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Faculty of Arts, Sociology and Social Policy, University of Sydney, Sydney, Australia
(Received 23 January 2014; accepted 2 August 2014)
This paper examines the relatively recent practice of non-medical egg freezing, in
which women bank their eggs for later use in conceiving a child. Non-medical egg
freezing has only been available for about the last five years, as new vitrification
techniques have made the success rates for actual conception more reliable than the
earlier method of slow freezing. I draw on interviews with both clinicians and women
who have banked their eggs to consider how this novel practice articulates with broader
issues about the relationship between sexuality, reproduction and the political economy
of household formation. Non-medical egg-freezing provides a technical solution to a
number of different problems women face with regard to the elongation of the life
course, the extension of education, the cost of household establishment and the iterative
nature of relationship formation, thematised by the ubiquity of internet dating among
the interviewees. I focus on the ways women used egg freezing to manage and
reconcile different forms of time.
Keywords: egg freezing; gender; fertility; time; new reproductive technologies
Introduction
Since the 1960s, human reproduction has become far more malleable, as the life sciences
revolution has found a ready market for its innovations among men and women who wish
to limit, augment and manage their fertility (Murphy 2012). While improvements in
contraception have dramatically enhanced women’s capacity to limit their numbers of
children, the advent of in vitro fertilization (IVF) in the late-1970s offers some methods for
prolonging fertility. The core business of the fertility clinic sector is assisting women over
35 to conceive children, as more women delay motherhood in order to establish careers
and household stability.1 The technical repertoire of this field has steadily developed to
address and manage more and more aspects of the biology of fertility, so the technique of
IVF itself is only one among many other strategies to reorder human reproduction in the
laboratory (Thompson 2005).
This paper is concerned with one aspect of the burgeoning reproductive bioeconomy:
the private tissue banking sector. While public tissue banks, for example blood banks,
depend on altruistic donation, where one person gives to another for therapeutic purposes,
private tissue banks allow clients to preserve their own tissues for future use (Healy 2006).
A significant segment of private tissue banking is focused on reproductive tissues and the
preservation of personal reproductive capacity through time. Women may variously bank
their child’s cord blood (Brown and Kraft 2006), their IVF embryos (Nisker et al. 2010)
and their breast milk (Ryan, Team, and Alexander 2013), while men may bank semen,
if, for example, they are facing a tour of duty in the military or a gonadotoxic cancer
treatment (Johnson et al. 2013). This paper examines a recent addition to this service
*Email: catherine.waldby@sydney.edu.au
sector, the practice of elective egg freezing, where women bank their eggs for later use in
conceiving a child. ‘Social’ egg freezing, as it is sometimes called, has only been available
for about the last five years, as new vitrification techniques have made the success
rates for actual conception much more reliable than the earlier method of slow freezing.
As I describe in detail in the next section, the uptake for this new kind of private tissue
banking is set to accelerate with the recent publication of peak medical guidelines
(ESHRE Task Force on Ethics and Law et al. 2012; American Society for Reproductive
Medicine 2013) declaring the practice no longer experimental.
In what follows, I will first consider the technique of egg-freezing and its relationship to
the broader field of cryobiology, the cold storage of living tissues so essential to the history
of biomedical innovation (Radin 2013). I will then draw on a series of interviews I recently
conducted in London, with women who had banked their eggs, and with clinicians and
business staff at two private fertility clinics that offer non-medical egg freezing.
In discussing this material, my analysis is broadly guided by my ‘tissue economy’ approach
(Waldby and Mitchell 2006). The idea of a tissue economy is that donated human tissues
(e.g. blood, embryos, organs, sperm, oöcytes) have a productivity that can be ordered in
different ways. While still inside the donor’s body, tissues are part of the self and help to
sustain the person. Once donated, they can sustain the life and health of the recipients
(for example blood and organ donation), they may be banked for future use (for example
cord blood) or they may become elements in laboratory research (for example embryonic
stem cell lines). In each case, tissues are procured, managed, banked and circulated in a
system designed to maximise their latent productivity. Tissue economies are not simply
technical matters, however, as the ways human tissues are procured and distributed involve
fundamental social questions about power relations (who donates to whom, under what
circumstances, with what regulatory protections?) and social values (what do particular
tissues mean and how do they count to donors, recipients, research facilities, commercial
biomedicine?).
