We are witnessing a growing boom in women who want to preserve their fertility for the future. According to recent data, the percentage of women who freeze their eggs has grown 50% in five years.
This fact, in itself, would not be surprising, given the important, necessary and increasingly clear incorporation of women in the labor market and, therefore, the delay in their desire for motherhood.
However (and there is always a "but"), the news also echoes the opinion of the experts: In many cases, chronological age does not coincide with biological age. Or, to put it more clearly: women who freeze their eggs, for the most part, are far from being in the ideal biological age. The average age of these women is 35 years, the limit imposed by the majority of those dedicated to assisted reproduction in order to guarantee optimal results. An average of 35 years means that there are many women who want to preserve their fertility around 40 years, when the results are far from optimal.
Biologically, the decline of a woman's fertility begins before age 30. At 35, the ovum supply begins to descend manifestly, and from 40 years, the chances of gestation with own eggs does not exceed 20%. If we add to this that, in the best of cases, and speaking of young women, when the eggs are frozen, the survival of these is 90%, the fertilization rate is 80% and that of pregnancy is 60%. What is really the possibility of pregnancy in women over 35 who have frozen their eggs?
The Spanish Fertility Society (SEF), in its Fertility Preservation Group, published that the efficiency for thawed ovum in women over 37 years was 5%, advising to freeze a minimum of 8 ovules and commenting that: The term "preservation" suggests a certainty that goes beyond what we can really offer.
For all the above, I wonder if we professionals are adequately informing the female population that comes to preserve their fertility for the future. And if so, if these women are aware that, as the SEF says, there is no commitment to "preservation", but a conservation for a hypothetical future motherhood. Women should be advised in a realistic way about the success rate and about the fact that oocyte preservation is not an insurance policy against age-related fertility decline.
Although social policies should work towards a framework that supports young families financially and structurally, egg freezing in this context could be seen as a technological solution for what is a biological and sociological problem. The technique allows the woman to choose autonomously when she wants to be a mother, but for this they must be fully informed of the possibilities of success and the problems that the delay of this maternity entails.
The doctor Rocío Núñez Calonge is an expert in Assisted Reproduction and Ethics
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