I had the chance to sit in on a press conference call held by the American Society for Reproductive Medicine this week, just ahead of their annual shindig (which will be in San Diego this year). The call's topic: the removal of the label “experimental” that they adhered years ago to a technique already in use.
Oocyte cryopreservation has only been 'experimental' in name. Reproductive treatment centers have been freezing women's eggs for years now. It's not as if we're talking about Frankenstein-level experimentation.
But in the name of safety and doing no harm, the ASRM approaches the recommendation of various procedures with conservative consideration. That's a good thing, especially here in the Wild West of Reproductive Medicine where just about anything goes, depending on the specialist.
In the press call, the doctors sounded about as old fogey as a doc can get. Still with the line “We can't say it's good for everyone just yet...” The opinion of the group's Practice Committee says even though the largest randomly controlled trial “comparing fresh vs. vitrified donor oocytes in 600 recipients revealed excellent clinical pregnancy rates, no different than in fresh cycles,” – the “data is reassuring” – they want more widespread clinic-specific data on safety and efficacy before universal egg banking can be recommended.
Their big hangup on not offering egg-freezing to young women as a kind of fertility insurance is based, they say, on balancing (a) the inherent dangers of any kind of medical procedure, and (b) the fact that only a small percentage of young women will actually be infertile and need those frozen eggs later.
But when it comes to all things fertility, women have been taking huge risks – financially, physically, and emotionally – of all kinds for eons. Why? Because there is nothing that any woman can do that has more impact on her entire life than getting pregnant. (Now there's an opinion that I could get hammered on, but I'll stand firm.) So we (women) already do crazy things, like take daily pills that haven't truly stood the test of time and rigorous scientific investigation just to avoid pregnancy, or hitch our wagons to myriad wrong men because our ovaries are commanding us to procreate. The list of wacky pregnancy-related behavior – as women can attest – goes on and on. Trust us: We know how big a deal it is to get pregnant.
So in my opinion (here we go again), worrying about a young woman's ability to make an informed choice about her reproductive capacity and future is, well, patriarchal and archaic.
I, too, think that the fertility industry has had a hand in steering perfectly fertile people into costly treatment. But some members of the same industry have been trying their damnedest to bring home the message that early detection equals early treatment equals greater take-home baby success. The ASRM got hit hard years ago by some women's groups when their public service program dared tell us that one of the keys to fertility was to stop putting off having babies so far into our future that our eggs were useless.
Unfortunately, except for at the church my son attends (where children are offered comprehensive sexuality and relationship classes that start in Kindergarten and are taught by parents), I have yet to see the American culture pick up the ball on the details of conception education, since most people are sadly mired in the fearful mindset that If You Teach It, They Will Do It.
There was a time when the idea of women having complete control over their reproductive ability was blasphemy. Later on, it wasn't so much heretical as it was just unbelievable. After all, what would women do if they weren't having and raising babies? (As I write this, I keep having visions of big, white men patting little pig-tailed girls on their wide-eyed heads.)
As far as I'm concerned, the unleashing of egg freezing as an option, now declared NOT experimental and actually quite successful, could very well be similar in terms of societal bend as was the birth control pill. Do I envision a Gattaca-like world in the future? No. But then could any of our ancestors imagine our world today?
There's a time for concern and worry and protecting the ignorant. Then there's a time to let go and have a little faith – in nature, in deities, in common sense, in whatever gets you through the night.
I say let 'er rip.