Community fertility services had its first successful pregnancy from egg freezing in 1999; since then, more than 25 babies have been born from this procedure, one of the largest groups of successful outcomes in the world. We have published two papers in peer-reviewed literature on our work, and professionals from AFS have given talks and lectures throughout the world on the use of egg freezing in reproductive medicine.
We continue to study and implement new technologies to make egg freezing an even more viable option for women who would benefit from this technology. Our most recent advance is to use a new technique for egg freezing called vitrification. Vitrification is a way of rapidly freezing eggs that improves survival of the eggs after thawing, thus giving patients a greater number of eggs to work with to achieve pregnancy. Since we began use of vitrification in our program, we have seen our egg survival rate after thawing go from approximately 60% to over 80%, and we have had 9 out of 23 (39% pregnancy rate) patients become pregnant after thawing vitrified oocytes.
To determine if you would be a suitable candidate for egg freezing, feel free to contact us at 317-621-0600.
Advantages of Egg Freezing
The advantages of egg freezing are many. Several categories of women may be candidates for and benefit from freezing their eggs for future use, including:
- Women undergoing assisted reproduction therapies such as in vitro fertilization, but who do not wish to have embryos frozen. Some individuals have ethical, moral, or religious objections to freezing embryos. If a couple does not want to freeze embryos, only a few eggs are fertilized and the rest are discarded. Freezing eggs before fertilization allows the eggs to be stored, providing additional eggs for further attempts at pregnancy if needed. This may allow an individual to undergo fewer (perhaps only one) egg retrieval procedures.
- Women with medical conditions that threaten fertility. Certain medical conditions or the treatments for medical conditions may decrease fertility or even cause irreversible sterility. The use of egg freezing procedures may provide women with these conditions or facing such treatment with an opportunity to preserve fertility.
- Women concerned about an age-related decline in fertility. Fertility declines as a woman ages. Some women want to freeze and store eggs at an earlier age in anticipation of attempting pregnancy later in life.
- Women who want to simplify donor egg procedures. Women who can no longer produce eggs can use eggs from a donor to conceive, but it can require considerable time and expense to coordinate the donor's and recipient's cycles and the fertilization/implantation procedures. The use of frozen donor eggs could greatly simplify this process for many women since the eggs are available for use whenever the recipient is ready.
Egg Retrieval and Freezing Procedures
Currently there are two basic approaches to egg retrieval and freezing.
- One approach involves obtaining eggs from the ovaries after they are stimulated to produce multiple eggs. These eggs are then frozen.
- Another method is to remove tissue from the ovaries. Ovarian tissue contains follicles, which in turn, contain eggs. The ovarian tissue is frozen and stored until use.
The methods used for egg freezing will vary depending on whether the eggs themselves or ovarian tissue is frozen.
Freezing and Retrieving Eggs
Freezing eggs involves the injection of medications that will cause your ovaries to grow multiple ovarian follicles. Normally, each follicle contains an egg. During this process, you are monitored by ultrasound examinations and blood tests to determine when the follicles reach a mature size. Follicles typically require about eight to twelve days of injections to reach a mature size. Once the follicles appear mature, you will receive a hormone injection to induce final maturation of the eggs. The egg retrieval is scheduled for about 35 hours after this final injection.
The egg retrieval is performed by transvaginal ultrasound guided aspiration. After receiving a mild anesthesia, an ultrasound is performed using a vaginal ultrasound probe. The follicles are viewed using the ultrasound, and a small needle is passed through the vaginal wall and into each follicle. The fluid in the follicle is aspirated through the needle and into an attached tube and given to the laboratory staff, who retrieve the eggs and prepare them for freezing.
To freeze the eggs, they are placed in a special solution (called a cryoprotectant), which helps prevent damage to the eggs during the freezing and thawing processes. The eggs are then cooled at a carefully controlled rate, and once they reach an appropriate temperature they are stored in liquid nitrogen tanks.
Freezing Ovarian Tissue
For ovarian tissue freezing, tissue is obtained through a surgical procedure performed under a general anesthesia. The tissue is placed in a cryoprotective solution, cooled at an appropriate rate, and stored in liquid nitrogen.
