On Tuesday's Morning Edition, NPR's Jennifer Ludden all but acted as an proponent of egg donation and freezing to preserve women's fertility, but failed to acknowledge the dangers associated with the donation process, ranging from negative psychological effects to kidney failure and death. Ludden barely touched on other risks to the procedures, such as using them to permit women over 50 become pregnant.
The correspondent began her report by hyping the emotion behind the problem the donation and freezing procedures aim to fix: the declining fertility of women 40 years of age and older:
LUDDEN: Two dozen women, all of a certain age, sit in folding chairs in a Manhattan office building. They balance cell phones and glasses of wine.
DOCTOR ALAN COPPERMAN: Hi, nice to meet you all, thank you for coming out tonight-
LUDDEN: Alan Copperman is with Reproductive Medicine Associates. He's headlining this seminar on how to take control of your fertility. He wastes no time laying out this harsh reality: by the time a woman hits her 40's, 90 percent of her eggs are abnormal. The chances of a typical 40-year-old getting pregnant in any given month: 10 percent- unless, she gets pregnant with her younger eggs, eggs she's frozen years before. He explains the procedure, introduces someone who's gone through it, and takes a flurry of questions- questions I'm not allowed to record because- it's clear from the many who don't want to speak with me- this is an emotional and private decision. The session wraps up in about an hour. (audio clip of audience applause)
Women crowd a counter to set up appointments with Copperman's clinic, which offers egg freezing. Sally Montgomery is among the youngest here, and most upbeat. Her mom had trouble conceiving, so she wants to be pro-active. But-
SALLY MONTGOMERY: I'm 31, your typical New Yorker. I'm single- like, I'm bouncing around, and I'd like the opportunity to have a family. And so, I just figured, why not? I mean, I don't think it's a guarantee, but it's a nice insurance policy, and I think it takes some of the pressure off.
LUDDEN: Others, though, slip out quietly. One 40-year-old says she wishes she'd learned about egg freezing earlier.
Ludden then summarized what the donation side of the burgeoning industry entailed and played up the benefits:
LUDDEN: The whole process- a week of hormones, the procedure to collect the eggs- runs 12 to 14 thousand dollars, and since it takes 10 to 20 eggs for a reasonable shot at success, some may need to do this several times, plus there's annual storage fees. Then, when you're ready to use your eggs, you'll need in-vitro fertilization, another pricey procedure. All told, costs can easily exceed 40 grand....This is not lost on Dr. Copperman. In his office, high above busy Madison Avenue, he says he hopes the procedure becomes easier and cheaper. Still, he says freezing eggs offers many women the biggest game changer since the birth control pill 50 years ago.
COPPERMAN: Women began to have reproductive choices. They got to decide when not to get pregnant. This technology has the potential to help women decide when they can get pregnant.
LUDDEN: ...Over the years, egg freezing has been offered mainly to cancer patients facing radiation, but success rates were pretty dismal. Of late though, the technology has exploded, thanks to scientific leaps, including a flash-freeze method called vitrification. In Copperman's lab, you can hear the sizzle as a tiny tube is plunged into liquid nitrogen.....With this better survival rate, more and more clinics are offering what they call fertility preservation, and the early adopters are starting to come back and use their eggs. (audio clip of infant making noises)
ROBYN ROSS: Yeah, that's right!
LUDDEN: In a New York high-rise, eight-month-old Camden bounces in her baby saucer. She's here thanks to eggs her mom froze several years ago.
What the NPR correspondent completely omitted is something even the New York Times recognized in a May 15, 2007 report: the down sides, to say the least, of the egg donation process. Reporter Roni Caryn Rabin noted that "egg extraction is time consuming, and it is not comfortable. For some women, it can be painful." She then listed the many detrimental side effects:
The drugs may cause bloating, weight gain, moodiness and irritability, and there is a risk of a rare condition called ovarian hyperstimulation syndrome that can cause life-threatening complications, blood clots and kidney failure.
The egg extraction itself is a surgical procedure in which a thin needle is inserted through the vagina into the ovary to retrieve the eggs and liquid from the follicles. Risks include adverse responses to anesthesia, infection, bleeding or the inadvertent puncture of an organ.
It is the long-term risks, both physical and psychological, that are harder to assess. Questions have been raised about whether extraction may jeopardize the donor’s fertility, and critics worry about the potential psychological harm to a donor of eggs as a young woman who later finds that she is unable to have children.
And since egg donors go through much the same process as women trying to conceive in vitro, there are concerns that they may be prone to the higher rates of certain cancers that some studies have found among infertility patients.
More recently, in a January 2011 article for First Things, bioethicist Wesley J. Smith, a one-time advisor for former President George W. Bush, highlighted the moral complications associated with the procedures: "Fertility treatments are big business, generating layers of people who depend on its expansion: Doctors who retrieve, fertilize, and implant eggs; pathologists and lab technicians who grade, sort, store, and test eggs and embryos; agencies that match donors and parents; lawyers to write contracts; counselors to screen donors and parents. There's money to be made — and the easiest, cheapest payoff goes to egg donors. Women's bodies become mere commodities in a larger business.
Despite all of this, Ludden pressed ahead in promoting this business for the rest of her report, only noting untried nature of the developing technology and the complications for women who are 50 years of age or older, all the while spotlighting its seeming benefits:
LUDDEN: Now, before you run out to a fertility clinic, there is a big note of caution. Dr. Eric Widra is with the Society for Assisted Reproductive Technology, which sets industry guidelines. The society still considers egg freezing experimental....Widra says only one to two thousand babies in the world have been born using frozen eggs. So far, they're fine- no abnormalities- still, he'd like a larger-scale, longer-term track record. It's not clear when, or if, a big-scale study might happen. But Widra says women should know: success rates will never be 100 percent.
WIDRA: It's an insurance policy that you may or may not actually ever need, and it's an insurance policy that if you do need, may not pay out.
LUDDEN: And yet, Widra agrees, egg freezing has appeal if it can help avoid the anguish of infertility. He offers it to his own patients. So, what a concept! Put your eggs in deep freeze, and disconnect from that nagging biological clock. But until when? How old is too old to use your younger eggs?
GEOFFREY SHER: There should be guidelines, I think, that are more clearly defined.
LUDDEN: Geoffrey Sher runs a handful of fertility clinics, and is based in Las Vegas. He says many clinics suggest a cut-off of 50, the average age of menopause. After that, pregnancy can be riskier, and the large age gap raises complicated social issues. But the limit's tricky to impose. Dr. Sher remembers one couple who wanted to use donor eggs to conceive. He was 45; she: 55. Sher hesitated.
SHER: And she said, that's discriminatory. If my husband was my age and I was his age, you wouldn't hesitate, and she had a point.
LUDDEN: The woman was healthy, and the uterus doesn't decline like eggs do. In some cases, it can actually be coaxed back into working order. Sher's ethics board said, okay.
SHER: And she went ahead and had a baby at 57 years of age without any problems whatsoever, and I get a postcard from them at Christmas every year.
LUDDEN: The bigger challenge, say Sher and others, is reaching out to younger women, getting them to take action before it's too late. They envision a time when society considers freezing your eggs an act, not of desperation, but empowerment. Jennifer Ludden, NPR News.