At what age should I consider freezing my eggs?
Oocyte cryopreservation is not for everyone. This technology should be reserved for women who are likely to experience a real decline in their fertility in the near future. Most women their 20s have a number of years before their fertility may decline significantly and therefore may be best counseled to postpone egg freezing for some years to see if they still need this option. Women in their early to mid 30′s who are not planning to start a family in the next few years are the best candidates for this technology. Women already in an age group where fertility is likely to be compromised – 40 and over, are less likely to benefit from egg freezing once those eggs are thawed. Our Fertility Preservation Egg Bank will be accepting patients for consultation between the ages of 30-40 years old. Women younger than 30 years may be considered if they have some evidence and/or a family history of a premature decrease in ovarian function. Women less than 40 may be considered if they have ovarian testing indicating good ovarian function and reserve, increasing the likelihood that egg banking for them may still be of benefit.
What is the optimal number of eggs to be frozen?
While there can never be “too many” eggs frozen in the pursuit of fertility preservation, an important lesson learned from our success with frozen eggs is that it is best to be prepared to encounter a percentage of eggs obtained that are either not suitable for freezing or unable to survive the treatment of the eggs. Based on current results, we recommend that women freezing eggs for fertility preservation consider cryopreserving 15-18 eggs. Especially in women at younger reproductive age, that many eggs may be available from just one stimulation/freeze cycle. In other women, the option for a second or perhaps third cycle may be needed to reach that goal.
How long can the eggs remain frozen?
At USC Fertility, we freeze eggs in the same manner as embryos, utilizing a freezing temperature of -196 degrees Celsius. Based on scientific evidence, as well as our experience achieving pregnancies with frozen embryos - in one case the embryo was frozen 10 years - we are confident that long-term storage of frozen eggs does not result in any decrease in quality.
1. How much will it cost?
Centers charge between $6,500 and $15,000 per cycle, according to Dr. Andrew Toledo, the CEO of Reproductive Biology Associates in Atlanta. RBA in Atlanta charges $7,600 per cycle, and NYU charges $12,000. Some women need more than one cycle to get enough viable eggs.
2. Will it work?
Shapiro at RBA estimates that a woman who freezes her eggs between the ages of 32 and 35 will have a 40 to 50% chance of achieving a successful pregnancy. If freezing between ages 35 and 38, the rate goes down to 35%. If freezing at 39 or 40, it's 20 to 25%, and if freezing eggs over age 40, the success rate will be less than 10%.
History of Egg Freezing
Given the recent media attention, you might think that egg freezing is a new technology. In fact, the first recorded birth from a frozen egg was over twenty-five years ago, in 1986. However, unlike sperm and embryo (fertilized eggs) cryopreservation, which have experienced high success rates for decades, egg freezing is an extremely difficult procedure because of the delicate nature of eggs. Human eggs, the body’s largest cell, have a very high water content, which makes freezing them a complex task due the increased risk of ice crystal formations. Recent advances in egg freezing, however, enable higher levels of egg preservation than ever before. Egg vitrification, the flash freezing of eggs, keeps delicate eggs intact for future implantation, greatly reducing the failure rate associated with older, slow-freezing technologies.
Egg Freezing for Cancer patients
Egg freezing may be especially useful for cancer patients. Health data in the United States from 2001 shows that 8% of women diagnosed with cancer were under the age of 40. In 2007, an estimated 180,000 women were diagnosed with invasive breast cancer. Approximately 5% of those women were under the age of 40 at the time of the diagnosis and therefore potentially interested in maintaining their fertility. In fact, about 30% of women under age 40 have never been pregnant. Many of these women are single. For breast cancer, 81% of these young women who undergo treatment with chemotherapy and radiation will be alive and free of disease after 5 years. Unfortunately, less than 5% of women diagnosed with breast cancer under age 40 will go on to deliver a live born child.
Unfortunately for these women of childbearing age, treatments such as chemotherapy and radiation have been shown to cause damage to maturing follicles in the ovaries. These treatments are used to kill rapidly dividing cells but may cause damage to the eggs stored in the ovaries as well. In many cases, women who undergo chemotherapy or radiation will enter menopause prematurely and be unable to ever have children using their own eggs.
Currently, the recommendation for men who are going to undergo treatment with chemotherapy or radiation is to collect several semen specimens so that they can be frozen before treatment begins. The frozen semen can later be used for intrauterine insemination or in vitro fertilization if the man becomes sterile as a result of his cancer treatment. This method is easy, inexpensive and highly effective. The man is not required to have a current partner and so it can be performed on young men.
If a woman who is diagnosed with cancer has a male partner with whom she wishes to conceive, but is not ready to attempt pregnancy, the best option for them is create embryos through IVF and freeze the embryos (embryo cryopreservation). Embryo cryopreservation has been performed successfully for many years and is currently considered the gold standard in fertility preservation.
Some women may not have a partner that they want to have children with or are too young to have partner. These women are ideal candidates for egg freezing.
How egg freezing works λ Extract eggs Woman receives drugs to produce multiple eggs. Ultrasound-guided needles are used to harvest eggs from the ovary. λ Identify The eggs, which are in fluid when extracted, are poured onto a flat dish. Individual eggs are identified with a microscope and withdrawn for freezing. λ Prepare for egg freezing Because ice crystals can form within the eggs and damage them, technicians remove the water from the eggs and bathe them in an 'antifreeze' solution before egg freezing. Laboratories vary in how they conduct the egg freezing process and freeze the female eggs. Some prefer a slow egg freezing technique, while others use a flash egg freezing process called vitrification. λ Freeze Eggs are stored in tubes in a liquid nitrogen storage tank. λ Thaw and fertilize each egg, is then thawed and injected with a needle containing a single sperm--a procedure called ICSI. Eggs begin to develop into embryos. λ Implant Embryos are implanted into the uterus using a catheter.
Specialists in in-vitro fertilisation (IVF) have issued a warning to women. They say healthy women who are worried about not getting pregnant as they grow older should not rely on getting their eggs frozen. They noted that success rates with this procedure are "patchy" and there is little chance of falling pregnant...
A report by the American Society for Reproductive Medicine found that advances in egg-freezing techniques now produce rates of pregnancy and healthy babies comparable to those seen with vitro fertilization (IVF) using fresh eggs. The society went so far as to remove the word "experimental" from the paper, in the hopes that insurance may begin to pay for egg preservation for young women who face gonadotoxic treatments, such as chemotherapy for cancer.
"Egg freezing can be used for patients with medical indications for losing their fertility, such as cancer, impending ovarian failure, or even genetic conditions like Turner syndrome," Dr. Samantha Pfeifer, the paper's lead author, said during a press briefing...
A new method of freezing human oocytes, which is ten times more successful at leading to pregnancy than currently available methods, has been developed by Japanese scientists. The rapid freeze technique, called Cryotop, has a survival rate of over 90%, compared with 60% in traditionally freeze-thawed eggs. Pregnancy rates stand at 41.9%, compared to 42% with fresh eggs...
But women who decide to have their eggs frozen are not infertile. They are making an "elective" or "social" choice to take advantage of a new technology. Does this make any ethical difference? No, argues Harwood...
As more women postpone motherhood, some doctors are offering them an option for preserving their fertility-egg banking, a method long used to preserve sperm.
Unlike men, who can reproduce well into old age, women are born with a finite number of eggs. The quality of these eggs begins to decline at about age 35, and the supply is exhausted at menopause. Egg cryopreservation already is being used to give patients who need fertility-destroying chemotherapy or require removal of their ovaries a chance to someday have a baby...