The survey results confirm what we learned long ago about fertility programmes which involve sharing eggs with women unable to produce them – that altruism and a wish to help are a strong motivation. More than 20 years ago, when the London Women’s Clinic introduced its egg sharing IVF programme, there were some who claimed the financial incentive (of no IVF costs) was tantamount to payment; many studies since then performed by the London Women’s Clinic and other fertility groups around the world showed that this was not the case, but was more a willingness to help other patients less fortunate than themselves.

The Freeze and Share programme at the London Egg Bank gives women wishing to store their eggs the opportunity to do so without cost if they allow a portion of the eggs collected to be retained by the egg bank for use in egg donation. These are patients unable to produce their own eggs because of conditions like an early menopause.

Among the comments received from the survey, one freeze-and-sharer said she and her partner were “really happy we had the possibility to help another family and pay less to create our own”. “Helping other women to conceive is the best gift I could ever make,” said another. “Sharing the eggs with someone was an important factor,” was another comment. “It was easier to go through a challenging situation when not only myself would benefit.”

Our survey carried out in 2021 thus shows that that same willingness to help is still a strong motivation, even though the end-results for the sharer are a little different today. Then, the outcome was financial support for immediate IVF for women who needed fertility treatment; today, freeze-and-sharers are not biologically infertile but simply are not yet ready to start a family with – and their IVF treatment is not immediate but kept on ice until the time is right.

Thus, while the motivations of today’s freeze and-sharers have not changed over two decades, the technology of their treatment has. The fast freezing technique of vitrification has revolutionised fertility treatment and made possible the successful freezing of eggs, which was not viable 20 years ago. Vitrification means that the cryopreservation of eggs is now a routine procedure in egg banking for egg donation and in storing eggs for personal use later on. Indeed, the eggs “shared” by our own freeze-and-sharers will be allocated not to an identified egg donation patient but to the London Egg Bank and made available from the online database to those who consider the donor suitable.

The London Egg Bank survey also confirms that the treatment procedure for “Freeze and Share” is conducted in a way which most recipients found “excellent” or “good”. Most began the programme with information gleaned from the LEB website, with the result that tests and initial procedures were all within expectations; 84% said they “felt confident” about the medical procedures and the freezing technology. Around one half of those surveyed said they expected to use their eggs within ten years, although the legal limit on egg storage – currently ten but a matter of legal debate. One respondent said: “I think it is imperative that the limit for using eggs is extended beyond 10 years. We cannot penalise women for being proactive early about giving themselves the best chance of healthy pregnancies down the line.”

Fertility preservation for personal reasons (also known as “social egg freezing”) is still a relatively new procedure and there are still many unanswered questions – not least how many women will actually return to use their eggs in storage or how many eggs are needed for the best chance of pregnancy later on. One respondent said she hadn’t yet decided “if I will go ahead with IVF in future, but I must say it is nice to have the option”.

Another respondent asked for “a bit more clarity about the actual costs involved, and then some more information on how many eggs will survive the fertilisation process and be suitable for freezing”. We do try to be clear on costs, and evidence suggests so far that more than 90% of vitrified eggs will survive freezing and thawing. Indeed, evidence from egg donation suggests that IVF with a frozen egg can be just as successful as with one freshly collected, but so far no-one can say with any accuracy how many eggs might offer the best chance of pregnancy in social egg freezing programmes. That number will depend on the patient’s age, and is likely to increase as she gets older, especially over the age of 35 when natural fertility begins to decline. But there’s still much to learn, and even the HFEA, the fertility sector’s regulator, describes egg freezing as “rapidly changing field”.

“But,” says Dr Kamal Ahuja, Scientific and Managing Director of the London Egg Bank, “as the HFEA also acknowledges, we are learning all the time, and the information provided by surveys like the London Egg Bank’s will tell us a little more, in the hope that programmes can be even more successful and an ever more reassuring experience for those taking part.”