By The Fertility Authority: Kyra Phillips, author of The Whole Fertility Plan


It’s the closest thing to a fountain of youth you can buy: It’s called "oocyte cryopreservation" or in layman's terms, “freezing your eggs.” It literally means that some of your eggs will be removed from your ovaries and stored in a freezer. That’s right, your DNA on ice. They’ll stay there, not aging, while the rest of you takes your time getting ready to have a baby. It is neither foolproof nor a long shot; it’s somewhere in between.

Until 2012, the American Society of Reproductive Medicine (ASRM) labeled egg freezing as an “experimental” treatment. It was unknown just how well the process of freezing and thawing an egg would go; it was known that freezing an embryo was effective, but just an egg?

But a technology called “vitrification” – fast freezing and thawing – helps eggs remain viable.

At NYU, Dr. Jamie Grifo, who is one of the pioneers in egg freezing, found that the first 80 IVF cycles using frozen eggs resulted in 30 successful pregnancies and four miscarriages. That’s just about the same success rate as using fresh eggs.  

Unsurprisingly, success rates are better when the woman freezing her eggs is younger – although there are always exceptions. The rates of multiples (twins, triplets, etc.) is also similar with frozen eggs and typical IVF – 21 percent and 25 percent, respectively, as of 2013. These numbers will likely go down as genetic testing becomes more and more common and doctors are able to implant just one genetically sound embryo (called a “euploid” embryo) at a time.

While egg freezing is a wonderful new way to add years to your fertility, it’s not infallible, so go into it keeping those success rates in mind – not all eggs are healthy enough to freeze and not all viable eggs result in a pregnancy.  

Because it’s still a recent technology, we also don’t know for sure if eggs deteriorate over time in storage.  We don’t think they do – just like how with airplane flights, the danger is really in takeoff and landing, that’s the case with eggs, too – the danger is in the freezing and thawing, but once they’re frozen, they’re stable.  

There are cases where eggs that have been frozen for 10 years have resulted in successful pregnancies, and Dr. Grifo has cases in his clinic where embryos have resulted in pregnancies after 15 years.

Decision Making

A lot of women ask me, “So when should I freeze my eggs?”  Here's what I tell them: When you’re getting to the point of considering whether or not you should do this and whether or not you need to budget for it, one of the things that may help you decide is to get an antral follicle count.

An antral follicle count can be done during your annual gynecological exam. It's a fairly routine procedure using transvaginal ultrasound, and it shows how many developing follicles you have, which can also provide you with an estimate of how many eggs you have remaining before your supply runs out.  It won’t tell you if those eggs are chromosomally normal, but it does at least give you a good idea of whether you still have a significant supply of baby-making material or whether you’re getting close to running out.

In cases that don’t involve urgent medical necessity, Grifo suggests that the right time to freeze your eggs is in your early 30s. There’s no need to do it before then because you really don’t know where your life is headed – at 21, you still have many years before you have to start worrying that you haven’t found the right guy or haven’t gotten financially stable.  By your early 30s, you’ll have a better idea of your life trajectory and whether or not you’re headed for the fertility danger zone.

It should be noted that the average cost of egg freezing is about $10,000.  Annual storage is around $1000 with the first year usually included in the cost of retrieval and freezing.  When the eggs are used, there are additional costs involved.  

Your age during pregnancy doesn’t count for much – within reasonable bounds, of course; what really makes the difference is the age of the egg. This is something doctors realized after older women failed multiple rounds of IVF; then quickly became pregnant and had healthy babies using donor eggs.  In fact, pregnancy rates among older women using donor eggs is about the same as younger women.

Having your eggs frozen is neither cheap nor simple, so most people have to weigh the pros and cons to decide if it’s a viable option. What it really comes down to is this: If you lose your shot to have your own biological children, will you be crushed?  Or would you be happy having a child another way (such as adopting or using donor eggs)?

Process

Freezing your eggs takes about two weeks and six to eight visits to the fertility clinic (make sure you do your research on every clinic you consider!)  After blood work and ultrasound tests to make sure everything is functioning right, you wait for day two of your next menstrual cycle. On that day, you begin injections meant to send your ovaries into overdrive and produce multiple mature follicles, which will develop extra eggs.  

The injections – which either you, your partner or a friend will administer – may include follicle-stimulating synthetic hormones, luteinizing hormones, or both. Whereas your body would normally release just one egg per month, the idea here is to get as many as possible so that you’ll have lots of chances at a future pregnancy.  While the numbers can vary from woman to woman, the average number of eggs retrieved at the end of all this is about 10.  There are a few different medications that might be used, and you will inject them two or three times per day, at scheduled times, into your abdomen.

A few days after you complete the stimulation round, you’ll start injecting another medication called a gonadotropin releasing hormone – or GnRH agonist, which stops your body from releasing luteinizing hormone (LH) and triggering ovulation.  In this case, you want that cluster of ripe little eggs hanging on the vine where the doctor can find them, and not spilling out all over your Fallopian tubes.

Ideally, you will do more than one round of stimulation and retrieval. You want to get as many eggs in the bank as possible. It all depends on how your body produces – you might get a dozen or more eggs in one round, or it might be just six or seven.  Most likely, not every egg will survive the freezing and thawing process, and not all will be chromosomally normal.  There are many factors that influence egg freezing success rates.  

If you're not ready to have a baby in your 20s, or early to mid-30s, harvesting and freezing your eggs is a great option for women. The history that is being written now is about an entirely different type of women's equality – it's about giving a woman the ability to put her DNA on ice – literally stop that biological clock from ticking.

Photo: monkeybusinessimages
Published: June 17, 2015