Getting eggs ‘out of the basket’: World-first study explores challenges with surplus frozen eggs

Deciding what to do with unused eggs kept in storage for IVF treatment is a challenge for many hopeful parents, a new study by the Monash Bioethics Centre and Monash IVF has found.

There has been a dramatic uptake of egg freezing to address the risk of future infertility in Australia in recent years. Despite this surge, only a small proportion of individuals have returned to use their frozen eggs in assisted reproduction.

This has led to a conundrum about what to do with surplus eggs with clinics struggling for space to store them. At the same time, the demand for donor eggs for research and for reproductive purposes continues to increase.

A world-first study by Monash IVF and Monash University’s Bioethics Centre published in Reproductive BioMedicine Online found people who had frozen their eggs faced complex decisions with limited information when deciding what to do with surplus eggs.  

Led by Dr Giuliana Fuscaldo, Dr Molly Johnston and Professor Catherine Mills from the Monash Bioethics Centre, and Professor Deirdre Zander-Fox from Monash IVF, it is the first to investigate the factors that might assist patients facing decisions about what to do with their stored eggs, including what specific supports are required for people considering egg donation.

"Deciding what to do with unused frozen eggs can be very challenging for some patients. It's important that we understand how best to support the growing number of patients who will soon face these decisions and ensure their preferences are honoured, where possible," co-author Dr Molly Johnston said.

Researchers surveyed individuals who had frozen eggs at Monash IVF clinics in Victoria. They found there were three broad categories of factors that can act as both enablers and barriers to decision-making about surplus eggs: information, communication and shared insights.

Among the findings:

  • 30 per cent were reluctant to discard eggs and described this as the option of last resort. One respondent said: “It’s not something I’d want to do because it would feel like such a waste because it’s such a complex and expensive procedure to get them in the first place.”
  • 46 per cent of respondents with eggs still in storage said they’d consider donating eggs to research if they were compensated (being paid or reimbursed storage fees).
  • 42 per cent did not know about the demand for donor eggs. As one respondent said: “I could have made the eggs available earlier.”
  • 36 per cent said unclaimed eggs should be allocated to research at the end of the storage period instead of being discarded.

“'We found that many patients were unaware of their options, the processes involved, and the implications of donation specifically,” Dr Johnston said.

“For example, some patients were unaware that eggs can be donated to non-relatives, that donors can find out whether their donation results in a child, and that anonymous donation is not permitted in Australia. These knowledge gaps may be preventing patients from making informed decisions."

Monash IVF Chief Scientific Officer, Professor Deidre Zander-Fox, said Australia has a drastic shortage of egg donors and hundreds of hopeful parents-to-be depending on donations to help them become parents.

“Demand for egg donors at Monash IVF is 20 times greater than our existing donor pool. About one in five of our patients needing egg donors rely on donations from strangers,” Professor Zander-Fox said.

“This research demonstrates that by raising public awareness and providing the right information at the right time to people with surplus frozen eggs, we can start to address the desperate need for egg donors and reduce the number of frozen eggs in storage.”

The researchers propose several strategies to make it easier for individuals to decide about surplus eggs, rather than discarding them, leaving them in storage indefinitely, or not returning to claim them.

These include providing more timely information about options for surplus eggs and sharing the lived experiences of those who have made similar decisions, as well as those who have received donor eggs and their families. This approach aims to support patients with frozen eggs in making informed and confident decisions.

You can read the study here.