The night before her double mastectomy, Melinda (who asked us not to reveal her name) had six embryos removed from her uterus and placed in deep freeze. A diagnosis of breast cancer coupled with the gene mutation known as BRCA1 had rearranged the geography of her life, and she was only in her early 30s. Working quickly to preserve her fertility gave her “a sense of having control over the situation,” she said.
Cryogenic storage of embryos has been possible since 1986 and is often used in cases like Melinda’s, in which, due to illness, injury or elective sexual reassignment, a naturally occurring conception is unlikely. The multicelled embryo often has a better chance of surviving the freezing process than an egg, according to Dr. Jane Frederick of HRC Fertility Clinic in Newport Beach.
A second option
Julie (last name withheld) was happily married and unable to get pregnant. A devout Christian, she was uncertain about in vitro fertilization. “It felt like playing God,” she said.
Her pastor offered reassurance, telling her, “If you break your leg, you get it fixed.”
Julie went through two rounds of IVF, which involved several weeks of self-administered hormone injections followed by surgical egg removal and intra-cytoplasmic sperm injection fertilization, a process in which the sperm is placed directly into the egg. She and her husband wound up with five embryos, implanted two and became pregnant with their daughter. The remaining three embryos were frozen.
“At 28,” Julie said, “I thought it was God’s will that I didn’t have children. I thought that searching for answers and trying to make it work wasn’t OK. But now, I think God gives us science, and it’s there to help.”
“Education for women is paramount,” said Dr. Lawrence B. Werlin of Coastal Fertility Clinic in Irvine. “Once women have information about what’s going on with their eggs, their bodies, they can make decisions about what’s going on with their lives.”
Actress Jennifer Frappier’s boyfriend suddenly turned out to be “so not the person,” of her dreams. “I was turning 35 and my life was not where I thought it would be,” Frappier said. Friends were married and having children, while she was starting from scratch. She read everything about egg freezing she could find. She worried about the expense and about being “baby crazy,” but ultimately, she concluded, “If I don’t do this, I’ll be sad.”
The preservation boom
Frappier is not alone. The American Society for Reproductive Medicine removed the “experimental” label from egg freezing in 2012. The number of elective procedures has jumped from just under 500 in 2009 to nearly 4,000 in 2013.
Freezing eggs as fertility insurance has been quickly embraced by companies such as EggBanxx, whose slogan is “Smart women freeze.” It offers “Let’s Chill” parties in large cities, serving information, encouragement and cocktails. Facebook, Intel and Google now offer elective egg freezing as an employee benefit and, as of January, active-duty members of the military have qualified for egg and sperm preservation.
Coastal Fertility has seen an uptick in fertility preservation requests and in attendance at quarterly egg-freezing informational meetings. Women are born with all their eggs, Werlin said. “With age, the genetic material breaks down and becomes less viable.”
According to Frederick, eggs are most viable between ages 25 and 35. She recommends freezing up to 30 eggs.
“The egg is a very fragile single cell,” she said. “It’s mostly made of water. In order to preserve the cell, we use a rapid-freezing sequence known as vitrification.” With this process, Frederick said, about 90 percent of the eggs survive the thaw and about 25 percent result in a pregnancy.
A high price for future babies
Getting to deep freeze was the end of a long journey for Frappier. “I was solo at the fertility clinic,” she said. She decided to film the process in order to share her story with other women going through a similar experience. The ordeal of twice-daily hormone shots was difficult, but also empowering. “Once I gave myself the first shot, I felt so euphoric. It’s my dream; I’m going to assume the right to pursue it.”
The right to pursue the dream does not guarantee the funding for the pursuit, however. While insurance companies may cover fertility treatments, coverage for elective fertility preservation is nearly nonexistent. Frappier estimates that the whole thing cost nearly $14,000, plus $365 per year for egg storage. Clinics and companies such as EggBanxx offer financing options. She lauded Apple and Facebook for setting a new standard for employee benefits and hopes this will encourage women to lobby other companies to cover egg and embryo freezing.
Viability and other concerns
Money is not the only delicate subject in this discussion. Decisions must be made about the disposal of unused eggs and embryos and those that don’t survive the thaw.
Once Melinda made it through chemotherapy and recovered from her surgery, she and her husband tried to get pregnant naturally. Eventually, they turned to the embryos, only to find that three of the five weren’t viable. She describes how Bon Jovi’s “Livin’ on a Prayer” was playing in the procedure room when they were being implanted. “We started to laugh and cry at the same time. That song will never be the same for us,” she said.
The embryos didn’t survive.
For Julie and her husband, the outcome was different but equally emotional. “The embryos were babies to me,” she said. “It was very important that we used them.” Of their three remaining embryos, two were intact and able to be implanted. She was happy to have so few embryos because the idea of donating them to another couple – one outcome for unused embryos – was hard. “I prayed about it,” she said. “It would have felt weird to ship those kids all over the country, but I would have. Everyone will do what they will do. It’s so personal.”
About 2 percent of Frederick’s patients have donated embryos to other couples. She wishes it were more, but she doesn’t see the embryos as children. “The tissue in my lab is not viable until I put it back in someone’s uterus,” she said. “It’s a possibility, but not a life.”
For now, Frappier is holding on to what her mother refers to as “frozen grandbabies.” Raised without a father, she worries that being an African American single mother will make her “another statistic,” but she knows her story is different. Her documentary short, “Chill,” screened in June. “I originally thought it would end with a baby, but for now, it’s ending with my decision to be a mom. That’s me moving toward something, and it’s the movement that counts.”
Melinda, too, has continued her forward momentum. She now has two daughters. “I used donor eggs,” she said, “and donor milk. I outsourced my whole pregnancy. My world expanded because of the way I had my children. This is our story.”
