What Is Social Egg Freezing
To understand social egg freezing, you need to understand normal ovarian aging. A person with ovaries is born with all the eggs they will ever have. With age, the number of eggs in the ovary naturally decreases.
This process of ovarian aging begins before birth. A 20-week old female fetus has between 6 and 7 million eggs in her ovaries. When that baby is born, the number has already decreased to just over 1 million. This is very different from males, whose reproductive systems create an estimated 250 million new sperm cells daily. The ovaries cannot produce new eggs.
Male fertility also declines with age, just not as rapidly and dramatically as it does in women.
As you get older, eggs decrease not only in quantity but also in quality. This is why there is a higher risk of miscarriage for a 37-year-old compared to a 27-year-old.
Ideally, from a purely biological perspective, if a person with ovaries wants to have genetically related children, they should start trying to have those kids before age 35. Before age 30 is even better. But many people are not ready, able, or prepared to have kids by 30.
This is where elective egg freezing comes in. If, for example, a 30-year-old knows they don’t want to or cant start having kids for another ten years, they can choose to have some eggs cryopreserved.
From Frozen Eggs To Ivf To A Beautiful Baby Girl
In May 2018, the couple decided to move forward with IVF at RMA with Dr. Micheline Chu, who practices out of RMAs Basking Ridge, West Orange, and Englewood locations.
Dr. Chu explained the process first, we will thaw the eleven frozen eggs. Then we will pair the ones that survive the thawing process with your partners sperm to see how many eggs fertilize. Then, out of the ones that fertilize, well see how many grow to the blastocyst stage.
Then, well conduct genetic testing on the embryos that matured to the blastocyst stage to see how many are normal and could lead to a healthy pregnancy and live birth. And then well see how many embryos are left for transfer.
Dr. Chu also explained that the chances of egg freezing leading to a live birth are higher if the frozen eggs are younger, and if there are more of them. Because the quantity and quality of a womans eggs decrease with time, a younger woman who freezes her eggs will not only likely be able to freeze more eggs than an older woman, but the eggs she freezes will have a higher chance of progressing to fertilization, blastulation, testing genetically normal and leading to a successful pregnancy and birth. In other words, the younger you freeze, the better.
This was all news to Betsy when she was told at 39 she had eleven eggs to freeze, she figured shed have some tough decisions to make in the future that shed have more embryos than she would want to use.
Micheline C. Chu
Success Rates For Egg Freezing
The chance of a live birth from frozen vitrified eggs is similar to the chance from fresh eggs which are usually used in IVF treatment. The two most important factors that determine the chance of having a baby from frozen eggs are your age when your eggs are frozen and the number of eggs that are stored.
The number and quality of the eggs that develop when the ovaries are stimulated decline with increasing age. A woman in her early thirties might have 15-20 eggs available for freezing after the hormone stimulation, but for women in their late thirties and early forties the number is usually much lower. Also, as women age they are more likely to have eggs with chromosomal variations.
We would expect:
- A stimulated cycle would result in the collection of 10-12 eggs
- Approximately 85-90% of eggs would survive the freeze and thaw process
Once an egg survives the freeze and thaw process, we would expect it to behave like a fresh egg, offering:
- Approximately 50-70% of eggs would fertilise
- 30-40% develop onto day five
- A single embryo would have a 25-40% chance of developing into a pregnancy depending on a womans age
The following graph, published in the journal Human Reproduction in 2017, estimates the probability of a live birth according to how many mature eggs a woman freezes at various ages. The graph shows:
Your fertility specialist will discuss how many eggs they recommend you freeze depending on your individual circumstances.
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Egg Freezing: Making An Informed Decision
I feel that you deserve to have a lot of information about egg freezing if youre asking this question. Detailed information, like exactly how its going to feel, how much its going to cost, what does it mean for you, is essential to the decision-making process. The only way you can really, truly make an informed decision is to talk to someone who actually freezes eggs. Now some people might say, I dont want to go in and talk to a doctor. That feels like too much pressure. You can do a lot of research online, but ultimately, if youre really interested and you think you might want to freeze your eggs, you should talk to a doctor directly.
Having said that, before you go in, you should make sure you tell yourself that you shouldnt feel pressured to freeze your eggs. Even if the doctor you see is great at freezing eggs and thinks youre a great candidate for egg freezing doesnt necessarily mean that its right for you. So again, I think doing some research online or talking to somebody who has been through it are good places to start. Ultimately, you should go in and see a specialist- someone who has a great reputation, whos done a lot of egg freezing, and someone youre comfortable with. Its always nice to get a recommendation from a friend! Resolve.org is a great resource for getting a referral for a wonderful board-certified reproductive endocrinologist in your area.
