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The fertility treatment options for single women

The options open to single women wanting to conceive are now more varied than ever. A study from Barcelona sheds more light on the motivation behind the choice to have a child solo.

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There are two fertility treatments for single women without a partner to fulfil their wish to have a family. One is intrauterine insemination or IVF with donor sperm and the other is egg freezing, in which mature eggs are frozen to use at a later time.

Both procedures have increased in use with the growing incidence of women in their thirties and forties who aren't ready to have a baby. Because we know that age plays a major factor in the quality of a woman's eggs over time, the wait to have a child can result in a decline in fertility. Egg freezing provides a possible long-term solution, while IUI or IVF with donor sperm offer a more immediate choice.

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The main factors reported for egg freezing were to offset the pressure of the 'biological clock'.

Barcelona, 2015: A new study concludes that the 'relevance of family ties' is an important determinant when opting for IUI or IVF. Every single woman having fertility treatment was asked about their background, relationship status, desire for motherhood, and family support and proximity. Significantly, the main reason (in around 70%) why they were seeking treatment was the lack of a partner. This conclusion is nothing new: there have been multiple studies with similar findings.

However, the study also found that most women reported the involvement of their families. This was significantly greater, in terms of emotional and financial support, in those patients choosing IVF or IUI.

The main factors reported for egg freezing were to offset the pressure of the 'biological clock'. Egg freezing allows a woman more time to decide and some insurance for future fertility.

 The investigators' finding from this study, therefore, was that women choosing IVF and IUI live closer to their relatives than those electing to freeze eggs. That they appear to receive stronger family support, both emotionally and financially.

It seems apparent that those opting for IUI or IVF had already 'made peace' with single motherhood. Those freezing eggs, by a large percentage, are still waiting for a suitable partner.

Some 40% of those choosing IVF or IUI were unaware that eggs could now be reliably frozen for later thawing and use. This implies how important it is that egg freezing is discussed in fertility counselling for single women.

The study found that around two-thirds of patients for both treatments had been single for more than a year at the time of the survey, and most were working, and university educated. Only a very small proportion in both groups had had any children. It seems also worth noting that around three-quarters of those surveyed came from France for treatment at a Barcelona clinic. This is simply explained by the requirement in France (in 2015, the year of the treatments) that all fertility patients are diagnosed as 'infertile' and in a relationship. This requirement is now being modified in an upgrade of French regulation which will very soon allow the treatment of single women.

 We also know, from a study of patient experience at the London Women's Clinic (from 2008 to 2017), that those who had frozen their eggs for social reasons were single at the time of freeze, with an average age of 37 years. They had kept their eggs in storage for just under five years, returning to use them at the average age of 42 years. However, 43% were still single at the time of thaw, and around half used donor sperm to fertilise their eggs. Such study findings are limited as so few egg freezers have so far returned to thaw their eggs and start a pregnancy. However, with the rapid uptake of egg freezing, our understanding of its who, why and when is beginning to take shape.

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