Latest / The Morning Edition / The big business banking on women freezing their eggs

Transcript

The big business banking on women freezing their eggs · The Morning Edition

0:04
S1: Egg freezing has become a popular choice for more and
0:07
S1: more young women, many of whom are looking for something
0:10
S1: of an insurance policy against missing out on becoming a mother.
0:14
S2: Having something like your eggs frozen gives you options down
0:17
S2: the track.
0:18
S3: This year I'm going to be having a crack.
0:21
S1: It's become big business, which means that fertility companies are
0:25
S1: beholden not just to their patients, but to their shareholders too.
0:29
S1: I'm Samantha Cylindromas, and you're listening to The Morning Edition
0:33
S1: from The Age and The Sydney Morning Herald. Today, reporter
0:36
S1: Bronte Gosling and deputy lifestyle editor Courtney Thompson on how
0:41
S1: successful egg freezing is and what it's actually like for
0:45
S1: the women who undergo it. It's August the 31st. Welcome,
0:51
S1: Bronte and Courtney to the podcast.
0:53
S4: Thank you for having us. Happy to be here.
0:55
S1: Okay, Bronte, let's start with you. Can you briefly take
0:58
S1: us through how egg freezing works, because in theory, it
1:01
S1: gives women the ability to press pause on their reproductive
1:04
S1: biological clock. Right?
1:06
S4: Yeah, it's pretty much in the name. Egg freezing is
1:08
S4: basically the process of retrieving freezing, storing eggs until someone
1:14
S4: decides they want to use them to have a child
1:17
S4: donate with an asterisk, donate or discard them. Obviously, for
1:22
S4: all of the advancements that science and technology and I
1:25
S4: guess culturally we've made, the biggest determining factor of a
1:30
S4: woman's fertility is the age of her eggs. So yes,
1:33
S4: in theory, freezing your eggs at a certain age kind
1:36
S4: of allows you to put pause on your reproductive biological clock.
1:41
S1: And Courtney, this brings me to you because elective egg
1:44
S1: freezing has really become quite popular in Australia and New Zealand.
1:47
S1: So I guess, Tess, tell us a little bit about this.
1:49
S1: How much demand is there for it now, and why
1:52
S1: are we seeing this massive uptick in young women in particular?
1:55
S5: So the most recent data shows that between 2020 and 2024,
2:01
S5: the number of young women freezing their eggs more than
2:04
S5: doubled and young women under 35 were the largest. They
2:10
S5: were the cohort that was growing the most across all
2:12
S5: age groups. So it tells us women are getting slowly
2:17
S5: younger who are choosing to freeze their eggs. And I
2:20
S5: think that's it's for a number of reasons. You know,
2:22
S5: I think it goes back to people are more educated,
2:27
S5: more educated. They're staying in the workforce. They're more ambitious.
2:31
S5: They want to travel. People are having wanting to start
2:34
S5: families later in life. You know, we talk a lot
2:37
S5: about fertility decline in Australia, but most of the research
2:41
S5: actually shows that rather than career or travel, it's the
2:45
S5: fact that women can't find eligible partners and men. And
2:49
S5: so a Yale anthropologist, Marcia Inhorn, calls it the mating
2:54
S5: gap where highly educated, heterosexual, professional women want the three
2:58
S5: P's of partnership, pregnancy and parenthood but are missing the
3:02
S5: three E's of eligible, educated, equal male partners. And so
3:07
S5: it actually just comes back to that simple point of
3:09
S5: like people not coupling up. And as a response, this
3:13
S5: technology has been presented by the fertility industry as a
3:17
S5: possible solution of just freeze your eggs. You'll have them
3:21
S5: there and you can take your time. And you don't
3:23
S5: have this kind of cloud looming over you making you
3:28
S5: stressed about your declining fertility, which we know is just
3:32
S5: a biological reality for women. So I think the broad
3:36
S5: kind of way that egg freezing is promoted and how
3:39
S5: it's shifted, I think in the last few years, it's
3:41
S5: really key to this story is that fertility clinics are
3:44
S5: sending out this message of your eggs are better quality.
