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.
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.
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.
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.
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.
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