How Safe Is Egg Freezing
Overall egg freezing is safe, but some patients experience side effects from the fertility drugs, which can range from mild discomfort to more severe issues.
The HFEA states that the main risks of fertility treatment are:
- a multiple birth
- possible birth defects
Multiple births:
It might be odd to think of multiple births as a serious health issues, but according to the authority, having more than one baby can cause serious harm to the health of mother and child, with at least half of twins born premature and underweight. Youre also more likely to have an early or late miscarriage if youre carrying multiple babies, the HFEA states.
When it comes to mothers, multiple births can result in high blood pressure, gestational diabetes, anaemia and occasionally haemorrhage. It is possible to reduce a womans chances of having a multiple birth if they choose an elective single embryo transfer , which involves transferring just one embryo into the womb instead of several as was previously common. All remaining embryos can be frozen and be used at a later date.
Its worth noting that eSET doesnt affect egg freezings success rate, but its not suitable for everyone.
Ovarian hyperstimulation syndrome
This is a reaction to the fertility medication and usually occurs around a week after egg collection. OHSS happens when a woman is hypersensitive to the drugs and develops too many eggs in the ovaries, which can result in them becoming enlarged and painful.
Ectopic pregnancies
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Getting Informed In Advance Can Help
It’s easy to feel overwhelmed when making decisions about your fertility, not to mention about your healthcare in general. Modern Fertility can help you take concrete steps now so you can get an idea of whether or not egg freezing is something you might want to consider. For example, learning about what your AMH levels are at right now can help you predict ovarian stimulation that’s when you take hormone medication to generate eggs or IVF success should you decide to freeze your eggs and use them later.
The Modern Fertility Hormone Test hooks you up with important information about up to six hormones : what they’re up to and what you might expect from them in the future . You’ll also get results and data points you can use to start a conversation with your doctor or your partner.
You’re not alone with your questions and concerns around egg freezing or any other aspects of reproductive health. We’re here for you.
What About Frozen Embryos
For prospective parents concerned about single-gene disorders or the embryo having greater or fewer than 23 chromosomes, a drawback of egg freezing is that genetic testing performed on unfertilized eggs is not predictive of the genetic makeup of the embryos they will become when fertilized. If possible, fertilizing the eggs through in vitro fertilization avoids this problem. However, IVF is an expensive procedure.
Dr. Ghadir and Dovirak agree that egg freezing is less expensive. Dr. Ghadir estimates embryo freezing is two to three times the price of egg freezing. At the Pacific Fertility Center of Los Angeles, egg freezing costs around $7,000 for a single cycle, $12,000 for two cycles, and $17,000 for three cycles, while embryo freezing is $9,000 for one cycle, $16,500 for two cycles, and $22,000 for three cycles. Embryo freezing also involves several steps not included in these prices, like preimplantation genetic screening and embryo transfer.
It is common practice for clinics to discount second and third freezing cycles.
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Businessegg Freezing ‘startups’ Have Wall Street Talking And Traditional Fertility Doctors Worried
In the past decade, the biggest change with egg freezing has been how they are actually frozen.
Eggs used to be cooled using a slow-freezing technology in which a computer-programmed machine would gradually drop the temperature.
That method wasnt tremendously efficacious, according to Catherine Racowsky, director of the In Vitro Fertilization Lab at Brigham and Womens Hospital in Boston and president-elect of the American Society for Reproductive Medicine. This was because the water in the cells would crystallize, immediately causing degeneration of the eggs, rendering some unusable upon thawing.
Now labs use vitrification, a process that drops the temperature of the eggs almost instantaneously.
Racowsky calls vitrification a pretty standard protocol that all clinics should be employing because it protects the eggs better. While many clinics now boast a 95 percent thaw success rate, there are still obstacles.
Were good at freezing them in terms of getting good survival , but eggs are pretty complicated, and its clear that we need to do more work, she said.
Goulet, the Dallas reproductive endocrinology and infertility specialist who finally got pregnant from her frozen eggs after multiple tries, is grateful every day for her 10-month-old, a boy named Charlie whom she is raising as a single mother. Charlie is crawling and standing on his own now, and starting to show his personality.
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In the past decade, egg freezing has undergone major technological improvements: a more reliable cooling method better analysis of embryos prior to being implanted more effective medications to stimulate the ovaries before retrieving eggs and more.
But Goulet and other experts are raising concerns that the technology, while constantly evolving, may not be keeping up with expectations of the women turning to it, especially as more patients than ever freeze their eggs in the United States: In 2009, only 475 women froze their eggs, according to the Society for Assisted Reproductive Technology, while in 2016, that number climbed to almost 7,300.
If you win, you get the best payout ever: You get a child. But if you dont win, you feel scammed.
