Considering the option of preserving your eggs? For women who are under the age of 40 and haven’t yet had children, it’s almost impossible to overlook the advertisements. Alliances have been formed between fertility centres and influencers, alongside women’s’ publications, and the social media feeds of young females, particularly on platforms like Instagram and TikTok, are brimming with individuals chronicling their experiences with egg preservation.
Preserving your eggs goes hand in hand with maintaining fertility to potentially enable you to conceive in the future via fertility treatments. Preservation of better quality eggs can be accomplished when done at an earlier age to be utilised when you’re older.
Previously, this procedure was only embarked upon by women with critical health diagnoses, but now private clinics are providing egg preservation as a voluntary procedure. Such clinics employ narratives like “self-care”, “controlling your own future”, and “providing your possible future offspring with the best chance” to attract those still unsure about their desire for children, or those who wish to have children but are currently not ready due to financial, professional or personal circumstances.
Though raising fertility awareness is commendable, the reality is that egg preservation isn’t cheap, it carries potential risks, and comes without any guaranteed outcome. So, here’s how to decipher the market.
Clinics specialising in fertility are like private healthcare providers, in that they’re free to determine their own costs. The price tags mostly shown are for a single egg-storage cycle and a serial charge for the continued storage of eggs, invoiced monthly via direct debit.
Having researched various mainstream Irish providers shows there’s quite a varied pricing structure, but it can be challenging to compare due to the potential differences in what exactly is included. For instance, Therapie Fertility charges €2,295 for a single egg preservation cycle, whereas at Waterstone Clinic, one has to pay €2,950 plus an additional €25 monthly for preservation.
Enabled payment schedules equate to a lower upfront fee, however, as is the case with any loans, the overall cost accrued over time will inevitably be more. For instance, Sims IVF charges €3,100 for the procedure, inclusive of a year’s storage costs. On the other hand, at the Merrion Fertility Center, the preservation procedure costs €3,690 with an annual storage charge of €300.
When picking a provider for egg freezing, it’s critical to evaluate their on-going charges. The accumulated cost over a period of ten years, from age 30 to 40 for example, can be substantial at €30 a month for storage reaching up to €3,600. It’s also essential to check whether the monthly storage fee stays constant or could increase over the years of storage.
Before you proceed, it’s necessary to enquire about the tests that the clinic recommends or requires. These tests are often billed separately, so arranging a budget is vital. For instance, the Waterstone Clinic charges €125 for an AMH (Anti-Müllerian Hormone) test, €120 for an ultrasound, and €175 for a specialist consultation. Conversely, the not-for-profit Well Woman Centre offers an AMH test at a lower rate of €95.
The freezing of eggs can be influenced by the number of eggs produced in one cycle. A single cycle might not yield enough eggs to guarantee the eventual prospect of a successful pregnancy. The UK regulator, the Human Fertilisation and Embryology Authority, states that on average seven to 14 eggs are collected from patients under the age of 38. Despite having no comparable authority in Ireland, the Health (Assisted Human Reproduction) Bill only passed on June 26th this year with the aim of providing a regulatory body for fertility.
According to Dr Edgar Mocanu, a fertility consultant at the Rotunda Hospital, “a treatment would typically aspire to collect 10 to 15 eggs in one go”. For a 90% chance of pregnancy, it’s usually necessary to undergo two cycles of treatment. Ria O’Sullivan, communications manager at the Waterstone Clinic also added, “The sooner you freeze your eggs, fewer of them will be needed for a reasonable possibility of success.”
As age advances into the late 30s, the number of eggs for storage needs to increase, with an approximate goal of twenty eggs. This might necessitate multiple rounds of treatment. It’s important to remember that one treatment cycle may not yield a sufficient number of eggs to increase your chances of future successful pregnancies. The costs for two cycles, disregarding freezing costs, could amount to roughly €6,000, particularly if there’s no discount for the second round. It’s prudent to inquire with the clinic about the possibility and costs of subsequent cycles.
The perception of egg-freezing as an obligation-free fallback option can be misleading as it doesn’t offer any assurances of successful pregnancies, particularly considering the substantial costs involved. The age at which you decide to freeze your eggs, and the quantity preserved, greatly impact your chances of having a baby, as asserted by a 2022 study published in Fertility and Sterility journal.
