What is Fertility Preservation?
Oocyte cryopreservation, or egg freezing, is a relatively new procedure in the field of assisted reproductive technologies. Overall, this technology increases a woman’s potential to have children later in life. Since the first successful pregnancy using egg freezing was reported in 1986, approximately 600 babies have been born. Currently, pregnancy rates are between 30 and 40 percent.
While human egg (oocyte) freezing, or cryopreservation, first had its start in the 1980’s, it has become more prevalent since 2007 with the improvements in egg (oocyte) vitrification (rapid freezing). Historically, egg freezing has been utilized for young women that are facing cancer treatments such as chemotherapy or radiation, who wish to freeze eggs so that if their egg supply is destroyed by the cancer therapy – they will still have their own genetic material available for childbearing.
Since the advent of better freezing techniques (i.e. vitrification) and media beginning in 2007, egg freezing has now become a more popular treatment offered at a handful of fertility centers worldwide for both cancer patients and for women who are concerned with their advancing reproductive age, but not in a position to have children yet. The concept of “fertility preservation” offers hope to women who previously had no options for the future creation of a family. Despite the growing successes of egg freezing for fertility preservation, this idea is still considered controversial and the American Society for Reproductive Medicine (ASRM) still considers egg freezing experimental due to the limited research data available in the scientific community. Some of the stumbling blocks that physicians, embryologists, and patients must deal with include:
- Challenges in the accurate counseling of women about the success rate for frozen eggs to ultimately yield viable embryos and successful pregnancy outcomes.
- Challenges in counseling women on the potential adverse side effects and safety of the process due to the relatively low number of live births that have resulted from egg freezing and insufficient data as to the safety of the procedure in regards to potential for increased rates of birth defects among other issues. As of mid 2009, approximately only 500-600 babies in the world have been born after frozen embryo transfer resulting from embryos derived from frozen eggs.
Since egg freezing is still a relatively “new” procedure, questions about its effectiveness will remain for some years. Regardless of its current shortcomings and the unknown, for many women who would otherwise have no other options, fertility preservation with egg freezing is a breakthrough that offers really hope for starting a family.
Who may benefit from fertility preservation with egg freezing?
It is a known fact that women in the 21st century are waiting longer than ever prior to trying to achieve a pregnancy. Meanwhile, age is a leading determinant and hindrance of fertility. Fertility in women is greatest between the ages of 20 and 28 years of age. In addition, by the age of 35, a woman’s chance of conceiving per month is decreased by half; by age 45, the natural fertility rate per month is as low as 1%.
At Advanced Fertility Care we are proud to offer egg freezing to women up to age 38 who are interested in this service, presuming that their ovarian function is not already compromised. Though egg freezing is still considered an experimental technology by the American Society of Reproductive Medicine, both internal (at Advanced Fertility Care) and external (published and unpublished) research data is now available to justify the use of egg freezing in fertility preservation.
Success Rates of Egg Freezing
According to much of the preliminary data, the expected pregnancy rates for frozen embryo transfers derived from frozen eggs is similar to those rates for frozen embryo transfers of previously frozen embryos rather than eggs. However, the success rate per cycle using embryos from fertilized eggs that have previously been frozen is usually lower than from the IVF success rates of transfer of fresh embryos (embryos created from eggs that have not been frozen). The overall success rate depends on several issues:
- age of the woman when the eggs were formed
- egg quality and maturity
- status of the egg at thaw
- quality of the embryos formed and any other factor that would otherwise influence IVF success such as sperm quality used for fertilization.
Survival of the egg can be variable but has been reported as high as 90% based in numerous studies. Recent data suggests that optimal success rates per cycle range from 30-40% range or higher per embryo transfer.
The maximum age of 38 has been set because current scientific data supports the notion that the egg that is vitrified and subsequently warmed has the best odds of surviving if retrieved and frozen prior to age 39. As the techniques and technology improves over time, this age limit may change. Therefore, if fertility preservation is the goal, the survivability and potential success of the egg once it is warmed must be considered prior to its freezing.
How does the IVF process work for the purpose fertility preservation?
As with anyone wishing to undergo IVF, the process of fertility preservation begins with a consultation with Drs. Zoneraich, Larsen or Kummer. Once the consultation is complete, the doctor will proceed with a similar diagnostic evaluation as would be required of any woman wishing to undergo IVF with some few exceptions. Once the diagnostic evaluation is completed confirming a woman’s eligibility based on ovarian reserve testing, the patient will then undergo the IVF stimulation process up to and including the egg retrieval. After the eggs are retrieved, the IVF laboratory will vitrify and store them for the patient’s future use. The entire process from screening to freezing will usually occur within two months from initial consultation.
Costs for fertility preservation?
The cost for fertility preservation takes into account that no embryo transfer is performed. However, the techniques and supplies needed to vitrify eggs in the laboratory do add a great deal of embryologist time and expense to the process. As of October 2009, the price of IVF with oocyte vitrification for fertility preservation is $7500 not including the cost of medication or anesthesia, however, this may be subject to change in the future. See complete price list for fertility preservation and egg freezing.
If you would like more information about this exciting, but currently experimental, technology please call our office to schedule an appointment with one of our physicians.