Egg freezing is becoming a popular alternative fertility method for women and couples planning on having children in the future. This treatment is ideal for those who do not wish to deviate from or cannot support a child based on their current lifestyle. Egg freezing allows individuals to pursue their life goals first and get pregnant only when they feel the time is right without sacrificing their rate of successful conception. To answer some general questions and concerns about the egg freezing, Dr. Lauren Weissmann from South Jersey Fertility Center is here to give her thoughts on the revolutionary fertility method.
Egg Freezing with Dr. Lauren Weissmann
Hi everyone, thank you for joining me. I am Dr. Lauren Weissmann and I’m a reproductive endocrinologist at South Jersey Fertility Center and I’m here to talk about egg freezing, which is an exciting topic. I’m just going to give everybody a few minutes to log on if they haven’t done so and then I’ll start talking about the process of egg freezing, where it came from and why people choose to do it – or I’ll be happy to take questions at any point. So I’m just going to give a few minutes here or a few seconds. Again, we are doing a Facebook live session to discuss egg freezing, which is a great way for women to preserve their future fertility. So I’m just going to start by talking about why the process is important and why it actually took so long to get to a place where it can be used for women anywhere to potentially preserve their fertility.
Moving On from Freezing Sperm
So as you know, as many people know, freezing sperm has been around for 50 to 60 years and is very easy to do because it’s a very small cell. That means that it can freeze and thaw easily. The issue with the egg is that it’s actually the largest single cell in the human body and has the highest water content – which as you can imagine when you freeze water, ice crystals form. The thawing process and all of that can greatly damage the cell of the egg and make it unusable. So it took many decades of research and experimentation to find the best way to freeze and thaw eggs without damaging them.
Freezing Eggs for IVF Through Vitrification
Within the last eight to ten years, a process called vitrification can now take eggs and quickly freeze them – which now every center in the world would and should be using to freeze and thaw eggs. By doing so, you minimize the chances of having any kind of ice crystals from developing and therefore damaging the egg, making it unusable. Since the technology improved, the results were translated into having outcomes improve. This means that frozen-thawed eggs, after the process of vitrification, made it very successful in terms of achieving pregnancy using those eggs. It became comparable to using frozen and thawed eggs to fresh eggs. So, if someone were to go through IVF and use fresh eggs, the pregnancy rates in many research studies were very similar to cycles in which the frozen-thawed eggs were used.
Brief History of Egg Freezing
Once the experimental label was taken off of egg freezing, which is why – in the last five or so years – you’ve seen a big push, a lot of discussions and a lot of mainstream press talking about the possibilities of egg freezing and finally having a way to preserve female fertility. Prior to 2011, it was experimental and primarily reserved to use under research protocols for young patients who were undergoing cancer treatments and would then lose their fertility potential by the toxic cancer drugs. That was really the only way to even attempt to allow them to have a chance to conceive in the future, even though it wasn’t as good of a technology as it is today.
Preserving Fertility with Social Egg Freezing
In the last several years, that technique has been perfected – and since the pregnancy rates are comparable to using fresh eggs, we can offer it for a variety of reasons in what’s called “social egg freezing,” or the way in which women can empower themselves to basically use egg freezing to preserve their own fertility while they may pursue other things in their life or just choose to delay childbearing by a few years if they wish to do so.
When Can You Receive Egg Freezing?
Typically we like to see patients during their reproductive years to discuss this possibility and really any person should be able to – and is free to – come in to have a discussion. What we would talk about is the process of going through to evaluate your fertility. What that involves is typically blood work to help us see how your ovaries are working at that time and an ultrasound. The combination gives us a sense of how many eggs one might expect to get in a single egg retrieval – and the egg retrieval is the actual procedure in which we get the eggs. That’s helpful to be able to counsel a woman to have an understanding of making such a personal decision. Is it worth it? Is it not worth going through with the process depending on how many eggs one might get as well as other factors such as concerns about age-related fertility decline.
The Ideal Age for Egg Freezing
When women age it can be very detrimental to the egg’s health. Unfortunately, it declines more so after the age of 35. Ideally in a perfect world, we could freeze eggs prior to a woman even turning age 35, that would be great because the quality of the eggs would be even better than in subsequent years, however it doesn’t mean that if one is over 35 means it’s too late because capturing one’s age in the present is much better in terms of chance of success than in the future.
Who Can Receive Egg Freezing?
So what is egg freezing and who does it make sense for? It makes sense for anyone who might consider delaying her childbearing by a measure of a few to several years. Certainly, there have been plenty of studies that if someone is 35 and they don’t foresee potentially getting pregnant until 40, then egg freezing is an ideal way to preserve that chance. A lot of it comes down to, as I initially mentioned, to how many eggs you have. People may choose to undergo one cycle of egg freezing or more depending on how many eggs you might get at the time. So for example, under the age of 35, you can have about a 50% chance of conceiving using those eggs if they were frozen under the age of 35 and having a live birth from that. However, if you are over the age of 35, that number declines so you might want to have more than 10 eggs.
