Podcast Review: Ideas – Egg freezing in an age of uncertainty

Alison Motluk has over a decade of journalism experience, with a special interest in reproductive technology, and publishes a weekly newsletter, HeyReprotech. Recently, her documentary, Egg Freezing in an Age of Uncertainty, was broadcast on CBC's Ideas.

The programme features four guests: Toronto-based lawyer Salima Fakirani, who speaks about her experiences with egg freezing, and academics Dr Lucy Van de Wiel, Professor Marcia Inhorn, and Dr Katie Hammond.

For just under an hour, the podcast combines lived experience, academic research, and critical commentary to discuss egg freezing, revealing how it is about 'navigating the uncertainty of life' (as Dr Van de Wiel succinctly puts it).

Egg freezing has hatched into a booming business since shedding its 'experimental' label in 2012. The lastest numbers from the UK's Human Fertilisation and Embryology Authority (HFEA) reveal that egg freezing procedures have more than doubled between 2019 and 2023. In the USA, the number of patients undergoing egg freezing increased by almost 300 percent between 2014 and 2021.

While so-called elective egg freezing – that is, egg freezing that is not motivated by medical issues – has been ongoing since the advent of this technology, Dr Van de Wiel explains how the trend crystallised (ironically) following the introduction of vitrification, which reduced the formation of damaging ice crystals on the eggs. Following this advent and increased efficacy and safety, the technology increasingly became marketed as 'fertility insurance', a primarily commercial and capitalistic endeavour. Egg freezing offered a sense of control.

Fakirani describes how egg freezing allowed her to overcome her 'failure' at fertility (as she was approaching 30 and in an insecure relationship) and make a decision that aligned with her sense of self, as a high achiever. Professor Inhorn picks up on this stereotypical egg freezer: drawing on her research, she discusses how egg freezing is a technological solution to the mating gap, allowing them to preserve their eggs – and dignity (see BioNews 1236).

However, this cryo-solution is imbued with controversy, as Dr Van de Wiel and Professor Inhorn describe, since it challenges 'natural' reproduction and traditional norms about motherhood, allowing women to delay childbearing.

As egg freezing has become safer and more effective, the technology was increasingly marketed as 'fertility insurance,' a primarily commercial and capitalistic endeavour – an often-repeated promise critiqued by Motluk and her guests.

The possibility of delayed childbearing was a boon to capitalism, laying the foundation for employers to offer fertility benefits (including egg freezing). However, as Dr Van de Wiel points out, companies are not offering these perks as a kindness but as a growth strategy, allowing them to diversify and retain their workforce. Looking at which employers offer this technology exposes the persistent reproductive inequity present, as those who benefit from such corporate-sponsored schemes (and consequently, whose reproductive choices are normalised) are also those who are more likely to afford this costly procedure.

While employers benefit financially from offering fertility benefits, these are dwarfed in comparison to the profits made by the fertility industry. Clinics cashed in on this hot technology, hosting 'egg freezing parties' to inform women of their options and engaged in aggressive marketing campaigns.

While fertility clinics market the procedure as empowerment and autonomy-enhancing, the reality is that it delivers probabilistic, not guaranteed, outcomes. Dr Hammond draws on her recently published exploration of consent processes surrounding egg freezing at Canadian fertility clinics, and discusses how clinics present success rates, and the potential for giving women false hope, querying whether those undergoing the procedure are actually providing informed consent.

I found the descriptor of egg freezing as a 'reproductive suspension bridge' much more apt, accurately capturing the risk, emotional strength, and requirement for heightened consent.

By drawing on academic work undertaken in the USA, UK, and Canada, plus Fakirani's experiences, the podcast offered an excellent overview of egg freezing. Drawing on recent and relevant research ensures listeners would leave with a balanced, researched, and thought-provoking outlook. I would highly recommend it for anyone who is looking for an apt summary of recent developments, as well as those wanting to learn about egg freezing more broadly.