Occasionally, and for various reasons, some women wish to postpone motherhood. The most common procedure used to achieve this is to freeze their eggs while young, generally before age 30. These are then thawed at a later stage when they wish to become mothers, and used in a reproductive process, generally in vitro fertilization (IVF).
The reasons for delaying motherhood are essentially medical or social. Egg freezing for medical reasons is due, in most cases, to treatments that the woman must undergo that can cause infertility. Her eggs are therefore frozen so that when her health recovers, they can be used in a reproductive process. There are two main social reasons:
1. the woman has not found a suitable partner with whom to have a child.
2. she wishes to delay motherhood so that a possible pregnancy does not interfere in the course of her professional career. It is the one known as “social freezing”.
Social freezing begins to acquired a notable public dimension when, in October 2015, two major companies based in Silicon Valley — Apple and Facebook — announced their intention to freeze the eggs of their female employees, according to them, “in order to attract and promote female talent”. (See HERE recent stories about this issue).
We cannot pause here to consider all the medical difficulties of social freezing, but merely to highlight some of them that affect both the mother and her child. These include complications that can accompany late motherhood and that might not have occurred if the woman had become pregnant earlier, as well as possible ovarian hyperstimulation syndrome secondary to oocyte stimulation. The latter, if moderate, causes fatigue, nausea, headache, abdominal pain, painful breasts or irritability only, but in 0.1% to 2% of cases, the consequences can be more serious.
The child born after social freezing may also have some medical problems, essentially prematurity and low birth weight.
It should be remembered that the use of assisted reproduction techniques like IVF in women who have no sterility problems, as in this case, means relinquishing a natural pregnancy and its unquestionable advantages (basically a higher probability of becoming pregnant and less risk for mother and child) over one achieved by IVF. It hardly seems reasonable to forego natural pregnancy for reasons that are not strictly medical. The possibilities of pregnancy could be significantly reduced, and any woman who decides to undergo social freezing should be made aware of this.
Accordingly, the British Fertility Society (BFS) and the Royal College of Obstetricians and Gynaecologists (RCOG) have stated that, while they approve egg freezing for medical reasons, they do not do so “as a way to delay childbearing as a lifestyle choice” (The Telegraph 7-09-2015). In the same sense, and in the same newspaper article, BFS chairman and RCOG spokesman, Adam Balen, says that encouraging social freezing is going too far because the technique does not guarantee a baby and also introduces objective risks for the woman because the ovarian stimulation is not risk-free.
Undoubtedly, though, it is the ethical issues that must be more carefully considered when proposing the use of social freezing. In our opinion, the main concern is that, although not explicit, it is implicitly objectifying the woman, by prompting her to make a decision that is masked with a good for her when, as already mentioned, this practice poses objective medical problems for the user, and also for her child.
According to Martinelli et al. (Croatian Medical Journal. 2015; 56: p. 387–391), “social egg freezing is a paradigmatic demonstration of how the medicalization of women’s bodies can be used to mask social and cultural anxieties about aging”.
However, we believe there is another ethical difficulty, derived from the fact that it is hard to guarantee the autonomy of the woman to make such a decision if she is not provided with adequate information of the risks and benefits entailed in social freezing, something that does not always occur.
Finally, another ethical concern that social freezing may raise is the possible social inequality between groups of women who work in economically powerful companies that can bear the costs of social freezing for their employees, versus those who work in companies that cannot do so. The question, therefore, arises of whether, in order to avoid social injustice, social freezing should be supported with public funds, which we believe is not right, given the myriad of medical problems that exist — some of the vital importance — that have to be treated with these funds. If this were the case, would it not be creating a problem of distributive justice?
To conclude, it should be remembered that the IVF that women who opt for egg freezing are compelled to use means obtaining several embryos from which some are selected for transfer while the rest are discarded or frozen, thus constituting a new, insurmountable ethical difficulty.
In view of the above, we believe that before proposing social freezing to any woman, this choice should be clarified with regard to the medical and ethical difficulties discussed here.