“What am I going to do with those eggs”: patients’ experience of and attitudes toward surplus frozen eggs

Research question
What factors influence and underpin patient decision-making regarding surplus frozen eggs?
Design
A mixed-methods study was conducted using an online survey (n=50) and follow-up semi-structured interviews (n=16). People who had frozen eggs but had not used all their eggs in treatment were eligible to participate. Participants were recruited between February and July 2023 from a large private fertility group located within the state of Victoria, Australia. Data were collected on the experience of egg freezing, attitudes toward storage limits, and decision-making regarding surplus eggs.
Results
Despite most participants initially expecting to use their frozen eggs, only a small percentage actually returned to use them. While the decision to freeze eggs was reported as easy, decisions regarding the disposition of surplus eggs were found to be emotionally complex and often misaligned with initial intentions. Several factors were raised as influencing egg disposition decisions. These were broadly categorised as: (1) external factors, (2) knowledge and awareness, (3) genetic ties, and (4) moral distress. Opinions on storage limits for frozen eggs were mixed, with many participants viewing these limits as unfair or adding unnecessary pressure to an already emotional process.
Conclusion
Several factors were reported to influence patient decision-making about their frozen eggs, with some factors perceived by patients as limiting their autonomy over their eggs and reproductive plans. It is incumbent on services that promote egg freezing to address and remedy the collateral problem: that contrary to what they expect, many people will end up with surplus eggs that can become a significant emotional burden, a source of moral distress, and present substantial logistical issues.