We are almost sorry for bringing up this subject once again after having discussed it extensively only recently, but a paper in one of our specialty’s leading medical journals warrants mention. In this study colleagues from University of California, San Francisco investigated regret and satisfaction levels following oocyte cryopreservation (egg freezing) for extension of reproductive lifespan. Sixteen percent of investigated women demonstrated moderate to severe regret about their decision to freeze eggs. Regret was often caused by low numbers of cryopreserved mature eggs. Adequate patient information and appropriate emotional support from staff increased estimates of patients about their chances of achieving a live births, and were found statistically associated with reduced risk of regret (Greenwood et al., Fertil Steril 2018. pii: S0015-0282(18)30203-6).
The media attention to this study was in in our opinion inappropriate. First of all, a 16% dissatisfaction rate regarding any kind of medical intervention has to be considered low. Indeed, 89% of study participants reaffirmed that they will be happy they froze eggs, even if they end up never using those. The media frenzy claiming a significant degree of dissatisfaction, therefore, was unwarranted.
More importantly, however, it appears to us that the media completely misunderstood the study. This study did not evaluate how women feel about the process 3, 5 or 10 years after they freeze their eggs, potentially never having to use them, potentially having used all of them unsuccessfully or successfully. This is the real question to be answered. What the study by Greenwood et al really describes is the analog of the shopper who buys something but, once at home unpacked, does not like the item and decides to return it. Except, of course, an egg retrieval cannot be returned!
The outcomes reported in this study, therefore, don’t tell us anything about what happens to women who freeze their eggs for the long term. We, indeed, still have no idea what outcomes patients can expect, and this is exactly why, as we in these pages have repeatedly emphasized, egg freezing should not be sold to the public as an established and predictable procedure but as a promising, though still experimental, approach to potentially extending a woman’s reproductive life.
This is a part of the June 2018 CHR VOICE.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
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