Understanding social oocyte freezing in Italy: a scoping survey on university female students’ awareness and attitudes

Abstract

In Western countries, a social trend toward delaying childbearing has been observed in women of reproductive age for the last two decades. This delay is due to different factors related to lifestyle, such as the development of a professional career or the absence of the right partner. As a consequence, women who defer childbearing may find themselves affected by age-related infertility when they decide to conceive. Fertility preservation techniques are, therefore, proposed as a solution for these women. Among all possible solutions, social freezing is an alternative strongly discussed from a scientific, social and ethical point of view. A survey among 930 female students at the University of Padova (Italy) investigated their knowledge and attitudes on social egg freezing and their potential intentions regarding this procedure. To our knowledge, this is the first study to examine the level of awareness of age-related infertility in Italian young women and their attitudes regarding acceptable indications for elective oocyte freezing, their potential personal use, the circumstances in which they would then decide to use cryopreserved eggs, and their attitudes towards cost coverage and oocyte donation. Data collected in this study revealed some important points about young women and their knowledge about social oocyte freezing in Italy as compared to other European countries and the United States. Overall, 34.3% of the students reported having heard about the possibility of oocyte cryopreservation for non-medical reasons and being aware of the meaning of this procedure; only 19.5% were in favour of social egg freezing and 48.4% thought that the cost for this procedure should be borne entirely by the woman herself. Regarding egg donation, the majority of students (64.9%) would not accept donating their eggs to a known woman or couple and 42.5% would instead accept donating to a biobank. Our study shows that young Italian women are significantly less aware of age-related decline in fertility and the possibility of using social egg freezing compared to their similarly situated counterparts in other Western countries.

Exploring women’s attitudes, knowledge, and intentions to use oocyte freezing for non‐medical reasons: A systematic review

“…Awareness of OFNMR was consistently evident in a significant proportion (over 75%) of women in five studies 21,23,25,28,29 . In four other included studies the reported rates of awareness were lower, 18,30‐32 with only 34% of students having heard of the procedure in one study conducted in Italy 32 . Lallemant et al reported a higher proportion of UK participants being informed about the procedure than participants from Denmark; 29 however, no other differences in awareness of OFNMR between nations in the studies reviewed were found.…”

Elective oocyte cryopreservation for age-related fertility decline

“…Surveys on women choosing elective fertility preservation reveal that the vast majority proceed with egg freezing due to lack of a suitable partner [ 39 – 42 ]. While women in their 20s or early 30s consider that their career aspirations would be a reason to consider egg freezing [ 43 , 44 ], for the majority of surveyed women who did freeze their eggs, their career was ‘not at all’ a factor which influenced their decision [ 41 ]. While career aspirations and financial parameters including childcare support or maternity leave can somehow be managed, finding the right partner is outside one’s control and can carry social stigma [ 45 ].…”

“…Several studies demonstrate a lack of awareness on how age impacts fertility for women [ 40 , 43 , 50 – 52 ]. For fertility preservation, the main prognostic factor for success rates is the age at egg freezing.…”

Knowledge about the impact of age on fertility: a brief review

“…In Italy, one-third of female university students had heard about the possibility of fertility preservation through egg freezing. Of these, 20% were in favour of egg freezing, and half of the women thought that the cost for this procedure should be borne entirely by the woman herself ( 54 ). Among women in the UK being counselled for age-related egg freezing, the average age was 36.7 years; this suggests that the women were not fully aware of the decline in egg quality from the age of 30 on ( 55 ).…”