Stop the clock

Financially independent, sexually liberated, Nineties woman lives like Nineties man in all but one respect: if she wants children she must have them while she's young. Not for much longer
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Indy Lifestyle Online
ON A SPRING day earlier this month an American couple, Christia and John Murdaugh, became the proud parents of a baby girl, Sidney Grace- Louise. Christia gave birth at Piedmont Hospital in Atlanta, Georgia, and Sidney, who is thriving, weighed 7lb 8oz. She was one birth among many in the city that day, but a crucial difference marks her out. Sidney was spawned from an egg of her mother's that had been removed and kept frozen outside her body for more than two years.

This wasn't the first birth from a frozen egg in the world - there have been isolated cases in Australia and Europe since the mid-Eighties - but the technology has been notoriously unreliable. The process in America was designed to be systematically repeated. The clinic that devised and administered the treatment, Reproductive Biology Associates in Atlanta, says that it should be available to the general population within five years, possibly sooner.

Similar advances are being made here. The Assisted Conception Unit of University College Hospital London was one of the first to experiment with freezing eggs. Paul Serhal, its medical director, puts a similar timescale on the process becoming generally available - within five years. At present, at its experimental stage, the unit does not deal with "ordinary" people but focuses on patients with special needs, for example on women who have cancer and will be made infertile by chemotherapy and radiotherapy. But Serhal expects that this will be extended. "There is no doubt in my mind that when the process becomes routine, some women will elect to freeze their eggs for the future," he says. "We will have egg banks like we have sperm banks now."

The implications are enormous. No issue more clearly defines the differences that persist between a man's lot and a woman's lot than children, and how and when we might have them. Ask any single woman in her thirties who thinks she might want to have a child. Ask any woman who worries that to have a baby will mean compromising a career that she has spent years constructing.

Or look in any newspaper, at the relentless coverage of what has become the burning social phenomenon of our time: the single woman in her thirties, caught between her body clock and her career; her desire for independence and her desire to have a child. This is the territory of

Helen Fielding's famous creation, Bridget Jones, forever worrying about her job, her restless love life and her ambivalence about relationships.

Underpinning it all is a sad and simple truth. Feminism has given young women the same life as young men - financial independence, sexual liberation, and thus the luxury of feeling equivocal about relationships for longer - except in one important respect: if a woman wants a child, she has to have one while she is still young. Medical technology has not kept up with social change. Waiting, we all know, carries a risk: a risk of not being able to conceive as fertility declines, a risk of increased danger of birth defects related to the age of the mother. That body clock tick tick ticking away does more to shape young women's decisions than anything else.

Now science promises to take the clock out of the equation, to offer a world where women, like men, can put the whole issue on hold for 10 or 20 years while they concentrate on their work or on sleeping around or on deciding once and for all whether the man is the man they really want. The The implications are enormous, for women's careers; their relationships; their freedom.

That world could be around the corner. Human eggs, kept at temperatures so low that metabolism is suspended, can be safely stored for years (although, as in the case of frozen sperm and embryos, mandatory limits would be imposed in this country). The clinical procedure for harvesting the eggs is relatively simple and requires only a local anaesthetic. Once defrosted, conception takes place in the laboratory using one of the established "test-tube" methods such as in-vitro fertilisation, and the fertilised egg is then impregnated into the woman. The IVF is the expensive part of the process: the harvesting of the eggs adds little

to the price of the whole operation.

IVF and similar techniques are already widely used by women who have problems conceiving and in some cases by post-menopausal women using donor eggs. After menopause, a woman stops producing fertile eggs and can no longer conceive naturally, but she still has the potential to carry a child to term if impregnated with a fertilised egg. There is no reason why a woman should not, in the future, be able to have her own eggs frozen while she is still fertile and become pregnant by her "own" child after menopause.

There are already women who are impatient for the opportunities this technology represents. Like University College Hospital, Reproductive Biology Associates explains its treatment is not targeted at women who want to buy time by lengthening the duration of their ability to have children. But it acknowledges that this will inevitably be a consequence. "We have been overwhelmed by calls from women who want to delay having children," says Hilton Kort, one of the clinic's founding doctors.

A woman's fertility starts to decline from about the age of 30 and drops rapidly from 35, something that many women who decide to wait to have children overlook. "I tell women they should have children by 35," says Paul Serhal. "It is very common for us to see women in their late thirties who believed that because their menstrual cycle was regular they would have no problems conceiving. But they do."

Fertility, of course, is not the only issue. Certain inherited genetic illnesses, including Down's syndrome, are related to the age of the mother's ovaries - a woman is endowed with her entire stock of immature eggs at birth and they age along with her. Now women could opt to freeze their eggs when they are relatively young and at their most healthy and then have children from "young" eggs later on.

All of which raises ethical questions. On one level, freezing eggs lessens concerns because it offers an ethically "soft" alternative to embryo-freezing, an issue that has always been controversial. Comment for Reproductive Ethics, an anti-abortion information service working in this area, is broadly in favour of egg freezing for this reason, but not for women who simply want to delay having children. "The reason must be acceptable, not just because a woman wants a career," says Josephine Quintavalle, director of CRE.

Even among the less partisan, the notion of meddling with nature for "selfish" motives carries a strong taboo. The medical profession shies away from too publicly encouraging the idea that this will be used by ordinary women choosing to delay having a family. "People working in fertility tend to be very happy when talking about treatment in relation to patients' pathological problems, but when it's about people having control of their lives, they become more shy," says Juliet Tizzard, director of Progress Educational Trust, an educational charity in the field of fertility and genetics. "Why? We don't have the same attitude to contraception."

