Infertility Aliyah and Egg Harvesting

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test tubes In A New Reason to Make Aliyah: Free Egg Freezing, Allison Kaplan Sommer reports on a new development in Israeli health insurance:

The state will now cover the freezing of 20 eggs harvested in up to four extractions from young, healthy women, which can be stored, should she decide to have kids at a later age and find herself unable to conceive naturally.

This can take the pressure off of women who hit their mid-30s, who may not have met Mr. Right, aren’t ready to single motherhood yet, or who simply want to delay childbearing for career reasons.

“Our main goal is to allow women to keep their own eggs for future pregnancy, thereby obviating the need for egg donation. We also expect the cost of treatment to be low,” the Health Ministry’s legal adviser, attorney Mira Huebner-Harel, told Haaretz.

Kaplan Sommer adds that Israel’s generous fertility treatment, including free egg-harvesting, could encourage aliyah for Jewish 30-something women. I know of an Israeli citizen who returned to Israel to get infertility treatment. Her husband visits once a month from the US–a different kind of commuter marriage. Another friend was advised to continue living in Israel for a year or two after her marriage, just in case she would need treatment.

Waiting until your 30s to harvest your eggs may be too late, however. IVF success increases when using younger eggs. In Getting Pregnant After 35, Rachel Gurevich writes:

Even though IVF [in-vitro fertiliization] success was less than 10% at age 40 using the mother’s own eggs, women who used an egg donor (from a much younger woman) at age 40 had a success rate of about 45%. That’s an even better rate than women using their own eggs in their early 30s.

Israel’s insurance is surely incentive for people of all ages to make aliyah. So why not women concerned about their fertility?

This process could also help avoid halachic issues surrounding egg donation.

More on egg harvesting for religious women.

You may also enjoy:

Abortion in the Religious Zionist Community

Single Motherhood in the Orthodox Community

Photo credit: The Wandering Angel

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Comments

  1. MIL – I was under the impression that human oocytes don’t tolerate freezing well. Do you know anything about that? Anyone?

  2. “egg harvesting” sounds easy, but it isn’t – and there can be a lot of nasty side effects that may even endanger the woman’s life… (I know what I’m talking about, I underwent fertility treatment in the past) – so I’m not sure whether that’s a good reason to make aliyah.

    • I agree. I had a friend who went through this. It is no easy thing. I understand that younger eggs might be a good thing, but it worries me that this will encourage healthy young women to feel pressured to do this just in case.

      I know this may sound insensitive, but do we want to encourage women to have babies when they are older? Maybe it’s good to feel a little bit of the ticking clock. It makes me very nervous what the freezing process is doing to these eggs. I am not a scientist, but I know that DNA and epigenetics are very sensitive. It seems that the freezing process could be creating genetic diseases that might not be caught until the “test tube babies” are having their own babies. Maybe Israel should re-examine the adoption process. Should it really be easier to go through the whole process of fertility treatments than it is to adopt a child who already exists with body and soul?

    • So the government will have to cover the treatment for the side effects too.

  3. Ariela – they’re doing better with it in recent years.

    Anima – yes, ovarian hyper-stimulation isn’t exactly something I’d recommend as an elective procedure,

    I still think that freezing eggs (or ovarian tissue, see http://fertilityblog.fertilitystories.com/2010/09/healthy-baby-born-after-frozen-ovarian.html ) should be reserved for cases where there is a medical reason why the woman would be impeded from having a child later on other than the natural course of menopause.
    LeahGG recently posted..Lost and FoundMy Profile

  4. i doubt this will have more of an effect on aliyah rates than the other purported financial incentives that deal with bigger and more widespread problems(e.g., government health insurance, cheap tuition, etc.)

    but an intersting development in israeli health care in any case

    • I agree, but it also depends on the value you put on just one or two Jews coming “home.” And for many, worrying about fertility is the first stem in, G-d willing, worrying about tuition.
      Yosefa recently posted..Perfect PopcornMy Profile

      • YOSEFA:

        i don’t know what “many” means, but i suspect that the numbers of people who suffer from infertility (*and* would have benefited from early banking) is much smaller than those who “suffer” from tuition. but then again, it’s difficult to gauge because infertility is usually a private matter whereas tuition is the headliner topic at the every shabbat table.

        as far as a promotion to bring one or two more jews back to israel, the money would probably be more effectively spent by improving the sal klita or better yet simple cash grants. (and besides, historically financial incentives have never worked as a stimulus in attracting american olim.)
        Abba’s Rantings recently posted..Teaching David Parsha Ora CrawlsMy Profile

  5. This is crazy. For a healthy woman in her twenties or thirties to have an operation to put eggs in the freezer, just in case, when she feels ready to have kids, she can’t?

    • CHANA:

      it is crazy, unless you’re the one who’s approaching the end of her conceiving years and would have benefited. maybe some women feel it’s an issue of better safe than sorry? perhaps no different than parents who pay a lot of money to bank cord blood (although of course the latter is not invasive and is much cheaper)
      also, i believe that in the non-to-distant future geneticists will be able to predict with reasonable certainty the course of an individual woman’s fertility, which would be able to establish which women are stronger candidates for banking.
      Abba’s Rantings recently posted..Teaching David Parsha Ora CrawlsMy Profile

      • I think environmental factors are playing a large role in infertility, not just genetics.

