Egg freezing allows a woman to preserve her fertility till she is ready to start a family. This option is available to women who are diagnosed with cancer or other illnesses which might affect their fertility and who are about to undergo chemotherapy/radiotherapy, the treatments posing threat to fertility potential. Thus it forms a part of Oncofertility service. It is also an option for healthy women who wish to delay attempting to achieve pregnancy until later, knowing that as we age our fertility function decreases. Many women freeze their eggs to “stop time” and delay their family planning either for school, a career, or any other reason. It is called as Social Egg Freezing.
During an egg-freezing cycle, a patient will go through many of the steps that are involved in a typical IVF cycle: ovulation stimulation with hormonal injections, ultrasound monitoring, and egg retrieval procedure. After egg retrieval, the eggs will be cultured for a few hours and then frozen the same day for future use. The cryopreservation is done using an advanced technique called as Vitrification & they are placed in storage in liquid nitrogen. Subsequently these will be thawed and used for mixing with the husband’s sperms to form embryos, which are then to be placed in the woman’s uterus.
Oocyte cryopreservation, or egg freezing, is a relatively new procedure in the field of assisted reproductive technologies. Overall, this technology increases a woman’s potential to have children later in life. This has a very clear intention that in the future, the woman may choose to have the eggs thawed, fertilized, and transferred to the uterus as embryos to facilitate a pregnancy.
- Egg Freezing, also known as fertility preservation, is the process of cryopreserving a woman’s eggs for fertilization at a later date wherein number of eggs are extracted, frozen and stored for the future use. This is best achieved through a competent freezing technique designed to increase the chance that the eggs will survive freezing ( cooling), thawing( warming), and fertilization. To have the best success at preserving fertility, it is important to find a best egg freezing facility with advanced techniques, individualized care and good success rates in ART & a track record of success and experience in working with women who are looking to preserve their fertility.
- Anmol Fertility & IVF Centre uses Vitrification which is the most advanced freezing technique & the best egg freezing process with nearly 98% survival rate of eggs after warming as against to the traditional freezing methods of past with 55% egg survival rates. It is a flash eggs freezing method in which they are brought from a body temperature of 98.6°F (37°C) all the way down to -320°F (-196°C) instantaneously. Vitrification dehydrates the cells prior to egg freezing using protectants to remove as much water as possible & also subsequently help restore the cell to its original form. This prevents the formation of ice crystals, which otherwise can damage the egg, sperm, embryo like in other conventional freezing techniques used in the past.
- Egg freezing is an option for women who wish to preserve their fertility at an age when their eggs are most viable. We recommend women freeze their eggs in their 20’s or by the age of 35. There is, however, no age limit – it all depends on the woman’s body and if eggs can still be retrieved from her ovaries.
The younger you are when you choose to freeze your eggs, the better the chance of success when you return to use them.
Who might get benefited with Egg Freezing?
The two most common reasons for women opting to freeze their eggs are:
- A recent diagnosis of cancer and fertility preservation before initiating cancer treatment
This breakthrough in fertility preservation allows women seeking reproductive tissue preservation to bank healthy eggs prior to medical treatments that may affect their fertility. Egg and ovarian tissue freezing has the potential to help women with cancer, as chemotherapy and radiation treatment can often have a harmful effect on fertility, rendering many of these women menopausal. The treatment needs to be started as soon as the diagnosis of cancer is made, most definitely prior to start of Chemotherapy /Radiotherapy which do affect ovarian function in a nasty way. A multidisciplinary mode of action with active participation of the woman’s treating Cancer Specialist ( Onco Surgeon & Onco physician ), physician treating associated morbidities & the fertility specialist is quite necessary to help the woman enroll timely in an Egg Freezing program and get benefited.
- Fertility preservation as a personal choice (commonly known as social egg freezing)
As women age, they may feel pressured to start a family to avoid the risk of trouble trying to conceive. By egg freezing, women can focus on other areas of their lives without sacrificing the chance to have a family. These who wish to have children at a later date can have eggs or ovarian tissue collected and stored.
The other less common indications are:
- Women who are at risk of early menopause, have a genetic disorder that could limit fertility.
- Some patients taking part in an IVF program have moral or ethical beliefs against freezing supernumerary or excess embryos and may prefer to store unfertilized eggs instead. The ability to cryopreserve eggs before fertilisation means that if they are surplus to requirements in the future, their disposal would not raise some of the moral or ethical dilemmas that the discarding of embryos may.