Its an expensive lottery ticket, Goulet said. If you win, you get the best payout ever: You get a child. But if you dont win, you feel scammed.
Goulet did ultimately get her payout almost two years after she started IVF. But it took seven grueling rounds of different kinds of IVF hormone shots, at a cost of tens of thousands of dollars. And that included multiple canceled IVF cycles attempts at fertilization or egg retrieval that had to be scrapped because they were likely to lead to poor outcomes.
That to me was the most devastating, when I could not even get past the start line, she said.
One of the fantasies is that when a woman is ready to have a child, that science will make it possible for them.
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How Your Age Impacts Your Fertility
Its no secret that pregnancy is very hard on the body, so it makes the most sense to have a baby while youre still in good overall health and relatively young. However, thanks to improved medical technology and treatment techniques, increased preventive care, and a culture that fosters good health into middle age and beyond, the age range is increasing.
While you may feel the healthiest and fittest youve ever been, your ovaries dont necessarily keep up with the times. No matter how well youve taken care of yourself over the years, youre still born with a limited number of eggs. As you age, those numbers decline, and so does the quality of your eggs.
For most women, fertility begins to decrease in their late 20s or early 30s and starts to fall rapidly by age 35. These changes can make it more difficult to harvest viable eggs for freezing, because fewer eggs will remain as time marches on.
As a result, even if youre otherwise healthy and fit, your declining fertility will reduce your chances of getting pregnant to about 5% by the time youre age 40. And having a natural pregnancy by age 45 without fertility treatments may be a miracle.
Standard Protocol In Egg Freezing
In an informal survey recently conducted by NBC News, many respondents said they are contemplating freezing their eggs, or wish they had done so.
The main concern among the approximately 150 people who responded was cost: Depending on how long you are keeping the eggs, the price can run upwards of $20,000 between egg retrieval fees, hormone treatments, annual storage, and IVF using the thawed eggs. And typically, it is not covered by insurance .
While using thawed eggs can be a crapshoot, the technology involved in freezing them has advanced considerably in recent years. The two clinics that one year ago suffered high-profile freezer malfunctions were a rare occurrence, according to experts, and while freezer tanks are not physically staffed round-the-clock, all should have 24/7 monitoring that alerts staff through a telephone chain to deviations in temperature.
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Things Every Woman Should Know Before Freezing Her Eggs
As women age, the likelihood of chromosomal abnormalities climbs, and with it, the risk of miscarriage, birth defects or disorders that makes conceiving more difficult. Egg freezing is seen by some as a way to stop the biological clock, expand reproductive options and preserve the younger, possibly healthier eggs. And for many women looking to extend their childbearing years, it has has become an increasingly attractive option.
The nation turned its attention to the issue in October when Facebook and Apple announced that they would cover up to $20,000 in costs for the procedure.
But just how successful is it? How invasive? How expensive? When it comes to the details, is this something women should seriously consider? And if so, who?
We turned to experts for the answers. Heres what they told us.
What does egg freezing mean, exactly?
The process of egg-freezing, or in medical speak, oöcyte cryopreservation, involves stimulating the ovaries with hormones to produce multiple eggs, retrieving the eggs from the ovaries and taking them to the lab, where theyre cooled to subzero temperatures to be thawed at a later date.
Why might a woman opt to freeze?
But its not all medical. About three-quarters of the women who freeze their eggs do so because they dont have a partner, Noyes said. She is the senior author of a New York University study released in May 2013.
How invasive is the procedure, and how risky?
Will the hormone shots make me crazy?
Noyes agreed.
What Is The Process Of Egg Freezing
Egg freezing is the process of removing young healthy eggs from the ovaries and freezing them in a lab. Medically, this process is referred to as oocyte cryopreservation.
The first step of this procedure involves going through a fertility and health assessment. The health assessment is to check for STIs. The fertility assessment is to determine the quality and quantity of eggs. Both assessments include pelvic ultrasounds and blood tests.
The reason why the health care provider may want to check the quality and quantity of eggs is to determine the number of eggs to freeze. For women who are between 37 and 40 years of age, freezing thirty eggs increases their chances of getting pregnant by 80%. Women who are under the age of 35 only need to freeze 15 eggs because their eggs are healthier and younger compared to those of women who are over 35.
The reason why older women need to freeze more eggs is that they do not have many quality eggs as younger women. However, the age factor is not the only reason. Certain conditions such as endometriosis can impact egg quality.
After your assessment, you are now ready to go to the next stage of the process. In the next stage, you may be required to take birth control pills for about a week or two to induce ovulation. After which, you will be required to take hormone injections for about 10 days to stimulate your ovaries to produce many eggs. Not all clinics require to take birth control pills during this process, but some do.
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