Egg Freezing Success Rates In Comparison to Age and Male Factor Infertility
A lot of information comes from particular studies that looked at certain women who underwent IVF for what we call male factor infertility. That’s helpful because we know the eggs are good, the female fertility is good and that we simply need to go through IVF just because of some male issues. What we’ve found is that, for example, if you’re 37 to 39 and if you have around 10 eggs, then the chance of pregnancy is roughly at 25% to 35% following those eggs. This is definitely better than potentially being 39 and trying to conceive on your own at that point and certainly if you do have difficulty and need to embark on fertility treatment. So in terms of the ideal age to freeze eggs, definitely, under the age of 35, there are plenty of women who are very successful between the ages of 35 and 39.
The First Steps of Egg Freezing
So how does the process work? After the initial evaluation – and the decision to undergo the procedure – typically within one menstrual cycle we can achieve the whole process from start to finish. It involves to weeks of multiple visits usually early in the morning before anybody’s workday typically starts. This entails an ultrasound, some blood work and some injectable medication that’s just like a subcutaneous injection under the skin – similar to what diabetic patients would use. Those injections help how the eggs develop and mature. Once they’ve reached a level of follicles that contain the eggs to reach a size and level of maturity that we would hope to achieve usually an average of 10 to 12 days of medication. Then we would give a final injection to prepare for the egg retrieval process.
The Egg Retrieval Process
The egg retrieval is the only day in the whole discussion, evaluation and treatment that we would ask that person to have the day off because you would typically have IV sedation. During that time while you’re asleep, we would go through the vagina with no incisions or anything with the use of a needle to go into each follicle where the eggs are, get all the fluid from the follicles and then remove the fluid. Our embryologist would then let us know at the end of the procedure how many eggs we have. Any mature eggs and ones that could be available for fertilization in the future are frozen. Then that process is done and you’d be back to yourself the following day to resume whatever activities or work functions you wish. So again, the actual treatment process goes over the span of approximately 12 to 14 days, depending on how many days you end up being on the medication.
How Long Do Egg’s Stay Frozen?
Some other questions include how long can a person’s eggs stay frozen? They can typically be frozen pretty much indefinitely – just like you can freeze sperm for many decades and then use that later. There’s no reason to think that, particularly if, for example, the patient freezing their eggs at age 35 would want to use them by age 50 or 55 that they should be usable.
Preparing for Egg Implantation
So essentially when a person comes back to discuss using their previously frozen eggs, the process to use them would be to prepare the lining of the uterus with estrogen to build up the lining by making it receptive for pregnancy. Then progesterone will be added a few days before the transfer. This is done in both the estrogen pill and patch form. The progesterone is an injection for about five days leading up to what we call the embryo transfer.
Receiving the Fertilized Egg Implantation
Once we know that everything looks perfect and we’re ready to thaw the eggs, we would then inseminate them using a process called exceed or intracytoplasmic sperm injection where you take a single sperm and inject it into the egg. This will allow the embryo to grow over a course of several days, typically five days until it reaches the blastocyst stage. We then place the embryo in the uterus and around 10 days following that perform the pregnancy test.
Egg Freezing: Highly Effective But Not Guaranteed
Very much like with anything else involving fertility and the female reproductive system that as fertility declines with age, the chance of success is age-dependent but not on when the embryo is transferred – the age dependency is contingent on the age of the egg itself. So if someone were using aged 32 eggs at the age of 40, they have a chance of a pregnancy of that 32-year-old. It is a very effective option and can be a very effective option. A lot of people like to think of egg freezing as an insurance policy and I think it’s a reasonable comparison. I certainly don’t want to give people false information or false idea that most people think of insurance policies as a guarantee that you do x or y, or you pay x for y and then something will happen as a result of that – and that “something” here being pregnancy. Unfortunately, it’s not a guarantee, but it makes your chances immeasurably greater than if one were to delay childbearing by several years from when they potentially would have preserved their fertility.
Egg Freezing Today
So hopefully that was a good bit of information on what people should think about egg freezing, fertility preservation and what the process entails. It is a very good option for women in this day and age that may have a different focus, long education, and different career goals. It’s become so popular that even actual companies such as Facebook and Google are actually paying for their employees to do egg freezing. It’s gained a lot of ground in the last few years in terms of its potential effectiveness in preserving fertility. If you have any other questions, please feel free to contact me or contact any one of us in our offices and we’d be happy to discuss it further. Thanks very much everyone!
Alternative Fertility Treatment Education
To learn more about the fertility treatments available to patients throughout the local New Jersey and Pennsylvania area, consider the expertise from South Jersey Fertility Clinic. Our dedicated practitioners are excited to field your questions and concerns to help you create a successful plan of action towards fertility preservation or possible infertility treatment. We invite you to contact us or take part in our next live video from our Facebook page to learn more about your fertility options. See you then!