What should you do when you have a population that is shrinking and ageing amid a very low national birth rate? The government of the Japanese city of Urayasu thinks the answer is to pay for women to freeze their eggs.
Working with Juntendo University Urayasu Hospital, the city has announced a three-year pilot project that will use public money to cover 80 per cent of the egg freezing costs for female residents aged between 25 and 34.
The aim is to boost fertility rates by facilitating delayed childbearing; the eggs will be used up to the age of 45. This is the first “social” egg freezing subsidy programme of its kind. I hope it is the last.
Egg freezing is onerous and risky for individual women. It’s also likely that the majority of those who undergo the procedure as an attempt to guard against age-related infertility won’t ever use these eggs in future attempts at pregnancy.
Those who do will have to resort to IVF, which poses additional risks and costs. Furthermore, egg freezing isn’t guaranteed to work. Live birth rates following egg freezing and subsequent IVF remain low. Equally worrisome, perhaps, is the amount of uncertainty surrounding the long-term effects of these technologies on the women and any resulting offspring.
Social egg freezing also raises ethical challenges of fairness about using resources that could go to those who need to freeze eggs on medical grounds, the over-valuing of pregnancy and having genetically related children, plusinformed decision-making.
There are also problems related to the ways in which the media portrays social egg freezing and the implications for women if it is normalised or mandated. These are some of the considerations raised earlier this week on a panel at apublic event on social egg freezing run by the Progress Educational Trust and hosted by the Royal College of Physicians of Edinburgh, UK.
Although some women may benefit from social egg freezing, this technology doesn’t benefit all women. Nor is it a reasonable solution to the “social problem” of low birth rates (or infertility) identified by Urayasu’s mayor.
This is because it merely offers an individual technological solution for what is a broad and complex social problem. Social and structural changes are needed to make it easier and preferable for women (and men) to have children and to do so when they are younger.
First, governments should invest in improved reproductive health and fertility education programmes. Women and men need better information about fertility, infertility and family-building options so that they can better plan their reproductive lives.
Second, women and men should have access to paid parental leave and they should have flexible work schedules or reduced workloads that are more conducive to raising children.
Third, the costs of living, such as housing and childcare, should be affordable. Financial and social stability can make it much easier to have children, if one chooses to do so.
Yes, Japan has a demographic problem. The population has been falling for several years amid a fertility rate of 1.4 children per woman, while the proportion of over-65s rises.
But by investing in subsidised social egg freezing, the city of Urayasu has effectively put all its eggs in the wrong basket. It has chosen a technological intervention that is risky to individual women and ethically problematic.
It is also an option that is likely to be ineffective because it targets individuals instead of trying to improve the wider conditions that shape both women’s and men’s reproductive choices.
Image via Pixabay
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