EMPLOYER SPONSORED FERTILITY PRESERVATION: DEBATING INSTITUTIONAL PROMOTION OF REPRODUCTIVE PROCRASTINATION OR CHOICE

Abstract

IntroductionElective fertility preservation, colloquially called "social freezing" or "egg freezing," has revived debates on the social norms, policy provisions and medical standards that govern the use of assisted reproductive technologies (ART). Essentially, "social freezing" is a trend in family planning strategies that repurposes existing ART techniques. The expression describes the election of presumably fertile females at peak childbearing ages to retrieve, cryopreserve and store sex cells as either unfertilized oocytes or gametes (fertilized eggs) for use in later childbearing attempts (ASRM, 2013). Although tissue and cellular freezing is used in numerous reproductive and non-reproductive medical procedures (Pegg, 2015), "social freezing" specifically connotes the socially motivated suspension of child creation processes for reasons such as partnership formation, career attainment or achieving economic stability. Some commentators have called fertility preservation the "ultimate type of family planning for today's professional woman" (Lockwood, 2014) because it allows the creation of genetically related children, while reducing the biological imperatives for early childbearing (Strathern, 2005). These benefits add to the relative lack of regulation on preservation processes. Cryopreservation processes are not restricted by the universalized standards that govern child adoption processes or the process bans or restrictions that have lead to jurisdictional inconsistencies in the recognition of surrogacy arrangements. In contrast, fertility preservation technologies (sometimes referred to as FTP) have developed into an unproblematic and routinely recommended medical effort to offset fertility loss resulting from treatments against potentially life threatening diseases such as cancer. Expanded interest in using preservation to retain fertility capacities in nonlife threatening situations has been a key reason for the rise in public concern on the need to create rules that control patient access to this novel option. Although similar to earlier debates on ART ethics, reservations on preservation can be understood as distinct in several respects. Among them, concerns on women's ability to successfully postpone the onset of family building link to equally unresolved questions on health care entitlements, protections for reproductive choice and institutionalized gender inequity. Few events allow so clear a view of these intersecting concerns as the pivotal announcement of a pioneering decision by high-profile, global technology corporations to pay for the cryopreservation costs of eligible employees.In mid-October 2014, the leading Silicon Valley technology company Facebook, Inc. (based in Menlo Park, CA) announced to major US news organizations details on a plan to fund two cycles of "egg freezing" or sex cell cryopreservation for eligible employees (Molina and Weise). Shortly afterwards, Apple, Inc. announced a similar decision to extend the same level of cryopreservation coverage to their employees (Frier and Higgens, 2014). This is believed to be the first attempt by large-sized publicly held companies to add cryopreservation coverage to existing health care and family benefits, despite unverified rumors of earlier sponsorship programs launched by privately held firms (Nicolette, 2016). By early 2015, both tech companies provided employees up to $10,000 USD per cycle for two cycles of oocyte freezing plus annual storage fees. This per cycle figure falls within the $10K to $15K range of estimated average fees charged by US providers for cell retrieval and freezing. Apple also included $500 USD per year for storage fees, or the approximate mode of US storage costs that range between $275 and $1000 USD year (ASRM, 2013). The public statements did not disclose information on awards for routine supplementary costs such as material transfers or restrictions on total storage periods (Tran, 2014).The stated corporate rationale was to give employees a personally and financially valuable perk, access to a full range of current health care options and the capacity to make family decisions across "multiple life phases" (Ogden, 2015). …