One of the major features that shape a tissue economy is the degree of affordance
particular tissues offer to technical intervention, the extent to which their biological
capacities can be preserved, controlled, amplified and redirected. Some tissues are durable
once outside the body (blood plasma for example), while others are extremely fragile and
rapidly lose functionality (e.g. solid organs like the heart and liver). Oöcyte banking is of
particular interest to considerations of tissue economy because, as I will describe in the
next section, oöcytes are historically very difficult tissues to manage compared to human
semen, for example, because they have proved so resistant to freezing and banking. While
oöcytes have been donated between women since the early-1980s (Trounson et al. 1983),
their extremely rapid loss of fertility once outside the body has meant that donation
involves very careful coordination and the co-presence of donor and recipient, in the same
clinic at the same time. The capacity to freeze tissue, and hence to preserve it through time
and transport it through space, is perhaps the single most important technical consideration
for the malleability of a tissue economy, because it dramatically expands the possible uses
of the material and hence its clinical and commercial value (Waldby and Mitchell 2006).
In what follows, however, I am interested in the ways those who bank their oöcytes
make sense of and utilise this technical capacity as an aspect of their fertile life course and
personal biography. To put it another way, how does the technical ability to preserve
fertility through time interact with quotidian and qualitative understandings of time and
different trajectories – of career, relationships, aging – that interweave at different rates
through the life course? In terms of an oöcyte tissue economy, what does this new ability to
freeze women’s fertility mean to the women themselves?
472 C. Waldby
ability to manage their fertility, although, as we will see, this management is not at
all straightforward, as they try to gain both time and leverage in the high-stakes game of
family formation.
went for egg donation, and she went to Cyprus last year to do it, and she asked me to be her
support person.
I: Oh! Did you go to Cyprus?
P: Yes. In summer last year, and that was really good, I think, for opening my eyes about how
the procedure worked. . . . [and] last year I went to a few information evenings, and I didn’t
know the actual statistics until they were put in front of me, and I just thought, ‘Oh, my god,
that’s so scary!’ Like, every year matters, you know? (Phoebe, late-30s, Environmental
Engineer)
Here we see Phoebe referring to the statistical analysis known as the ‘fertility cliff’.
This analysis demonstrates that the probability of conception falls away sharply after the
mid-30s. It has its origins in mathematical modelling of the rate of loss of ovarian follicles
(the biological structures that produce oöcytes), which shows accelerated exponential loss
after the median age of 37 (Faddy et al. 1992). This truncation of fertility in the late-30s
was felt to be quite out of step with their sense that they themselves were not ‘old’:
I thought about it [egg freezing] maybe for half a year, and I was 39 then. I’m now 40,
and I thought, ‘Well, I read that by 40 your fertility’s declining’. . . . My grandma, she had
a child in her 40s. So I’m not concerned about myself – I wasn’t – but I thought I’d just go
and see someone. . . . when you turn 40, even though I don’t feel 40, it is kind of a society
[pressure], I think it was more outside influences than an internal thing, ‘Oh, I’m getting
old!’ It was more like that thought, ‘Well, I’m told I’m getting old, so I better do something
now!’ (Melissa, early-40s, media producer)
In the clinical setting, the ovarian reserve tests are designed to give patient and
clinician a metric for future fertility and to introduce a degree of calculative rationality into
what until then had been experienced as incoherent anxiety and a subjective sense of lost
time. Poignantly, as this clinician observes, poor test results can themselves exacerbate a
sense of lost time:
People who freeze their eggs tend to think there’s absolutely nothing wrong with them,
and for some of them it’s a real shock when the egg quality is [poor] . . . . You’ve made that
decision . . . . You’re empowered into thinking, I’m going to do this, I’m not going to
worry about it. But then you have your AMH test and it makes you [start] thinking, what
have I done with my life? (Fiona, Patient Coordinator and Embryologist)
Here we can see that test results are not simply decisional devices for the women
seeking to preserve their fertility. While they introduce some quantified, objective
information into a situation heretofore experienced as personal and opaque, the
interpretation of their meaning for the woman being tested is inflected through a complex
and deeply felt field of desires for the future and regret for time past. It is for this reason
that the result itself did not determine the subsequent course of action. As is evident in the
above two cases, tests that indicated a low ovarian reserve did not necessarily deter women
from proceeding. For some of those interviewed and for other clients described by clinic
staff, a low count was reason to proceed with haste, to leverage what possibilities
remained. In other words, the decision emerged from a complex sense of personal
biography and the way the woman understood their body’s history and future possibilities.
