“Until recently I was embarrassed to say that I had frozen my eggs. I hid it from my surroundings. Except for close girlfriends and family members, nobody knew. Today I no longer have a problem, and I have a lot of girlfriends doing it, and I’ve become a kind of ‘mentor’ who advises them.”
So says Or (not her real name), who will celebrate her 40th birthday this year. About three years ago she underwent the process called “social fertility preservation,” which means freezing eggs for non-medical reasons – in other words, by choice.
Or’s change in attitude within a few years is not unique to her. More and more women in their thirties have undergone the process or are seriously considering freezing their eggs to preserve fertility – a process that is supposed to increase their ability to become pregnant even at an age when nature already piles up difficulties and the success rate plummets. This option, which is also quite expensive, is already on the table – in women’s clinics and fertility clinics, and in conversations among girlfriends and even family members.
According to the figures of Ayala – the Israel Fertility Association, in the past seven years, since the process was approved for implementation in Israel, there has been a dramatic increase in the number of women who choose social fertility preservation. If in 2011 fewer than 100 women underwent the procedure, in 2014 there were already about 300 women, 450 in 2015, and 950 in 2016, some of whom had more than one cycle of extracting eggs; in that year there were about 1,600 cycles of egg extraction for the purpose of preservation for non-medical reasons.
Updated figures for 2017 are still unavailable, but Ayala, like the fertility clinics in the hospitals and private institutes, report a continuation of the trend.
“We saw an increase of about 20 percent [in 2017], and in other places there was an increase of up to 50 percent compared to the previous year,” says Prof. Raoul Orvieto, director of the unit for in-vitro fertilization (IVF) at Sheba Medical Center in Tel Hashomer. “The awareness of difficulties in becoming pregnant that come with age, and the possibility of freezing eggs, is filtering down, and a friend brings a friend,” he says.
There’s nothing trivial about the social or medical discussion related to pregnancy, birth or parenthood, certainly not in a country like Israel, which is a world leader in IVF, and where children and family are a supreme value. Still, the choice to freeze eggs without any acute medical need requires a sober, at times almost painful personal assessment.
Medical advances enable (some would say require) women in their early thirties to prepare seriously for the possibility that they won’t find love and start a family in an entirely natural way, at least not according to nature’s timetable. If there’s a need for consolation it can be found – beyond a good chance of a successful future pregnancy – in the fact that in Israel quite a number of women are sharing similar feelings and experiences surrounding the choice to undergo the process of freezing eggs.
The “fertility preservation” process, freezing eggs, was designed to preserve women’s ability to become pregnant in the future by means of IVF, and until 2011 it was allowed in Israel only for medical reasons – in cases of an increased risk of an early end to menstruation due to various chromosomal syndromes, carriers of a fragile X gene, autoimmune diseases or for women suffering from cancer, whose fertility could be damaged by chemotherapy and radiation.
In such cases the procedure was publicly funded by the health services basket. But since 2011 the law permits freezing eggs for non-medical reasons as well, for women aged 30 to 41. According to the law, the women can undergo up to four cycles of egg extraction, or until 20 eggs are extracted, whichever comes first.
A treatment cycle lasts between one to three weeks, with the process of extraction preceded by a period of taking hormonal medications, accompanied by sonograms once every few days in order to take full advantage of the process and to produce as many eggs as possible. The cost of the treatment, which is paid for privately, ranges from 16,000 to 20,000 shekels (about $4,600-$5,800), not including the cost of the medication, which can reach 8,000 to 10,000 shekels.
“We think that this is something welcome,” says Prof. Talia Eldar-Geva, chairwoman of Ayala. “I don’t like the concept ‘social egg freezing.’ The more correct description is ‘elective egg freezing,’ because the need for the process is biological – related to age and a decline in fertility. There is something very right about it, like women who freeze eggs before treatments that will damage their fertility due to an illness,” she says.
In Israel they began offering the process about six years ago. “In the past year to year and a half, women are already beginning to thaw the eggs and there are already pregnancies, and there are already several children. Some of the women who came to thaw eggs have found partners since then, but were unable to become pregnant naturally. So that the choice to undergo the process doesn’t mean that these are women who have given up and decided to be single mothers, they simply separated between the two,” says Eldar-Geva.
And age really does bite into the rate of success in getting pregnant. In the early thirties the chances of a pregnancy ending in a birth is about 32 percent per IVF cycle, while in the early forties the chances plummet to only 3 percent to 5 percent, while the “watershed” from which the dramatic decline in women’s fertility begins, according to most doctors, is age 35. “When a woman comes to me at the age of 38 I explain to her that instead of freezing eggs it’s preferable for her to freeze fetuses, and I send her to bring a sperm donation,” says Orvieto.
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