How Can Freezing My Eggs Help Me With Conceiving In The Future?
Across the globe, more women are choosing to delay having children. As ovarian reserve and egg quality are known to decrease with age, many opt to preserve their eggs for future use. Egg freezing allows autonomy over education, work or building relationships without pressure from a biological clock.
Why should I freeze my eggs?
There are many reasons why an individual may opt to have their eggs frozen:
- You are preserving good-quality eggs to use in the future1. After age 35, there is a steeper decline in egg quality and number. For those 35 and older, the remaining eggs are more likely to have chromosomal abnormalities, affecting the chances of achieving a successful pregnancy. Egg freezing allows individuals to capture these eggs in their “younger” state to be used later.
- You are undergoing gender-affirming hormone therapy1. Many transgender or gender non-conforming individuals choose to undergo a medical transition like HRT. After approximately six months of testosterone therapy, ovulation and menstruation typically come to a halt. Egg freezing before HRT protects the eggs from any damage that may arise from gender-affirming HRT while providing individuals with a variety of conception options in the future.
- You have a condition or are undergoing a treatment that can affect future fertility1. Certain conditions and treatments can impact fertility, such as autoimmune disorders, stem-cell transplants to treat sickle-cell anemia, or chemotherapy and radiation to treat cancer. Many choose to freeze their eggs early in their diagnosis or before treatment to protect them from any damage.
At what age should I consider freezing my eggs?
Many have the misconception that egg freezing is only applicable for those in their 20s. However, this is not necessarily the case. A Spanish study by Cobo and colleagues (2016) investigated a group of 1500 women freezing their eggs for social reasons (not due to cancer treatment or other illness-related reasons) to discover the average ages that women freeze their eggs. Researchers found that the average age of these women was 37, with 63% freezing between ages 37-39 and 16% freezing over age 40. Interestingly, ages 26-30 only accounted for 1.6% of total women that opted for egg freezing.
However, egg freezing might look different depending on a patient’s age. Two of the most important factors determining success with the eggs in the future are:
- The age at which you freeze your eggs
- The number of eggs you freeze
As we get older, our egg quality declines and eggs become more likely to create aneuploid embryos, which are not usable for transfer. Therefore, physicians usually recommend that older patients freeze more eggs to increase the number of embryos eligible for transfer. In the previous study by Cobo et al. (2016), researchers found that women under 35 who froze 15 eggs had an 80-90% chance of achieving a live birth from the eggs2. Conversely, for women over 35 that froze the same number of eggs, this rate dropped to 30%.
Knowing this, naturally, one might think that preserving eggs as early as possible is the best option. While this might be true if you have reason to believe you might need IVF in the future (such as the reasons highlighted above), most women in their early 20s have a large window of opportunity ahead to conceive naturally. If patients at this age were to freeze their eggs, there is a good chance they would not return to use them.
However, for patients who have difficulty conceiving later in life and require IVF, preserved eggs can save time and money. Younger eggs are more likely to create better-quality embryos, which can increase the likelihood of implantation. In the long run, these eggs may decrease the number of failed IVF cycles a patient must go through, as they are more likely to result in a successful pregnancy.
How does the process work?
After being referred to a fertility clinic, a physician will order a fertility assessment to determine if egg freezing is right for you. Here, blood tests and a vaginal ultrasound will help a fertility physician establish your unique fertility baseline. After your assessment, if you decide to pursue egg freezing, the whole process should only take two weeks.
For ten days, you will receive hormone medication that stimulates the ovaries to produce many eggs. The resulting changes to hormone levels can sometimes produce side effects such as nausea, headaches, bloating, fatigue, and bruising around the injection site. Occasionally, these injections can lead to a condition known as ovarian hyperstimulation syndrome (OHSS), where the ovaries swell and begin to leak fluid into the body. This condition can lead to more serious complications if severe and left untreated, so it is essential to discuss the signs and symptoms with your doctor before treatment.
When the eggs are ready to be extracted, egg retrieval is performed in the clinic. This is a quick process, usually only requiring 15-20 minutes under conscious sedation. During the procedure, a vaginal ultrasound is first inserted to visualize the follicles storing the eggs. A needle with a connected suction device is then used to harvest the eggs. Shortly after harvesting, the eggs are “vitrified” or flash-frozen in liquid nitrogen, using agents that protect the embryo from ice crystal formation. This process preserves the eggs and halts the aging process for later use.
If you return to use your eggs in the future, the process looks similar to a traditional IVF cycle. The frozen eggs are thawed, combined with sperm, and incubated to allow the embryos to develop. After approximately six days, an embryo can be transferred into the uterus. The remaining embryos can be refrozen for future use.
Is egg freezing a guarantee?
Like natural conception, not every frozen egg will become an embryo. Some will fail to pass the milestones that must occur before implantation. First, an egg must be successfully fertilized, and the resulting embryo must develop to the blastocyst stage. Even after passing these checkpoints, an embryo may still fail to implant. Therefore, most clinics typically recommend that younger individuals aim to freeze approximately 20 eggs. For individuals 35 and older, this number is generally even higher.
However, these numbers are not always realistic for every patient in one retrieval cycle, depending on their unique fertility baseline or the presence of other health conditions. Your fertility doctor will use information gathered from your fertility assessment to give you a better idea of what you can expect from your egg retrieval.
If you have questions about preserving your eggs or are interested in discussing your options with one of our fertility specialists, book your consultation today.
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