Frequently I discuss with patients the concept of age related decreased ovarian reserve and its negative impact on the chances of conception. Most of the time, the patient will have the same response: "I wish I had tried to conceive when I was younger." This usually leads to a realization that there were good reasons to defer trying to conceive until now. I have observed that many patients with age related infertility feel very frustrated that they did not fully understand the impact of age on conception.

 

Over the last several years, egg freezing (elective oocyte cryopreservation) has been touted as the solution to this dilemma. A patient could simply have her eggs retrieved and frozen when she is younger. She could then have more freedom over her reproductive choices and pursue a career or other life goals, knowing that her "fertile" eggs are waiting for her when she is ready.

 

Until recently, my standard reply regarding egg freezing was that it was an experimental procedure with limited success in only a few select programs around the world. Obstacles to success with egg freezing included problems with ice crystal formation that led to intracellular damage and poor egg survival rates upon thawing. However, the use of techniques such as vitrification have led to a dramatic improvement in post-vitrification oocyte survival, fertilization rates, and pregnancy rates. Most importantly, these successes are being reported by many different centers worldwide. The reproducibility of current techniques from center to center is a tremendous break through and heralds the advancement of egg freezing from a status of highly experimental to an emerging technology.

 

There have been approximately 1,000 births reported worldwide from egg freezing.  Based on those reports, combined with our own successes, GIVF is pleased to offer this option to younger women.  Personal Egg Banking from GIVF is a means of improving their chances of conception if they plan to delay childbearing. The experience so far with frozen eggs would predict that a patient in her 40s would significantly improve her chances of a successful pregnancy if she were able to use eggs that were frozen at a younger age (e.g. 30s).

 

A major part of offering Personal Egg Banking to women who plan to delay conception is appropriate counseling. Key points to appreciate include:

 

1) Egg freezing requires ovarian stimulation and egg retrieval. Current protocols require the freezing of multiple mature eggs to have a realistic chance of conception. In a natural menstrual cycle, only one egg is matured each month. Therefore, patients undergoing elective oocyte cryopreservation are given medications to mature multiple eggs in a single cycle (same treatment protocols as infertile IVF patients). To appropriately time the egg retrieval, frequent office visits are required for blood tests and transvaginal ultrasound to monitor the development of the eggs. The eggs are retrieved by placing a needle through the back of the vagina into the ovary. This is an outpatient procedure performed in the office under anesthesia.

 

2) Freezing eggs is not a guarantee of future pregnancy. Since egg freezing is an emerging technology, it is difficult to accurately assess the chance for pregnancy and delivery. Based on published data, largely from donor egg cycles, it is estimated that a single egg that is warmed from the vitrification method has a 4% chance of resulting in a live birth.  These rates may be lower in women over the age of 32 since fertility is known to decline with advancing age and age is not the only determinant of egg quality. More recent reports and our own current experience suggest live birth rates will improve as techniques and protocols are refined, but are expected to remain low due to the inherent limited potential of a single egg producing a successful birth.  
 

3) Not every woman is a good candidate for egg freezing. Women who already have significantly decreased ovarian reserve (poor egg quality) may not benefit from egg freezing. At GIVF, we are not recommending egg freezing for patients over 40 years old, or if ovarian reserve testing is significantly abnormal. Additionally, young women (under age 30) need to carefully consider whether freezing eggs will be of later benefit to them. These women are more likely to conceive without assistance because they have many more years to conceive naturally.

 

A significant percentage of infertility is simply due to the modern trend of women choosing to delay childbearing.  Elective oocyte cryopreservation, or Personal Egg Banking, represents a significant advancement over current options for women who plan to delay conception. As with all assisted reproductive techniques (e.g IVF, ICSI), further study and experience will clarify the risks and benefits of egg freezing. At GIVF, we are excited to offer this option and welcome the opportunity to discuss the hopes, promises, and realities of elective oocyte cryopreservation.

 

If you would like to learn more about Personal Egg Banking at GIVF, please don't hesitate to schedule a consultation or request more information or click to call.