Egg freezing offers options for having children later in life.
It is well known that age negatively affects a woman’s fertility. Fertility begins to decline as a woman enters her mid- to late-20s and decreases more rapidly after age 35. Every woman is born with a limited supply of eggs (ovarian reserve) and over time, the quantity and quality of her eggs are constantly decreasing, making it more difficult to achieve a healthy pregnancy. For many women, the natural end of fertility occurs around age 45 despite the fact that most women at this age are in great health and the uterus is still perfectly capable of hosting a pregnancy. Freezing eggs offers women a way to preserve their fertility so they can have the potential to have healthy babies later in life.
Who should consider freezing eggs?
Egg freezing can be beneficial in a number of different scenarios and each individual’s reasons can vary depending on her unique situation and family-building goals. Some common indications for egg freezing include:
Women who want or need to delay having children in order to pursue educational, career or other personal goals should consider egg freezing.
Because the decline in fertility is known to be due to a decrease in ovarian reserve and egg quality, freezing eggs at an early reproductive age will result in the best chance for a future pregnancy. Younger women have better ovarian reserve and better egg quality, so the eggs they freeze will likely be healthier eggs than the eggs that are remaining when they are ready to conceive. Since the ability of the uterus to carry a pregnancy does not generally decrease over time, women who freeze their eggs while they are younger can act as their own egg donor once they are ready to have children. Pregnancies resulting from younger eggs have a lower risk of miscarriage and chromosomal abnormalities like Downs’ Syndrome because these are outcomes that are related to the age of the egg, but not the age of the uterus.
Women diagnosed with cancer should freeze eggs before starting cancer treatment. Egg freezing offers a chance to save eggs prior to chemotherapy, surgery or radiation for cancer treatment. Many of these treatments are destructive to eggs and can lead to infertility and premature menopause. The main factors that influence the impact of these therapies on future fertility are age at the time of cancer treatment, type and dose of chemotherapy, and location and dose of radiation. In some cases, viable eggs may be preserved after cancer treatment but it is always best to freeze before treatment if possible. Fertility options vary depending on age, type of cancer, and cancer-treatment plan.
At California Fertility Partners we offer expedited consultations and discounted services to cancer patients preserving fertility. We work with organizations including Livestrong, Heartbeat and Team Maggie because we are passionate about making fertility preservation accessible to patients with cancer. Our team is internationally renowned for their expertise in caring for patients with all kinds of cancer, even the rarest forms. This is important to consider in choosing your fertility clinic because cancer patients often have unique needs and concerns that are different from patients with infertility or women freezing eggs for non-cancer related reasons. Our team has the experience to address those specific needs and to optimize both the safety and effectiveness of fertility preservation procedures in patients with cancer.
Egg freezing is an important option for transgender teens and men who are medically transitioning from female to male, but want the potential to become a biological parent in the future. Puberty-suppression treatment, prescribed to stop undesired pubertal changes in transgender adolescents prevents maturation of eggs and causes infertility. Long-term hormone treatments with testosterone therapy also affect fertility, and may cause irreversible damage. Freezing eggs before initiating the gender transition is the optimal time.
Women with objections to storing frozen embryos for religious and/or moral reasons may consider freezing eggs instead. Following a standard IVF treatment cycle, many couples will have excess embryos. The decision of whether to freeze these unused embryos may be challenging from an ethical and religious perspective without knowing the ultimate disposition of the embryos – will they be used to achieve pregnancy in the future or not? The option to fertilize only as many eggs as will be utilized in the IVF process and freezing the remaining unfertilized eggs may offer a comforting solution for those with concerns about freezing embryos.
Women with a family history of premature menopause. Some forms of early menopause (premature ovarian failure) are genetically inherited. If a woman has a history of early menopause in her family members, she is at higher risk for early menopause and infertility herself and should think about freezing her eggs.
When choosing a fertility clinic for egg freezing, it is important to keep in mind three important factors that influence the chance that you will have a successful birth once you are ready to conceive: 1. Expertise and experience in the freezing process, 2. Skill and technology to optimize survival of the eggs when it comes time for unfreezing (thawing) the eggs 3. An excellent IVF laboratory to ensure optimal embryo growth after the eggs are combined with sperm.
