Discussion

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arjie: If you're curious what it's like for a couple of normies doing IVF, I wrote down our experience here to the degree I remembered: https://wiki.roshangeorge.dev/w/IVF

Teever: > Lastly, the stem cells we're planning to use to make these eggs accrue mutations with age, and we don't currently have a good method to fix these before making them into eggs. These mutations will bring additional risk of various serious diseases, only some of which we currently have the genetic screening to detect.I've always found this one fascinating. Somehow human cells age and humans get old and die but humans can somehow make an entirely new creature through reproduction where that is reset and most of the defects from the parent are gone as well.How does that work and what stumbling blocks exist that prevent us from replicating it?

strangefellow: I don't know anything about this subject, but I thought it was just natural selection that effectively filtered out the 'bad eggs', as it were. On that same note, I've worried about the effects that modern medicine might have in short-circuiting evolution/natural selection. Would love to hear from someone with qualifications to speak on this matter.

pbh101: Isn’t that what stem cell therapy is?

the_real_cher: It's wild that in the year 2026 modern science can't recreate a SINGLE cell (which is what a human egg/ovum is).

jokowueu: it's possible to convert stem cells or skin cells into functional egg cells (ova) in lab settings, though the technology remains experimental and not yet ready for routine clinical use

arjie: Well, that seems a bit reductive because nothing can create a single cell right now. All cells are self-copied-and-divided. Omnis cellula e cellula, as they say. There is no cell constructor anywhere. Both Nature and Artifice use the same device to make more cells: a previous cell.

gopalv: > Somehow human cells age and humans get old and die but humans can somehow make an entirely new creature through reproduction where that is resetI think the eggs aren't dividing as you age (you are born with them, so to speak) and the sperm is held "outside" the body.One is in original packaging and the other is produced in a "cooler" enviroment by the billions with a heavy QA failure of 99.9999%.

xyzzy_plugh: Modern medicine absolutely short-circuits natural selection. If you have an older sibling who was delivered via C-section chances are you wouldn't exist.

shrubble: That’s not true for the USA however.The large award for a medical malpractice trial was the reason for doctors pushing for a C-section if there’s any possibility of a complication. (Sometimes called defensive medicine.)Most people point to the cases won by John Edwards, trial lawyer and vice presidential candidate as the reason for the great increase in C-sections. His case wins include 30 trials at which he won at least $1 million dollars each.

DanielHB: In my generation (80s-90s) pretty much everyone in Brazil that was born in a hospital was born through C-section. Only recently did the practice of defaulting to c-section is beginning to fade.

SoftTalker: It's also the optimal age to have children. Fertility is highest, the woman is likely healthy and strong, lowest risk of complications.

yosefk: The optimal age to have children is way before you need to rely on frozen eggs (one reason among many being that this process doesn't always work)

stavros: I don't see a very big reason mentioned: You might not need it at all. Sure, the optimal age to freeze might be 19, but if 80% of women are done with children by age 30, why would you have every woman spend the equivalent of buying a small car on something they're overwhelmingly not going to need?Waiting to get a good balance of "your eggs are still reasonably healthy" and "if you haven't had kids until now, it'll probably be a while still" is probably the reason behind the current advice.

davidelettieri: Having done IVF with my wife I think this is the most underrated fertility advice available today.I don't understand why governments of countries with increasing average age and low birth rate don't pay for this for all women. This is one the best pro-family policies that can be implemented.

CrossVR: That money is better invested in providing affordable family housing. Even if IVF is available no one is going to actually have kids if you do nothing to make it economically sustainable to start a family.Do we really want to rely on IVF to solve the fact that people can only afford a family home once they're well into their 40s? It's insanity if you ask me.

alistairSH: We, in the US, don't even have universal day care, or hundreds of other sensible things that would make child-rearing easy/less expensive. Jumping straight to "let's cover expensive IVF programs" is... well a big leap.

stavros: It's also the optimal age to not have children! You're still figuring out your life, probably no stable partner or job, time to do some stuff you'll regret later, etc.

