Egg Freezing: A Backup… But No Guarantees
This week I read a very good article in the June 2018 edition of Marie Claire, Australia magazine:
The article begins by describing the new trend of egg freezing offered as an elective or ‘social’ choice through information sessions, which take place at Genea Horizon, Australia’s first ever dedicated egg freezing clinic. Women gather around eager to learn about how egg freezing could potentially give them a backup if their life doesn’t go to plan, like a fertility ‘insurance policy’.
Egg freezing, or oocyte cryopreservation, is the process where a woman freezes some of her eggs to be fertilised by a sperm at a later date. It first began being done for women who were undergoing cancer treatment, helping to preserve their chances of having children later when their fertility would be affected by the cancer treatment.
However, now it is becoming popular amongst women who are starting to feel their ‘biological clock’ ticking but aren’t in the right circumstances to have a baby. They could be still looking for Mr Right, they might not be financially able to afford a child, they may be focused on their careers or they might have been advised of some medical issues which may affect their fertility in the future such as endometriosis or a low egg count.
These days, the process of egg freezing is routine but still takes quite a few steps; see the box at the bottom of this article for a thorough overview of the process (as I understand it).
In the past, egg freezing and thawing was relatively unsuccessful, I assume because the eggs were too fragile whereas embryos have a higher success rate being more robust. However, recently a new flash-freezing process called vitrification was introduced which radically improved the success rates.
It is widely reported that women are having babies later in life, which is often understandable, but sadly our biology hasn’t changed. From 35 years old our fertility begins dropping off whether we are ready or not. For some of us at 35 we aren’t at the stage yet to have children and perhaps freezing our eggs give us the ability to have a backup plan.
Apparently, in the past 30 years, an estimated 2,000 ‘ice babies’ have been born, mostly to cancer patients, using frozen eggs. The Marie Claire article revealed that most frozen eggs are actually not being used and remain in storage, often to be discarded. They have been put aside as a backup but are then not needed; however, for me that isn’t an issue. If not fertilised naturally, those eggs would have been discarded by the body anyway, at least this way some could be a potential baby when the woman is ready. They provided hope for the woman and relieved some time pressure of their biological clock.
Despite offering this comfort, people need to be told clearly about the statistics for success that surround egg freezing. It needs to be made clear to women that egg freezing does not guarantee a future baby. The article outlined the story of a prominent 39 year-old pro-egg freezing advocate who had undertaken the process herself. Later when she was ready, the 11 eggs were thawed but only one went on to create a blastocyst (healthy embryo). Unfortunately, this ended in a miscarriage. So quickly her backup had failed.
The bottom line is that, like IVF, egg freezing does not provide a guarantee. It is not an easy, quick fix.
In addition, egg freezing costs around $10,000 and that is only if you can collect enough healthy quality eggs the first time; you may need more than one collection.
Overall, I believe it is a wonderful option to give women. It provides them with a safety net and a backup for their fertility which is particularly important for women with health issues. But every woman should understand that it has its limitations and it is the responsibility of IVF clinics to be clear about the success rates.
It is also hard because the best time to do egg freezing is before 35 when women may not be ready to freeze eggs yet and probably don’t have the money to. If I had known about the issues we are now facing I would have frozen eggs in my 20’s. Hindsight right…
Finally, yes, this is a controversial topic but it is one that I don’t think is going away any time soon. In the near future, egg freezing will become more available and more people will take it up. Not everyone will agree with it but ultimately I think it is a very personal choice. I would hope that no one would attack someone who does it, just as I hope no one would attack someone who doesn’t agree and chooses not to do it. It’s available as an option and every woman has the right to choose to take it if they want (and can afford it).
You only have one life and it is yours to live the way you want.
The process of egg freezing is routine these days but still takes quite a few steps:
1. You will likely first meet with a fertility specialist who will most likely send you for some blood tests to check your health and possibly your anti-mullerian hormone (AMH) which is your egg levels. They will then discuss the process with you, get you to sign some forms and organise payments;
2. You will then be given a hormone protocol which basically just means a list of hormones you will need to inject. The protocol will be whichever your specialist best thinks suits your needs and the levels your blood test came back with. You will take one hormone to stimulate multiple follicles to produce eggs (normally your body focuses its resources into only producing one good egg) and then another hormone to stop your body from releasing any eggs until they are ready for them to be released;
3. You then contact them the day your period begins and they will arrange a time for you to come in for a blood test based on these results they will tell you when to begin taking your hormones. The hormones are normally in the form of an injection into your stomach which they will show you how to do;
4. For around 10 days you will take those hormones. The main side affects you will feel is bloating as your follicles expand, hopefully containing an egg;
5. From around day 5 – 7 you will begin being monitored. This will involve a blood test and an internal scan. You specialist will be looking for your estrogen levels and on the scan for the size of your follicles. When your levels look right they will tell you to take your trigger injection;
6. This injection makes the eggs go through the final process to make them mature and then release them. The trigger injection needs to be taken at the exact time your specialist tells you;
7. Exactly 36 hours after the trigger injection you will have the egg collection. You will arrive at the day clinic. Once there you will speak to the scientist, the fertility specialist and the anaesthetist. They will wheel you in and the egg collection will take place;
8. The eggs are collected through an ultrasound probe with a needle in it. It sucks the fluid out of the follicle and gets put into a test tube, the test tube is then passed to the scientist who determines if there is an egg in it;
9. Once all the follicles are cleared, the procedure is over. When you wake up they will tell you how many eggs were collected;
10. They will then freeze the eggs and store them. Not all will freeze or thaw properly. Some won’t make it but hopefully some will successfully become embryos and babies.
***Remembering I am not a medical expert! This is just from my experience and research