Egg Freezing Procedure: Purpose, Risks, Treatment, and Results

After the first birth of twins in 1986 “Chen at all” revolutionized the technique of egg freezing and it has been increasingly developed and widely applied since then.

At the time of birth, women usually have 2,000,000 eggs in their ovaries. However, by puberty this number decreases to approximately 4 lacks to 5 lack eggs. At the time of menopause, this number drops to negligible.

The basic difference in a male and female is that, these egg cells are going to be fixed throughout the life of a woman while in a male sperm are produced daily. makes age being a very important determinant for pregnancy in case of a female. With the onset of periods, a woman lose around 500 to 1000 eggs every month. As she advances in her age the ovarian reserve declines. Unfortunately, the quality of eggs also decreases with age. For example, in a woman at 30 years of age around 60 to 70% of eggs are genetically okay, whereas in a 40 years old woman only 30 to 40% eggs are genetically healthy.

State of the art  freezing methods makes it possible to preserve gametes today. Originally, technique was developed for sick people who were suffering, who were receiving life saving therapy having negative effects on fertility, for example chemotherapy or radiotherapy for cancers. In such cases young childless patient’s were advised to freeze their healthy egg or sperms before chemotherapy or radiotherapy in order to have their children with their own gametes at a later date. Today, due to our lifestyle, the fertility preservation has become more common. More and more women are postponing their pregnancies often because of their careers or they are not able to find a suitable life partner for them.

Studies and surveys have shown it that females are postponing their pregnancies well beyond mid 30s to early 40s . However, the best time to have a pregnancy with good quality eggs in a woman is their 20s to early 30s. If a woman is already 40 years old, a spontaneous pregnancy is only possible for a maximum of 10%, if they are over 45 years of age a spontaneous pregnancy is a rarity.

Fertility preservation

for those who are in need for treatment of other medical conditions that may affect the ovaries and fertility.

Career over fertility

According to the trend of society, the role of women is increasingly enhanced and the need to focus on career, personal development also increases. If they are not ready for childbirth right now then freezing eggs and waiting for a more appropriate time can be a smart choice today.

Social  egg bank

Egg freezing to create an egg bank for humanitarian egg donation or scientific research is also one of the important purposes of egg storage.

Ethical issues

In some countries or in the opinion of some couples, the embryo is a living organism. Creating an embryo without using it is considered a serious violation of morality. Egg storage can be an alternative in this case.

Indications for storing eggs

• Cancer patients: who are about to undergo special treatment procedures like chemotherapy radiotherapy
• Patients with diseases: sickle cell anemia, myelogenous disorder syndrome who must undergo treatment or surgical procedure that may affect reproductive health.
• Patients at risk of loss of fertility due to genetic abnormalities:  BRCA mutation, Turner syndrome, fragile X syndrome.
• The patient is undergoing IVF however on the day of over pick up sperms are not available due to any reason.
• In some cases, patients with PCOS, poor ovarian response may be offered egg storage.

Ideal time to store eggs

Studies have shown that the success rate of an IVF cycle decreases rapidly as the woman’s age increases especially over 35 years of age. Presently there is not a unified number, but most believe that women in view of storing their eggs should do it well before the age of 35.

How many eggs should / can be stored?

Among all the factors that influence the probability of giving birth from frozen eggs, the number of mature eggs  is the most important.

• Cases which require urgent freezing due to pathology, there is no consensus on the minimum number of eggs to ensure success because the disease process per say will affect reproductive health and ability to carry pregnancy.
• In cases of woman with normal reproductive health, for women under 35 years of age, freezing of 8 to 15 eggs is a reasonable number.
• For women older than 35 years, should be encouraged to freeze more eggs, from 11 to 20 eggs to achieve a survival rate of up to 60% after thawing.

How does egg freezing work?

First and foremost understand the patient’s requirement and aspirations. Then carry a detailed reproductive health examination.

Based on the examination your healthcare provider /doctor will advise the patient in length about the procedure, predictive results, advantages, risk, and costs.

Once the patient has understood and is willing for the procedure, the process will begin on day 2 or 3 of the menstrual cycle and usually last 10 days (12 or 13 days maybe). During this time period, the patient will be given injections, medicines for the development of eggs which are monitored through ultrasound

A final injection for the maturation of all oocytes is given called trigger injection.

Read Blog: Healthy Sperm: Improving your fertility

After about 36 hours of the trigger injection, the procedure of collecting eggs is done under anesthesia.

After collecting the eggs the embryologist will evaluate the quality of the eggs, look for their maturity and discuss with the patient the quantity of eggs which can be freezed.

For storage, eggs will be brought down to minus 196°C, using a freezing preservative and a container dedicated for this purpose.

Once freezed, the eggs can be stored in the IVF lab for a long time. Whenever patient want to use the eggs, the eggs are thawed to return to normal temperature and are used by the embryologists to create embryos. These embryos then can be used to achieve patient’s pregnancy.

What are the possible risks of egg freezing?

the risk lies mainly at 2 steps

1. during the process of ovarian stimulation: Ovarian hyperstimulation syndrome can complicate the stimulation process. To understand more about this risk refer to the article ovarian hyperstimulation: rates, symptoms, and complications.
2. Risk in the process of freezing: Eggs are the largest and most sensitive cells in the body, especially the spindle is most susceptible to temperature changes during egg storage and thawing. Changes in the spindle filament can damage the egg and stop it from growing after thawing.

Age of frozen eggs?

If a 25 years old woman decides to freeze her egg cells and doesn’t wish to have children until she is 40, then the quality of the egg does not correspond to the 40-year-old woman but still to the 25-year-old. The probability of pregnancies is correspondingly higher and above all the risk of congenital disability is significantly lower. If one wants to use their frozen eggs at a later date they can simply opt for IVF and become mothers with their own gametes even at the age of 40 or later.