Social Freezing: Pressing Pause on Fertility

Abstract

Increasing numbers of women are undergoing oocyte or tissue cryopreservation for medical or social reasons to increase their chances of having genetic children. Social egg freezing (SEF) allows women to preserve their fertility in anticipation of age-related fertility decline and ineffective fertility treatments at older ages. The purpose of this study was to summarize recent findings focusing on the challenges of elective egg freezing. We performed a systematic literature review on social egg freezing published during the last ten years. From the systematically screened literature, we identified and analyzed five main topics of interest during the last decade: (a) different fertility preservation techniques, (b) safety of freezing, (c) usage rate of frozen oocytes, (d) ethical considerations, and (e) cost-effectiveness of SEF. Fertility can be preserved for non-medical reasons through oocyte, embryos, or ovarian tissue cryopreservation, with oocyte vitrification being a new and optimal approach. Elective oocyte cryopreservation is better accepted, supports social gender equality, and enhances women's reproductive autonomy. Despite controversies, planned oocyte cryopreservation appears as a chosen strategy against age-related infertility and may allow women to feel that they are more socially, psychologically, and financially stable before motherhood.

Keywords: age-related infertility; delayed childbearing; elective egg freezing; fertility preservation; oocyte cryopreservation; oocyte vitrification; social egg freezing.

Figure 1

Elective oocytes cryopreservation: worldwide map (data provided by International Federation of Fertility Societies’ Surveillance [11], created with Mapchart.net).

Figure 2

A systematic search for the keywords “social freezing (oocytes)” on the PubMed^® database (all-time topic) retrieved 124 results (30 reviews and meta-analysis), filtered to 54 papers refined to Medline and 25 refined to “human” since the first clinical report in 1983 [12], one systematic review [13], with three papers published during the last year.

Figure 3

Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) diagram describing our systematic search and study selection process (RCT, randomized clinical trial; CT, clinical trial).

Figure 4

Results retrieved for on-topic search keywords “embryo” AND” cryopreservation” AND “social” AND “human” in the Web of Science^® Core Collection and Medline^® databases. The systematic search retrieved 303 results (all-time) with 90 published papers during the last ten years in all databases, from which we excluded books and others; 56 results were retrieved after data filtering, of which 23 were reviews, and 31 were articles. We identified four main papers focused on the EC topic.

Figure 5

The OMICS technologies used for oocytes assessment.