3:47
S5: The younger you are, which, which is a fact. You know,
3:50
S5: the younger you are. But it's kind of a kernel
3:52
S5: of truth that is a little bit more complicated. And
3:55
S5: these young women are hearing this, who are 28 or
3:58
S5: in their 20s. I need to be thinking about freezing
4:01
S5: my eggs, because this is actually going to give me
4:04
S5: the best shot if I ever do need to go
4:06
S5: back and use them.
4:07
S1: Okay, Bronte. First of all, can you just tell us
4:09
S1: how tough is it for any woman, really, but younger women?
4:13
S1: Because they're the bulk of them, I guess. How tough
4:15
S1: is it for them to go through this process? Because
4:17
S1: you interviewed numerous women and they spoke of not just
4:20
S1: financial pressure, but emotional demands too, right?
4:23
S4: Yeah. I want to be really, uh, have a bit
4:26
S4: of a disclaimer here because every woman does have a
4:29
S4: different experience with egg freezing, different clinics and different doctors.
4:34
S4: They follow different specific treatment plans and protocols that generally
4:41
S4: can be tailored to different circumstances. But in a general sense,
4:45
S4: on the physical side of things, it can be quite intense.
4:49
S4: We spoke with some people who felt so nauseous that
4:53
S4: they couldn't eat. So fatigued that they didn't want to
4:56
S4: leave the house. There was 131 year old Sydney content creator,
5:00
S4: Chloe Barry Hang, and she basically said she felt like
5:04
S4: if she was still working in corporate finance in her
5:08
S4: full time job, which she no longer has, she felt
5:10
S4: like it would have been impossible or difficult to actually
5:13
S4: do just because there are so many appointments as well
5:16
S4: that you need to do, you have to do a
5:18
S4: lot of internal ultrasounds, which aren't pleasant blood tests and
5:23
S4: the like, but she also felt like she was quite
5:25
S4: nauseous and tired. She said she had intense brain fog.
5:29
S4: She felt like she had one. Brain cell is exactly
5:30
S4: what she said. I mean, you're seeing on Instagram right
5:33
S4: now the American politician Alexandria Ocasio-Cortez, she is injecting herself
5:38
S4: with follicle stimulating hormone injections.
5:42
S5: Yeah, she's documenting it on social media. And actually, that's
5:44
S5: a great point because we should have acknowledge in the
5:48
S5: rise of egg freezing and how it's becoming popular among
5:51
S5: young women. Social media, and it's the predominance of egg
5:56
S5: freezing content on social media is totally a driving factor
6:00
S5: to its growth. But again, it's kind of you have
6:03
S5: people like AOC who are having a great experience and
6:08
S5: wants to just shed light on the process. And because
6:12
S5: a lot of people don't know what is actually involved.
6:15
S5: And then you have other people who have a really
6:17
S5: awful experience.
6:18
S4: Yeah, yeah. I mean, even somebody that did do elective
6:21
S4: egg freezing is Brooke Boney. She is the former presenter
6:26
S4: of the Today Show. She did it at 33 after
6:30
S4: a breakup. She did two cycles and she's now 39.
6:33
S4: And she's happily paying her storage fees for her eggs
6:36
S4: with no plans to use them currently. But she loved it.
6:40
S4: She said she had a great time. Obviously she felt
6:42
S4: some pain as her follicles were growing, but she was
6:46
S4: well enough that she came to work every day, and
6:48
S4: her colleague Allie Langdon injected her backstage so she was okay.
6:52
S4: But yeah, Chloe didn't have a great time. I think
6:55
S4: it also depends on, and this is what one doctor
6:59
S4: did make a point of emphasizing to me. It depends
7:02
S4: on what the expectations are going in. And that's to
7:05
S4: Courtney's point as well. If you're seeing on social media
7:08
S4: people living their lives and it looks quite glamorous, it
7:11
S4: might take you by surprise. Chloe Barry Hang she definitely
7:15
S4: said that she was taken by surprise, by how intense
7:18
S4: it was just because she didn't expect it. It depends
7:20
S4: on what you're bringing to it.