        • in general i think that genetic determninism with regards to medical issues is becoming clearer every day. of course i don’t mean to exclude environmental factors, but some people are just stuck with “bad” genes and the environment is irrelevant.

          as far as infertility, i am a complete am haaretz. why do you think that it is environmental?
          Abba’s Rantings recently posted..Teaching David Parsha Ora CrawlsMy Profile

        • also i think that in discussions of fertility i would distinguish between (what i would call) chronic infertility and late infertility. the former describes women who for whatever reason naturally suffer from infertility, whereas the latter describes women who are “nomally” fertile and later experience “infertility” because they are trying to conceive at (or wait until) ages when it is known that it is much harder to conceive. i do think that geneticists will be able to determine at what point women individually will suffer from “later infertility,” thus making them more likely candidates for banking.

          but again, i freely admit i have no idea what i’m talking about
          Abba’s Rantings recently posted..Teaching David Parsha Ora CrawlsMy Profile

        • Environmental factors like birth control getting in the water supply? Sure. But it’s going to be hard to distinguish it from genetics when the chemicals in the environment start manipulating our genes. Do I sound like a conspiracy theorist?

          But you can’t deny that age is a factor. And it seems that this new egg freezing thing will mostly help older-ish women.

          And when you talk about reasons for infertility, you can’t compare women who get pregnant with their 7th child when they’re 40 to women who are trying to get pregnant with their first at 40. Again, I’m no scientist, but I know that women have a set number of eggs. So it makes sense to me that a women who’s been loosing only a couple eggs a year between all the time she spends being pregnant or nursing will probably be more fertile than a woman who’s been loosing one a month since middle school. It’s just a theory, and I know there’s evidence that young eggs are better, but if you want to get pregnant, having more than one egg left will help.

          • It’s not a genetic test, but there’s a simple blood test nowadays for ‘ovarian reserve,’ which is a rough estimate of how many eggs you’ve got left. It’s done routinely for women starting infertility treatments.

            Yosefa – one is born with thousands of eggs, way more than the few hundred that one would normally ovulate over the course of ones fertile lifespan. For whatever reason, only a small fraction of the eggs are ever used (aka ovulated), but the unused ones die at a high rate. How much time one has spent suppressing ovulation, whether by pregnancy/nursing or by hormonal birth control, isn’t really relevant to the question of how many eggs one has left in the bank.

          • Hi Gila, That’s interesting. I didn’t know eggs just die naturally. This this happen even before puberty? Just one more reason it seems that environmental conditions could lead to infertility. What do you think?
            Yosefa recently posted..Leftover Party- Sushi SaladMy Profile

          • Yosefta,

            Eggs don’t only die before puberty, but in fact, begin to die off before a baby girl is even born.

            When a girl is born, she is about one million eggs… by the time she reaches puberty, only 300,000 are left.
            Rachel Gurevich recently posted..Where Does the Term Test Tube Baby Come FromMy Profile

    • Yeah, it’s crazy, unless you are in your 20s (or teens) and have just been diagnosed with cancer, and you know the treatment will leave you infertile. At that point it starts to look like a really terrific idea.

      I have frozen ovarian tissue, but unfortunately there’s not much that can be done with it. The usual procedure (well, it’s not *usual* … but I’ve read about it a number of times) is to reimplant a small amount of the tissue somewhere like your arm, where it can go about its business and make some eggs to be harvested for IVF. However, the reason my ovarian tissue is in a deep-freeze somewhere instead of in my pelvic cavity is that I had tumours in both my ovaries — so none of my doctors are willing to try it, because odds are any ovarian tissue they put back in my body will just grow more tumours.

      I had a baby via donor-egg IVF when I was “only” 28. We would have liked to have more, but since we are in Canada, where IVF is neither covered by regular health insurance (i.e., free) nor covered by supplemental (employer-sponsored) health plans, it took us 5+ years to save up enough money for another try, and it was unsuccessful (twice). Now I am 36, and we have a big debt and no new baby coming. So I must confess I think the Israeli system sounds a lot better.
      sylvia_rachel recently posted..Mom loses sight of child for 10 minutes at large public event Nothing bad happens Film at elevenMy Profile

      • Sylvia-Rachel, I’m so sorry. For the record, we’re only talking here about women with no medical issues that could affect fertility. Freezing eggs/sperm before cancer treatment has been covered for as long as the technology has been available.

        • I should have been clearer: the actual freezing was in fact covered (as were all my surgeries and other cancer treatments, as well as all the medical costs associated with my prenatal care, my daughter’s birth, and our visits to the IBCLC). The thing we’ve paid all the money for is all those IVF cycles (four in total). We have it good here in Canada in a lot of ways! What makes me a bit insane, though, is that now there are these immature eggs of mine sitting in a freezer, and every time I ask I’m told there’s nothing that can be done with them, because all research on maturing human ova outside the human body has been halted by the somewhat draconian legislation on assisted reproduction that was passed about 5 years ago. At the time when the ovarian tissue was frozen — beginning of 2000 — we were told there was an excellent chance we’d be able to use them to conceive within about 5 years. Turns out … not so much.

          I agree that freezing eggs for healthy young women is maybe a slightly odd choice … but after all, you never know what health problems might crop up for those young women later on. And since, as someone else pointed out upthread, it’s hardly an easy or pleasant procedure, I somehow can’t see gazillions of women flocking to take advantage of this new coverage: people who choose to do it will have reasons.

  6. MIL, thanks for the link to my site! And also, thanks for giving me an interesting thing to blog about. I didn’t hear about this!

    Of course, I’ll be sure to include a link back to your site in my post.

    I’m not sure how I feel about this one, though… I need to get writing to find out. It sounds kinda good, but… I don’t know. Something doesn’t *feel* right.
    Rachel Gurevich recently posted..IVF in the ClassroomMy Profile

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