Egg freezing, also known as oocyte cryopreservation, is now a reality in the specialty of reproductive endocrinology and infertility. It has opened new treatment options for assisting infertile patients and also has new applications for women wishing to preserve their fertility for medical indications or personal reasons. Arizona Associates for Reproductive Health provides egg freezing at our Phoenix and Phoenix offices. To learn more about this amazing procedure, contact a member of our team today.
Cryopreservation is not something new in the world of Assisted Reproductive Technologies (ART). Medical clinics have been freezing sperm since the 1950s and embryos since the 1980s. While sperm and embryo cryopreservation have become routine, egg freezing has presented greater challenges and is a relatively new technology. The first baby born from frozen eggs occurred in 1986.
Freezing of eggs can trigger premature hardening of the zona pellucida which surrounds the egg. Normally zona hardening occurs after the sperm penetrates the egg, thus protecting it from being penetrated by other sperm. Fortunately, hardening of the zona can be overcome with the use of Intracytoplasmic Sperm Injection (ICSI), a routine procedure already proven successful for many years in treating male infertility.
The high water content of eggs has also presented challenges since it increases the risk of cellular damage during the freeze-thaw process. Additionally, eggs are at a sensitive stage of the meiotic cell division cycle. The egg chromosomes are aligned within a fragile structure known as the spindle apparatus. These inherent difficulties have limited the success of egg freezing in the past. Recent studies over the last 5 years have reported improved results with adjustments in freezing protocols. In particular, extremely rapid cooling rates with a technique known as vitrification appear to minimize chromosomal damage and the formation of intracellular ice. Many fertility programs throughout the world have recently demonstrated good success with freezing and thawing of eggs with live births using egg vitrification technology. There have now been approximately 1,600 babies born worldwide from frozen eggs.
Arizona Associates for Reproductive Health ((AZARH)) doctors and embryologists have been involved in research to develop successful techniques for freezing sperm and embryos for many years. More recent research with an egg freezing process known as vitrification has allowed (AZARH) to offer egg freezing under IRB oversight for patients who may be reluctant to freeze embryos. Egg freezing may be used by women who wish to delay childbearing for different reasons. Three groups of patients can benefit from egg freezing:
In today’s society, many women want to delay child bearing until they are older. Egg freezing provides fertility options for women who choose to delay pregnancy for either medical or elective reasons. Fertility decreases with age, slowly declining until age 30, then declining more quickly thereafter. By age 40, the chances of spontaneous pregnancy are less than 50% of what they were at age 30, and other risks such as miscarriage and Down’s syndrome are significantly higher. With the recent improvements in egg freezing technology, we can now offer women the option of freezing and storing their eggs at a younger age, allowing a woman to choose when she is ready for a family.
In traditional IVF attempts, extra embryos are frozen for future use. However, some patients have ethical or religious concerns with creating extra embryos and making decisions about disposition once hey have completed their families. For some, freezing eggs before they are fertilized may be a better option.
Donor egg banks are now a reality. Similar to large sperm banks, the advantage to donor recipients is a much larger selection of potential donors than would otherwise be possible. After freezing, donor eggs may be quarantined until repeat infectious disease testing can be completed, similar to donor sperm banking. Frozen donor eggs also eliminate the need to synchronize the donor’s and recipient’s menstrual cycles for treatment purposes.
While fertility specialists share much optimism that egg freezing provides options for groups of women who might otherwise have few or none, many in the scientific community still consider egg freezing to be experimental and consequently the process should be carefully considered. The American Society for Reproductive Medicine (ASRM) advises clinics to perform egg freezing under Institutional Review Board (IRB) approval and ongoing oversight. ASRM will continue to consider egg freezing experimental until published studies regarding risks, benefits and overall safety and efficacy are sufficient to regard the procedures as established medical practice.
Most assisted reproductive technologies are no longer considered experimental. The American Society for Reproductive Medicine (ASRM), which has more than 10,000 fertility specialists worldwide, considers the following procedures to be established medical care:
Arizona Associates for Reproductive Health ((AZARH)) fully complies with the ASRM recommendation to provide egg freezing services under IRB review. (AZARH) only offers egg freezing after carefully reviewing IRB consents for egg freezing with each patient. The goal is for each patient to fully understand the possible risks, benefits and current success rates with egg freezing before deciding to pursue this treatment option. Providing egg freezing under the observant eye of an IRB helps ensure the freezing and storage of eggs is done using techniques that provide your best chance for success as well as long term safety of your eggs in storage. There are currently egg freezing programs that operate with no IRB approval or oversight. Ask any program you may be considering if they provide egg freezing under an ongoing, approved IRB certificate.
Three of the most important factors in determining your chances for potential success with egg freezing are your serum FSH, baseline follicle count of your ovaries and ovarian reserve testing. These studies are used to gain an understanding of the ability of your ovaries to produce healthy eggs that will allow for successful freezing, thawing, fertilization and embryo development. These are vital steps to establish a successful pregnancy. Due to the natural egg aging process, it is more ideal to freeze eggs in women who are younger than 38 years old. To date, there have been few ongoing pregnancies reported in women over 38 from frozen eggs. This is mostly due to lower age cutoffs in egg freezing studies. Pregnancies are routinely achieved in women up to age 43 using fresh embryos. We may find with further egg freezing research that we are able to mimic these fresh rates.
Please contact our office to schedule a pre-consultation evaluation of your Follicle Stimulating Hormone (FSH) and estradiol levels. These tests should be scheduled for the third day of your menstrual bleeding prior to your initial consultation with the doctor.At your consultation, your physician will review your medical history and will outline your evaluation and treatment. Based on your ovarian reserve, which is determined by your internal reproductive hormones, a stimulation protocol will be formulated by your physician.
Group 1 – Best Chances for Success
Group 2 – Good Chances for Success
Group 3 – Moderate Chances for Success
Group 4 – Lower Chance for Success
Group 5 – Lowest Chance for Success
Group 6 – Minimal to no Chance for Success – Not eligible for egg freezing at (AZARH)
The process for egg freezing is similar to a traditional IVF cycle and typically takes 3 to 6 weeks. Egg freezing uses standard protocols to stimulate egg production and retrieve the eggs. A woman usually takes birth control pills followed by hormone medications to stimulate the ovaries to produce multiple eggs. The eggs are retrieved and the mature eggs are frozen that same day. The eggs are stored in liquid nitrogen at temperatures where there is no cellular activity and, therefore, are not impacted by length of storage. The number of eggs produced and the percentage of mature eggs recovered is variable from person to person.
Once a woman is ready to conceive, an (AZARH) physician will coordinate with your oncologist to ensure you are healthy, able to use fertility medications, and ready to carry a pregnancy. Some patients may be unable or advised not to carry a pregnancy following cancer treatment. (AZARH) offers treatment using a gestational carrier (a woman who will carry the pregnancy for you). With approval from your oncologist, (AZARH) will allow transfer of embryos to women up to the age of 50. Patients starting a treatment cycle will begin taking medicine to prepare the uterus for pregnancy. The eggs are thawed and fertilized and then cultured for 3 to 5 days before embryo transfer. Extra embryos can be stored at (AZARH).
To learn more about egg, embryo, and sperm freezing, contact (AZARH) today.