donor. [I think] . . . genetics play quite a strong part in personality and character. It’s
fascinating. Which is why I wouldn’t have a donor. (Jennifer, early-40s, company director)
Jennifer wants to conceive with her own oöcytes because she wants to maintain the
genetic relation with the future child, as well as the gestational relationship. She cannot see
the point of maintaining the genetic legacy of another, unknown woman.
The logics of generational time were also evident in the ways many of the interviewees
evoked their own happy childhoods and families in their thinking about egg-freezing, and
in the frequency with which parents, particularly mothers, offered support and attended
clinics and surgery with their daughters as they went through the process. In five cases,
families contributed money, paying either for part or all of the procedure. In these cases,
we can see that egg-freezing was regarded as a way to enable family continuity and the
transition from one generation to the next, a technology so valued not only by the women,
but by their parents.
Participants also desired a genetic relation with the future partner – not a relation of
descent, but rather a horizontal genetic relation, in the sense that they wished for their
combined genetic contribution to the conception. This is evident in the fact that the
majority of the participants had not actively entertained the option of sperm donation to
conceive a child or to create and bank embryos.2 In the case of sperm donation, the woman
is committed to single motherhood and any resulting child would be her genetic offspring,
but not related to any future partner. For the single lesbian respondent, this desire for a
horizontal genetic relation was also in evidence. While only one woman in a same-sex
couple can have a direct genetic relation with a child, one of the clinics involved in this
study specialised in giving lesbian couples the option for one to donate eggs to the other,
who then gestates the child. This strategy is compatible with egg-freezing and Phoebe
planned to use her eggs in this way if she found the right partner. Here we can see the ways
lesbian couples use Assisted Fertility Technologies to ‘weave together old and new
understandings of relatedness in complex patterns and that this enables them to assert
authority as parents’ (Nordqvist 2012).
Conclusion
So, in summary, what does the new oöcyte tissue economy made possible by non-medical
banking mean to the women who use this service? As we have seen, women use egg-
freezing to reconcile otherwise incommensurable differences between the time scale of
their reproductive biology, the steadily elongating nature of the life course and the
increasingly iterative structure of portfolio careers and relationship formation. These
differences involved not only the instrumental calculation and management of time, its
allocation among competing priorities, but also the value and meaning of time. While the
women interviewed habitually resorted to the motif of the biological clock, I would argue
that it is inadequate to the experience it is deployed to describe, precisely because of
these issues of value and meaning. Clock time ticks away in regular increments, each the
same value as the last, equalising one moment to the next and organising time in an
instrumental, homogenous forward flow. However, for the women interviewed, their sense
of urgency arises from the way the loss of fertile capacity steadily accelerates, compounding
loss on loss, so that the sense of lost time becomes more and more acute and compelling.
