**4. Discussion and conclusion**

Several challenges that assistive reproductive technologies face stems from certain misconceptions regarding their use and a lack of understanding the power and limitation of these technologies. Adding to these challenges are dishonest marketing campaigns overestimating the success of these procedures, a difference in success rates in different clinics and a misunderstanding of the process involved in the procedures. There is an imminent need for oversight and regulation of this technology and marketing because enthusiastic entrepreneurs target women at cocktail parties and other informal events to convince them to "freeze their eggs" before it's too late, suggesting that "smart women freeze" and the others miss out. These statements and marketing strategies are ethically and morally unacceptable, especially when women are not provided the complete picture with regards to the costs, time and risks involved and the low success rates of the procedure which is typically not covered by insurance. Information such as the number of cycles to freeze enough eggs, the cost involved in each cycle of cryopreservation, including the medications and time involved, the cost of storage of eggs per year, the age-related decrease in success rates of the procedure, the cost of the use of future eggs with intracytoplasmic injection of the sperm, the risk to the women of ovarian hyperstimulation syndrome occurring as a result of ovarian stimulation and the side effects, and more importantly the chance that there will be no baby at the end of the risky procedure should all be communicated to the patient in clear terms to facilitate them making an informed decision. These discussions should also involve the fate of the gametes in case of death, disease, disability or if the donor decides to not personally use the gametes. Patients that are already confused with the options available to them will need to be guided into the system by developing trust and by portraying transparency through standardization of care. Otherwise, there is a risk that they will be further confused by the deluge of information available and might withdraw from options available to them. Finally, there is an urgent need for a change in the curriculum when training OB/GYN residents and primary care physicians to include information about fertility decline and the options available to couples and women. To eventually promote successful reproductive decision making in patients and to

respect the rights of autonomous choices of women, it is important that OB/GYNs can provide the necessary knowledge for them to make an informed decision.
