Watch the webinar in which Prof. Luciano Nardo, MD MRCOG, Consultant Gynaecologist & Specialist in Reproductive Medicine is explaining the egg freezing process and presents a few patient case studies from his clinic.
Prof. Nardo started his talk by explaining that the ethics committee of the American Society for Reproductive Medicine (ASRM) found egg freezing to be permissible and to promote social equality. It should not be however a form of reproductive insurance, women should make an informed decision about freezing their eggs not because they are planning to delay motherhood but simply because they believe that freezing their eggs at a time when it’s possible will offer them a better chance to have a family should that be needed at a later stage.
The best time to freeze eggs is when women are healthy, young, and they haven’t got any underlying medical problems, not when they are in their late 30s. Egg freezing is very much an option for women who are looking to preserve their fertility. There are many indications for egg freezing, some medical reasons, for example, patients with cancer can freeze their eggs, others can be social indications, such as not being in a relationship or they’re aware of some underlying family circumstances, and they may be at risk of a reduced overall reserve later on in life. In Europe, many women decide to freeze their eggs because of workplace factors or lack of a partner. However, as Dr Nardo emphasised, you should not be freezing your eggs because you are intending to delay your motherhood.
Some data shows that women undergoing egg freezing have learned about egg freezing from some webinars, but mostly, in more than 50% of cases, they’ve heard that from a friend. It is, therefore, a topic that is being discussed. What is interesting is that nearly 80-85% of women embarking on egg freezing are, at the time of undergoing the egg freezing program, single. Prof. Nardo explained that being single or being in a relationship should not be the main reason why women pursue egg freezing, instead the decision to undergo an egg freezing problem should come from an informed decision of one day perhaps seeing the ovarian function declining, and that day may well be the time when they use their eggs.
In the UK, the issue is that the eggs can be frozen and stored for 10 years. Hopefully, things will change, but there is still an argument if you were to freeze your eggs at the age of 30, you could potentially use them up to the age of 30 when you’re more likely to see a decline in ovarian reserve. However, if you freeze your eggs at the age of 20, you may be required to use them by the age of 30, which is still a good age to potentially conceive naturally.
However, there are some limitations and risks of egg freezing. Before you embark on the egg freezing program, you should not just be told that because of your age, whether you’re suitable or not, you should have some ovarian reserve tests done. These are the AMH test and an ultrasound scan, and to assess the number of antral follicles. Once you have had the ovarian reserve test, then a fertility physician will have the information to advise you on whether it is possible and about your chances of success.
Again, it is crucial to remember that age, as well as AMH level or AFC, will not be able to tell you your egg quality or if they will survive the thawing. We need to remember that and accept that there are some limitations before deciding on an egg-freezing program. Before going ahead with the egg freezing program, you need to have your ovarian reserve checked so that you can make an informed decision.
Amongst the risks of egg freezing, there is Ovarian hyperstimulation syndrome (OHSS), which is when the ovaries produce too many eggs. There are also some risks with the surgical procedure to harvest the eggs, although it’s very simple, there is a risk of bleeding and infection.
It’s very much age-dependent, but in women under 35, up to 80% of the eggs can be frozen and again, about 75 to 80% of these eggs will survive the thawing process (defrosting), and the fertilization rate of the eggs that survive their thawing is comparable to fresh eggs. This doesn’t mean that if you are older than 35 you should not freeze your eggs, but simply that you have to set your expectations so that you will not be disappointed. There is evidence to suggest that women that embark on egg freezing will have the same chances of achieving a live birth if they’re using fresh eggs, and there are several studies published that are looking at the use of vitrified or frozen eggs with fresh eggs providing the same live birth rate.- Questions and Answers