Egg Freezing Preserves Your Fertility Chances

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1 Egg Freezing Preserves Your Fertility Chances

2 There are numerous reasons why some women struggle with fertility. As many as 12 percent of women in the U.S. have difficulty conceiving or carrying their baby full-term without some form of modern reproductive assistance. The good news for these women, as well as those who encounter fertility challenges as the result of age or a cancer diagnosis, is that innovative medical technology is tackling the problem head on. Oocyte cryopreservation, or egg freezing, can serve as a fertility insurance policy for many women who suspect that fertility will become an issue for them in the future.

3 While cryobiology, the process of preservation by chilling or freezing, seems like a relatively modern idea, it has actually existed for about 4500 years. Early human civilizations noticed that the decay of organic materials slowed down in the presence of colder temperatures. Thus, as far back as 2500 BC, astute healers would use cold for medical purposes. However, the ability to freeze and thaw cellular tissues was not perfected until the mid-1950s when the first frozen sperm was used to create a live, healthy human baby. Once that medical feat was accomplished, medical scientists got to work even more enthusiastically, finding the right combination of factors to successfully freeze and preserve the female egg so it could be used to increase the success rates of assisted reproductive technology once it was thawed again. Their perseverance has paid off. The first baby conceived using a frozen egg was born in Now, egg freezing is becoming an increasingly popular means of fertility preservation for multiple populations of women. These include: Women diagnosed with a cancer that affects fertility or requires treatment that may cause infertility. Career-focused women who understand the connection between age and fertility and want to preserve viable eggs for future assisted reproductive technology (ART). Women who want to use ART but aren t interested in using frozen embryos. 3

4 Women in their 30s who haven t found a life mate yet but know they want to experience pregnancy, birth and motherhood. Women who have a family history of early menopause, primary ovarian insufficiency or other medical conditions linked to infertility. Are You a Candidate for Egg Freezing? Considering the scenarios listed above, let s go into a little more detail about the types of women who are most commonly interested in freezing their eggs. Facing a cancer diagnosis. Women facing a cancer diagnosis, especially cancers that affect the reproductive organs and/or that require treatments associated with infertility, are excellent candidates for egg freezing. This population is one of the driving forces behind the research that has been done in regards to fertility preservation. Once a woman s cancer treatments are completed, eggs can be thawed and fertilized, and the resulting fetuses can be implanted (typically one at a time) via in-vitro fertilization. In some cases, married couples also appreciate the idea of banking frozen eggs because, in worst-case scenarios if the cancer diagnosis becomes terminal - the husband s sperm can be used to fertilize the egg and a gestational carrier can be used to carry and deliver a healthy baby that carries on the maternal line. 4

5 If either case applies to you, you will work closely with your oncology team as well as a trusted egg bank to retrieve the eggs and store them as quickly as possible so your cancer treatment can commence without delay. On the career track. There is no mistaking that maternal age plays a large part in fertility success. By the time a woman reaches age 40, her chances of becoming pregnant via unassisted reproduction decrease dramatically. Thus, younger women who do not foresee becoming mothers prior to age 35 years or older are increasingly drawn to egg freezing as a way of protecting their chances of becoming biological mothers to their future children. Please Note: this should NOT be a reason to delay conception longer than you would have otherwise since freezing eggs does not guarantee you will be able to get pregnant. Not interested in frozen embryos. There is no doubt that cryopreservation of eggs brings along a host of concerns and, potentially, ethical dilemmas. Some of our clients find that while they are comfortable with the idea of egg freezing, they feel less comfortable with the idea of frozen embryos. Their eggs can be retrieved and frozen in their younger years. Then, when they are ready, the eggs can be unfrozen and fertilized one at a time, or in small batches, to produce fresh embryos, mitigating the need for using frozen embryos for IVF cycles. 5

6 Haven t found your life mate yet! If having a life partner and family are a priority for you, it can get pretty stressful as the years tick by and you re still waiting for the love of your life to enter the picture. Odds are, he or she will appear, but freezing your eggs can help to preserve your fertility chances if parenthood isn t a possibility until your biological clock has stopped ticking. Down the road, your partner s sperm will be used to fertilize the egg and the resulting embryos can be used for IVF. Women with a history of early menopause or medical conditions associated with infertility. Many conditions linked to female infertility, like early menopause, primary ovarian insufficiency and polycystic ovarian syndrome (PCOS), are genetic. If your mother, grandmother, aunts or sisters have experienced them, there s a good chance you are at riskas well. Freezing your eggs earlier on in your 20s or early 30s can increase your chances of conceiving via IVF if you aren t able to conceive on your own. We can t emphasize the connection between age and fertility enough. If any of the above issues are a concern for you, contact Columbia Fertility Associates or a reputable egg bank to learn more and discuss your options. If you do decide to freeze your eggs, time is certainly of the essence and younger eggs mean increased chances of IVF success down the road. 6

7 What are the success rates for using frozen eggs for in-vitro fertilization? Currently, the success rates for using frozen eggs are just as good as using fresh eggs. If you enjoy reading medical studies, you can read this one and that one, both of which show that frozen and fresh eggs yield nearly identical implantation and live birth rates when the frozen and fresh eggs are age matched. The operative words there are AGE MATCHED.

