'What am I going to do with those eggs': patients' experience of, and attitudes towards, surplus frozen eggs

What factors influence patient decision-making about surplus frozen eggs?

A mixed-methods study 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.

Despite most participants expecting to use their frozen eggs, only a small percentage returned to use them. The decision to freeze eggs was reported as easy, although decisions about 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, broadly categorized as external factors, knowledge and awareness, genetic ties and 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.

Several factors were reported to influence patient decision-making about their frozen eggs, with some perceived by patients as limiting their reproductive autonomy. It is incumbent on services that provide egg freezing to remedy the collateral problem: that, contrary to what they expect, many people will end up with surplus eggs, which can become an emotional burden, a source of moral distress and present substantial logistical issues.