Attempting to get pregnant with frozen eggs isn’t always successful, as most women found out according to the research conducted at the New York University Langone Fertility Center. The findings could be seen as a reality check for women, particularly as many tend to have a positive bias about their odds of having a baby via this method, explained Dr Marcelle Cedars, president of the American Society for Reproductive Medicine.
Cedars made it clear to her patients that the pregnancy rate might not meet their expectations, candidly reminding them that a frozen egg is merely a chance at pregnancy, not a guaranteed baby.
To have a 90% chance of getting pregnant, two treatment cycles might be necessary. The research found that the overall chance of giving birth to a live baby from frozen eggs was 39%. However, for women who froze their eggs before they turned 38 years old, the live birth rate was 51%. This figure could increase to 70% if women under 38 also chose to defrost 20 or more eggs.
Dr Edgar Mocanu states that the likelihood of successful egg-freezing is significantly greater in women who are in their 20s and early 30s. While the survival rate of frozen eggs is commendable, the rates of fertilisation are only between 60-75%, which indicates that not every egg fertilised will develop into a viable embryo that ultimately results in a child.
Dr Mocanu proposes that women should research thoroughly before committing to a clinic. Key questions include the typical number of eggs that could be extracted for someone of the same age, and how many eggs, out of a given amount, can be expected to survive the thawing process. It’s also crucial to question a clinic’s experience with women using their own eggs to conceive, as that’s a primary consideration. A clinic with experience limited to only a couple of women giving birth with their own eggs is not ideal. Where possible, one should also inquire about the clinic’s success rates regarding pregnancy.
Paying for fertility treatments can be managed in various ways. Several clinics, including Therapie, the Waterstone Clinic, and the Merrion Fertility Clinic, collaborate with financial providers like Humm to facilitate payment plans that allow the cost to be spread over a certain timeframe. Although this means a smaller upfront payment, it can end up being more expensive in the long term due to interest accrual.
For example, borrowing €2,295 via Humm, payable over 36 months, at a 15.93% APR, results in a total repayment of €2,849.39. This comprises a €40 application fee, a monthly fee of €4 for 36 months, 36 monthly payments of €74.04, accumulated interest of €370.39, and fees of €184. Late payments beyond 24 hours will incur an additional fee of €9. In comparison, a personal loan, such as one from Bank of Ireland, might be more cost-effective. Borrowing the equivalent amount at an 8.5% APR would result in monthly instalments of €72.18. The total repayment would be €2,598.55, resulting in savings of €251 compared to the Humm quote.
Patients are often reminded that egg-freezing does not equate to having a child in storage, but rather a possibility of conceiving. Similar to IVF, the egg-freezing process involves hormonal injections over a number of days. The clinics prescribe the necessary medications but they must be purchased separately from a pharmacy. With a DPS card, the maximum monthly cost for such prescription medicines is €80. While clinics may suggest a particular pharmacy, shopping around could yield better prices.
Many fertility clinics claim a 20% tax rebate on egg-freezing expenses via the Med1 form. Nonetheless, when choosing a provider, you should also consider the ongoing cost of preserving your frozen eggs. According to Revenue, tax relief for healthcare is limited to the prevention, diagnosis, relief or treatment of various physical conditions and for pregnancy care. They note, however, that it is unclear whether elective egg-freezing qualifies for such relief. Revenue emphasizes that each case is unique and eligibility must be decided accordingly.
Your health insurance might cover fertility treatment. Some schemes by Irish Life cover half the cost of egg-freezing, up to a one-off maximum of €1,000. Certain Laya packages may cover up to €1,500 in a lifetime. It is worth noting that one cannot claim both health insurance reimbursement and tax relief.
In an economic context, the decision to have children has become more significant. Fertility rates in Ireland have decreased from 2.0 in 2013 to 1.5 in 2023, as per CSO data. The population is typically assumed to be self-sustaining with a fertility rate of 2.1. The International Federation of Fertility Societies suggests that expanded paid maternity leave, parental leave, childcare services, and more accessible fertility treatment are needed to reverse this global trend.