Should you freeze your eggs? IVF websites don’t crack the surface – Sydney Morning Herald

Posted: October 13, 2020 at 11:55 am

IVF clinics vied for patients in this highly competitive environment knowing women considering freezing their eggs scoured clinic websites and social media for guidance, Dr Beilby said.

"There's a lot of money involved in fertility preserving technology, and it's great to know this technology exists to meet the demand," she said.

But clinics had an obligation to provide clear, accurate information alongside their marketing material about what egg freezing entails, the chance of success, and the cost. "That's what we're not seeing," Dr Beilby said.

None of Australia's 21 most prominent fertility clinic websites specified whether the egg-freezing success rates they quoted were based on patients using their own eggs or donated eggs from cohorts of 20-something women.

Only half provided success rates based on a woman's age and fewer than one-third included the cost of the procedure, according to the analysis published in the Australian and New Zealand Journal of Obstetrics and Gynaecology.

One in three clinic websites published a percentage figure for the chance of getting pregnant after egg-freezing, but only one in 10 published the chance of having a baby.

Overall, the researchers rated 43 per cent of the clinics as "poor" and 57 per cent as "moderate" on an American matrix designed specifically to assess the quality of information on egg freezing.

Co-author Dr Karin Hammarberg said women need to be properly informed of these high costs, potential health risks and chances of having a baby before they decide to undergo egg freezing.

The chance of having a baby from frozen eggs depends on two numbers: the age of a woman when her eggs are frozen, and the number of eggs she freezes, Dr Hammarberg said.

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The quality of a woman's eggs declines the older she gets. The older the woman, the more eggs she'll need to freeze to have a reasonable chance of having a baby.

For a women under 30, the chance of taking home a baby per initiated IVF cycle if she uses her own eggs is 19.7 per cent, the latest official IVF data from the Australian and New Zealand Assisted Reproduction Database shows.

FFor women aged 30 to 34, it is 17.5per cent, dropping to 12.1 per cent for 35- to 39-year-olds, 4.6 per cent for 40- to 44-year-olds and 0.4 per cent for women 45 and over.

Freezing 10 eggs at 35 or younger gives a woman a 69 per cent chance of having a live birth, dropping to 50 per cent for 37-year-olds and 30 per cent for 40-year-olds.

The number of stimulation cycles needed to retrieve enough eggs increases with age. Most women over 35 will need more than one egg retrieval to collect enough eggs to have a reasonable chance of success.

More than half of the women who freeze their eggs when they are in their mid to late 30s will need at least two hormone stimulations to get the number of eggs that gives them an 80 percent chance of having a baby when they use their eggs. Almost all women aged 40 or more will need at least four hormone stimulations for the same chance.

There is also a third number to consider: cost. The egg-freezing process can cost $7000 to $10,000 per egg retrieval plus the additional cost of storing the eggs (approximately $200 to $500 a year).

"Something that may not be obvious is that in order to have a good reasonable chance of having a baby you might need to spend $30,000," Dr Beilby said.

The egg retrieval process also involves health risks, such as ovarian hyper-stimulation syndrome (OHSS), which is associated with the hormone injections required as part of the procedure.

Dr Beilby hoped clinics would use the audit to develop a checklist of information to include on their websites, and where possible publish clinic-specific success rates.

"There is a lot of hope tied up in this, and we need to err on the side of caution to align women's expectations with reality," Dr Beilby said.

Professor Luk Rombauts, President of the Fertility Society of Australia, said a consultation with a fertility specialist - not the internet - was the appropriate setting for a woman to be given the information she needed to make an informed decision about egg freezing.

"Just because it's not on the website doesn't mean patients won't get that information," Professor Rombauts said. "They will get it from their doctor, which is exactly where the information should be coming from. Most importantly, we will take into account a patient's personal circumstances."

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Professor Rombauts said the fertility industry had done exceptionally well when it came to transparency in advertising compared to other medical specialities.

It was impossible - particularly for smaller clinics - to provide meaningful success rates when only a very small proportion of women have returned to use their frozen eggs.

"A lot of women who freeze their eggs fortunately never have to use them because they do find a partner," he said. "That doesnt mean we couldn't improve the reporting on our websites."

In Australia, the FSA's Reproductive Technology Accreditation Committee sets standards for ART clinics through an audited Code of Practice, which states their websites "must include but not be limited to: processes, costs, risks and outcomes" but does not specify a minimum level of detail.

"This paper could give [clinics] another useful tool when they're considering what information they could include on their websites," Professor Rombauts said.

Kate Aubusson is Health Editor of The Sydney Morning Herald.

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Should you freeze your eggs? IVF websites don't crack the surface - Sydney Morning Herald

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