Egg freezing, the reliable fertility preservation procedure affording women the opportunity to put their fertility on hold is now the UK’s fastest growing fertility treatment, according to the Human Fertilisation & Embryology Authority (HFEA), the UK regulator. The HFEA’s latest report (HFEA, 2023. Fertility treatment 2021: preliminary trends and figures), which records all fertility treatments performed each year in UK clinics, reveals record numbers of patients freezing their eggs for future use, with 4215 identified in 2021 compared with 2447 in 2019, a rise of 64%.

The nation-wide upturn seen in egg freezing is reflected in our own figures at London Women’s Clinic, where women turning to egg freezing continue to increase steadily. More and more young women, for reasons defined by their age and personal circumstances, are choosing to freeze their eggs until they feel right for pregnancy and a family.

However, the data also show that the numbers of women donating eggs for treatments in women unable to produce their own eggs declined a little (-6%) between 2020 and 2021. Our Freeze and Share programme at partner clinic, London Egg Bank aims to address this decline by providing free egg freezing in return for a donation of half the number of eggs collected to the egg bank for egg donation treatment.

The figures continue to emphasise the effect of female age on the outcome of all fertility treatments – a heavily important implication for those considering egg freezing. Thus, while the average overall IVF pregnancy rate with fresh embryo transfers increased from 10% in 1991 to 29% in 2021, there was also huge variation according to female patient age. Those aged 18-34 had the highest pregnancy rate (per embryo transferred) at 41% in 2021, but those aged over 40 recorded much lower rates (5-15%). It was also found that the average age of IVF patients increased to 36 years in 2021, while the overall average age of natural childbirth was 30.9 years.

These figures reflect a generally rising age for childbirth but also suggest an age-related increase in infertility, as more and more women and couples defer their plans for a family. There’s an indication in the HFEA figures that many women as they get older are turning to IVF in response to their own inability to conceive naturally. Studies report unequivocally that female fertility begins its decline to the menopause at around the age of 35.

The greatest increase in IVF use was found among single patients (44%) and those in female same-sex relationships (33%). Significantly, both patient groups, who represent a core treatment specialty at London Women’s Clinic, are rarely defined as ‘infertile’ but are part of a growing body of patients for whom ‘infertility’ treatments are appropriate. Our results of single women and lesbian couples at London Women's Clinic (LWC) between 2004 and 2016, have been the subject of a 2021 comprehensive publication spanning 13 years of retrospective research into 3333 women (45% single, 43% from same-sex and 12% from heterosexual couples), (Linara-Demakakou et al., 2021).

The HFEA report noted that ‘very few single and same sex patients qualify for NHS funding’, while generally recording a decline of 4000 fewer IVF cycles funded through the NHS between 2019 and 2021 - a 17% reduction of NHS funded cycles in England, 36% in Wales and 1% in Scotland. ‘So although more people than ever are having fertility treatment, our data shows that more people than ever are now also paying for it,’ said the report.

Age remains a defining factor in UK fertility treatment, and one reason why egg freezing is so increasingly popular. Celebrities today are using their platforms to speak out on the impact age has on a woman’s fertility status, including Jennifer Anniston who missed the boat on egg freezing at a younger age and Priyanka Chopra taking the advice of her obstetrician-gynaecologist mother to freeze her eggs in her early 30s. This process requires a significant commitment from our fully conversant embryologists, responsible for the safe long-term storage of oocytes and embryos.

At London Women's Clinic, we advise freezing eggs as early as possible, ideally during a woman’s mid-20s to early 30s, as after the age of 35 egg quality and egg quantity both begin their decline, evident in an increase in genetic abnormalities and a decline in ovarian reserve. The former is usually expressed in chromosome irregularities while the latter is the natural exhaustion of follicles as the ovary makes its steady progress to menopause.

The message here for egg-freezers is that age - and particularly the age of egg - is a crucial factor in determining success. We see this most clearly in figures for egg donation, where HFEA data (HFEA, 2022. Trends in egg, sperm and embryo donation 2020) shows comparable birth rates in different age groups of recipient patient, whether in her 30s or 40s. It’s the age of egg which matters, not the age of the recipient. Our own results from vitrified donor eggs in different age groups, are captured in our recent study noting factors predicting clinical outcomes at London Egg Bank, (Pataia et al., 2021).

• If you are considering egg freezing visit London Women's Clinic
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• If you are interested in our egg donation services or Freeze and Share programme please see London Egg Bank