Egg freezing (oocyte cryopreservation) is now a clinically available and successful option available to patients at many fertility clinics (including InVia Fertility Specialists). This is largely due to the development of a fast freezing technique, vitrification, that minimizes ice-crystal formation making it now possible to freeze eggs successfully.
The process of retrieving eggs for freezing is the same as for an in vitro fertilization (IVF) cycle. In brief, the process involves stimulating the ovaries to produce multiple eggs using fertility drugs for 10 – 14 days. The egg retrieval is a simple in-office procedure lasting about 15 minutes, done under intravenous sedation. Using a vaginal ultrasound probe as a guide, a needle is inserted through the vaginal wall into the ovary and the follicles are aspirated to harvest the eggs.
Who should freeze their eggs?
Indications for egg freezing include: 1) fertility preservation in cancer patients, 2) fertility preservation for social reasons, 3) egg donation programs, 4) people who wish to limit the number of eggs fertilized during IVF (usually for religious reasons). Other clinical indications are rare and include 5) minimization of ovarian hyperstimulation syndrome risk and possibly 6) egg accumulation in low-responder patients. A couple of these are described in more detail below.
Fertility preservation in cancer patients
People with cancer are often treated with chemotherapy or radiation, which can render them sterile. Egg freezing is an excellent option for these women to preserve their fertility—especially as advances in cancer treatments are resulting in many patients either being cured of cancer or surviving for many years after treatment. For married women or women with partners, the preferred option is usually to fertilize the eggs and then freeze the embryos. For single women, egg freezing is usually preferred.
Fertility preservation for social reasons
It is now possible to offer egg freezing to healthy, otherwise fertile women who wish to postpone pregnancy for social reasons such as education, career demands, or because they have not yet found a partner. At InVia, we recently had a patient who was 36 years old and 6 years into an unhappy marriage and wanted to freeze her eggs. She sought to preserve her eggs for potential future use while they were still fertile. This is just one example of why some women find egg freezing beneficial, as it allows them to practice their reproductive autonomy while increasing their chances of genetic motherhood.
Historically, social egg freezing was controversial as there were reservations about the success rates and concerns about potential risks to the mother as well as to the future child. There have since been two large studies that have evaluated children born with frozen eggs and both showed no increase in congenital abnormalities when compared to natural conception or children born with IVF. In 2008, the Practice Committee of the American Society for Reproductive Medicine declared egg freezing to be no longer experimental. For the year 2015, the Society for Assisted Reproductive Technologies has started collecting data on egg freezing cycles.
The Israeli Government has recently approved egg freezing to “avoid age-related fertility decline”. As presented in a recent paper by Shkedi-Rafid and Hashiloni-Dolev (Fertility and Sterility, 2011) the Israeli Government now permits egg retrieval from a woman “who is not undergoing infertility treatments, but wishes to preserve fertility for reasons related to age”. These women may undergo up to four retrieval cycles, or the retrieval of 20 oocytes (whichever comes first). Oocytes will be frozen for a period of 5 years, which can be extended at the woman’s request (by additional periods of 5 years each). Egg freezing is to be permitted for healthy women aged 30 to 41 years who are concerned about future loss or decline in fertility due to age. Thawed fertilized eggs can be implanted until the age of 54, in accordance with the new Israeli legislation allowing women to use donated eggs until that age. Age-related egg freezing (treatments and preservation) is officially supposed to be paid for out of pocket by the patient; however, it is likely that the various Israeli health funds (health maintenance organizations) will step in and subsidize some of the costs for those who have supplemental medical insurance. The Israelis now consider egg freezing to be an act of “preventive medicine” against future age-related infertility leading to the use of egg donation.
Success rates with egg freezing
There was concern previously about the success rates with egg freezing. Over the last five years, the success rates have improved to a point where they are now similar to those with fresh cycles. There are at least 3 egg banks in the US currently. It generally takes six eggs to generate the one or two embryos needed for embryo transfer.
It is very important that women freeze their eggs at a relatively young age. The ideal age is probably less than 32 years. The pregnancy rate is not good after age 38 years.
At InVia Fertility Specialists, we have been offering egg freezing since 2010. We have had many patients freeze their eggs, but have had few thaws. We have had a handful of patients with "emergency" egg freezing due to the husbands not being able to produce a sample on the day of egg retrieval. These have then attempted pregnancy with their frozen eggs and the pregnancy rate has been similar to that with fresh cycles.
If you are a woman who wishes to preserve your fertility, egg freezing allows you to give yourself the gift of time. To see a Board Certified physician who is skilled and experienced with egg freezing, schedule an appointment at one of InVia's four Chicago area fertility clinics.