Egg freezing: Questions every woman has before preserving her eggs

What is egg freezing?

The process of egg freezing is also known as mature oocyte cryopreservation and it is a method by which a woman can preserve her eggs as a backup. Generally, this is done by young women who are planning to become mothers at a delayed age.

The method is also an effective choice for women who will undergo chemotherapy. The process has been around since 1986 but it is only in the past few years, it has become more popular.

The first baby born through this process of cryopreservation was in Singapore, in the year 1987. In the UK, the average age of a woman experiencing her first pregnancy is over 30 at present. The situation is similar in the USA too. 

The process involves the extraction of an egg from the ovary and preserving it without fertilization. After a specified period, the egg is taken out, thawed, combined with sperm and replanted in the uterus.

In earlier freezing techniques, there was the formation of ice around the embryo. This resulted in cellular damage and most embryos did not survive the process.

The recent technique of vitrification uses an ultra-rapid freezing method that has increased the overall potency of the process. However, according to the experts, the object is simply a frozen piece of tissue and it does not guarantee a baby at a later date.

Now, there is a significant statement made by a renowned gynaecologist which states that “Not every egg makes an embryo, not every embryo results in pregnancy and not every pregnancy makes a baby.” It has been found that if the eggs are frozen at an age lower than 35, then the chances of successfully giving birth are much higher.

Why is egg-freezing done?

At present, egg freezing is a process that is giving women the flexibility to enjoy motherhood at a time when it suits them the best.The process of egg freezing takes place due to a variety of reasons including social pressure, economic instability, better career opportunities and the lack of a partner.

While these reasons prevent the possibility of pregnancy at the present date, eggs freezing makes it possible to get pregnant at a later date. Some of the main reasons behind the process are listed below.

• The primary reason is to preserve the younger eggs for use at a much older age. This will help a woman to get pregnant when she is ready to become a mother from all aspects.

• The process is useful in case a woman has a condition that affects her fertility. This includes conditions like sickle cell anemia or an autoimmune disease like lupus.

• In case a person is undergoing special treatment that can affect fertility. This includes treatments for cancer which include radiation or chemotherapy.

• In some cases, in vitro fertilization is done through egg freezing. This is done due to religious or ethical reasons.

• In many cases, the process is conducted when the woman is not in a relationship that is conducive to bearing children.

It is to be kept in mind that the thawed egg can be fertilized with sperm from a partner or from a donor. The embryo can also be implanted in the uterus of another person who can carry the pregnancy forward.

Egg freezing and in vitro fertilization

The two processes are different in purpose and technology. The egg freezing involves preserving the egg for future use. During in vitro fertilization, the sperm and egg are combined in a laboratory and the embryo is implanted back into the uterus. Egg freezing process takes a period of 14 days in total and it consists of the following steps.

• Hormonal injections are given to the woman so that the body produces multiple eggs through stimulation of egg production. This step is known as ovarian stimulation and it is monitored through multiple tests.

• The eggs are collected from the ovaries through a surgical process called egg retrieval. Multiple eggs can be retrieved from the follicle and the process is conducted under anaesthesia.

• The retrieved eggs are frozen immediately by the process of vitrification. They are then stored in a secure facility for future use.

The process of in vitro fertilization or IVF takes around a month. In the process of IVF has the first two steps are similar to that of egg freezing but the difference arises from the third step.

• The retrieved eggs are fertilized with a sperm in the laboratory and the embryos are formed. The embryos are monitored closely as they develop under care.

• When the embryos are matured enough, they are transferred into the uterus through a non-surgical procedure.

• After a period of development, blood tests are conducted to check for pregnancy. If pregnancy is confirmed, the process is considered as successful.

What are the risks associated with egg freezing?

As already mentioned, the process is similar to in vitro fertilization in the first few stages which can be considered as invasive. The entire process is supervised through vaginal ultrasound. During the process of egg retrieval, mild anaesthesia is used and a needle punctures the vaginal wall.

The suction device attached at the tip of the needle enters the follicle and collects the eggs. The entire process is done very gently and it takes around 10 minutes of time. Since a needle is used for insertion, there is a risk for infection. But doctors consider it as a very mild risk.

What symptoms need medical attention?

In some cases, the woman can develop ovarian hyperstimulation syndrome from the hormonal treatment that happens prior to retrieval. This is caused when the body reacts aggressively to the hormones and the ovaries get swollen and painful.

Other symptoms can include nausea, vomiting and abdominal pain. This generally occurs in younger patients and only around 5 percent of the patients suffer from this condition. In some severe cases, there can be a blood clot or even a kidney failure.