The age of the mother is the most controversial aspect. The average age of motherhood is rising all the time - for the first time the number of 30- to 35-year-old women giving birth in this country has overtaken the number of 20- to 25-year-olds - and if women increasingly rely on technology to defy time and have children in their forties or fifties, we will have whole generations of children who grow up without grandparents and whose parents die when they are relatively young.

"A woman's early twenties are the ideal age for child-bearing and the earlier you have children, the longer those children will have parents," says Ms Quintavalle. "The interests of the child should be the most important consideration from the outset. We are not in favour of birth after the natural menopause."

Ms Tizzard is not convinced. "This is a great development, especially for women with cancer and other illnesses that affect their fertility," she says. "But it is also attractive to ordinary women who want control over their lives. It is easy to over-react. People won't necessarily be queuing up for this treatment just because it's there - they are more sensible than that. They will only put their bodies through this if it is what they really, really want."

Although, as with IVF using donor eggs, this technology would theoretically allow women into their sixties and beyond to have children, legislation and tight licensing in this country should control this. Some women slip through the net - notoriously last year in the case of the 60-year-old mother Elizabeth Buttle who received fertility treatment - but the rules have, thus far, proved pretty effective in limiting the use of fertility treatment in this country.

Treatment is governed by the Human Fertility and Embryology Act 1990 and, although this does not explicitly exclude anyone on the grounds of age or for any other reason, it insists that the welfare of the child be taken into account. In practice this means that older women and women with life-shortening illnesses such as Aids are excluded.

As and when egg freezing becomes viable its use will be governed by the same rules. Clinics wishing to freeze and use eggs will need a licence from the Human Fertilisation and Embryology Authority, as they do now if they wish to freeze sperm or embryos. The application will have to include detailed evidence supporting the effectiveness and safety of the procedure and the authority will insist on high security standards. "A good application would be well received," says Martin Johnson, professor of reproductive sciences at Cambridge University and a member of the HFEA.

Not everyone is convinced that this is the future. "I don't think that we'll be egg freezing," says Lord Robert Winston of the Hammersmith Hospital, one of the most famous names in fertility medicine. His department is researching freezing ovarian tissue and then producing eggs from this in the laboratory - he maintains this method is more effective and the eggs are less prone to damage. It is also less enticing to women who are interested only in putting time on ice, but then he feels these will be a small percentage of patients anyway. "Most people will not want to change the way they conceive in our lifetime," he says. "These techniques will be used mainly by infertile couples and women with injuries."

He may be right, or women may embrace this new technology to transform the way that they plan their families. It is not beyond the realms of possibility that this technology could alter women's lives in a way that hasn't happened since the introduction of the contraceptive pill.

For: 'I resent nature over this'

LUCIE, 33, WRITER

I don't know whether or not I want children in the long term but I do know that I'm not ready yet. This was one of the reasons behind the recent break-up of a long-term relationship - my partner knew that he definitely wanted to have kids and was worried that I'd continue to prevaricate until it was too late, and, to be honest, that worries me too. I do resent nature for this. I've got a friend, a man who is in his late forties, who is looking for a serious partner for the first time in his life because he suddenly realised that he wanted children, and I am concerned that the same thing will happen to me but that, unlike him, I won't be able to do anything about it. There's this terrific pressure on women in their thirties, a lot of whom I think are ambivalent about children, that if they don't have kids then they'll regret it. Although that prospect frightens me, I think it's a terrible reason to do it. I also think that a lot of women who really do want children start to panic and compromise enormously in terms of their partner, and that just means we end up with more broken or unhappy homes. So, yes, if I had the opportunity to freeze my eggs I definitely would do so. I would just love to have that pressure taken off me and be able to feel the way that men feel.

Against: 'kids are not a commodity'

ANNABEL, 36, TRAINING AND DEVELOPMENT MANAGER

I'm getting married next year and we're planning to have children but I'm conscious that I'll be 37 when I start trying to conceive and that I might have problems. If that is the case we would have to think about having fertility treatment, but I'm not certain that I'd do it. If I can't have children I am determined not to let it ruin my life - we'd just do other things. I know that if I'd had the option to freeze my eggs when I was younger I wouldn't have done so. I think it's making life too easy. It's treating children as a commodity. You should have children because you really want them and because you're in a position to have them, not because it's what you feel you need. If you choose to delay having children so that you can do other things then you should have to live with the consequences, which is the risk that you will not be able to have them later. I don't feel that people have the right to everything and if you want children, you have to make sacrifices. It also seems ethically wrong that people can just call on their eggs when they want them. It's taking nature out of the equation. Biologically we have a time to conceive and a time to have children and a time when not to and there's a reason for that.

not decided: 'fatalism is necessary'

STELLA, 36, ARTIST

I definitely want children but I'm not in a long-term relationship and I'm not interested in having children on my own, although I might change my mind about that as I approach my forties. I see the compromises that women make in terms of their relationships in order to have children and also afterwards, in order to stay together, and I feel very uncompromising about the kind of relationship I want. So although I feel that my ideal would be to find the right relationship and have children within it, there is the distinct possibility that I won't find that relationship in time. I go through phases of seeing children in the street and physically aching for one but most of the time, when I'm really involved with my work and my social life, it doesn't worry me. I think I will be ready to have children at the age of 45. This technology will probably come too late for me but it's certainly something that I would have considered otherwise. I've always thought until now that, were I never to have children, I wouldn't let it embitter my life, and that a certain degree of fatalism is necessary. I don't believe I have a right to have a child. But it will be interesting to see if I feel the same when I'm in my fifties and male friends are having children.

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