How do I know if egg freezing is for me?

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Egg freezing is on my mind. At 36, I'm at an age when many of my friends have had babies, and the few who haven't are weighing up their options. If they plan on having children at some point in the future, should they be freezing their eggs now?

It is an incredibly personal decision, and it's not always an easy one. While egg freezing is often sold as a fertility insurance policy-eggsurance"-we're still not entirely sure how successful the procedure is likely to be for any individual person, or how success rates vary by age.

We do know that it is expensive-we're talking potentially tens of thousands of dollars for hormonal treatments, egg collection procedures, and years of cryopreservation. And we know that it's not without risks.

Around 16% of women who freeze their eggs end up regretting their decision. So researchers are now working on tools to help people considering egg freezing make the right decision for them.

People choose to freeze their eggs for all sorts of reasons. But the women who do so for social reasons tend to fall into one of two groups, says Zeynep Gurtin, a sociologist of women's health at University College London.

The first group is made up of women in their 20s or early 30s. These women know they want to have children someday-perhaps in around five years' time-but they're not ready yet. They might be studying or training for their career, or traveling, says Gurtin. They're [egg freezing] as a proactive measure," she says.

The second group includes women in their late 30s or 40s, who want to have children but aren't in a position to do so, usually because they aren't in a relationship with someone who feels ready. Many of those women say they had hoped to be mothers by now," says Gurtin. They know their fertility window is closing, and they want to give themselves the best chance of pregnancy in the near future, she says.

When it comes to making a decision on egg freezing, Gurtin thinks it's vital that people be fully informed on four issues: the success rates, the risks, the side effects, and the costs.

Finding this information is not always straightforward, not least because we don't fully know what the success rates are. While many women have had their eggs frozen, only a fraction have returned to use them, says Gurtin. That's partly because the technology is still relatively new-egg freezing only lost its experimental" label around 10 years ago. People who froze their eggs five years ago might still not be ready for pregnancy, or might have conceived without them.

The data we do have suggests that around 21% of the women who freeze their eggs end up using those eggs to become mothers. That figure includes women who have their eggs frozen for medical reasons-perhaps as a precaution before undergoing chemotherapy that could damage healthy eggs, for example. When you look at women who choose to have their eggs frozen for social rather than medical reasons, the figure shrinks to 17%.

The average banked egg has around a 5.9% chance of becoming a baby, according to a study. So why do some women-including 6% of the volunteers in that study-think the chance of having a baby after freezing eggs is up to 100%?

Part of the problem is misinformation. Egg freezing is a big business, and fertility clinics have been found to fudge the numbers somewhat when it comes to describing the success rates of their procedures. In a study published last year, Gurtin and her colleague Emily Tiemann found that clinic websites tend to be persuasive, rather than informative, in their language.

Fertility clinics tend to emphasize the benefits of egg freezing while minimizing the risks and the costs, the pair found. The clinics are, after all, trying to make a sale. These findings echo those of similar studies performed in the US and Australia.

So I was pleased to hear that researchers are working on a more impartial approach. Michelle Peate at the University of Melbourne and her colleagues have developed a decision aid for people who are considering egg freezing.

The online tool works by first providing the facts on egg freezing-how it works, what we know about outcomes and risks, how it might make people feel both during the process and afterwards. The hormone treatments that help people release a glut of eggs for collection can cause mood swings, bloating, and headaches, for example. And they come with a small risk of ovarian hyperstimulation syndrome, a potentially serious complication that can cause difficulty breathing and, rarely, blood clots in the lungs and legs.

It then asks users to allocate a level of importance to potential benefits and drawbacks. One benefit, for example, is feeling prepared for the future. And one drawback is that egg freezing does not guarantee a baby.

These answers will be used to generate an overall score that can be placed along a scale-is the person leaning toward egg freezing or against it? Users will also be offered guidance on where to find more information, such as from a GP, fertility specialist, or counselor.

The tool is currently being trialed in a group of research volunteers and is not yet widely available. But I'm hoping it represents a move toward more transparency and openness about the real costs and benefits of egg freezing. Yes, it is a remarkable technology that can help people become parents. But it might not be the best option for everyone.

Read more from Tech Review's archive

Anna Louie Sussman had her eggs frozen in Italy and Spain because services in New York were too expensive. Luckily, there are specialized couriers ready to take frozen sex cells on international journeys, she wrote.

Michele Harrison was 41 when she froze 21 of her eggs. By the time she wanted to use them, two years later, only one was viable. Although she did have a baby, her case demonstrates that egg freezing is no guarantee of parenthood, wrote Bonnie Rochman.

What happens if someone dies with eggs in storage? Frozen eggs and sperm can still be used to create new life, but it's tricky to work out who can make the decision, as I wrote in a previous edition of The Checkup.

Meanwhile, the race is on to create lab-made eggs and sperm. These cells, which might be made from a person's blood or skin cells, could potentially solve a lot of fertility problems-should they ever prove safe, as I wrote in a feature for last year's magazine issue on gender.

Researchers are also working on ways to mature eggs from transgender men in the lab, which could allow them to store and use their eggs without having to pause gender-affirming medical care or go through other potentially distressing procedures, as I wrote last year.

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