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What are the benefits of freezing your eggs and when to consider it?

Foteini Chouliara, MD, MSc
Obstetrician & Gynaecologist , Assisting Nature - Human Reproduction & Genetics
Category:
Egg Freezing
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From this video you will find out:
  • What is egg freezing?
  • How is egg freezing performed?
  • What happens next after you have your eggs frozen?
  • Who can benefit from this procedure?
  • What factors affect life-birth rates after egg-freezing?

What are the benefits of freezing your eggs and when to consider it?

During this event, Dr Foteini Chouliara, Obstetrician & Gynaecologist at Assisting Nature, walked us through the ins and outs of a groundbreaking procedure called ‘social freezing’. She has shared valuable insights on preserving fertility for future family planning, overcoming medical conditions that may affect fertility, providing a viable option for those undergoing certain medical treatments, and ensuring fertility options for those who haven’t found their ideal partner.

What is Egg Freezing?

Egg freezing is the process of preserving a woman’s eggs to delay having a baby until later in life. Dr Chouliara explained that it is the first step in an IVF treatment, which involves a meticulous medical history, blood workup, and stimulation protocol selection. The administration of daily gonadotrophin injections stimulates the ovaries, leading to the maturation of multiple eggs.

The egg-freezing process includes detailing the stimulation protocols, the addition of antagonists, and the final triggering shot to mature the oocytes. The oocytes are retrieved through minor gynaecological surgery, followed by examination, washing, and maturation assessment by the embryologist.

Egg freezing allows women to preserve their fertility for various reasons. Initially, it was offered to cancer patients facing gonadotropic therapies. However, today, it is available for women for medical and social reasons. Dr Chouliara mentioned women with primary ovarian insufficiency, certain medical conditions, or those producing a large number of eggs during stimulation as potential beneficiaries. It can also help in situations where there is difficulty obtaining sperm, and couples with religious beliefs regarding embryo storage. Additionally, women who choose to delay pregnancy for career, personal, or relationship reasons may consider egg freezing to preserve their fertility options.

Social Reasons for Egg Freezing

Dr Chouliara highlighted the growing number of women choosing egg freezing for social reasons, such as career advancement, financial stability, or a lack of a stable relationship. Delaying pregnancy may increase the risk of infertility, and egg freezing offers these women the choice to preserve their potential to have genetically-related offspring while following their life plan.

Egg freezing acts as a safeguard in unpredictable life circumstances. For instance, if a partner withdraws consent during IVF, having frozen eggs allows the individual to proceed with their family planning. It also provides flexibility if life circumstances change due to loss, divorce, or starting a family with a new partner.

However, it is important to note that the studies on social egg freezing’s success rates are limited due to the difficulty in collecting data from women who have frozen their eggs but have not utilized them yet. Dr Chouliara emphasized that encouraging data on donor egg freezing reveals the early challenges faced in preserving eggs due to their vulnerability during retrieval and the associated cellular damage caused by the freezing process.

Dr Chouliara highlighted the safety aspect of oocyte cryopreservation, backed by evidence showing no significant increase in chromosomal abnormalities or birth defects between frozen vitrified eggs and fresh eggs. The presentation also mentioned how the process is ethically permissible and widely offered to women with medical conditions and for social reasons, promoting reproductive autonomy and social equality. It is recommended to freeze eggs at a younger age, before 35–37 years old, to optimize the chances of obtaining a higher number of mature eggs during the stimulation cycle. The number of eggs needed for a good chance of live birth increases with age, underscoring the significance of freezing eggs early.

Is Social Egg Freezing Worth It?

Dr Chouliara addressed the question of whether social egg freezing is worth considering. She highlighted its revolutionary nature, safety, and effectiveness in potentially overcoming fertility issues later in life. However, she also acknowledged the high private treatment costs associated with the process and emphasized that egg freezing is not a guarantee of future fertility.

Conclusion

The presentation concludes by stressing the importance of proper counselling when considering social egg freezing. Patients should be well-informed about safety, success rates, and limitations associated with age. It also highlights the need for skilled embryology staff and the necessity for more time to evaluate any potential long-term effects of the procedure.

 

- Questions and Answers

Can you tell me what are the chances for a 36-year-old with low AMH who only managed to freeze 2 eggs? I feel that now this may not have a good result.

Unfortunately, it is quite common for women with low ovarian reserve to face challenges in accumulating eggs for freezing. However, your age of 36 still offers a relatively good egg quality compared to being older. If you have the emotional stamina and financial resources to support IVF treatments, I wouldn’t be against trying egg freezing because of your age. Even having a few eggs frozen can still offer possibilities due to your relatively young age.

I understand the advantage of my age (36), but I’m concerned about the limited number of eggs frozen. What would you recommend considering my situation?

