All about the eggs?

We just celebrated Easter, so naturally eggs are on the brain. They dominate springtime decoration as a reference to new life, for both their obvious role in bringing forth new chickens and for their longtime association with the Christian celebration of Easter. Some scholars believe eggs have been associated with the coming of spring and a symbol for fertility since the early days of the Anglo-Saxons.

Whatever the case, the association between eggs and new life is a natural one, with both symbolic and literal significance. The eggs in a woman’s ovaries are essential to the creation of new human life. If you’re a woman hoping to bring new life into the world, having some healthy eggs is certainly part of the equation.

I recently saw a poster “It’s all about the eggs,” accompanied by the caption “Getting pregnant is all about the #eggs.” Without disputing whether the rest of the caption is true (“Your uterus can continue to bear children even after no more quality eggs remain”), left at face value, this comment is highly misleading. This was posted by kindbody, a self-described “comprehensive women’s healthcare platform,” whose services include egg freezing. But lest this notion seep into the female psyche, let’s discuss a few reasons why when it comes to conceiving and bringing forth new life—it’s not all about the eggs.

Why it’s not “all about the eggs”.

Whether a woman is pursuing pregnancy naturally or through fertility treatments like IVF, it’s not “all about the eggs”. Many factors are at play in a healthy pregnancy.

Let’s not forget the men.

Though not the focus of this blog, I can’t breeze past the importance of healthy men and healthy sperm to the creation of babies. Men—even in the most narrow sense, the sperm they produce—are an essential part of the equation. Sperm are smaller and much more numerous than eggs, but they still provide half of the genetic material at fertilization. A number of things impact men’s sperm count and health.

Eggs are just one piece of the pregnancy puzzle.

Conception, the 9 months of pregnancy, and giving birth are wondrously intricate and require a huge amount of coordination. The natural process of creating, developing, and birthing a healthy baby are nothing short of a miracle, so it’s no wonder that medical replication of any part of the process could get pretty complex. The idea that the age of one’s eggs is all that matters glazes over the numerous other factors at play.

What other factors are at play in a healthy pregnancy?

From start to finish, pregnancy is a complex process.

First, healthy, ovulatory cycles are not just about ovulating a healthy egg. They also require the build-up of a uterine lining that is sufficiently thick to receive and nourish an embryo. Additionally, they must allow enough time after ovulation for the embryo to implant before the thickened lining sheds. In a naturally conceived pregnancy, the Fallopian tubes must allow for travel of the embryo to the uterus. From implantation on—the rest of pregnancy unfolds. This new baby develops over the course of 9 months before finally being born.

It’s not simply enough to conceive or get a positive pregnancy test. The outcome women are pursuing is the delivery of a baby, and a lot needs to run smoothly to get to that point.

Considering our age – not just that of our eggs.

The 40-yr-old may conceive with her 29-yr-old egg, but she—and the rest of her body—are still 40. She assumes the risks associated with “advanced maternal age”—in reference to women bearing children at or after age 35. Many, many healthy babies are born annually to mothers 35 and older. But as age increases, pregnancy and birth carry increased risk of several complications. These include gestational diabetes, high blood pressure, premature birth, stillbirth, and emergency C-section. If we think that stopping the clock on our eggs is enough, we ignore challenges that could arise due to our age. Again, most women giving birth after age 35 deliver healthy babies; but we must not equate “my eggs are 29” with “I am 29”.

The importance of knowing that it’s not “all about the eggs”.

The vast majority of women will pursue having children without having previously frozen their eggs. Even a woman who freezes her eggs at one time in life may end up trying to have kids naturally. In one 2013 study, 59% of respondents viewed egg freezing as a “backup plan” in case “natural pregnancy became impossible”. In this study, 96% of respondents ranked “natural conception” as the most desirable means to have a child.

Other gynecological concerns may need treatment.

If women have been educated to think that the age of their eggs is all that matters, they may not know to look for signs of gynecological concerns unrelated to the age or health of their eggs, like polycystic ovarian syndrome, endometriosis or anovulatory cycles. Concerns like these can negatively impact a woman’s ability to achieve pregnancy naturally and may increase risk of some complications during pregnancy.

A woman’s body will naturally produce signs that give her a window into her hormonal health. If we’re not taught to observe or interpret those signs, we can miss an opportunity to get needed treatment.

Even women with healthy, ovulatory cycles may be unaware of ways to optimize their chances of getting pregnant naturally, like timing intercourse around ovulation, based on signs her body produces (not averages of when some women ovulate).

Egg freezing doesn’t guarantee a successful birth.

Even if it were “all about the eggs,” freezing one’s eggs when young and healthy does not guarantee a future pregnancy, let alone a live birth. The chance of a live birth depends on a variety of factors, including egg age and number of eggs retrieved. (Not to mention the several steps between egg thawing and implantation of an embryo.) There is little solid data to pronounce a success rate—over 20,000 American women have had their eggs frozen, but the vast majority have not used those eggs to attempt pregnancy.

Stopping the clock on our eggs doesn’t stop the clock on us.

Furthermore, the topic of egg freezing is part of a broader conversation about what it means to facilitate later and later childbearing among women. Even if we’ve figured out how to (maybe) stop the clock for one piece of the puzzle, we must also discuss the other risks, challenges, and difficulties associated with having children at a later age than what is biologically optimal.

So, what’s the point?

Pithy phrases are common to modern-day decoration – found on posters, coasters, magnets and any number of other mass-produced products. If that’s all the “all about the eggs” poster is trying to be, then let it be just that. But to take it at face value and allow it to influence how we think about our health and fertility, then we miseducate women on their own bodies, oversimplifying a process that is wondrously and beautifully complex.