Egg Freezing Cycle: Understanding the Process
Our healthcare team will guide you through every step of your egg freezing cycle, which typically is 10–14 days long, beginning with the first day of medication and ending with the egg retrieval.Initial Egg Freezing assessment involves a consultation with a fertility specialist ascertaining whether egg freezing is a suitable option for an individual case and also to estimate the number of eggs that might be expected from one cycle of treatment. The success of egg freezing depends on the age of the woman which will reflect the number and quality of oocytes. Some women need to undergo several cycles of treatment in order to bank enough eggs.Evidence shows that at least 8-10 mature eggs are required in order to give a reasonable chance (approx. 40% in ≤ 35 year olds and 20% in ≥ 36 year olds) of having a baby.
Steps:
- Controlled ovarian stimulation with hormonal injections:
An egg freezing treatment cycle involves the stimulation phase of in-vitro fertilisation (IVF) cycle. Here the eggs are collected but instead of fertilizing them with sperm, the mature eggs are cryopreserved for future use. Each ovary contains a number of follicles; these are fluid-filled sacs that each contain an immature egg or oocyte. Medications are used to encourage the growth and development of a number of mature follicles in the ovary. This is known as a Controlled ovarian stimulation.
You’ll be prescribed hormone injections for 8–11 days; these hormone medications stimulate your ovaries to produce multiple eggs in one cycle (instead of just the one egg produced in a typical menstrual cycle), increasing the doctor’s chances of finding healthy eggs later. It is important to note that not every egg will lead to a baby even if the woman is young.
- Ultrasound monitoring
Our specialists will perform a baseline transvaginal ultrasound and if required hormone blood testing on the 2nd day of your menses. Monitoring visits and hormone injections typically begin on the second or third day of your period. The exact type and dosage of hormone medication prescribed will depend on individual biology, but usually include 2-3 different types of injections. The final medication, known as a “trigger,” is injected 36 hours before the retrieval, prepping your body to release the eggs at just the right time.
The doctor will check in on your progress throughout the process with 5–7 short “monitoring” visits which may include a blood test and/or an ultrasound to assess how your body is responding to the medication. Because each body is different, the doctor can use the information gained at these visits to adjust your medication or your egg freezing cycle schedule, refine the protocol if necessary.
- Egg retrieval procedure
The developing follicles are monitored and when they are large enough, they are carefully emptied to collect the eggs that they have produced. They are collected by a needle aspiration procedure via vaginal route while the patient is under short general anaesthesia, in theatre, in the fertility clinic. Under ultrasound guidance, a thin needle is introduced to the ovary and the fluid aspirated from each follicle. This fluid is expected to contain an egg. The mature eggs are cryopreserved and stored until you choose to thaw them for fertilization. Eggs will be held in storage for a fixed period of one year from your egg freeze date and then for periods of 5 years thereafter (for which there will be a fee payable in advance)
Using the Frozen eggs at a later date:
Following a review consultation, a fertilisation/embryo transfer cycle will be arranged. Hormone tablets are used to prepare the lining of the uterus for embryo transfer. A number of eggs will be thawed and fertilized with your partner’s, or donor, sperm depending on the case, using ICSI (intracytoplasmic sperm injection). The fertilized eggs will be monitored for embryo development in our laboratory. Embryo transfer will take place three or five days later & the embryo(s) is carefully deposited in the endometrial cavity. Two weeks later a pregnancy test is performed.
Since the first successful pregnancy using egg freezing was reported in 1986, hundreds of babies have been born. Currently, pregnancy rates are between 30 and 40 percent. Egg freezing however does not give any guarantee of having a baby from those frozen eggs and also to note that live-birth rates from frozen eggs are lower than those achieved with an IVF cycle using fresh eggs where embryos are created.( approximately 14% Live birth rate) However if, in the future, you wish to become pregnant and require IVF, then using those ‘younger’ frozen eggs may result in a higher chance of having a baby than using your own fresh eggs then which may be several years older. In this instance, having frozen eggs stored can be an advantage.
Anmol Fertility & IVF Centre has had great success in the field of fertility preservation and storage of eggs and embryos and is looking forward to help many more women realize their dream of parenthood with Fertility preservation.