EGG FREEZING
When should I consider fertility preservation?
Prior to treatments compromising your fertility.To potentially extend your reproductive window of opportunity.
Should I freeze my eggs?
Fertility preservation may help extend your reproductive window.
Reproduction is an individual’s choice.
We can choose to have children or not, but our reproductive years are limited. Often we can be undecided, and even change our mind.
If having your own genetic offspring in the future is important to you, then elective egg freezing is something you should consider. Otherwise, there is the option of donor eggs, or adoption, if you are unable to conceive in the future.
When should I freeze my eggs?
This is a balancing act.
We know the younger we are, the eggs are better quality, and the higher the chance of pregnancy from the frozen eggs.
So this would suggest freezing eggs in our 20s would be the way to go.
If we freeze eggs to early, we may be doing a lot of unnecessary egg freezing, as many will go onto have children, and not need to use the frozen eggs.
There is the cost of the cycles, and ongoing storage costs which may not be an option whilst we are young.
The sweet spot of not freezing too early, or leaving it too late and compromising on quality, is the early to mid 30s. Again, everybody’s circumstances will be different and require individualized discussion.
Any tests I should do beforehand?
AMH- A test to determine your ovarian reserve. This is helpful to see if you have an ovarian reserve which is adequate for your age. It helps with the dose of the medication required and the number of eggs we expect to retrieve from the IVF process.
Pelvic ultrasound- Checking no concerns before IVF commenced and antral follicle count (AFC)
Infectious screening bloods
What is the process?
You need to undergo IVF treatment which involves:
1. Stimulating your ovaries with FSH injections.
2. Medication to suppress ovulation
3. Monitoring with blood tests and ultrasounds
4. An egg retrieval procedure.
Success rate?
When you come back to use your eggs, the eggs will need to be thawed and fertilized with sperm.
1. Oocyte survival (Thaw rate) is 80-90%
2. Fertilization rate of eggs once thawed with ICSI is 70- 80%
3. Slightly less embryos from frozen eggs compared to fresh eggs
4. Similar live birth rates from frozen eggs compared to fresh eggs.
There is a greater number of women who have frozen their eggs, than have come back to use their eggs. Hence it is difficult to give individual clinic success rates for now. A study by Cobo (2018) found the return rate of women coming to use their egg was 12.1%.
When it comes to advice on success from the frozen eggs, it is based on your age and the number of eggs you have frozen.
Goldman RH 2017 study provided modeling to predict probability of a women having a live birth based on age at egg retrieval and number of mature eggs frozen.
For example if you had 20 mature eggs frozen at 34, 37, 42 years of age the likelihood of at least 1 live birth is 90, 75, and 37%.
To have a 75% likelihood of at least 1 live birth at 34, 37, 42 years of age you would need to freeze 10, 20, and 61 oocytes.
Based on this information it may be recommended that you have more than one IVF cycle to give you a reasonable chance of a livebirth in the future.
Let us know if this information is helpful.
Call rooms on 9411 2637 if you would like more information or a PDF.
References
Eshre Guideline: female fertility preservation. HR open, pp1-17, 2020.
Goldman RH etal, HR vol 32, No4, pp853-859,2017
Cobo a etal, pp1-10, 2018
Saumet J etal, JOGC pp1-12, 2017
