For many years, men have been able to freeze sperm. Recent scientific advances have made it possible to cryopreserve eggs for women. Now women have the ability to cryopreserve eggs for the same situations that men have been able to preserve fertility, before undergoing chemotherapy or radiation therapy for cancer and avoiding the effects of aging on reproductive capacity.
The freezing process called vitrification has allowed egg freezing to become a reality. Vitrification involves a rapid freezing process that prevents ice crystals from forming within vitrified cells including eggs. Ice crystal damage to the cells that occurred with slow freezing protocols that were used for decades for embryos and sperm did not work well for egg freezing. IRH has extensive experience with the vitrification freezing process over the last few years while cryopreserving embryos. This experience has allowed us to have early success with oocyte vitrification.
Egg freeing or cryopreservation was changed from experimental to non-experimental status by the American Society for Reproductive Medicine (ASRM) in the fall of 2014. Prior to that we offered egg freezing under an IRB approved experimental protocol. Since the ASRM change, IRH has been offering egg freezing to our patients. IRH has ongoing pregnancies and delivered pregnancies as a result of oocyte freezing. IRH has helped patients freeze their eggs to avoid damage from cancer treating chemotherapy and/or radiation therapy. IRH has patients who have cryopreserved their eggs for delaying childbearing for social reasons. IRH has cryopreserved donated eggs resulting in pregnancies. IRH also has pregnancies from eggs that were cryopreserved as their partner had an unexpected lack of sperm on the day of retrieval. In this situation the eggs were cryopreserved and thawed later when sperm was available and subsequent pregnancies have resulted.
As women get older, they may encounter difficulty getting pregnant (conceiving) with a healthy baby. Women are born with about 1-2 million eggs. Most of the eggs die off so that by the time a girl reaches puberty, she is left with about half a million eggs. As women enter their mid- to late-30s and 40s, the eggs disappear more quickly. Also, the eggs that remain might be less able to lead to a healthy pregnancy because of the normal age effects on egg quality. Biologically, it is easier to get pregnant before age 30. However, due to professional, social, or health reasons, a woman might not be ready to get pregnant at that time and she might choose to defer having a child until the time is right for her. Understanding the normal age effect on future fertility, these women may seek out treatments to remove and freeze eggs to be saved for potential use in the future.
The actual treatment process involves part of the in vitro fertilization (IVF) process. Briefly, a woman would have 10-12 days of daily injections to cause a group of her eggs to mature and develop. During this time, blood levels and ultrasounds will be done to monitor her response to the medicines. To remove the matured eggs, the woman then undergoes a brief in office outpatient procedure under light anesthesia to remove the eggs. Once removed and inspected by an embryologist, the mature eggs will be frozen until the woman would want to use them.
No. Even in younger women (i.e., <38-years-old), the chance that one frozen egg will yield a baby in the future is around 2-12%. As women get older and egg quality goes down, the pregnancy rate per frozen egg drops further. It is common for a group of 6 frozen eggs from a woman less than 38 to result in a singleton 40-50% livebirth rate in the future. Some women are lucky enough to get 2-3 groups of 6 eggs from 1 IVF cycle. However, many others may elect to do 2 or 3 IVF cycles to get enough vitrified eggs to help improve the chances of getting a live birth in the future.
Before starting a freezing cycle, a woman would need to speak with one of the IRH physicians to determine if egg freezing is appropriate for her. Every woman is different regarding the effects of age on her fertility, keep in mind; some women in their early 40s do not suffer infertility. However, most experts agree that elective egg freezing is most successful for woman younger than 38 years of age. Blood work and ultrasound measurements of the ovaries can help guide the decision process for an individual woman.
Cryopreserved eggs are not a guarantee of a future baby. One concern is that a woman might have a sense of “false security” if she freezes eggs. She might delay her attempts to conceive until she is much older (whereas she might have started trying at an earlier age, with greater success, if she had not frozen eggs in the first place). In addition to thinking about success rates of using frozen eggs, women should also understand the potential medical risks and psychosocial concerns of parenting at an advanced age. Many of the studies showing successful pregnancies with frozen eggs have been reported on women freezing their eggs in their 20s or early 30s. Pregnancy rates will not be as high for women freezing eggs in their late 30s or early 40s.
Most insurance plans do not cover elective egg freezing. However, for patients at high risk for premature menopause (menopause before 40)–i.e. patients about to undergo certain cancer treatments–some insurances might offer partial or complete coverage.
Costs can be divided into 3 broad phases:
Please contact IRH for costs associated with egg freezing at IRH.