Vardit Ravitsky is associate professor and Marie-Eve Lemoine is a PhD candidate in the bioethics programs at the University of Montreal.
The recent announcements from Facebook and Apple that they plan to cover the cost of egg freezing for female employees has been causing quite a stir in the media. What's all the fuss about? Isn't it a wonderful thing to give women this option, allowing them more freedom to focus on their careers at the most competitive stage in life? Doesn't it allow them to better sync social expectations with biological constraints? And doesn't it level the notoriously uneven playing field for women? After all, men were always able to become fathers in their 40s and 50s, so why shouldn't we?
While more control over reproduction has been a long-standing goal for feminists, this particular move is extremely problematic. First, although the technique for freezing eggs has indeed improved significantly, the procedure for extracting them remains medically risky. It requires hormone shots, which are painful and burdensome, as well as anesthetic. The use of these stored eggs later requires in vitro fertilization, which entails its own medical risks and remains uncovered by most insurance plans.
More importantly, women are pushed to take these risks and subject themselves to these burdens with very low chances for the desired outcome. For women under 38, the chance that one frozen egg will lead to the birth of a baby is estimated by professionals at 2 to 12 per cent; for older women, the odds are even lower. So for most, egg freezing represents false hope. It will not actually allow them to achieve motherhood later in life.
It turns out that most women don't know that. Studies have shown that about 60 per cent of women are unaware that reproductive technology is less effective at 40 than at 30. Many buy the illusion that money is the only barrier to achieving delayed motherhood and that IVF can probably resolve infertility in the late 30s or beyond. But this is far from the biological reality.
While covering the cost of egg freezing may be packaged as enhancing women's reproductive autonomy, it may actually further corner them, by sending an even stronger social message that choosing motherhood at a younger age is inappropriate. Coverage can be seen as a double-edged sword – it provides access to a pricey technology, but it diminishes the legitimacy of choosing motherhood earlier in life, a choice that is biologically safer.
What needs to be done? First, women should be informed about the biological realities so that their choices are meaningful. But infertility prevention campaigns addressing women's age directly have been met with strong opposition from feminists. These messages have been perceived as pushing women back into traditional roles by encouraging motherhood at an earlier age.
We argue that reproductive freedom must be based on fact, not fiction. Fertility decreases with age and no magical solutions are in sight – not even egg freezing. So women face tough decisions, but they should face them well informed.
Second, we need to stop framing this as the problem of individual women that can be solved by subjecting them to high-tech interventions. Rather, we need to acknowledge that this is a social issue requiring social solutions. Yes, the great achievements of feminism allow women to be more present than ever in the work force, but as a side effect, they have created another problem. Delayed motherhood is a growing trend in all Western countries. Women are having their first child later and later in life, and their choices are shaped by social pressures to first establish their careers and achieve financial and relationship stability.
This social trend is costing women the chance to become biological mothers, or pushing them to take on the medical risks involved in assisted reproduction. We've created a social problem while expecting women to pay the price individually. But the key to reproductive freedom is not high-tech medical interventions that put women at risk while giving many false hope – it's in public and corporate policies that ensure family-friendly work environments, generous parental leaves for both men and women, access to childcare services, flexible hours and the possibility of working from home.
Beyond policy, what we really need is cultural change. We need to level the playing field by changing workplace culture to encourage parenthood at an age that's biologically attainable and safe for both men and women. And we need to endorse a culture that supports men and women when they decide to take parental leaves or slow down their career to build their families.
This week, The Onion published a satirical piece announcing that companies now offer to "freeze female employees' newborn children" until the employees are "ready for child-rearing." This humoristic take hides a sad truth: By endorsing egg freezing, companies are further cornering women, who are already under tremendous social pressure. Instead, let's instead endorse social and cultural change that truly promotes choice.