to unintended childlessness with devastating consequences for these individuals,” Goldman wrote.
The extent of some women's regret was striking. Half of them reported some degree of regret a few years after undergoing the procedure. Most said their regret was mild, but 16 percent described moderate to severe regret.
Regret is a fuzzy concept and can be difficult for someone to articulate in the real world. Study co-author Eleni Greenwood, a UCSF clinical fellow, noted that a previous study involving a telephone survey of women who had undergone egg freezing asked this question explicitly. None said she experienced any regret.
In the UCSF research, regret was measured in five different dimensions using a scale developed by scientists who study decision-making. Questions covered a woman's satisfaction with her decision, her conflict about what to do, any feelings of distress or remorse and health outcomes.
“Only recently have we started putting more emphasis in how patients get involved in their health care and how they view it after the fact,” Greenwood said.
Yet why women felt as they did remains unclear. There was a correlation between regret and women who got a lower number of eggs in their egg-freezing cycle, with those who got 10 or fewer eggs being four times more likely to have regret. “It's possible that patients who have lower numbers of oocytes retrieved might interpret this as a sign of low fertility or impending infertility, which evokes distress and increases regret,” the researchers wrote.
Huddleston said many factors likely are involved. Many of the study participants said they would have liked more emotional support during the process or would have liked to speak with a counselor.
“That they were saying this surprised us,” Huddleston said. “I think it's not something that practices are doing as well as they could.”
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