Egg Preservation and the Changing Medical Landscape
Sperm preservation, primarily in the form of sperm donation, has moved into the American mainstream in recent years. Yet its counterpart, egg preservation, has generally remained off the radar, despite the fact that the first pregnancy as a result of cryopreserved eggs dates back to 1986 (Chen, 1986). The procedure is primarily used as a starting point for future in vitro fertilization, and has played a role in allowing women to gain more control over their reproductive futures. However, cryopreservation of eggs is expensive, impeding widespread development and use. Even today, over 30 years after the inception, procedures cost upwards of 15,000 (Hamblin, 2016). Fortunately, a new fertility clinic, through lower costs and improved safety, might be reshaping the field.
The clinic, called Extend Fertility, was founded by a group of entrepreneurs and physicians with efficiency in mind. Utilizing a process dubbed “super-specialization,” the scientists can focus solely on egg cryopreservation, and avoid much of the overhead cost that would be associated with a more general fertility clinic (Hamblin, 2016). This economic efficiency has led to a bold business model: if a woman is young and in good health, she pays a flat sum (a little under $5000) and the clinic promises at least a dozen eggs (Hamblin, 2016). That is, even if the procedure does not work the first time, it will be repeated until it is successful for no additional charge.
However, claims of lower costs have been somewhat unfounded. In reality, the egg retrieval process is only a piece of the cost. The hormone therapy and longer term storage, which are required for the success of the procedure and for the practical use of the eggs in the future, drive up the actual price of the process to somewhere near the current market price (Hamblin, 2016). Regardless, the group has stated that its method will eventually decrease costs and improve outcomes.
The establishment of such a clinic, beyond its specific purpose and outcomes data, presents a set of interesting and important questions for the medical community. Primarily, when steep prices are involved, the medical field must ask itself whether or not economic inaccessibility may lead to differential health outcomes. Specifically, it has been well documented that younger women, and younger eggs, have better IVF success rates (Wang, 2011). If this model is successful in lowering prices, it could help equalize IVF opportunity. Additionally, this hyper-specialized form of health care, where providers become incredibly well-versed in a single procedure or small subset of procedures, has been seen in other branches of the healthcare field, especially with specific orthopedic surgeries, and suggests a direction the field field as a whole might be moving in (Hamblin, 2016). There are, of course, field specific implications, including a need for additional, rigorous research about the effects of egg cryopreservation, donor age, and IVF success, but only time will tell what this small clinic means for the field as a whole.
Chen, C. (1986, April 19). Pregnancy After Human Oocyte Cryopreservation. The Lancet, 327(8486), 884-886. doi:10.1016/s0140-6736(86)90989-x
Hamblin, J. (2016, September 15). One Clinic Is Promising to Cut the Cost of Egg Freezing in Half. Retrieved September 16, 2016, from http://www.theatlantic.com/health/archive/2016/09/how-one-clinic-is-cutting-the-cost-of-egg-freezing-in-half/500144/
Wang, Y. A., Farquhar, C., & Sullivan, E. A. (2011). Donor age is a major determinant of success of oocyte donation/recipient programme.Human Reproduction, 27(1), 118-125. doi:10.1093/humrep/der359