One of the newest advances in fertility treatment — retrieving and freezing eggs — can give a woman better odds for starting a family later in life. That’s because life doesn’t always cooperate with a woman’s plans for motherhood.
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Fertility begins to decline early 30s and drops rapidly in the late 30s and 40s. The risks for miscarriage and birth defects both rise with age as well.
“Some women postpone starting a family while building a career or may not meet their partner till later in life. Unfortunately, by then their chances for getting pregnant and having a successful outcome are greatly diminished. Egg freezing enables a woman to bank her eggs when she is young in order to have the same high fertility potential when she is ready to conceive later in life.” says Jeffrey M. Goldberg, MD, who heads Cleveland Clinic’s fertility program.
“The first birth from a frozen egg took place in 1986,” Dr. Goldberg says. However, success rates remained low world-wide over the next two decades until the technique was perfected. Recent studies show that there is no difference in fertilization, pregnancy and birth defect rates between fresh and frozen eggs and in 2012 the American Society of Reproductive Medicine declared that egg freezing is no longer considered an experimental procedure.
Odds for pregnancy: excellent
Prior to freezing, the woman receives injections of fertility medications (similar to an insulin shot) to stimulate maturation of multiple eggs. Fertility experts monitor the ovaries with ultrasound as the eggs mature.
“We use a vaginal ultrasound-guided needle to retrieve the eggs without surgery while the patient is under deep sedation. It takes about 15 minutes and patients don’t feel a thing,” says Dr. Goldberg. They go home about an hour later and the retrieved eggs are frozen and stored indefinitely. When the woman is ready, the eggs are thawed, fertilized with her partner’s or a donor’s sperm, then one or two embryos (fertilized eggs) are placed in her uterus using a small flexible tube through the cervix. The procedure feels like a pap smear.
He says that 90 percent of the eggs obtained survive the freezing and thawing process. About 70 percent of the eggs fertilize and 55 percent of the patients are pregnant each time embryos are placed in the uterus, same as with fresh eggs.
“That means that 90 percent of women become pregnant within three embryo transfers,” says Dr. Goldberg.
Egg freezing is much more successful and cost-effective using eggs that are frozen rather than fresh when the woman’s reproductive age is advanced.
Other applications of egg freezing
Egg freezing was initially used to preserve women’s fertility before having treatment for cancer that would likely leave them sterile.
It is also used for couples going through in vitro fertilization (IVF) who are uncomfortable freezing embryos for religious reasons.
“In that case, only a few eggs are fertilized and the rest are frozen,” says Dr. Goldberg. “This is also a good strategy to avoid the problem of dealing with frozen embryos after the family is completed.”
While discarding frozen embryos may be an emotionally charged issue, there is no ethical concern with discarding unfertilized eggs, he adds.
Next step: egg banks
IVF with donor eggs may be the only fertility treatment option for women who are older, who have had their ovaries removed or who have gone through early menopause. Successful egg freezing opens up the possibility of creating commercial donor egg banks, similar to sperm banks. This would provide a ready source of eggs.
Other advantages for egg banks include the ability to choose the donor’s physical characteristics and to retest the donor for infectious diseases while the eggs are stored.
“It’s also a much more efficient use of a limited resource,” says Dr. Goldberg.
Egg freezing and other new fertility treatment technologies are giving women more options and better outcomes. Just what you need when life interferes with your parenting plans.