Rise in Australian women seeking to freeze their eggs as social and medical issues hamper having a family

Australia’s fertility rate is at a record low, having dropped to just 1.48 children per woman and is predicted to decline further.

It has already fallen way below the replacement fertility rate of 2.1 children per woman needed to keep the nation’s population size stable without migration.

Having a baby has become a complex decision for many Australians involving relationships, finances, careers, lifestyle choices and health issues.

A record number of young Australian women are now seeking to give themselves reproductive options by freezing their eggs in a bid to enable them to have children in the future.

New data published in August show there has been a massive increase in the number of ART (assisted reproductive technology) cycles carried out in Australia to preserve fertility rather than get pregnant straightaway.

There were 8776 cycles performed for fertility preservation - usually the freezing of eggs – in Australia in 2024, equating to one in seven of all fresh cycles carried out.

This was 141 per cent higher than the 3642 cycles for fertility preservation done in 2020.

More than one third of those 8776 cycles were undertaken for non-medical reasons, most commonly not having a partner, which is known as social or elective egg freezing.

Perth reproductive endocrinology and infertility specialist Tamara Hunter said egg freezing was increasing exponentially in ART, including for non-medical reasons.

“I personally would see someone regarding elective egg freezing in every clinic that I run now,” she said. “So that’s at least half a dozen women each week, and that’s just me. Every other fertility specialist, I’m sure, would be seeing similar amounts.”

Why are more women choosing to freeze their eggs?

Women have been increasingly delaying motherhood for years. The average age of a first-time mother in Australia has now reached almost 30 years old compared to 28 years old in 2010. Meanwhile the proportion of mothers in their 20s has more than halved since 2010.

Unlike men’s sperm, a woman’s egg quality declines significantly as she ages. Female fertility begins to drop from the age of 30, plummeting in the late 30s.

Around one in 16 babies born in Australia is now conceived through in vitro fertilisation (IVF) or ART treatment.

Traditionally IVF and ART have been used to treat infertility among people who have been unable to conceive and have a baby naturally, including older women who are naturally less fertile.

This growing cohort of patients using ART services – elective egg freezers – may have no fertility problems and are seeking to preserve their younger eggs to have a baby later.

Dr Hunter, who is medical director at Monash IVF in Perth, said the number of women electing to freeze their eggs to preserve fertility was rising not only because of education, career or lifestyle choices but also through being unable to find a suitable partner.

“We are in such a difficult socio-economic time. Inflation’s going up. The cost of living is going up. There’s pressure on girls to pursue careers,” she said.

“By far and away, the biggest reason that women electively do egg freezing is they don’t have a partner.”

Fertility specialist Fiona Langdon, who works at Monash IVF in Perth, offers bulk-billed consultations for women to discuss egg freezing with her.

“I have been so saddened by the number of women having poor outcomes with IVF later in life and them having no idea bout the option of egg freezing years earlier,” Dr Langdon said.

“The bulk-billed consults are to try and reduce barriers to women having these conversations to make an informed choice about whether it would be helpful for them and making them aware of the treatment.

“Even if they don’t proceed now, maybe in the future they may consider it as life situations change.”

According to the YourEggFreeze website, which is an independent guide funded by the Australian Government, a single egg freezing cycle costs between $7000 and $12,000 upfront, plus $500 to $1000 per year for storage.

Egg freezing that is done for medical reasons, such as diseases or treatment that may affect fertility such as cancer or severe endometriosis are eligible for a Medicare rebate, which can reduce the patient’s bill by thousands of dollars.

But, if there are no medical reasons, women get no rebate.

Dr Hunter told the Fertility Society of Australia and New Zealand’s annual conference in Canberra last month that this created an equity issue in terms of access to and affordability of treatment.

She argued that elective egg freezing should be considered preventative medicine like pap smears, skin checks and mammograms.

“Elective egg freezing should be seen in the light of providing women with reproductive options while sparing the public health budget of the huge costs of Medicare subsidies to later fund repeated IVF cycles that may not be successful,” Dr Hunter said.

Research shows the vast majority of women who freeze their eggs end up not using them.

A 2022 study of 645 women in Taiwan who did elective egg freezing found that only eight per cent of them ended up thawing and using their preserved eggs.

Dr Hunter said this was usually because women, especially those who froze their eggs at a younger age, met a partner and conceived naturally or did not meet a partner or decided against becoming a parent.

“I don’t think it should be seen as a failure of the process,” she said. “It enlightens us and maybe makes us stop and think about a minimum age below which we should be saying no.”

Dr Hunter said it also raised the question of what women should do with their frozen eggs if they end up not using them.

“We should talk more about donation, including the concept of patients storing half their eggs for themselves and half for somebody else,” she said.

Earlier this year, a Federal Government-funded online calculator “Your Egg Freeze Estimator” was launched to help women plan and understand how egg freezing could work for them.

Professor Georgina Chambers, from the University of NSW in Sydney who led its development, said it was co-designed with women in response to the huge increase in elective egg freezing but a lack of independent information.

“The three things that they mainly want to know is, “How many cycles will I need to do, the costs and then how many eggs do I need,” she said.

“The estimator really breaks it down. A lot of women may think one egg equals one baby. Well, it certainly doesn’t.”

Dr Hunter also warned that egg freezing is not a guarantee of a future live baby or protection from future fertility problems.

An expert in health economics, Professor Chambers took a wider view of the issue.

“As a society, we should be supporting women and men to have children when it’s most biologically sensible and emotionally sensible for them to have children,” she said.

“Elective egg freezing is a great option in terms of giving women reproductive choices, but as a society, we would be better to support men and women to have children when they can, and I know that’s a difficult, huge societal question. I think manipulating women’s reproduction isn’t the best way to achieve that.”

When Stacey Miller was told the stage four endometriosis was threatening her fertility, she knew it was time to act.

Ms Miller, a nurse who lives in Como, decided to freeze her eggs because endometriosis – a chronic condition where tissue similar to the lining of the uterus grows outside of it causing pain and damage to other organs and tissues – was affecting her ovaries.

“I’m at the point where if they do another surgery, because my endometriomas (cysts caused by endometriosis) are so big that there’s a chance that they’ll take my ovaries,” she said.

“When they said that, I said ‘right well I need to take things into my own hands’.”

Ms Miller has just completed one egg freezing cycle under Dr Hunter’s care and plans to do a second cycle, which is the most she can afford for now.

While she has frozen her eggs for a medical reason primarily, Ms Miller said that, as a 34-year-old single woman, it felt like a weight had been lifted off her.

“I’ve always known I wanted to be a mother. That’s something personally I’ve never been unsure about,” she said. “But you know, generally finding someone to build a life with isn’t as easy.”

Ms Miller’s first egg freezing cycle cost around $12,500, with about half of that amount rebated by Medicare because of her medical condition.

She believes that the Medicare rebate should be also applied to elective egg freezing so that more women can have the option.

“I feel like I’ve got peace of mind essentially. If I do need it, then I’ve done the right thing,’ she said.

“It’s an investment into my future, and it’s in my control whether I use them or not.”