Al Jazeera's Amanda Burrell is in her 40s, childless and single. She would like to have children one day and is weighing up the available options. Among them is oocyte cryopreservation or, as it is more commonly referred to, freezing her eggs. The process, which involves collecting and then preserving a woman's eggs with a view to thawing them for use in IVF at a later date, is growing in popularity. But it can also be expensive, painful and physically and emotionally taxing.

As Amanda weighs up the pros and cons of going ahead with the procedure, she also explores the medical, social and ethical issues surrounding it. 

Motherhood on Ice follows Amanda as she meets other women facing the possibility of a childless future, grapples with her own feelings about it and, ultimately, decides whether or not to freeze her eggs.

From the correspondent:

By Amanda Burrell

Two years ago, my mother gave me – her then 41-year-old daughter – a newspaper cutting about an obscure sounding process called oocyte preservation, which is more commonly known as egg freezing. Using a technique called vitrification, a woman's eggs are frozen very rapidly in order to preserve them in as pure a state as possible. They can then be stored for years at minus 196 degrees in liquid nitrogen with the view to potentially being thawed for use in in vitro fertilisation (IVF).

Having never been sure whether or not I wanted children, I was curious about the prospect this offered for women to preserve their fertility until such a time that they might.

My life was fulfilling, fascinating and fun – it still is – and I felt perfectly happy without children. But the article prompted me to do some fertility tests. They showed that everything was in order. While I didn’t discount the idea of egg freezing, neither did I make deciding whether or not to do it a priority. I was too busy settling into my life in Istanbul and my new job as manager of in house productions for Al Jazeera Turk. I was making friends, learning Turkish, taking belly dancing classes and generally keeping busy.

As 2013 turned into 2014, deciding whether or not to freeze my eggs was still on my 'to do' list. I made a conscious effort to make up my mind. After all, I was 42, so if I was going to do it, I’d have to do it quickly.

As I was to learn from the experts I consulted in Istanbul and London, 42 is pretty much ancient when it comes to child-bearing. Of course, I was aware that a woman's fertility declines with age but I had no idea that it took a nosedive after 37. At school, we were taught all about the reproductive system - and then told how not to use it. Thirty years on, and not only were my eggs running out, but the ones that were left were likely to be of poor quality. At 42, the chances of them being chromosomally abnormal were a massive 80 percent.

Still, encouraged by some test results which my consultant in Istanbul told me were good for a woman of my age, I explored the idea further.

I'm not alone in leaving it late to consider starting a family. In fact, I'm part of a growing trend. In Britain, where the average age for a woman to have her first child is now 30. Three times as many women are having children in their 40s,as in my mother’s generation. One in five women in Britain and the US are childless in comparison to one in 10 in my mother's generation. And for women born in the 1970s, like me, that could be as high as one in four.

The usual assumption, of course, is that childless women have focused on themselves and their professional aspirations rather than on starting a family. But many of the women I met during the making of this film challenge that stereotype. Jody Day had always wanted to be a mother. But she was unable to conceive with her husband and divorced when she was 37. By the time she reached 43, she still hadn't met a man with whom she wanted to settle down. Feeling devastated by this, she set up an internet support group to help other women come to terms with a childless future. The reasons she encountered for childlessness were many and various – not meeting a suitable partner in time, being with a partner who says they want children but for whom the time is never quite right, being unable to afford to have a child on their own, putting off having children while being unaware how quickly fertility declines after 35, failed attempts at IVF, being unable to afford IVF, realising too late that they wanted a family and on and on the list goes.

As I spoke to Jody and to other women, I felt reassured that I was not alone. But it worried me to learn that there are so many facing the possibility of childlessness or living with the pain of a childless future. And, for those who feel it, the grief of childlessness can be particularly difficult to deal with because it is largely invisible to the wider social community and rarely publicly acknowledged or discussed.

Dr Susanna Graham talks to Amanda Burrell about her PhD research exploring the experiences of single women becoming mothers through donor sperm

The fact that I might never have children was something I had to confront during the course of making this film. It wasn't easy to do on camera, with a potential audience of millions. But the need for an honest exploration of this subject, which might help other women in a similar situation, outweighed my fears about my own vulnerability. And the more women I spoke to on my journey, the more strongly I felt this.

It became clear to me that, while I am sure I could continue to live a happy life without children, I might feel a massive gap. But I also realised that I don’t want a child at any cost; it would have to be with the right partner in the right situation. No single motherhood or donor sperm for me, an option which is growing increasingly popular as more women decide to start a family alone.

For me, egg freezing was a way of being able to do something in my current situation. But I'm far from being the ideal candidate. It should really be done before a woman reaches 35 and her fertility starts to dip. I’d given myself until my 43rd birthday to reach a decision, and a number of consultants, upon learning my age, suggested that I should try to get pregnant naturally instead. But without a committed partner, that wasn’t an option.

So, after many sleepless nights and much pondering, I decided to go ahead and freeze. But given the potentially low rate of return, I didn’t feel that the roughly $9,500 cost quoted to me for one freezing cycle in the UK was worth it. But I was lucky. I happen to live a 90 minute flight away from Cyprus, where the cost of treatment is less than half of what it would be in the UK. I found a reputable clinic which offered me three cycles, should I need or want them, for the price of one. This, together with the fact that I had been told by my consultant in Istanbul that my ovaries looked like those of a 32 year old, were two of the main factors swaying me.

It would have been great if I had frozen my eggs when I was 32. But the technology wasn't available back then. It was only in 2012 that the American Society of Reproductive Medicine Freezing said that freezing a woman's eggs should no longer be considered experimental. Since then, growing numbers of women are choosing to take this route or, like the employees of Facebook, Apple and NASA being encouraged to consider it.

Having gone through the process of working out whether or not freezing was right for me, I am fully aware that it is a deeply personal issue that raises complex practical, emotional and psychological questions each woman must process for herself. It’s not something to be done en mass. Egg freezing isn't right for everyone, even if they can afford it. And its newness means that its success hasn't yet been fully proved. From the hormones you must take in order to prepare the ovaries for collection to the invasive and sometimes very painful procedure, the experience is intense and draining. And no one can be sure of the long-term effects on the woman or future child.

I underwent my first cycle of egg freezing during the making of the film. Unfortunately, only five mature eggs – those that can later be used for IVF – were collected. This means that I'll need to go through the process again as ten is the smallest number of eggs I would need in order to make a cycle of IVF worthwhile.

I hope I'll never have to use my frozen eggs and will be able to start a family naturally. Even if I don't, at least I'll know that I did all I could in the circumstances. As challenging as it has been to explore such a personal issue on camera, I'm grateful for the opportunity. In our busy, high-speed lives, it's all too easy to put off thinking about future motherhood. If there was one piece of advice I’d pass on to younger women after making this film, it would be to educate themselves about their fertility, and to really think about whether they might like to have a child in the future before they are 35, which is when fertility first takes a dip.

 

Source: Al Jazeera