This is an interesting story. But our three reviewers thought it fell short in evaluating the quality of the evidence, in not providing a full description of potential harms, and in framing the issue in a way that smacks of disease-mongering.
Many women face worries about infertility. They need accurate and objective descriptions of the possible treatments. The lack of crucial long-term evidence of safety in this case seems crucial to any discussion about these emotional issues.
The story includes the high price tag for freezing eggs and the possibility that a family may need more than a single “freezing.” The story quotes about $40,000 for a safe number of eggs in storage and seems to imply that price includes the in- vitro fertilization required. But we wish they had done a better itemizing more ofl the costs of a high-tech pregnancy, including the possible higher risk of twins and pre-term delivery.
Yes. The story is generous with describing the potential benefits.
There are risks of pre-term pregnancy because of in-vitro fertilization. There are risks to babies from being one of multiples – such as
twins or triplets. These risks are just as important to discuss and weigh as the risks that the story puts forward as reason for this high-tech solution – having “old” eggs as a woman of 40 years. Yet the story does not discuss these.
The story fails to give us the context for judging the egg-freezing technique. It correctly calls the procedure “experimental” but only quotes an expert chosen from the Society for Assisted Reproductive Technology. He points out how few procedures have been done, but he calls the technology “close” to proven effective. Such a long feature had plenty of reporting time – and could have included a much more skeptical voice and better discussion of evidence.
Our medical editor who reviewed this story felt there were elements of disease-mongering in the framing of the story. She wrote: “I am not sure that waiting until you are out of the window for a specific biologic function is a disease. The story framing almost makes a disease out of a life choice in this particular example of women who want to risk waiting until they might not be expected to have normal fecundability/fertility and higher risk.”
Is “Nudging Young Women To Think About Fertility” akin to creating a new disease that’s not really a disease?
The story did a good job with asking a variety of potential patients for their opinions. It did not do quite so well in providing a diversity of medical experts.
No head to head data are provided. The story doesn’t say how different outcomes are for embryo vs. oocyte freezing, and could have included more information (less dramatically) about natural changes in fecundability and pregnancy outcomes with age. ASRM has identified the “best practice” as encouraging women to consider pregnancy whenever possible within the optimal timeframe rather for hoping for a technology fix.
The story barely meets this requirement. It describes the procedure as something gaining acceptance, but still “experimental.” What isn’t emphasized is that this is not offered by many centers that can freeze ooccytes and far from all infertility programs have successful protocols in place.
The story does a decent job of explaining that the technique is experimental.
The story obviously required in-person reporting of a group meeting of women worried about fertility. However, it could have been improved with phone calls to a wider diversity of medical researchers.