Opinion – What Happened to All Those Frozen Eggs?

Frozen Eggs was supposed to be as revolutionary as birth control. It hasn’t lived up to the hype — but it has still changed women’s lives.

Frozen eggs – The potential for egg freezing to allow women to pause their biological clocks is one of the most astonishing developments of recent fertility science. The promise was thrilling: Women could enjoy more time to find the right partners, break up with the wrong ones and become emotionally and financially ready to become mothers.Egg Donations

Enthusiasts even fantasized the technology would promote gender equality by giving women control over their fertility so that they wouldn’t have to scale back their career ambitions during their 20s and 30s. “Freeze Your Eggs. Free Your Career” blared a 2014 cover of Bloomberg Businessweek.

When Facebook and Apple announced that same year that they would pay for egg freezing for employees in a “game-changing perk,” Apple said in a statement, “We want to empower women at Apple to do the best work of their lives as they care for loved ones and raise their families.”

Egg freezing was an act of self-care — and professional advancement — for the modern woman.

“All the talk in the beginning was about how egg freezing would be as big as the birth control pill and liberate women,” said Janet Takefman, a reproductive health psychologist at McGill University in Montreal, who has counseled more than 200 women considering egg freezing.

And women responded to this promise. In 2009, the first year the Society for Assisted Reproductive Technology started collecting egg freezing data, 475 women went through the procedure, in which an average of 10 eggs are surgically removed and preserved in liquid nitrogen after 10 days of hormonal stimulation. In 2017, more than 9,000 women froze their eggs.

Now we have a chance to look back and ask: Did egg freezing live up to its hype?

The most obvious question is whether egg freezing worked by allowing women to have children later. Although SART collects data on pregnancy rates using frozen eggs, it doesn’t break out whether women had frozen them as part of in vitro fertilization treatment or fertility preservation during illness, or to delay childbearing. So I contacted four fertility clinics that have been in the field the longest to find out. (I froze my eggs at two of them and haven’t yet thawed.)

nytimes.com, by Sarah Elizabeth Roberts, December 21, 2019
Click here to read the entire article.
 

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Source: Time for Families

Opinion – The Big IVF Add-On Racket

PGS, PGD

IVF Add Ons – This is no way to treat patients desperate for a baby.

There are few things as unsettling as sitting in an in vitro fertilization clinic hearing you need a team of experts — embryologists, lab techs and nurses along with a reproductive endocrinologist — to help you become pregnant.embryo

What comes next can be a blur. First, you meet with the clinic’s financial counselor to assess whether you have enough money for a complex, invasive $15,000-$20,000 IVF cycle. What follows are drug injections, blood tests, invasive ultrasounds, surgical egg retrieval, and fertilization ahead of an embryo transfer. Before your first hormone shot, you’re well into head-spinning, unfamiliar territory.

Then the doctor tells you there are “add-ons” you might want to consider.

Might you have interest in endometrial scratching? What about vasodilation, human growth hormones, intralipids, assisted hatching, oocyte activation, physiological intracytoplasmic sperm injection, or embryo glue? Post-fertilization, there is also embryo pre-implantation genetic testing to consider. Interested?

These extras come with price tags ranging from hundreds to thousands of dollars. All are presented as ways to increase your chances of a pregnancy. What are you willing to try? What can you afford? The ball is in your court.

This is no way to treat patients at their most vulnerable.

That’s the conclusion my colleagues and I arrive at in a new paper on the ethics and regulation of IVF add-ons.

An add-on is anything that is not essential to carry out an IVF cycle. Such measures, patients are told, will improve the likelihood of a live birth — and yet our examination revealed a startling absence of robust research into the effectiveness and the safety of these add-ons. Despite this, their use is widespread, and regulation of them is minimal.

The most expensive add-on category is pre-implantation genetic testing. These tests were originally developed to identify embryos at risk for genetic diseases. Today, however, they are primarily sold, at a cost of $6,000 to $12,000, as a way to screen for chromosomal abnormalities that could lead to failed implantation or miscarriages.

In October, however, a large study found that a single abnormal cell does not doom an embryo and determined that one of the tests, PGT-A, made no difference to rates of live births. Worse still, patients who opted not to transfer embryos based on the test’s results may have lost potentially viable ones.

There is also endometrial scratching, a procedure, sometimes costing as much as $500, that purposely irritates the endometrium, the innermost lining of the uterus, before IVF While it’s promoted as increasing the chance of an embryo implanting, a recent large randomized trial found no benefit. Beyond significant patient discomfort, risks include bleeding, infection and uterine perforation.

Then there are intralipids, an emulsion of soybean oil, egg phospholipids and glycerin administered intravenously and described as a way to decrease natural killer cell activation in the immune system and ostensibly aid in embryo implantation. This emulsion is priced around $400 per infusion; typically several are recommended. Side effects include headache, dizziness, flushing, nausea and the possibility of clotting or infection. A meta-analysis last year found that intralipids and other forms of immunotherapy should not be used in routine clinical practice.

Such procedures are often presented to patients in the form of a stack of papers, written in legalese or medical jargon. Resourceful patients might take to the internet to learn more, where searches might deliver densely written scientific articles, and ads might direct them to companies or clinics eager to promote their own brands of add-ons.

Why is all this happening? It’s because IVF remains an under-regulated arena, and entrepreneurial doctors and pharmaceutical and life science companies are eager to find new ways to cash in on a growing global market that is projected to be as large as $40 billion by 2024.

NYTimes.com, December 12, 2019 by Pamela Mahoney Tsigdinos

Click here to read the entire article.

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Source: Time for Families

Anthony M. Brown Featured on the Podcast, The Mentor Esq.

The Mentor Esq

The Mentor Esq., a new legal podcast, recently featured Anthony M. Brown, founder of Time For Families Law, PLLC.

The Mentor EsqThe Mentor Esq. was founded by Andrew J. Smiley, the famed personal injury attorney in New York City, to help younger attorneys, and seasoned attorneys, to learn more about specific areas of the law and about the profession of law itself.  Episodes of The Mentor Esq. cover such topics as civil rights work to women in the law, as well as the ABCs of trial work, from opening statements to cross examination.

This is the first season of The Mentor Esq. and Andrew is currently planning for season 2.  While there are numerous areas of the law, and attorneys, that he could focus on, I am grateful that Andrew allowed me to tell my story and share my concerns for the future of LGBTQ law in New York, as well as in the Country.

Anthony’s Start in The Law

Andrew reached out to Anthony to join The Mentor, Esq. podcast to discuss two separate issues.  On episode four of the podcast, Anthony discusses how he came to the law after a career as an actor and a medical massage therapist.  Andrew asked Anthony about how he started his practice and who guided him along the way.  Click here to listen to Anthony talking about his pathway to the law.   Younger attorneys will find this episode particularly interesting because Anthony discusses new ways to look at your career, especially at its inception, by thinking outside of the box and planning ahead for what you want your legal practice to focus on and how it intersects with your personal life.

LGBTQ Family Law

Andrew asked Anthony back to the podcast to discuss more specific topics such as LGBTQ family formation and the current state of surrogacy in New York.  With current legislation in New York up for a vote very soon, Anthony discusses the specifics off The Child Parent Security Act – the pending law which would legalize compensated surrogacy and provide for parentage orders, which would allow for lesbian couples with known sperm donors to avoid the second parent adoption process altogether.  The Child Parent Security Act would bring New York’s family law into the 21st century.

If these issues mean something to you, it is definitely worth your time to check out The Mentor Esq.  A full episode list can be found here.

Anthony M. Brown, November 26, 2019

 

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