NOTE: While we have a great deal of experience in this technology, we want you to understand that egg freezing is still a very new procedure. As such, we do not know with any certainty if, for example, pregnancies resulting from frozen eggs are at higher risk of birth defects or chromosomal anomalies. We are currently gathering data from patients to explore these issues and how different patient-related factors impact egg freezing.
For example, a woman's age is likely to have a strong impact on the successful freezing and thawing of eggs because of some of the effects that aging has on her eggs. Because of such issues, and because the procedure is relatively new, some organizations, such as the American Society for Reproductive Medicine, recommend that egg freezing be considered investigational while more data is collected to measure the success of this procedure.
Egg freezing has received a great deal of media attention in recent years, and many centers and clinics now claim to offer egg freezing services for preservation of fertility. At Community Fertility Specialty Care, we suggest that you ask the following questions:
- What is your experience with egg freezing? How long have you performed this procedure, and most importantly, have you ever thawed eggs or achieved pregnancies with this technology? For many women, especially those seeking egg freezing to preserve fertility for the future, the success or failure of a particular clinic's approach may not be evident for several years—that is, until her eggs are thawed. Thus, it is important to know what procedure for freezing eggs is being used by the clinic and whether there is documented proof that the procedure has been successful.
- What is the clinic's overall pregnancy rate with IVF, and with frozen embryo transfer? If a clinic has a successful frozen embryo transfer program, this shows that it can use freezing technology in an appropriate fashion, which in turn suggests that the clinic may be proficient in freezing eggs.
- What is the cost of egg retrieval, freezing and storage? Some programs charge more for egg freezing than they charge for an IVF cycle. While the cost associated with egg or ovarian tissue retrieval will vary somewhat from woman to woman, we believe our average costs are very competitive.
Will my eggs be stored on site or shipped to a long-term storage facility?
Some programs do not maintain frozen eggs on site, but use long-term storage facilities that charge a separate storage fee. We store your eggs on site in liquid nitrogen tanks kept in our laboratory. While we do not anticipate this situation will change, if circumstances make it necessary to ship eggs to a long-term storage site we will notify you well in advance so you can decide if you would like to have your eggs stored at a facility of your choice.
What happens to my eggs if I want them discarded, or if I die?
If you decide you no longer want to have your eggs stored, and would like to discard them, we ask that you sign a release form that tells us that you want to have your eggs discarded. Your signature needs to be witnessed by either a staff member or a certified notary public. Upon receipt of the signed consent the eggs are then discarded. We encourage anyone discarding their eggs to be present at our facility when the eggs are discarded. We have found that patients are more comfortable when they actually witness that the eggs have been discarded.
If you die and have eggs stored, we will discard the eggs upon being notified of your death.
If you have more questions about egg freezing and storage, please call us at 317-621-0600.
While the cost associated with egg or ovarian tissue retrieval will vary somewhat from woman to woman, we believe our average costs are very competitive. Fees for ovarian tissue freezing are variable and need to be discussed on an individual basis. We would be happy to discuss costs with you and help you with any insurance inquiries on an individual basis.
To determine if you would be a suitable candidate for egg freezing, feel free to contact us at 317-621-0600. We will be happy to discuss the procedure in detail and refer you to our physician, Dr. David Carnovale, for a consultation.
Generally, we suggest that some testing be performed to determine if you are likely to produce a suitable number of eggs for freezing. These tests involve blood tests that measure specific hormone levels to determine your "ovarian reserve," or the likelihood that your ovaries would produce a sufficient number of eggs for freezing. As a general rule, older women (greater than 38 years of age) are more likely to have diminished ovarian reserve. Based on the outcome of these tests, we will counsel you on the likelihood of successfully undergoing the process. If your ovarian reserve is low, we may advise you to not undergo the egg retrieval and freezing process. To date, there have been no ongoing pregnancies reported in women over age 38 from frozen eggs. Because each patient is different, however, we have not currently established an age cutoff past which a woman is excluded from undergoing the procedures.