7:21
S5: And I think, you know, researchers have looked at social
7:25
S5: media content about egg freezing posted by influencers, and they
7:28
S5: found that they often overemphasize the benefits and fail to
7:33
S5: acknowledge some of the downsides, the realities of it. And
7:37
S5: one study found a mere 11% of the social content
7:41
S5: about egg freezing mentioned how much it costs.
7:49
S1: After the break.
7:50
S5: They're making a lot of money off of. But when
7:52
S5: you then step back and consider those numbers that we
7:54
S5: were talking about earlier, it's like the insurance policy from hell.
8:02
S1: Well, this is what I was dying to ask you,
8:04
S1: because you can tell the listeners how much. Molly Bennett 25,
8:08
S1: I believe when you interviewed her, how much she spent
8:11
S1: on her five cycles.
8:12
S4: Yeah. So Molly, basically this all happened when she was 24,
8:16
S4: and then she finished her five cycles at 25 and
8:19
S4: she's now 28. And she does say, to be clear,
8:22
S4: she doesn't regret doing it because she she's under the
8:25
S4: impression that she had to because she was advised that
8:28
S4: by her specialists. But she said basically by the end
8:31
S4: of the process, she physically, emotionally, financially had nothing left.
8:35
S4: So she paid $50,000 in upfront payments. That was her
8:39
S4: housing deposit fund. But she said she wants to be
8:42
S4: a mother more than anything, so she was happy to
8:44
S4: do so. But to be clear, because Molly was a
8:47
S4: medical case and she therefore fell under the Medicare rebate,
8:51
S4: she got about $15,000 back in Medicare rebates. So it
8:55
S4: was about $35,000 in total.
8:57
S5: And when you take that into account, fertility clinics in Australia,
9:02
S5: some of them advertising freeze your eggs for starting from $2,500.
9:08
S5: You start thinking, well, that's quite misleading. And it is misleading.
9:12
S4: Yeah. I mean, Chloe Barry, for example, she wants to
9:16
S4: have three children and she was told that to do
9:18
S4: that based on her ovarian reserve, she would need to
9:20
S4: do three cycles per child to get one live birth
9:25
S4: per child.
9:26
S1: Well, and there's no guarantee which know which. Courtney, I
9:29
S1: wanted to ask you about because there's a there's a
9:31
S1: fact you had in your story, which, you know, I
9:33
S1: was quite astounded by, which is that even though there's
9:36
S1: all this pressure on women to freeze their eggs and
9:39
S1: there's all this disproportionate reporting, if you could call it
9:41
S1: that on social media, which sort of really up plays
9:45
S1: the the positives and perhaps downplays the risks and the
9:48
S1: challenges and the negatives is the reality that very few
9:51
S1: women actually go on to use their eggs that they've
9:54
S1: frozen and very few live births actually result from all
9:58
S1: these egg freezing cycles. So what's going on here? Like,
10:01
S1: is the technology faulty? Is it something else? Tell us
10:05
S1: the stats and then what's happening.
10:06
S5: So in the kind of the most comprehensive look that
10:09
S5: we have at the moment at elective egg freezing in
10:12
S5: Australia and New Zealand, it is a 15 year kind
10:15
S5: of scoping review of all the numbers of what we
10:18
S5: know about it. It's currently under peer review, but just
10:21
S5: under 400 babies have been born from approximately 30,000 egg
10:27
S5: freezing cycles. And so it works out at about, I
10:31
S5: think 30% of women go back to use their frozen eggs.
