Preserving fertility for the future - Freezing eggs

Dr Ashwini Anil Kumar Sirapanasetty *

Many women want to have children someday. But what if you haven’t found the right partner, need more time to establish your career, want to accomplish other life goals, want to establish financial security or are facing a medical procedure that could impact your fertility?

Freezing your eggs is an option that may help you realize your dream of motherhood when you’re ready. Having your eggs extracted and stored for future use (called cryopreservation) may give you the best chance of conceiving later on, especially if you’re facing a medical treatment — such as chemotherapy, treatment of severe endometriosis or gender affirming surgery — or a health condition such as an autoimmune disease that can affect fertility.

Who is eligible for freezing eggs?

Whether or not freezing eggs is a good option for you depends on a few different factors that you need to discuss with your doctor. For example, if you’ve been diagnosed with cancer, your eligibility for egg freezing may depend on what type of cancer it is and if you’ll have time to complete the fertility preservation process before cancer treatment begins.

Your egg supply or quality of eggs starts to decline more rapidly around age 33-38. By 40, 90% of a woman’s eggs are abnormal, which means they don’t have much quality of the eggs which carry the potential for pregnancy.

Women who freeze their eggs before age 40 have a greater likelihood of achieving pregnancy with those eggs in the future. But a reproductive endocrinologist (infertility specialist) can provide testing to see if you’re a good candidate.

“Freezing eggs after the age of 40 is not typically recommended but may be considered on a case-by-case basis”. Clinics in India generally accept women between the ages of 18 and 45 for egg freezing, catering to both single and partnered individuals.

This procedure offers significant benefits, including the preservation of fertility options at a younger age when egg quality is typically higher. However, it’s important to note that success rates can vary based on factors such as age and overall health.

Process to Freeze the eggs.

While egg freezing is a multistep process, it’s a lot more straightforward than you may think. It’s the exact same process as for In vitro Fertilization, the only difference is that after egg retrieval we store the eggs rather than fertilizing them.

1. You self-inject two to three hormone medications every day for 10–12 days. (A friend or partner can help with this if necessary.) This encourages a group of eggs to develop at the same time.

2. To track the development of the eggs during this period, you also have four to six pelvic ultrasounds and frequent blood tests.

3. Once those eggs have matured, you undergo an ultrasound-guided surgical procedure to retrieve them. The outpatient procedure takes 20–30 minutes under anaesthesia.

4. An embryologist (a person trained to examine eggs and embryos) will verify that the eggs are mature, which means they have the potential to become fertilized.

Where are eggs stored?

After eggs are harvested, they go through vitrification — a method of quickly putting eggs into a deep freeze. They’re stored in liquid nitrogen tanks in an embryology lab.

A good embryology lab has the following:

o Around-the-clock monitoring systems with alarms to ensure equipment is properly functioning and the correct temperature is maintained.
o Manual checking of temperatures.
o Embryologists who oversee lab operations and a lead embryologist with certification as a high-complexity clinical laboratory director.
o Certification by Clinical Laboratory Improvement Amendments, a government agency that regulates all laboratory testing.

What happens when you want to use the eggs?

When you’re ready to use the eggs, a group of them are thawed and fertilized with sperm from your partner or a donor.

“We generally recommend intracytoplasmic sperm injection to fertilize eggs because we’ve found natural methods of fertilization aren’t as successful once the eggs have previously been frozen.”

Wondering how long you can keep eggs frozen? Egg freezing has only recently become more widespread. So, if there’s a limit on how long eggs can stay in liquid nitrogen and remain viable.

In India, according to current practices, you can freeze eggs through cryopreservation for up to 10 years. While there is technically no limit on how long eggs can be frozen with advanced techniques, most clinics in India consider a storage period of around 10 years to be safe and reliable.

”However, we’ve been freezing embryos for a long time. We’ve had pregnancies from embryos that were frozen for more than 10 years.” We assume that eggs would behave similarly if frozen.

What are the costs associated with egg freezing in India?

The costs of egg freezing in India vary depending on the clinic and the specific services included. Generally, costs can range from ¹ 70,000 to ¹ 1,20,000 per cycle, excluding annual storage fees for frozen eggs.

Success Rates and Statistical Data Based on Age

o 20s: Higher success rates due to better egg quality and health.
o 30s: Success rates vary but generally decline compared to younger ages.
o Early 40s: Success rates significantly decrease due to diminished egg quality and quantity.

Tips for Women in Their 20s Considering Egg Freezing

o Consider Long-Term Goals: Assess career and personal aspirations alongside fertility planning.
o Consult Early: Seek fertility counselling and medical advice to understand options and risks.
o Maintain Healthy Lifestyle: Focus on nutrition, exercise, and overall wellness to improve egg quality.

Tips for Women in Their 30s Considering Egg Freezing

o Evaluate Fertility Status: Assess ovarian reserve and egg quality through fertility testing.
o Understand Risks: Be aware of age-related declines in fertility and egg quality.
o Financial Planning: Plan for the costs of egg freezing and potential future fertility treatments.

Tips for Women in Their 40s Considering Egg Freezing

o Act Promptly: Understand that egg quality and quantity decline significantly in the early 40s.
o Explore Options: Discuss alternative fertility treatments with a reproductive specialist.
o Emotional Support: Seek counselling to navigate the emotional aspects of fertility preservation.

Lifestyle and Health Considerations for Different Age Groups

o 20s: Focus on establishing healthy habits early to support future fertility goals.
o 30s: Balance career and personal goals while prioritizing reproductive health.
o 40s: Prioritise overall health and well-being to support fertility treatment outcomes.

These tips are designed to help women make informed decisions about egg freezing based on their age, lifestyle, and health status, ensuring they maximise their chances of future fertility success.