It is this cascading loss that forced an acute awareness of the ways egg freezing could
potentially redeem both past and future, by arresting fertile time, stabilising its power to
create new lifetimes. Once stabilised, they hoped to better synchronise the otherwise
conflicting timescales that shaped and constrained their lives. Here the synchronic arts of
480 C. Waldby
the IVF clinic have been extended beyond the logistics of in vitro fertility into a more
general social space. Women purchase this synchronic power not in the service of
immediate conception, but as a way to create a margin for deliberation and relational
negotiation, without the ever-accumulating pressure created by dwindling fertility.
The women needed this margin so that they could grapple with their place in the flow of
generational time and the best way to ensure family continuity in both the genetic and the
social sense. Their actions were not prudential, but hopeful, oriented to the creation of
future possibilities for life and family.
Acknowledgements
I would like to thanks Rachel Carr and Michelle Jamieson for invaluable research assistance and the
women who generously shared their stories.
Funding
This work was supported by an Australia Research Council Future Fellowship FT100100176.
Notes
1. So in Australia for example, between 2007 and 2008, 55% of births were due to women aged 30
to 39, with a significant proportion of them to women over 35 (Australian Bureau of Statistics
2009). In Britain, the number of live births to mothers aged 40 and over nearly trebled between
1990 and 2010 (Office for National Statistics 2011).
2. Four of the women acknowledged that they were prepared to consider sperm donation if they
could not find the desired partner.
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Résumé
Cet article examine la pratique relativement récente de la congélation non médicale d’ovules, grâce à
laquelle les femmes conservent leurs ovules pour un usage ultérieur, en vue de concevoir un enfant.
Cette pratique n’est possible que depuis environ ces cinq dernières années, c’est-à-dire depuis qu’il
est démontré que les nouvelles techniques de vitrification ont de meilleurs taux de succès pour la
conception réelle – et sont donc plus fiables – que la première méthode de congélation lente.
J’utilise le contenu des entretiens conduits aussi bien avec des cliniciens qu’avec des femmes qui ont
conservé leurs ovules pour envisager comment cette nouvelle pratique s’articule avec des questions
plus larges sur le rapport entre la sexualité, la reproduction et l’économie politique de la formation
d’un foyer. La congélation non médicale des ovules constitue une solution technique à un certain
nombre de problèmes rencontrés par les femmes au regard de l’allongement de la vie, du
prolongement des études, du coût représenté par la formation d’un foyer et de la nature itérative de la
manière dont se forment les relations, thématisée par l’ubiquité des rencontres sur Internet parmi les
participantes. Je prête une attention particulière à la manière dont les femmes utilisent la congélation
non médicale des ovules pour gérer et agencer différentes formules du temps.
Resumen
El presente artı́culo examina la relativamente nueva práctica de congelación de óvulos, que permite
que las mujeres guarden sus óvulos con el fin de usarlos posteriormente para concebir. La
congelación de óvulos para usos no médicos se encuentra disponible desde hace aproximadamente
cinco años. Las nuevas técnicas de vitrificación han dado lugar a tasas más elevadas de concepción
exitosa que el anterior método de congelación lenta. Con base en varias entrevistas realizadas tanto a
médicos clı́nicos como a mujeres que han utilizado este proceso, la autora analiza cómo esta práctica
novedosa se articula con cuestiones más amplias vinculadas a la relación entre sexualidad,
reproducción y la economı́a polı́tica de la creación de hogares. La congelación de óvulos con fines no
médicos brinda una solución técnica a distintos problemas enfrentados por las mujeres en términos
de la elongación de su ciclo vital, la prolongación de su escolaridad, el costo de establecer un hogar y
la naturaleza iterada de la conformación de relaciones. Esta última es ejemplificada por el uso de los
ubicuos servicios de citas en Internet por parte de las entrevistadas. La autora se centra en las
maneras en que las mujeres aprovecharon la congelación de óvulos para administrar y reconciliar
distintas formas de tiempo.
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