Women Storing Eggs in Fertile Period for Later Pregnancy

Women Storing Eggs in Fertile Period for Later Pregnancy

by Dr Gautam Allahbadia

Technological advances now allow women to preserve their fertility potential by freezing and storing their eggs. All women share a common dream of becoming a mother. Female fertility begins declining in the late 20's, however conception rates remain high into the 30's. After age 35, the decline accelerates and reaches nearly zero pregnancy potential by the time the woman reaches age 45. In addition, women over 35 have an increased risk of miscarriage and/or genetic abnormalities in their children as a result of age-dependent changes in egg quality. There are two distinct reasons for women to choose to freeze their eggs. The first is for health reasons; in particular, for women who wish to preserve their fertility before undergoing cancer treatment. The second is for personal and social reasons as many women delay childbearing beyond their most fertile years which increases the risk of age-related infertility.

Egg-freezing also known as oocyte cryopreservation is the latest development in the field of Assisted Reproduction Technology (ART). The American Society of Reproductive Medicine removed the "experimental" label from the technique of egg freezing in 2012 and it has since been included in mainstream fertility practice. A woman is born with all the eggs she will ever have. In fact, the strength of her oocyte reserve is finalised when she is in her mother's womb. This number promptly becomes half by the time of birth. The eggs lie dormant till hormonal activity starts at puberty. Each month, a bunch of eggs start their journey towards ovulation.

Only the best are selected and the rest are discarded naturally. By the age of 37, there is a sharp decline in the egg reserve and the number steeply declines till the age of 40-plus, when there are but few good ones left. At this point when women have not considered pregnancy, it becomes necessary to preserve her fertility so that she can get pregnant when she wants in the future. Oocyte cryopreservation is considered as an important component of human assisted reproductive technology.

his technique gives women an opportunity to slow down their biological clock by freezing their eggs till they are ready for conception. When they decide to get pregnant, the eggs are thawed, fertilised in-vitro and transferred back into the uterus. Busy pursuing educational and career goals, most women these days delay marriage and pregnancy. There are many women who cannot contemplate marriage in the near future as they are still looking for the right partner or have many compulsions like working their way through their careers. Freezing eggs is a woman's biological insurance against ageing. However, many women are complacent and believe that egg-freezing can be done at any age. They wait till they turn 40, but by that time, it is too late! Eggs are best frozen between the ages of 25 and 37. Women who can afford this option should not waste time. Freezing eggs at an early age may ensure a chance for a future pregnancy. Reproductive specialists can help women figure out which category they are in, which is an important factor to consider when thinking about freezing eggs. In addition, women over 35 have an increased risk of miscarriage and/or genetic abnormalities in their children as a result of age-dependent changes in egg quality.

Am I a candidate for Egg Freezing?

If you are between the ages of 25 and 35, not in a stable relationship and you wish to increase your chances of conception with your own eggs in the future, Egg Banking is a suitable option for you. This is also a good option for young women diagnosed with cancer, women with a family history of early menopause and those with chronic diseases where the medication may have a detrimental effect on oocyte function. Even women who want or need to delay childbearing in order to pursue educational, career or other personal goals can also opt for egg banking. 

Like all new fertility techniques, egg freezing brings not only new options but also tough decisions that previous generations of women never had to face. If you do freeze your eggs, don't be lulled into a false sense of security. You and your partner should still try for pregnancy as soon as you are ready. Freezing eggs for one's own future use has become a growing trend.

The process and procedure of egg freezing and storage

The patient is initially tested for HIV and Hepatitis B and C. Women who wish to freeze and store eggs are given a course of fertility drugs to stimulate the ovaries to produce a large number of eggs. When the eggs are mature they are retrieved and frozen €" either by cooling down slowly or by vitrification i.e. fast freezing. Recent studies have shown that egg-freezing by vitrification method increases conception rates. That's because the chances of the eggs surviving the freeze-thaw process is comparatively higher. Eggs are frozen at a temperature of -196 degrees C in liquid nitrogen and liquid cryoprotectant to ensure long-term storage. During this period, the woman can decide if she wants to use the eggs herself or donate them to help another woman get pregnant.

In oocyte cryopreservation, the eggs are harvested by a process similar to the natural cycle. The patient will be made to grow more eggs, with the help of hormonal injections, which are patient-friendly and can, in most cases, be self-administered. The eggs are later retrieved by a 10-minute procedure under short anaesthesia. The patient can resume normal life within a day. The eggs are cryopreserved using advanced vitrification process, which causes minimal damage to the eggs they can be maintained for many years.

How long can you store your eggs in cryo bank?

Theoretically, eggs or embryos may be frozen indefinitely, as no biological activity takes place during cryopreservation. In medical literature, the longest reported time for an embryo to be frozen, thawed and result in a viable healthy delivery is twelve years. Freezing and thawing protocols continue to improve, making it possible that eggs / embryos frozen more recently may have even better outcomes. Based on this scientific evidence, it can be said that 15 -20 years of storage does not result in any decrease in quality of eggs.

How do you use frozen eggs to achieve pregnancy?

Once you are ready to start a family with your partner/husband, you will be prepared for a recipient cycle with medications to prepare your uterine lining. Your eggs will be thawed and fertilized using the ICSI (Intracytoplasmic Sperm Injection) technique with partner/husband's sperm. The embryo transfer will then be planned after 2 or 3 days.

What can go wrong during this entire process?

Sometimes things don't go as planned. There is a small possibility that during egg retrieval no eggs are collected or the collected eggs are not mature and hence not suitable for freezing. It may also happen that none of the frozen eggs survive the thawing process, or they may not get fertilized in spite of successful thawing.

Is egg freezing safe?

To date, approximately 2,000 babies have been born from frozen eggs. The largest published study of 900 babies from frozen eggs showed no increased rate of birth defects when compared to the general population. Additionally, results from one study showed no increased rates of chromosomal defects between embryos derived from frozen eggs compared to embryos derived from fresh eggs.

Most insurance companies don't cover the cost of egg freezing, not even for medical reasons when a young woman's fertility is jeopardized by cancer. So the decision by Facebook and Apple to foot the bill is a significant benefit for women who want to freeze their eggs.

Dr. Gautam Allahbadia is a renowned IVF, Fertility and Infertility Specialist in Mumbai, India and runs the clinic Rotunda - The Center For Human Reproduction. Dr. Gautam says infertility can be one of the most stressful situations you may encounter, emotionally, physically and sometimes financially.