Be Empowered and Take Control of Your Reproductive Future with Egg Freezing
by Melissa A. Esposito, M.D. / 0 Comments / 219 View / April 1, 2016
Advances concerning the technology of egg freezing (cryopreservation) have been getting much more attention lately as some well-known, high-profile women are choosing to openly discuss how they are utilizing it to “extend their fertility.”
While those in the medical community have been able to cryopreserve embryos successfully for many years, eggs didn’t do as well with this technology until recently.
This is because human eggs are large cells and, as such, are vulnerable to intracellular damage from ice crystal formation from the older “slow-freeze” protocol, whereas embryos, which are multicellular organisms, fared much better than did the egg.
However, the newest freezing technology, known as “vitrification,” is a fast-freeze technique. Vitrification has revolutionized the technology of egg freezing. Vitrification freezes the egg so quickly that there is virtually no damage to the internal structure of the egg. Proper thawing shows success rates nearly equal to that of fresh eggs.
A Woman’s Age Has a Profound Effect on Egg Quality
Women are born with a full complement of eggs, and as we go through our reproductive lifespan, we continually lose eggs. This process expedites around the age of 35 until we reach menopause, at which point our monthly cycles stop and our ability to reproduce ceases.
Thus, the age of the female is probably the most critical determinant in the ability to conceive a healthy child each month. Not only does it become harder to conceive as women age, but the incidence of miscarriage increases, as do the odds of having a child with a chromosomal abnormality (such as Down syndrome or any other abnormality in which the child has anything other than the normal complement of 46 chromosomes—23 derived from each parent).
This is likely because women ovulate the best and most chromosomally competent eggs when they are younger. As women age, not only do the number of eggs diminish in the ovaries, but the percentage of chromosomally normal eggs also diminishes as well, thus increasing the risk that the couple will conceive a chromosomally abnormal child.
As many women are now delaying childbearing for a multitude of reasons (to advance their educational, professional, and/or work-related goals; to find the right partner; or to attain financial stability), the option of egg vitrification has given women the choice to embark on the path of motherhood when the timing is right for them. They no longer need to feel that they are victims of their own “biological clock.”
In the not-so-distant past, concerns over the adverse effects of reproductive aging on ability to reproduce successfully left many women feeling powerless, anxious, and not in control. Now the situation has changed for women who cannot, for whatever reason, reproduce at the young age that our bodies have been designed for.
We are empowered to make that all-important choice when we are ready emotionally, financially, and in every other way to become a mom.
If a woman opts to cryopreserve her eggs when she is younger, she can decide when and if to thaw the eggs and have them fertilized with her partner’s sperm (or a sperm donor of her choice), and her success rates are similar to women in the same age group at which the eggs were cryopreserved.
So, for instance, if a 40-year-old female cryopreserved her eggs at age 32, even though she is now 40 and would most likely face challenges becoming pregnant with her 40-year-old eggs, she can rest assured that if she becomes pregnant with her 32-year-old eggs, her child will have the same advantages as that of a 32-year-old pregnant female.
Cryopreservation Helps Safeguard Fertility Prior to Cancer Treatment
One of the other major indications for egg cryopreservation—and actually a reason that egg cryopreservation was done even when far less successful and before it was “socially acceptable”—is the case of oncofertility.
In this situation, young, childbearing-age women who have been diagnosed with cancer, depending on the cancer and how aggressive it is, can be given the option of first doing a round of ovarian stimulation to harvest eggs from the ovaries to cryopreserve for later use when they have been deemed “disease free” by their oncologists.
For many types of cancer, the chemotherapy and/or radiation therapy used to help “cure” the cancer is toxic to the ovaries and will leave the female sterile after she is done with the treatment. It is now standard of care for these women to at least be given the opportunity to consult with a reproductive endocrinology and infertility specialist to discuss the options of egg/embryo vitrification, so that they may experience motherhood once their cancer has been adequately treated.
Not every patient will be a candidate for this process, depending on the nature and severity of the cancer. In some cases, the cancer is diagnosed and treatment must commence immediately. There may not be enough time for the patient to cryopreserve eggs in this situation; however, if this is not the case, it is nice for the patient to be given her options and to let her decide if this is something that she would like to do.
Be Selective When Choosing a Fertility Center
When looking for a center, women should ask for a center’s statistics on how many egg vitrification cycles the center does a year and the rate of success with egg thaw cycles at that center, including fertilization and pregnancy rates from vitrified eggs.
At the same time, patients should remember that egg freezing is still a comparatively recent technology. Relatively little data has been published regarding pregnancy rates using frozen eggs for elective purposes.
For women who wish to cryopreserve eggs electively, Shady Grove Fertility has found that 90 percent of patients have coverage for the initial ovarian reserve testing and physician consultation. Other costs associated with the process include: medication costs, procedural costs, and yearly storage fees.
Understanding that cost may be the most constraining issue for many patients, check with the clinic to see if they have financial programs and discounts available so that this exciting technology may be accessible to women across all socioeconomic groups.
More than 40,000 babies and counting have been born with the help of our 35 physicians at Shady Grove Fertility. We are honored to have helped them achieve their most important goal—having a child and creating a family. BW
Melissa A. Esposito, M.D., is board certified in obstetrics and gynecology and reproductive endocrinology and infertility. Dr. Esposito is a member of the American Society for Reproductive Medicine and the American College of Obstetricians and Gynecologists. Dr. Esposito has been the recipient of numerous awards and honors from the American Medical Women’s Association, the Philadelphia Area Reproductive Endocrine Society, and the American Association of Gynecologic Laparoscopists, among others. Dr. Esposito is also actively involved in teaching the medical students at Georgetown University School of Medicine. Dr. Esposito sees patients in the Shady grove Fertility Camp Hill office. For more information, visit www.shadygrovefertility.com
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