Alan Copperman C’85 believes it may someday be commonplace for young women and even teenagers to take a medical test to determine whether they should freeze their young eggs for future baby-making. Copperman—director of the Division of Reproductive Endocrinology and Infertility at New York’s Mount Sinai Medical Center and co-director of Reproductive Medicine Associates, a fertility practice in the city—has appeared on news programs like 20/20 to discuss fertility and hosts seminars about egg freezing that draw capacity crowds. Copperman contends that egg freezing and similar breakthroughs will change society the way the birth-control pill did in the 1960s.
“I do foresee a day when there will be genomic tests done of young women in their teens or their twenties to know whether they are destined to be fertile into their fourth decade of life and beyond, or whether they will have reproductive issues and should consider electively freezing their eggs,” Copperman says. “The birth-control pill once freed up women to not get pregnant when they didn’t want to, and now this technology will help them get pregnant when they want to.”
A history and sociology of science major at Penn (with minors in chemistry and biology), Copperman says his academic background “helped me understand the historical significance of what we’re doing now. If you understand the history of the birth-control pill, the liberties it gave women decades ago, I see a societal parallel.”
The difficulty of getting pregnant at 40 wasn’t a pressing concern back when the Pill was first helping remake society in the 1960s. In 1970, a woman’s average age at marriage was 20.8, according to the US Census (for men, it was 23.2). By 2010, it was 26.1 for women and 28.2 for men. The age of first births climbed as well during that period, going from 21.5 to 25.4, according to the Centers for Disease Control & Prevention. From 1970 to 2006, the percentage of first births to women over 35 increased eightfold. In fact, the number of births to women ages 35 to 39 has risen 57 percent from 1990 to 2006, according to the CDC.
The range of social factors driving this trend—from women’s desire to establish themselves professionally to men’s reluctance to commit to marriage to the dim economic prospects of recent years—have been extensively (even exhaustively) covered in the media. But women’s bodies haven’t gotten the memo.
Women are born with one to two million eggs, and at the start of menstruation, perhaps 400,000 remain. As women proceed through their twenties and thirties, many of the remaining eggs become damaged. When a woman ovulates in a given month and the egg is one of the damaged ones, it may stop her from getting pregnant at all, or she may miscarry, or she may give birth to a child with a birth defect. According to the American Society for Reproductive Medicine (ASRM), a 30-year-old woman trying to get pregnant has a 20 percent chance of succeeding in a given month. By age 40, her chance is “less than 5 percent.”
Since the birth of the first test-tube baby in 1978, IVF has come to provide an infertility-treatment option for some couples who can afford it or whose medical insurance covers it. In 2010, American fertility clinics conducted 146,693 cycles of IVF. Older women can use IVF to get pregnant with donor eggs from younger women. Or, if they use their own eggs, doctors can isolate the most healthy-looking ones for implantation. Still, for women 41-42 who used their own eggs in 2010, the average success rate with IVF at American clinics was only 12.5 percent per cycle. For women under 35, the rate was 41.7 percent.
It’s no wonder doctors would like younger women to be able to freeze their eggs for use later—if the process works reliably.