Big companies, such as Apple and Facebook, have recently announced that their female employees would be offered free “egg freezing.” The idea behind the process of egg freezing, or oocyte cryopreservation, is that a woman who is not ready to have children may freeze her eggs and later re-implant them in her uterus via an in vitro-fertilization process when she is ready for children. Freezing eggs puts a halt on their biological activity and, literally, ‘freezes them in time.’
A woman’s eggs stay with her from pre-birth until menopause, so just like we get older, so do our eggs. Our eggs don’t gray and wrinkle, but they certainly age; and the aging process may cause serious issues in the chromosomes of the eggs. You have probably heard that the risk for Down syndrome (a condition caused by having an extra chromosome 21) is increased in older moms. That is because their older eggs are more prone to having errors in meiosis, the process of chromosome division.
The cost of egg freezing nears $10,000 for every round, plus $500 or more annually for storage. It seems like these large companies are finding that losing their valuable employees to maternity leave and family time is detrimental, and that women should feel encouraged to plan out the lives they want if they want to get set on their careers first. Not surprisingly, there has been a lot of buzz around these announcements from Apple and Facebook, ranging from full support to skepticism of using egg freezing for non-medical purposes (one particular piece I enjoyed reading was an op-ed in the New York Times from a few weeks ago).
While career building may be a valid motive to freeze eggs, there are other reasons a woman may consider this process. I have been asked whether egg freezing would be a good option from some women who have not yet met the man with whom they want to build a family, in case they do not get a chance to start their family until they are older. There are also medical reasons a woman may decide to freeze her eggs. For example, women who undergo cancer treatment which may be toxic to their eggs may decide to preserve their eggs before they begin their therapy. In addition, women facing certain genetic conditions that lead to premature failure of ovarian function may also choose to freeze their eggs–some examples include those with Turner syndrome or fragile X premutation carriers. In addition, women who are BRCA carriers may opt to remove their ovaries to reduce their risk of developing breast and ovarian cancer, but may not be ready to have children. These women could freeze their eggs for a later pregnancy.
Of course I also need to mention that older women who are having babies (whether or not the eggs have been cryopreserved) tend to have older spouses. Because of the large number of cell divisions in spermatogenesis, the process of sperm development, the mutation rate in certain genes is higher in men than women, and increases with age. So we are finding that certain genetic diseases are more common in babies with older dads as well. Such diseases include certain forms of dwarfism, some types of craniofacial disorders, and some more complex diseases such as autism, schizophrenia and cancers.
The American Society for Reproductive Medicine does not recommend the use of egg freezing for purposes of delaying childbearing, since data on safety, the efficacy, and the cost-effectiveness, and emotional risks are insufficient. They say that “marketing this technology for the purpose of deferring childbearing may give women false hope and encourage women to delay childbearing.” Nevertheless, egg freezing for career reasons is a reality. But should it be?
My personal and professional worlds recently collided when I sat with my 9th grade son, Brian, to review for his upcoming Biology exam. The subject was the reproductive system, the stages of pregnancy, and fertility. The chapter ended with infertility issues and in-vitro fertilization (IVF), which allowed me to take his Biology unit one step further and explain to him the amazing technology known as “pre-implantation genetic diagnosis (PGD),” a topic on which my Program for Jewish Genetic Health colleagues frequently educate the Jewish community. At first, probably like most teenagers, he didn’t want to learn any more than what he HAD to know for his exam. But I was able to pique his interest by giving him a real life example of the miracle of PGD.
When Brian was 12 years old, one of his Little League teammates, Cody, had a younger brother named Jack who had Familial Dysautonomia (FD), one of the Jewish genetic diseases. Jack was like the team mascot, always there to cheer on Cody and run around the bases after many games. Cody also had two, twin toddler siblings often running around on the sidelines. While Brian knew that something wasn’t quite right with Jack, he was unaware that a modern day technology – PGD – enabled Cody’s mom to subsequently give birth to healthy twins.
So while reviewing infertility and IVF – and harking back to his previous Genetics unit – I was able to bring his Biology unit to life. I first showed him my MyJewishGeneticHealth.com “work” video of Cody’s mom, talking about how the miracle of PGD enabled her to give birth to two healthy twins and know they would not be born with FD. I then signed in to our full MyJewishGeneticHealth.com lesson to show him real video of how PGD is performed…plucking cells from 3-day old harvested embryos and testing them for disease, before implanting the healthy embryos into the womb. It was a real “Whoa, that’s cool!” moment for him, to see video of this technology at work, and to understand the peace of mind it gave to Cody’s mom and dad when they gave birth to their twins.
It’s often a challenge to make your child understand why the material they are studying in class is worthwhile. By showing Brian how modern day science can truly make an impact and prevent heartache in people’s lives, I was able to interest him in learning more than he needed to know for his exam.
If you haven’t yet heard, last week we launched our new GeneSights lesson about Preimplantation Genetic Diagnosis (PGD). Well, I should say, it’s not a GeneSights lesson anymore. After listening to the feedback we’ve been getting, we decided to change the name of our online education series to one that can be more easily recognized and understood. Welcome to MyJewishGeneticHealth.com!
Our new lesson on PGD is a very exciting one, and one which we hope will be a valuable resource to the community. Our speaker, Dr. Harry Lieman, is the Director of the Division of Reproductive Endocrinology and Infertility at the Albert Einstein College of Medicine, as well as the Director of Montefiore’s Institute for Reproductive Medicine and Health, and the Liaison for Fertility and Reproductive Technologies at the PJGH.
Our PSA, Robin’s story, can be seen here. Speaking with Robin and understanding her story was pivotal in understanding why we needed to develop a lesson about PGD.
As was true for GeneSights, signing up for MyJewishGeneticHealth.com is free, and obviously does not replace regular medical care or visits with your doctor. We hope this lesson will help inform you and your loved ones about the process and utility of PGD!
Come learn with us!