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Ethical issues in egg freezing

Ruth Macklin bioethics
They only recently, fairly recently, has it been possible to freeze human eggs. There were some technical problems but those are largely overcome. And the question is, why would anyone want to freeze her eggs? Well, the traditional reasons have been largely those of women who would be for example planning to undergo chemotherapy where that the chemotherapy could do some damage to the eggs. So that is a risk related disease related reason for women who want to ensure that they can have eggs in the future. More recently however egg freezing has become a commercial enterprise and there’s advertising for egg freezing.
I saw one ad that showed a group of very, very happy women who were pleased to be able to freeze their eggs. Now why would women want to do that if they don’t have a reason like chemotherapy for doing it? Well, this is partly a demographic question, especially professional women and even other women delay child bearing, whether they currently have a partner or in many cases women don’t have a partner and they want to ensure their future fertility.
The problem is that as women get older, particularly over 30, but especially over 35, their fertility declines rapidly and they in addition not only does their fertility decline but there is a greater chance of having birth defects with older eggs, let’s call them. Therefore, women are being informed and in some cases induced or enticed by payments. Now I heard that some companies will offer women the possibility of egg freezing and this costs a lot of money to do it. For the companies, why would companies want to do this?
Well, it ensures a smoother transition for example if women are pregnant and especially if they have a maternity leave which people don’t get much in the United States but most enlightened countries do offer maternity leave, that disrupts the workplace and it makes it very difficult either to replace women or to have them come back. So this is in the interest of the companies to have women have the continuity actually of work and so women are being induced to freeze their eggs. Is there anything ethically wrong with it? Well, it is another example of the commercialisation of this kind of activity.
Some people are unalterably opposed to what they call commodification of women’s bodies, which simply means treating human bodies and body parts or body products such as eggs and sperm, treating them like commodities on the marketplace one might say like pork bellies. However, whether one is opposed the payment for this or not it does provide benefits or potential benefits to the women. There is not much evidence of how much this is needed but it is like an insurance policy, preserve your eggs by freezing them, even though it costs a lot of money, and you may be given an incentive of some sort from their employer.
So my own view is I don’t see anything intrinsically wrong with it although there may be many women who will choose to undergo it as a form of insurance. So the controversy over this really has to do largely with the payment and the increased commercialization of what should be thought of as a medical practice.

As we have seen, egg freezing is a fascinating and growing technology but there are still potential problems in terms of access, outcomes and expectations.

In this interview, bioethicist Ruth Macklin lays out what she believes are the key ethical challenges involved in the practice of social egg freezing.

First, Professor Macklin highlights the advertising that is sometimes used in the private sector. In these adverts, the real statistics can sometimes get lost. At worst, they can be deliberately obscured.

Professor Macklin then discusses the issue raised in the previous video, of some companies offering egg freezing as a ‘perk’ to their female employees. This is by some accounts an increasing trend, especially in large, multi-national technology companies.

One consequence from this might be that an expectation of delayed childbearing is created, and that other options, such as workplace childcare, will not be prioritised.

In addition, a female employee with frozen eggs might find it harder to leave the company, as she would then need to cover the costs of egg storage and IVF herself.

Going back to our ethics glossary in Step 1.2, both of these ethical concerns would be examples of potential harm that a woman might be subjected to.

To make the correct ethical decision, we would need to assess the balance of harms by weighing up the effect of offering the technology versus not offering it, and weigh up in each case what would be in the best interests of the person in question.

For discussion: What do you think? Do you think the advertising can be misleading when it comes to social egg freezing? And is it ethical for companies to offer to cover the costs of egg freezing to their female employees? Please give your reasons either way.

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