SoftTalker: Yes, I was only speaking biologically."Figuring out your life" was not a thing when humans evolved.

conductr: I went through it with my wife too and expecting a 19 y/o women to go through the IVF process as an insurance policy is a bit insane to me. In our modern, western society, this is age is still solidly childhood with not much definitive thoughts of future family, marriage, etc.Governments need to make COL more affordable, birth rate will go up naturally

wredcoll: Aside from the part where you have to raise them, sure.

jliptzin: If everyone had kids at 18-20, then the grandparents could take care of the grandkids while in their 40s while the parents build their careers from 20-40, then start taking care of the grandkids as the cycle repeats

mfitton: And then you end up raising your grandkids instead of the kids you gave birth to. It's not something that comes without cost. And what if you don't particularly trust your parents to raise kids? I suppose you would have no idea whether you did or not, because they would not have parented you...

tonymet: Employers encouraging egg freezing by offering egg freezing benefits is an abysmal conflict of interest. Employers reap tremendous benefits and the woman bears all of the risks -- in this case the biggest risk of all .Employers should be required to pay for future maternity disability care insurance e.g. 2-3 years of maternal leave fully paid, elective at any time, even after they separate from the company.

drakonka: Most 19 year olds probably wouldn't opt into injecting themselves twice a day for weeks and dealing with the side effects of the injections, then the subsequent extraction procedures (likely for multiple rounds) even if it was paid for. Which is reasonable, considering most women who want children will have them without IVF and don't need to go through any of that.

ElevenLathe: Doesn't that just make it a cheaper policy to implement, since very few will take advantage of it?

fweimer: It still might end up as yet another thing we do to women's bodies.

tonymet: how were the adverse effects during the hormone / endocrine therapy for her?

fweimer: Apparently the harvesting procedure typically (but not always?) involves general anesthesia. That alone is never entirely risk-free. In this context, the temporary loss of bodily autonomy could be particularly problematic. All that comes on top of the required hormone treatment. It's not a trivial procedure.On the other hand, it may be a useful tool to resist expectations to become a mother until it becomes socially acceptable to say no. So it might be important even if the eggs are not getting used.

morkalork: My parents and my spouse's parents were all in their late 30s having children, now we're in the same position due to infertility and now finally going through IVF. We're happy it's working but at the same time it's sad knowing they'll grow up never really knowing their grandparents.

conductr: The grandparent situation is sad af. It's also pretty sad being a mid-40s year old dad that doesn't have the energy to keep up with their kid. I pitched a little league game yesterday and it wiped me out. Also, the fact I (and you) will not know our grandchildren very well also is quite sad.If my son has his first kid the same age I had him, I'll be in my 80s when that kid is starting little league (or that age). Then, factor in the fact that I don't know of any men in my family that have lived past 80 and it gets really grim. They were all heavy smokers and drinkers I remind myself with fingers crossed.The most sad part for me, is I realized by delaying parenthood - I was just being selfish - and the net result is I minimized "shared time on earth" with the person I love the most. It's easy to say I wouldn't have been a good parent or I wanted X job/income first, but it's all just excuses and selfishness.

morkalork: >by delaying parenthood - I was just being selfish.. I minimized "shared time on earth"Exactly. My advice to anyone is not wait. If we hadn't, we would have found out sonner that we needed to go through that process. It's not a "wake up and schedule an appointment tomorrow" kind of thing, it's a treatment of last resort and you can burn years trying, going through evaluations and alternatives first.

znpy: Of course, there are too many “learing” centers draining resources…

Aurornis: This is an article that you need to read critically, beyond the headline.Even a few paragraphs down they say this:> The optimal age to freeze eggs varies depending on the source and metric, but almost all sources agree it's sometime between 19 and 26.So there's some heavy bias inserted already into the title.The next chart shows a peak around 19, but if you read the fine print it's not a chart about eggs at all. The subtitle says it shows:> probability of getting pregnant for couples not on birth controlNot the quality of eggs frozen. They're saying one thing in text and showing a chart of something else. If you can't imagine why couples in their early 20s might have a higher rate of pregnancy than couples in their 50s then you might want to think a little deeper about the factors that go into that.The writeup then goes into polygenic embryo screening, which then jumps to improving IQ by selecting embryos, which gets to their final argument which is that it's easier to collect more eggs when younger. So freezing a lot of eggs when you're younger allows for more boosting of your child's IQ through genetic screening based on a company called Herasight's data. Herasight has been widely criticized for overselling their abilities. Also, why do so many rationalist writeups end up back at a conversation about genetics and IQ?

rsynnott: Well, the website is called lesswrong.com, and not correct.com.