Having a baby is a life goal shared by many. In fact, for most the question is not whether they will have a child, but when they will have a child. Fortunately, this goal is achieved spontaneously for most, but for others, personal circumstances, career choices or medical conditions can pose limitations to becoming a parent.
Recent advances in fertility treatments have given people more flexibility and options to plan for parenthood through such popular technology as oocyte cryopreservation (egg freezing) and embryo cryopreservation (embryo freezing). In the media, egg freezing is often treated as a trendy or frivolous lifestyle choice. However for some, it is the only current option they have available for protecting their reproductive future.
There are many reasons why someone is prompted to take advantage of their egg viability for future pregnancy via egg or embryo freezing. Whether it’s a decision based on career, educational pursuits, or current social or health circumstances, egg/embryo freezing offers the same option for all: preservation of their current fertility, thus leaving their reproductive options open for the future. Some common reasons for egg/embryo freezing include:
• Health-related causes, such as a recent diagnosis of cancer
• Rapidly declining ovarian function
• Family history of early menopause
• Unexpected changes in social or personal circumstances, such as divorce
• Anticipated delaying of childbearing due to career choices
Egg freezing, through a rapid freezing process called vitrification, offers is a reliable option for proactive people who do not want their age to dictate personal life and family planning goals and decisions. Vitrified eggs demonstrate strong survival, fertilization, and embryotic development rates after thawing several years later. In fact, pregnancy rates and the incidence of miscarriage or genetic abnormalities will be based on the age of the person at the time of the egg freeze, not on the age when the eggs are ultimately used.
The process of egg freezing starts with the evaluation of an individual's ovarian reserve, which is an estimate of the quantity of eggs in the ovaries available for potential fertilization. The evaluation consists of a combination of reproductive hormone blood tests and an ultrasound of the ovaries. With these results, we can determine if egg freezing is right for you and help tailor your treatment regimen to obtain an optimal number of eggs retrieved.
Egg freezing is very similar to the beginning of a typical in vitro fertilization (IVF) cycle. The process lasts about 2 weeks during which time you will give yourself daily hormone injections to stimulate the ovaries. In our office, we will monitor the growth of your egg follicles using blood tests and ultrasounds. At the end of the 2 weeks, the eggs are then retrieved under deep sedation and immediately frozen. When you are ready to use the eggs in the future, they will be thawed and combined with sperm from your partner or sperm donor. The embryo will then be transferred back into your uterus in anticipation of pregnancy.
When is the best time to freeze eggs? Fertility begins declining slightly in the 20s, but pregnancy rates will remain high into the mid 30s. From the mid to late 30s, the decline in fertility starts to accelerate. In addition, people over 35 have an increased risk of miscarriage and offspring with chromosomal abnormalities as a result of age-dependent changes in egg quality. Therefore, from a simply clinical standpoint, egg freezing is optimal and most reliable when done in the early 30s, but is ultimately a personal decision and must be individualized for each person depending on their circumstances.
People seek egg and embryo freezing for similar reasons. The main difference is that instead of freezing unfertilized eggs, the eggs retrieved after the 2 weeks of hormonal injections are fertilized with sperm from a known partner or donor sperm prior to freezing. The frozen embryos can later be immediately thawed and transferred to achieve pregnancy. Embryo freezing is actually a more reliable and excellent option for fertility preservation in people with a partner or for people with limitations in egg quality and/or quantity.
Today, there are numerous options when it comes to planning not only for a career, but also for future family. While some people who freeze their eggs may not use them in the future due to getting pregnant spontaneously, it is a great option for people who know they want to have a baby later when the timing is right. People who freeze their eggs are not simply delaying pregnancy; they are making a conscious choice to protect their chance for parenthood. In fact, experts predict that egg freezing, like the birth control pill, will have the potential to empower people when it comes to taking charge of their reproductive future and extending their fertility potential.
Dr. Nurudeen is double board certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. She is a member of the American College of Obstetrics and Gynecology, American Society for Reproductive Medicine, Society for Reproductive Endocrinology and Infertility, Houston Gynecological and Obstetrical Society, Houston Medical Forum and Mary Susan Moore Medical Society. She is the new Medical Director of the Sparkles of Life IVF Grant and has special interests in fertility preservation, diminished ovarian reserve, ovarian aging, and third party reproduction (egg donation and gestational carriers). Dr. Nurudeen is the Director of Fertility Preservation at Houston Fertility Institute in Houston, TX.
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