Medical versus social egg freezing: the importance of future choice for women’s decision-making

Abstract

While the literature on oncofertility decision-making was central to the bioethics debate on social egg freezing when the practice emerged in the late 2000s, there has been little discussion juxtaposing the two forms of egg freezing since. This article offers a new perspective on this debate by comparing empirical qualitative data of two previously conducted studies on medical and social egg freezing. We re-analysed the interview data of the two studies and did a thematic analysis combined with interdisciplinary collaborative auditing for empirical ethics projects. Despite their different contexts, major similarities in women’s decision-making and reasoning were found. We developed two main common themes. Firstly, women felt a clear need to plan for future options. Secondly, they manipulated decision-times by postponing definitive decisions and making micro-decisions. The comparison highlights that the passage of time and the preservation of future choice seems to permeate all aspects of the patient experiences in both studies. As a result of considering real-world lived experiences, we suggest that there are many overlaps in women’s reasoning about egg freezing regardless of why they are making a decision to freeze. These overlaps are morally relevant and thus need to be further integrated into the existing arguments that have been canvassed in the flourishing egg freezing and fertility preservation debates across the field, and in policy and practice globally.

Imagining motherhood and becoming a mother after egg freezing. An anthropological study in the French context

“…Indeed, despite its disruptive potential (e.g., single motherhood, lesbian motherhood, motherhood beyond the reproductive span), this new ART is being used to reproduce heteronormative motherhood, the nuclear family, and the normalized desire for biogenetic motherhood. Moreover, it appears to reinforce the idea that women can (and want to) become mothers regardless of their particular conditions -some authors (Birenbaum-Carmeli et al, 2021;Pérez-Hernández, 2021;De Proost & Paton, 2022) have shown that some of those who have frozen their eggs chose not to have children. Interestingly, the analysis of the desired and imagined path towards motherhood that I made in this paper corresponds to what some authors (McMahon, 1995) have studied as a middle-class vision of motherhood.…”

Women Who Perform Social Egg Freezing as Moral Pioneers: The Case of Ultra-Orthodox Communities in Israel

“…In contrast to neo-liberal risk society that conceptualizes SEF as an individual form of pro-active assumption of responsibility for risks associated with reproduction (De Proost & Paton, 2022), the traditional Jewish context envisions SEF as a technological tool to build large families even in late marriages. Thus, SEF can be experienced as religious obligatory effort -'hishtadlut', as studied by Teman et al (2016) in relation to other reproductive choices.…”

Eggsurance? A randomized controlled trial of a decision aid for elective egg freezing

“…Our data suggest that a 12-month follow-up may be insufficient to capture an intervention effect since median time to decision about EEF is around 2 years ( Sandhu et al , 2023a ). Final decision-making may be motivated by multiple factors including changing relationships ( De Proost and Paton, 2022 ) and increasing age ( Sousa-Leite et al , 2019 ). Our participants were on average 30 years old and may not have felt the urgency to decide.…”