10:36
S5: And then of that cohort, only one third achieve a
10:40
S5: live birth. One of the experts that I spoke to
10:43
S5: said she. She was like, those numbers aren't great. They're
10:46
S5: quite bad, they're sobering. And she's like. And it's really
10:49
S5: important that young women know that a lot of the
10:53
S5: experts in this space talk about informed consent. And the
10:57
S5: most important thing in all of this is that for
10:59
S5: anyone considering this, they need to reckon with. There is
11:03
S5: no guarantee that you will come out of this with
11:05
S5: a with a child. So why are the numbers so low?
11:08
S5: It's not. The technology's not faulty. It's that women just
11:11
S5: don't often go back. What happens is that they go
11:13
S5: on and they conceive naturally. They meet someone or they.
11:17
S5: They don't meet someone. And that's, that's a reality. And
11:21
S5: they don't want to become a single parent. So they
11:23
S5: just leave them. And then there are women who do
11:26
S5: try and use their frozen eggs. But once you go
11:28
S5: to use your frozen eggs, then go through a process
11:31
S5: of they need to be thawed. They need to be fertilised.
11:34
S5: Then they need to be transferred to become an embryo.
11:36
S5: So there's like, there's all these steps even after you
11:39
S5: have frozen your eggs, that I think sometimes, or I
11:42
S5: worry that women who are going into this process and
11:45
S5: thinking of it as an insurance policy are not considering.
11:48
S5: It's like you've only really gotten maybe one third of
11:51
S5: the way through this process, and there's all this other
11:54
S5: stuff that needs to come after. And, you know, one
11:56
S5: of the doctors said he was like, it's promoted as this,
12:00
S5: you know, freeze your eggs and you'll be fine. But
12:02
S5: that's not always the case. And it's incredibly disappointing. It's
12:06
S5: disheartening when these women go back and try and use
12:09
S5: their frozen eggs and they can't.
12:11
S4: Can I just point out something that Courtney said earlier,
12:13
S4: particularly the significance of the unused eggs? I think what's
12:17
S4: important to remember is that we've had a lot of
12:20
S4: market research recently, and particularly one report from Ibisworld. It
12:24
S4: projected that the Australian fertility industry's annual revenue will reach
12:29
S4: $1 billion in 2031. And what was identified as a
12:33
S4: favorable driver of this growth is elective egg freezing, particularly
12:40
S4: because we had an analyst at UTS run a bit
12:43
S4: of numbers based on the most recent data that we
12:45
S4: have available. And basically, she estimated that based on the
12:50
S4: amount of egg freezing cycles done for fertility preservation, which
12:55
S4: is when you are going to freeze your eggs and
12:57
S4: use them later, not immediately proceed with IVF. That basically
13:01
S4: contributed about $53 million in 2024 to the industry. And
13:04
S4: then of that, the cycles for elective reasons, not medical
13:08
S4: reasons that contributed anywhere between 13 million and $26 million.
13:13
S1: And I guess, Courtney, what ethical questions does this raise
13:16
S1: then for the fertility industry? You know, like a lot
13:19
S1: of women are taking it as an insurance policy, though
13:22
S1: they're being told at some point, okay, it's not actually
13:24
S1: an insurance policy.
13:25
S5: Yeah. And everything that we've said in the marketing, how
13:29
S5: it's promoted on social media, the puzzle pieces start coming
13:31
S5: together when you consider that the Australian fertility industry is
13:36
S5: dominated at the moment by private equity. It's kind of
13:39
S5: come in and now 80% of the fertility market in
13:43
S5: Australia is made up of just four major for profit
13:47
S5: and corporate companies, which creates some ethical concerns about transparency,
13:53
S5: about accountability and accessibility for the industry, because suddenly these companies,
13:59
S5: they don't have a duty of care to the patients.
14:01
S5: Their duty is to their shareholders, and their duty is
14:04
S5: to drive profit, which can distort the provision of care
14:07
S5: for patients. And it kind of something that really made
14:11
S5: everything make sense to me when I was doing this
14:15
S5: story was one of the researchers said, you know, when
14:17
S5: you consider fertility clinics, once upon a time, they were
14:21
S5: just for people who were trying to conceive or struggling
14:23
S5: to conceive. But egg freezing, that changed that because suddenly
14:27
S5: any woman who might conceivably want to be a mother
14:31
S5: one day becomes a potential customer by virtue. And it
14:34
S5: doesn't matter her age. It doesn't matter her fertility status.
