Q: The concept of freezing eggs is becoming more and more prevalent, or maybe I’m becoming more aware of it. I’m twenty-nine and not planning on having a child in the next five years, do I need to freeze my eggs? What does that involve? Isn’t it an expensive and intrusive procedure?
A: Yes, egg freezing a hot topic! In fact it may be one of the hottest topics in reproductive medicine today (along with stem cell culture).
At the moment, the American Society of Reproductive Medicine has taken the position that fertility clinics should not charge for egg freezing for fertility preservation because the technology is still regarded as experimental. Having said that, in the light of exciting new developments in the technology, their position on egg freezing could change in the coming months. Stay tuned.
The truth is egg freezing requires IVF (in vitro fertilization) technology, which is expensive. A woman has to be stimulated with injectable drugs to produce multiple eggs at once. This requires monitoring to determine when the eggs are mature. An ultrasound guided needle aspiration is required to retrieve the eggs from the ovaries, so yes, that is intrusive. These eggs can then be frozen. There are currently clinics that will freeze your eggs for you. The problem is that outcomes are as yet uncertain and ultimately may not reach your expectations. Many of these clinics have very few or no pregnancies from egg freezing in their own hands (they may be quoting statistics from other labs, so be careful).
Egg freezing isn’t for everyone. Clearly the best results are produced when good quality eggs are frozen. Most of the pregnancies from this technology worldwide are when the frozen eggs used come from young women. Our clinic (Reproductive Biology Associates in Atlanta, Georgia) has recently reported high pregnancy rates using frozen eggs from young women (IFFS meeting Durban, South Africa May 2007). The numbers, however are small (nine of eleven women with ongoing pregnancies reported, we now have fourteen of sixteen pregnant) and more work needs to be done. Older women and particularly those with impaired ovarian reserve are not good candidates to have their eggs frozen. Unfortunately, it is older women who are often the ones most interested in egg freezing.
Egg freezing is useful at the moment for young, unmarried women with cancer or other diseases that require treatment with radiation or chemotherapy that will render them infertile. Eggs can be frozen for later use. Then, when they have recovered and want to start a family, it may be possible for them to do so using their own eggs that have been previously frozen.
Other applications of egg freezing still need a little time to develop. I believe the next practical application of egg freezing will be to develop egg banks that will freeze young women’s eggs for the purposes of egg donation to women unable to produce their own eggs. This will give results quickly with regard to pregnancy rates and birth rates, which is most important to know before you consider freezing your own eggs purely for fertility preservation, which you may or may not need.
At twenty-nine, you are still young. If you have good ovarian reserve, pregnancy rates for someone thirty-five and younger are good. You still have time. Give this technology a year or two to develop before you make the decision to freeze your eggs. Watch the news for reports of pregnancy rates. Keep in touch with the ASRM for changes in their recommendations.
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