8 Since age is linked to egg viability, and younger eggs are typically more viable than older eggs, the success of the frozen eggs in future IVF cycles will depend largely on the age of the women when the eggs are harvested. If eggs are frozen when a woman is in her 40s, then the success rate of those eggs will be lower than fresh eggs from a woman in her 30s. How are eggs frozen, anyway? This is a good question, and the answer would vary depending on when you asked it. Eggs are more challenging than sperm to freeze and then thaw as a result of their high water content. When water freezes, ice crystals are formed. In the case of human egg water, these crystals often damage the genetic material located in the egg, making it nearly impossible to yield viable eggs able to be fertilized and create genetically healthy babies without a very precise process. Thus, scientists experimented with freezing methods (slow-freeze and fast-freeze techniques) and different cryoprotectants (chemicals that act like anti-freeze) to prevent the eggs from forming as many of the detrimentalice crystals and to yield ever-higher success rates. Although cryopreservation techniques still vary from clinic to clinic, most methods use processes similar to the following: 8

9 Ovarian stimulation. First, the woman will be given fertility hormone injections that stimulate the ovaries, causing them to mature multiple eggs at a time. This takes about two weeks, at the end of which a medication is administered, causing the body to release all the eggs at the same time. Egg retrieval. Once the eggs have matured and have been released, the woman will visit the clinic to have the eggs retrieved via the vagina using an ultra-sound guided needle. Depending on your body and how it reacts to the egg retrieval process, this can take anywhere between two and five weeks. Egg freezing. The eggs go through a vitrification process in which they are placed in a bath, or solution, containing cryoprotectants and sugars. The sugars help to draw a little of the water out of the egg and the cryoprotectants protect it from developing crystal formations. Then nitrogen is used to flash-freeze them, which further prevents crystals from having time to form. Egg thawing. Eggs are thawed rapidly to minimize the breakdown of vital genetic material and they are quickly removed from the vitrification solution. Fertilization. Once they have been thawed, the eggs are fertilized by intracytoplasmic sperm injection (ICSI), whereby a partner s or a donor s sperm is directly injected through the egg s outer membrane, which becomes slightly hardened by the cryopreservation process. 9

10 The resulting embryos can be implanted via IVF procedures right away (with fresh embryos), or the embryos can be frozen and stored until the mother is ready. What are the benefits of egg freezing? Egg freezing has exponentially expanded the chances of biologic fertility for certain females at risk for infertility. Prior to the advent of successful egg freezing techniques, women with reproductive cancers, medical conditions that rendered them infertile, and those who wanted to become mothers beyond their most fertile windows had two options: adopt children or use donor eggs for IVF. While both of these are viable options, and are often recommended depending on a couple s particular infertility diagnosis, neither results in a child that is biologically related to the mother. Oocyte cryopreservation has changed that for good. Now, modern women have the option to freeze eggs in the hopes that they can conceive a biological child of their own when they are ready to become mothers. Another advantage of egg freezing is that you have the benefit of time and scheduling on your side when it comes to the other end of the ART process: your in vitro fertilization cycle. As we mentioned above, you must go through a relatively intense two to five week period of fertility hormone injections leading up to the egg retrieval process. This in itself can be physically and emotionally uncomfortable. 10

11 By undergoing the egg freezing process ahead of time, you can enjoy a few months or a few years off before you commence your IVF cycle. This gives couples more flexibility to save money, travel, relax, work a little longer, enjoy life with a cancer-free diagnosis and so on before pregnancy, labor and parenthood take over their lives. 11

12 How do I find the best clinic to freeze my eggs? Unlike IVF rates, which are published by the CDC each year (always two years behind), there is no way to verify the success rates of any one clinic s frozen eggs. This data simply isn t tracked yet. Thus, we recommend taking a different approach. If you are freezing your eggs, you are going to require at least one round of IVF in order to yield a live baby from the stored eggs. Your best bet, then, is to begin researching fertility clinics and work your way backwards from there. If you find a fertility clinic you like, ask if they offer egg freezing technology inhouse. If not, chances are high that the clinic will have connections with egg banks or other clinics that can do the egg freezing for you. Odds are that if a fertility clinic has high IVF success rates, they only associate with the very best egg banks in the nation. Columbia Fertility Associates partners with several egg banks in the D.C. area and across the nation. We ll be happy to assist you in finding a reputable resource that is convenient for you and your schedule. 12

13 Contact Columbia Fertility Associates to Learn More About Egg Freezing and Fertility Preservation Do you fit the profile of a woman who might benefit from egg freezing? Would you like to learn more about the fertility preservation process? Please contact Columbia Fertility Associates today. We can speak with you on the phone, schedule a face-to-face consultation or send you detailed materials regarding egg freezing and your modern reproductive options. CFA looks forward to keeping your dreams of fertility and parenthood alive and well for as long as it takes.

14 Washington, DC 2440 M Street NW Suite 401 Washington, D.C Phone (202) Fax (202) Bethesda, MD Fernwood Road Suite 301A Bethesda, MD Phone (301) Fax (301) Arlington, VA 1635 N. George Mason Dr. Suite 155 Arlington, VA Phone (703) Fax (703)