14:38
S5: She just needs to be kind of interested and wants
14:41
S5: and to desire that at some point in her life,
14:44
S5: which then opens the doors to a huge customer base that,
14:49
S5: as Bronte pointed out with her numbers, they're seizing and
14:51
S5: they're making a lot of money off of. But when
14:53
S5: you then step back and consider those numbers that we
14:56
S5: were talking about earlier, it's like the insurance policy.
14:59
S1: But is there.
15:00
S5: Is.
15:00
S1: Is there any suggestion, though, that, you know, you say
15:03
S1: that the duty of care of of these companies is
15:06
S1: not to the patients, it's to the shareholders, but obviously
15:09
S1: the doctors, they've got a duty of care. The doctors
15:11
S1: that work for these companies have a duty of care
15:13
S1: to the patients. Like, is there any suggestion that the
15:15
S1: doctors are swayed by the companies that, you know, run
15:19
S1: the clinics?
15:20
S5: It's hard to say, but there's I think you need
15:22
S5: to consider that these doctors are getting paid a lot
15:25
S5: of money and they're paid high rates and the doctors
15:31
S5: working are there. You know, there's been stories come out
15:35
S5: about the more cycles you do, the more bonus you
15:39
S5: get or you kind of work on commission.
15:41
S1: Wait, wait, wait, are doctors getting paid more? Depending on
15:43
S1: how many live births result from their patients?
15:46
S4: It was a historical case in New South Wales or Australia,
15:50
S4: but basically they were encouraged to do a certain amount.
15:54
S4: Once you hit a threshold of cycles and you continued
15:57
S4: to upsell these cycles, if you hit a certain number,
15:59
S4: you would get a significant bonus, but it's unclear if
16:02
S4: that program is still in force. That was from 2017. Exactly.
16:06
S4: It is important to recognize that one doctor we spoke
16:09
S4: with in particular, she said she spent more time talking
16:12
S4: young women out of doing elective egg freezing than actually
16:17
S4: performing the procedure on women who were healthy and of
16:20
S4: a certain age obviously have to add that in. So
16:22
S4: I think but the issue is that you're not going
16:25
S4: to get every doctor is not going to approach it
16:27
S4: like that.
16:28
S1: But tell us, why was she doing that?
16:30
S5: Because women who are 25, who are coming in because
16:33
S5: they believe they need to be freezing their eggs. And
16:36
S5: she looks at them and she's like, your ovarian reserve
16:38
S5: is too good. You've got great. You've got plenty of time. Like,
16:41
S5: why are you freaking out?
16:42
S6: So just to wrap up then.
16:43
S1: How are experts then helping women that want to start
16:46
S1: a family make the right decision. That is the best
16:49
S1: option for them, whether that's financially, physically, both because I
16:52
S1: believe you spoke with a research fellow in obstetrics, gynecology
16:56
S1: and newborn health at the University of Melbourne, and I
16:58
S1: think she's got a tool. Is that right that she uses?
17:01
S4: So there's a few things to unpack. The first thing
17:03
S4: I would like to point out is that a really
17:05
S4: it's been a really tricky line to walk with this
17:07
S4: story because with all of the context of private equity
17:11
S4: owning a significant majority of the fertility clinics in Australia,
17:14
S4: we don't want to take away the agency of these
17:16
S4: women who are seeking out these procedures. I know Brooke
17:18
S4: Boney in particular, felt a real passion. She's 39 now.
17:22
S4: She did her process six years ago. She's still single.
17:25
S4: She's not taking any steps to become a mother right now.
17:28
S4: She still happily paying for her storage. And she said
17:31
S4: she doesn't view egg freezing as an insurance policy against childlessness.
