NYTimes column on mismanaged egg freezing highlights the industry’s problems

Norbert Gleicher, MD, CHR’s Medical Director and Chief Scientist, responds to a Modern Love column in which the author outlines the broken promise of “egg freezing as reproductive insurance.”

Reading Ruthie Ackerman’s recent article in The New York Times on her egg-freezing experience, two thoughts come immediately to mind:

  1. First, how difficult it can be for women to plan their reproductive future, even if they are self-aware, educated and have foresight.
  2. And, second, how totally inadequate our profession’s handling of fertility preservation services for women is in almost every aspect.

Cryopreservation of eggs (oocytes) has become big business, not only because it has become “an industry to invest in,” but mostly because it has become an industry rather than a medical service, which it should be.

Putting the personal aspects of the author’s rather heart-breaking story aside, if one just concentrates on the medical management she received, it well demonstrates all that is wrong with the rapidly growing egg-freezing industry.

It is very apparent that she did not receive appropriate informed consent, as under medial ethical guidelines every patient must receive before being exposed to a medical procedure. The writer points this out very well, when stating that she “did not understand that per thawed egg, pregnancy chances were only 2-4%.”

Her totally inadequate informed consent is, however, also indirectly made obvious in that she underwent only one egg retrieval that resulted in only 14 frozen eggs. Anybody could have – should have – told her as part of her informed consent that, should she ever have to resort to her frozen eggs, this was not a large enough number of eggs for a reasonable chance of even a single baby. In a way, an analog to the medical mismanagement in this case would be to give a patient antibiotics for only one day, when everybody knows that five days are required. What is the purpose?

There is much more to say about Ackerman’s piece in The New York Times, and we will not mince words in a future issue of The VOICE, CHR’s monthly newsletter, because what is happening in the egg freezing industry is starting to stink to heavens.

In her case, 14 eggs resulted in only 3 surviving embryos, a highly disappointing outcome but not unusual in our experience, when human egg freezing becomes an “industry” rather than a carefully individualized clinical service. We see patients with similar stories all the time. Until the public is equipped to differentiate between medical care and commercial services, women, unfortunately, will continue having these experiences.

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned reproductive endocrinologist, 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.