Documentary Review: Freezing Fertility

'Freezing Fertility' is a documentary by the Dutch broadcaster VPRO, which delves into the opinions and policies on egg freezing around the world. Currently available on YouTube, the short movie not only documents facts, but also shares the views and the experience of individuals undergoing the egg freezing procedure itself – women who are not planning to get pregnant now but are investing in their future fertility. It also features the entrepreneurs who have seen a market opportunity opening.

Martin Varsavsky, an entrepreneur, experienced fertility problems himself but also saw a potential investment opportunity in this field. He pioneered egg freezing, which is seen as slowing down the biological clock as it alleviates the pressure of women to have children early in their lives. Egg freezing does not guarantee pregnancy in the future, however, it does give the opportunity for establishing the so called 'ova banks' which store eggs similarly to sperm banks.

Egg banks also give the opportunity for women to donate their eggs. Dr Enrique Criado, CEO at Ovobank, had the clever idea to open the first European egg bank in 2012 in Marbella, Spain, where egg donation is permitted and great genotypic diversity is an advantage. Spain quickly developed into the fertility paradise of Europe, and Dr Criado's clinic now ships eggs to different parts of the world, matching client's needs to donor's phenotypic features.

The process of egg freezing is not as straightforward as I thought. As Dr Criado briefly explained, ovaries normally produce one mature egg cell per month. To increase this number, a hormone called follicle stimulating hormone is injected at higher than physiological levels multiple times until ovarian follicles have grown and eggs are mature enough to be collected by doctors, and this process comes with pain and risks.

As a woman in her late 20s, I asked myself the question if I should freeze my eggs, pressured from family to have kids saying that now is the time, and that within a few years it will be too late. The biological clock is ticking and egg freezing gives you the option to buy yourself time. I couldn't help myself from Googling the price of egg freezing in the UK. It turns out freezing the wish to have children is expensive. If I can't afford egg freezing at this stage of my life, does it mean I will never get pregnant?

The answer is that most women won't use their frozen eggs and will conceive naturally, according to the fertility doctor Stuart Lavery, who opened a private egg freezing clinic in the UK. He pointed out the advantages of having your eggs frozen, which gives power and extra choice for women about their reproductive life. However, he is concerned about the commercialisation aspect of egg freezing – advertising is often based on fear and promising fertility in the future.

I immediately wondered if the concept of egg freezing gives a false hope to prospective parents. It can be seen as the one solution to all fertility problems as it is sometimes advertised. Do clinicians offering egg freezing have patients' interest at heart or only see it as a money-making business?

Dr Lucy van der Wiel, the author of the book 'Freezing Fertility', flags up another issue. With egg freezing women become more dependent on technologies and doctors. The procedure involves both medical and financial risks. The marketing techniques create a sense of urgency and concern. In the USA young women are urged to 'freeze your fertility at your peak, which is in your 20s'.

On the other hand, the first not-for-profit fertility clinic in the UK is being set up, which will provide services such as egg freezing and IVF treatment. A representative from the charity behind the clinic (Dr Marta Jansà-Pérez, an embryologist) believes that the financial burden associated with fertility treatment is a huge challenge for parents and the profit private clinics are making is concerning.

But what if egg freezing is not the only answer to fertility freezing? The IVF specialist Dr Simon Fishel suggests an alternative approach, whereby ovarian tissue fragments with egg cells are being frozen and then transplanted into the patient when the right time comes.

The new procedure is becoming popular in Brazil where it is marketed as an anti-ageing treatment delaying menopause (oestrogen from the transplanted ovarian fragments is secreted in the circulation and thus mitigates menopausal symptoms).

The documentary also touched upon on the discussion of fertility being not only a biological issue but also a social and political one. Overpopulation used to be a concern, however, fertility issues and lower birth rates have changed governmental views on family policy and population shrinkage. Governments now interfere to increase birth rates by scrapping IVF fees or providing egg freezing for free. Martin Varsavsky is surprised that fertility is a not a governmental priority in every country. In fact, it is intriguing that big corporations like Amazon, Google, Microsoft, and Apple have realised the potential of egg freezing and cover the cost for it for their employees.

Overall, the documentary elegantly combines the science and policy behind egg freezing with the personal stories of women who have or are undergoing the treatment. From a personal point of view, it made me think if egg freezing is a good investment to be considered – emotionally, physically, financially – and whether the cost is worth it given that fertility success is not guaranteed. Freezing your eggs provides one layer of protection for women who choose to have kids in the future, but there is a long way to go before it is an affordable and accessible service.