At California Fertility Partners, we are pioneers in freezing technology. In fact, the first baby ever born from a frozen embryo in the United States was achieved by our team way back in 1986. Since then, we have continued to be at the forefront of our field in advancing and refining freezing technology, and currently are one of a select number of IVF laboratories worldwide that have been approved to utilize the Japanese device and media. This special device from Japan has demonstrated consistently higher oocyte survival rates of >95%. We know that oocytes are more fragile than embryos when it comes to freezing so we have found that using this gentler device with a thinner tip than most devices allows for the actual freezing to happen more quickly and more safely for your eggs. Once you are ready to use your frozen eggs, our state of the art IVF laboratory provides optimal conditions to promote the growth of your embryos (fertilized eggs) and give you the highest chance of pregnancy.
What is the egg freezing process?
The first step in your egg freezing journey is to schedule an initial consultation with one of our experienced and distinguished physicians. During the consultation, your doctor will give you individualized information based on your medical history and family-building goals that will help you decide whether freezing eggs is right for you
In order to determine whether you are a good candidate for egg freezing, tests to measure your ovarian reserve will be performed either at the time of your initial consultation or shortly after. This will typically include a blood test to measure hormones including Anti-Müllerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol levels, and a transvaginal or internal ultrasound to count follicles in your ovaries. In some cases, contraceptive methods such as birth control pills can affect the accuracy of these tests so you may want to consider taking a break from pills about one month prior to completing these tests.
The egg freezing cycle consists of ovarian stimulation (hormone injections) followed by an egg retrieval (minor surgery).
- Ovarian stimulation: In order to retrieve eggs for freezing, you will take hormone injections for approximately 10-12 days to allow your eggs to mature. These hormones are identical to the ones your body produces during a natural ovulation cycle but in higher amounts. Only mature eggs can be frozen and fertilized by sperm, so the goal of the ovarian stimulation is to induce multiple eggs to mature.
- Egg retrieval: Once the eggs have adequately matured, they are retrieved with a needle placed through the vagina using an ultrasound probe for guidance. This procedure is done under intravenous sedation and is not painful. The eggs are then immediately frozen. Most women experience mild to moderate cramps on the day of the surgery, but feel significantly better by the day after surgery and are able to carry out normal daily activities like driving and walking. Most women gradually feel completely back to normal within 7-10 days after surgery.
What is the ideal age to freeze eggs?
Since younger age is associated with superior egg quality, freezing eggs should ideally be done while a woman is in her 20s or early 30s. However, we have achieved healthy babies from eggs frozen in women in their 40s, so it is an option that can be considered.
How many eggs is enough to freeze?
In general, the more eggs you can freeze, the higher the overall chance of success, especially if you think you would like to have more than one child. It is important to know that no matter how many eggs you freeze, there can be no guarantee of future pregnancy. Since younger women tend to have a higher proportion of good quality eggs, a woman who freezes her eggs at an age < 35 can have an excellent chance of future pregnancy even if she freezes a relatively low number eggs. Based on outcome data from our center, egg thaw rates of 95% and fertilization rates of 80-90% are anticipated in women up to 38 years of age. We therefore recommend that at least 10 eggs be stored for each pregnancy attempt for women who freeze eggs in this age group. Women older than 38 may need to freeze closer to 20 eggs to achieve an optimal chance of a live birth. The number of eggs retrieved per cycle varies a lot from woman to woman and from cycle to cycle, but your ovarian reserve tests can be helpful in predicting how many will be retrievable in your case.
How long can the eggs stay frozen?
Based on decades of experience with frozen sperm and frozen embryos and increasing data from women who are achieving pregnancies using their frozen eggs, there is good reason to believe that eggs can stay frozen as long as you need. The length of time that you keep your eggs frozen does not negatively impact the quality or viability of the eggs or the chance of a successful pregnancy.
What factors affect the success rates?
Age, egg quality, expertise and techniques used for freezing and thawing, conditions of IVF lab. At California Fertility Partners, we have the experience, skills and technology to give you the highest chance of success with egg freezing. Testing of the uterus and screening for medical diseases such as thyroid disease, that could impact the health of the pregnancy should be completed at least a month or two prior to using the eggs.