You are correct that with egg freezing, we cannot immediately assess the quality of the eggs, unlike in traditional IVF where fertilization can be observed. To increase the chances of success, we usually advise freezing as many eggs as possible, especially if you are around or below the age of 35. The recommended number is 10 eggs, but storing more, like 15, can further improve the odds since we can’t predict the success of each individual egg. This approach aims to maximize the chances of a successful pregnancy given the constraints of low ovarian reserve.

I am 50. I did three IVFs, two at the age of 48, and one at the age of 50. My stimulation protocol was always 300 IU of Gonal F for 9 or 10 days, adding Cetrotide at day 7, triggering with Gonapeptyl. The number of collected oocytes ranged from 7 to 22, with 3 to 9 mature. Fertilized eggs were 3, 2, and 7 for each IVF cycle, respectively. Nine embryos were frozen at day 3, and two of them tested normal but did not implant. Now my new clinic wants me to take really high doses of stimulation medicine, starting with 375 units of FSH, and at day 4, 300 units of Gonapeptyl, and 150 Menopur.

Firstly, I am amazed that you have had so many eggs at the age of 50.  This is quite rare, as egg quality and implantation potential typically decline significantly with age. As for the doses of stimulation medicine, I don’t believe that changing them to higher levels will dramatically change the outcome. Studies have shown that even higher doses don’t necessarily lead to better results. The issue may lie more with the age-related decline in the number of embryos that are suitable for transfer, despite a good response in terms of eggs retrieved.

Are there any side effects of the injections used for ovarian stimulation in IVF?

This is a very common question, and many women worry about the potential side effects, particularly the fear of developing cancer. However, I want to reassure you that this concern is largely based on misconceptions. In the early days of IVF, studies showed higher incidences of certain cancers in infertile women, but it was not directly linked to the medication used for ovarian stimulation. The medications used in IVF are safe and do not cause cancer. The most common side effects of these medications are typically related to estrogen. Some women may experience breast discomfort or increased vaginal discharge. Emotionally, some women might feel more sensitive or edgy during the treatment. However, most women tolerate the injections very well and do not experience significant issues.

I’m 52 and going through treatment. I have been prescribed Prednisolone. Are there any side effects? I’m using donor eggs.

Prednisolone is commonly used in endometrial preparation cycles. We typically use it at low doses, around 8 to 10 milligrams, to minimize any potential side effects. While taking prednisolone, it’s important to be cautious with consuming salty or very sweet foods. The medication aims to bring about a milder immune response from the body, which can help with implantation. We usually start it alongside progesterone preparation and often continue it through the early stages of pregnancy, gradually tapering off around the ninth week.

My clinic prescribed me 150 units of FSH, 150 units of Menopur, and Progesterone 10 milligrams, but starting from day three of my cycle, not the same day two. Is this acceptable?

Starting your medication on day 3 is still acceptable. While we usually prefer to start as early as possible to maximize oocyte recruitment, day 3 is a common starting point and should not be a significant issue. So, don’t worry about the slight delay in starting the medications.
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Authors
Picture of Foteini Chouliara, MD, MSc

Foteini Chouliara, MD, MSc

Dr Foteini Chouliara is an Obstetrician and Gynaecologist with a special interest in Reproductive Gynaecology at Assisting Nature since 2018. She was awarded the Bachelor of Medicine and Bachelor of Surgery degree (M.B., Ch. B) by the University of Glasgow School of Medicine in 2005. After completing Foundation Year 1 post-graduate training she started her residency in surgery following by the residency in Obstetrics & Gynaecology at Hippokration Hospital of Aristotle University of Thessaloniki/ Greece. Since 2017 she is working as a qualified Obstetrics & Gynaecology Consultant. She received her Master of Science (M.Sc.) Degree in “Human reproduction” from the Democritus University of Thrace in 2019. She is also a Research Fellow of the Aristotle University of Thessaloniki carrying out research work on the role of particular biomarkers in the pre-surgical assessment of ovarian tumours as part of her Doctorate. Dr Foteini Chouliara is deeply committed to the supervision of the International Patient Department at Assisting Nature. Her current scientific interests include: Biomarkers of ovarian cyst and their value in Human Reproduction, PCO, Prenatal first trimester diagnosis in Reproductive Patient. She has been a part of scientific publications, presentations, papers, such as: Najdecki R, Chouliara F, Timotheou E, Tatsi P, Chartomatsidou T, Asouchidou E, Pakaki F, Bouchlariotou S, Humaidan P, Papanikolaou E. Single follicular degarelix, a new long-acting GnRH-antagonist for LH surge suppression during ovarian stimulation in oocyte donors. A randomized controlled trial. ESHRE Annual Meeting, Vienna 2019 (oral presentation) Prevalence of antenatal depression and associated factors among pregnant women hospitalized in a high-risk pregnancy unit in Greece, Social Psychiatry and Psychiatric Epidemiology, 2016 Jul. Antenatal depression among women hospitalized due to threatened preterm labour in a high-risk pregnancy unit in Greece, Journal of Maternal and Fetal Medicine, 2017 Mar 21.
Event Moderator
Picture of Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.
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