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Family Planning Should Include Egg Freezing, Says Fertility Doc

05/12/2017 08:24 EDT | Updated 05/16/2017 09:33 EDT

"Let’s remove the word infertility from our vocabulary and replace it with fertility."

For Dr. Sonya Kashyap, the medical director at Genesis Fertility, this notion isn't just good business — it's empowering.

The company is one of many across Canada providing IVF and egg freezing services, and Dr. Kashyap is adamant in her belief that knowing about these options will provide more choices for women.

"Contraception was made readily available in the '60s. Abortion made legal in the '70s. All of these things contributed to women being able to focus on a career. What they didn’t do was focus on was ‘how do we have that family,’" she points out.

fertilizing eggs

Women are born with a finite number of eggs, and as their bodies age, so too does the reproductive quality of those eggs. While lifestyle factors can make a difference — Dr. Kashyap notes smoking will accelerate the time to menopause by about two years, and health conditions like endometriosis, polycystic ovarian syndrome and certain STIs have an impact — the most important determinant is age.

"Professional women make choices that professional men aren’t faced with," Dr. Kashyap says. "When it comes to fertility, at the current moment, there is a gender gap. Our eggs are the age we are, whether we’re 25, or 35 or 40. But if we have a male partner, his sperm is only two months old."

At age 30, your fertility starts to decline slightly, but more steeply at age 35, and even more by 37, notes Dr. Kashyap. If you freeze your eggs before age 35, the prognosis for getting pregnant is better — there's an approximately 60 per cent chance of having a baby from those eggs.

"It’s not a guarantee, but it’s the best that we have," she says.

"Our eggs are the age we are, whether we’re 25, or 35 or 40. But if we have a male partner, his sperm is only two months old."

Canadian statistics from 2011 (the most recent on record) show a woman's average age for first childbirth is 28.5 years, the highest ever recorded. StatsCan attributed this rise to a variety of social influences, including less interest in religion, effectiveness of contraception and women's participation in the workforce.

In response to changes like these, companies like Apple and Facebook have publicly announced employee benefits that include IVF and egg freezing, as a way to encourage women to build their careers without necessarily having to worry about starting a family.

A 2015 article published in the Canadian Medical Association Journal seemingly written in response to Apple and Facebook's offer, however, emphasizes the potential risks of both "social" egg freezing and pregnancy at an advanced age.

newborn

The piece points out there is limited data with regards to the effects of ovarian stimulation and egg retrieval on younger women (vs. the older women for which the procedure is more common). As well, the side effects of ovarian stimulation are noted — fatigue, nausea, headaches, abdominal pain, breast tenderness and irritability, as well as the more rare "severe ovarian hyperstimulation syndrome," in which blood clots, shortness of breath, abdominal pain, dehydration and vomiting and even death are possible.

Then there's the risks associated with IVF itself, such as multiple pregnancies, high blood pressure, premature delivery, delivery via surgery and babies with a low birth weight.

The costs of egg freezing are also significant, because it's not a one-off price. Best Health reports the price of retrieving the eggs to be from $3,500 to $5,850, while fertility drugs are around $3,500, egg storage is about $1,000 for five years and the cost of IVF to implant the eggs about $3,000 to $4,000 a try.

Often people aren't thinking of freezing their eggs until it's almost too late.

Ontario and Quebec both have health care policies in place to cover IVF in various forms, according to Global News, but other provinces currently just cover testing for fertility, as well as surgeries to correct fallopian tube issues.

And while Dr. Kashyap readily admits egg freezing isn't the answer for everyone, she wants couples and families to at least have the education to make that choice. But often people aren't thinking of it until it's almost too late.

"We would love it if women would come to us before age 35, but most people don’t. It might be because they haven’t thought of it, because they aren't financially ready, or because they’ve only started to realize their biological clock is ticking.

"Until women experience reproductive freedom, gender equality at home and in the workplace is limited, unfortunately. I think education about family planning should centre as much around egg freezing as contraception. The fact is, there are advances in recent years that will afford us the opportunities and choices to have reproductive freedom, more than ever before. It's not perfect, but it's more than ever before."

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