Most Elective Egg Freezers’ Will Need to Decide What to Do With Their Unused Eggs.

Post by Lucy Caughey

Elective egg freezing is an option women choose to preserve their fertility to have a genetically linked child in the future, for reasons such as not having met a suitable partner to have a child with. Elective egg freezing became available in Australian in December 2012, when the procedure was no longer labelled experimental. Since then egg freezing has grown exponentially and in 2020 there were 2900 freeze all egg cycles in Australia and New Zealand. On average women freeze approximately 9 eggs per cycle depending on their age (9 eggs if they are under 35, 9 eggs if they are 35-39, and 6 eggs if they are aged 40 plus). 

Therefore, many women are choosing to freeze their eggs, however research tells us most women (68% to 94%) do not return to use their eggs, resulting in an abundant but unquantified number of eggs in storage. Women do not return to use their eggs for many reasons such as, conceiving naturally, reaching an upper age-limit of willingness to become mothers, and not wanting to be a single parent (having not met a suitable partner and choosing not to use donor sperm). Despite the low usage rates of stored eggs, the majority of women do not regret freezing their eggs, because a principal reason of women freezing their eggs is having no regrets or as much choice as possible for their parenting future. This is a concept many people, not faced with this situation, seem to have difficulty grasping, as they view the only successful outcome of freezing eggs is to have a child. However, women who freeze their eggs, like women who naturally conceive, prefer to bring a child into the world in an ideal situation, financially, emotionally and providing enough time and support for a child. 

Therefore, we now have many eggs in storage in Australia and because most jurisdictions of Australia have a 10-year storage limit for gametes, most elective egg freezers now and in the future will have to decide what to do with their surplus frozen eggs. This is called a disposition decision. In Australia women can choose to  

1. Donate to a family member or friend.
2. Donate to known others, who were previously unknown, but met specifically for egg donation purposes (e.g., people advertising for an egg donor [often online] or introduced through friends or family).
3. Donate to an unknown people - egg bank or people on an egg donor waiting list at a fertility clinic and whom women do not meet before donating your egg.
4. Donate to research (e.g., research could involve thawing and freezing eggs or training techniques for embryologists however by law this would not involve creating a life from the egg).
5. Discard  - involves the clinic thawing and disposing of unused eggs.
6. Reclaim - involves the fertility clinic releasing the thawed eggs to women for personal reasons such as, to have a closure ceremony with the eggs, or because it reassures some women to know exactly what has happed to their unused eggs. These eggs are no longer viable for family formation due to the thawing process.

 
Oocyte disposition decision outcomes and the factors influencing the decision have been explored for the first time in the study Elective egg freezers' disposition decisions: a qualitative study.
 
This study found that the disposition decisions are dynamic and often women’s preferences at the beginning of the process of freezing their eggs is not their preference at the time they have to make their final decision depending on a number of factors. One of these factors was whether women achieve motherhood or not. When women first achieve motherhood they are in an emotional state of happiness and want to share the joy of motherhood, therefore they are open to donating their eggs to others. The wish of wanting to share the joy of motherhood are driven by feelings of empathy for others who have faced similar fertility challenges, reciprocity for those women who have received donor sperm and now feel they would also like to reciprocate by donating to others and altruism , the feeling of just wanting to give to others in need. However, when these women are actually faced with making their final decision their focus changes to the child. The child being the child or children they are raising and the impacts on that child. For instance, the concern their child may have too many half-siblings so the child feels overwhelmed or has too many half-siblings to have real relationships with. The potential egg donors are also concerned about the child resulting from their egg donation, will they have family identity issues or not feel they fit in to their family. These are serious concerns women have. 

For those women who did not achieve motherhood, they are in a grieving process and feel isolated and misunderstood. They feel misunderstood as their loss is not tangible like a miscarriage but conceptual, the loss of a dream of being a mother. These women are unlikely to be able to consider donating to others as their dream has not come true, so they move on to deciding whether to donate their eggs to research, to discard them or to reclaim them. Reclaiming their eggs to take them home to have a closure ceremony helps some women in their grieving process.