In general, the patient can resume normal activities within a week of egg retrieval. Certain symptoms can indicate some complications which need medical supervision. These include the following.

• A fever higher than 101.5 F (38.6 C)

• Severe abdominal pain or cramps

• Weight gain of more than 1 kilogram in 24 hours

• Heavy vaginal bleeding

• Difficulty in urinating

What are the pros and cons of egg freezing?

The process of egg freezing is often debated and judged both from a medical and social point of view. Some of the major advantages of the process are listed below.

• The process allows more time and reproductive freedom for a woman. She is no longer under time pressure to become pregnant.

• Even in the scenario that there is no partner available, the woman can choose to become pregnant.

• There is a reduced need for undergoing infertility treatments which can include higher costs and adverse side effects.

• There are also fewer chances of facing regrets at a later age for not taking advantage of the available technology.

• It provides women a better chance of pursuing their careers and any education goals. On the whole, this is a big step towards woman empowerment.

This is also an effective option for those who do not opt for embryo cryopreservation due to moral reasons.

Like many medical processes, egg freezing also has its own disadvantages.

• There is a certain amount of medical risk involved with the process which can be related to hormonal treatment.

• Some women can also consider the process of being invasive in nature.

• The overall costs of the process are high and it can lead to commercial exploitation.

• Even though the process offers a way to optimize career success and family planning it does not guarantee motherhood at a later period. It is often said that the process generates false hopes and a false sense of security.

• Data obtained from the UK shows that the process has a current success rate of around 18 percent. Hence there is no certainty of a successful pregnancy in the future.

• The process can remove the focus from the necessary social changes related to normal pregnancy. This includes flexible work environments and better leave policies for women who become mothers at the right age.

A few misconceptions around egg freezing

While egg freezing is often considered as an “insurance policy” for women, it is debatable as to how much security it provides. The fact is that the entire procedure is quite complex both from the physical and psychological point of view. Here are a few myths that are associated with the process.

The process is simple

In truth, the process involves subjecting the body to a lot of trouble for a month or more which costs a large amount of money. It involves hormonal treatment, constant monitoring and finally the egg retrieval process. Apart from the process expenditure, the patient also needs to make an annual payment for storing the eggs which can vary depending on the facilities.

The insemination of the eggs at a later date will also cost a significant amount. In case there are complications related to the process the costs can be even higher.

The frozen egg guarantees a baby

It is to be noted that a frozen egg does not represent a future baby. The number of eggs stored is not equal to the number of babies that you can have in the future. For a woman under the age of 38, the chance of a single egg developing into a healthy baby varies between two to twelve percent. Firstly, the retrieved egg must be matured enough for freezing.

Next, it should be able to survive the thawing process. Eggs are extremely sensitive to damage from water and ice and a large percentage do not survive the process. After fertilization, the resulting embryos needed to grow to a certain stage before they are transferred back to the uterus.

Finally, it is also to be noted, that live birth rates vary depending on the age of the patient and the quality of the embryo. On the whole, the process involves a lot of factors that need to work perfectly for a positive outcome.

All clinics are the same

All clinics are not the same when it comes to egg freezing. The quality of the clinic and the type of facilities matter a lot and so does the experience of the laboratory technicians. The labs play the most important role in the process as they deal with handling and preserving the fragile eggs.

Ideally, the patients should enquire about the success rates of a lab for egg retrieving, freezing, thawing and fertilization. The technology used in a lab also determines the outcome of the process. So it is necessary to consider the overall quality of the lab before choosing one.

All you need to do is freeze the eggs and nothing else

This is another misconception as a woman needs to pay storage fees for the entire period of storage. This means that the longer the period of storage, the higher are the costs. Life and career situations can change in five to ten years which can lead to various complications.

In case the patient changes her location, then there will be additional costs of travel. There are also the expenses of fertilization and embryo development to be considered. It is also to be noted that the more the number of eggs that are stored, the better are the chances of getting pregnant. Hence many women store eggs in multiple stages which involve higher costs.

Conclusion

Since egg freezing does not guarantee a baby at a later date, the people undergoing the process need to understand the various factors related to age and costs that are involved. Many experts suggest that it should be treated just as a backup and biological reproduction should not be ignored.

The process opens up a lot of ethical questions regarding human health and well-being and also about sexual equality. The decision about freezing an egg is a complex step that depends a lot on the equation of an individual person’s life.

So for an individual or a family, it is necessary that the physical and psychological risks are judged and the decision is not based solely on the fear-factor.

References

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