17:36
S4: She views it as an insurance policy against regret. And
17:40
S4: so it is really important to highlight that a lot
17:42
S4: of women do actually feel that this is quite empowering.
17:46
S5: And it's important to acknowledge that all the research that
17:48
S5: has been done, looking at the psychology behind the decision
17:52
S5: making and how women feel about freezing their eggs, it
17:56
S5: says that they don't experience regret. They don't regret it
17:58
S5: at all. They feel like this is something that they
18:01
S5: could do that was in their power, a step that
18:04
S5: they could take to kind of help their future selves. And,
18:07
S5: you know, a lot of the experts and the doctors
18:10
S5: will say, like, just think of your future self and
18:12
S5: how she might feel. But it's also, you know, you've
18:15
S5: got to weigh up lots of different factors.
18:17
S4: Look, that there is a tool that has been developed
18:19
S4: with Unsw and it's called the your IVF success calculator.
18:23
S4: And they also have a your egg freeze estimator. And
18:26
S4: so it's an independent, government funded website designed to offer
18:29
S4: transparency in the space. Basically, you can enter in information
18:32
S4: such as your age, the age of your partner, if
18:35
S4: you're doing the IVF calculator, any kind of medical history
18:38
S4: that you have, and they can give you an estimate
18:41
S4: of how successful your chances are of one live birth
18:45
S4: will be.
18:45
S5: And the egg freeze estimator is great because it actually
18:49
S5: gives women a really good idea of how many cycles
18:53
S5: they might need to to do, which I think can
18:55
S5: be kind of you think, oh, I'll just do one
18:58
S5: cycle and that'll be enough. But sometimes you don't get
19:00
S5: many eggs in one cycle, and that's if you're going
19:03
S5: to do it. You want to, you know, give yourself the,
19:06
S5: the best chance, which means you probably need to do
19:10
S5: more cycles. But this, this calculator gives you that full
19:13
S5: picture of what the egg freezing experience. So it's not,
19:17
S5: it's not a perfect, you know, like an all of
19:19
S5: the doctors and all of the experts who will talk
19:22
S5: to you honestly about this. We'll say you can't take
19:26
S5: anything as gospel in this world because there is there
19:29
S5: is no there is no certainty.
19:31
S1: It's not a precise science.
19:33
S5: It's an estimator.
19:34
S1: Yes.
19:35
S5: But, you know, I think as we've said, there are
19:39
S5: so many different factors that go into the decision to
19:42
S5: freeze your eggs. It's really confusing. It can be overwhelming. And,
19:47
S5: you know, research has shown that there's high degree of
19:49
S5: uncertainty when women do consider freezing their eggs. And so
19:53
S5: that is why Doctor Shireen Sandhu has worked at the
19:56
S5: University of Melbourne with a lot of the researchers who
19:59
S5: kind of we spoke to for this piece to develop
20:02
S5: a decision aid, which will help women kind of make
20:06
S5: an informed decision that aligns with their personal circumstances. And
20:10
S5: so it provides detailed information that alongside practical kind of
20:15
S5: exercises that they can do to help them come to
20:18
S5: an informed decision. Because really the most important thing here
20:21
S5: is informed consent. And whatever decision is right for you,
20:25
S5: there's no right or wrong. As long as it's you
20:29
S5: have all of the information and, you know, the research
20:31
S5: does say the only time that they ever regretted it
20:34
S5: was when they weren't given all of the information at
20:36
S5: the beginning.
20:40
S1: Wow. Well, thank you so much, Bronte and Courtney for
20:43
S1: your time.
20:44
S7: Thank you. Thank you Sam.
20:58
S1: Today's episode was produced by Josh towers. Our executive producer
21:02
S1: is Tammy Mills, and our podcasts are overseen by Lisa
21:05
S1: Muxworthy and Tom McKendrick. If you like our show, follow
21:09
S1: the Morning Edition and leave a review for us on
21:12
S1: Apple or Spotify. Thanks for listening.