Fertility, Egg Freezing, and You

How egg freezing

works

You may have heard a lot about egg freezing lately,
but what is it? Find out about the history and
how it works.

How Egg Freezing Works

What is egg freezing?

The technical term for egg freezing is human oocyte cryopreservation. It’s a technology in which a woman’s eggs are extracted, frozen and stored. Later, when she is ready to try and become pregnant, the eggs may be thawed, fertilized, and transferred to the uterus as embryos in a process known as IVF.

Egg freezing for the purpose of delaying childbirth is fairly new. However, for over 30 years, young women with health problems have been freezing their eggs for potential future use in IVF.

The first successful IVF pregnancy in an infertility patient using a frozen egg was reported in 1986.17 Since then, the technology and methods for freezing eggs has improved. Traditional egg preservation methods included a slow-freeze process; but, since eggs are largely composed of water, the risk of ice crystal formation was high. This made egg freezing difficult to achieve and led to poor results.18

Today’s methods include oocyte (egg) vitrification, a process that essentially flash freezes the egg, resulting in higher success rates than previous “slow freeze” methods.19 Additionally, trials comparing results from IVF using frozen eggs vs. fresh eggs from young infertility patients and egg donors showed that implantation and pregnancy outcomes were similar.20  It’s important to note, however, these results may not be the same in different fertility clinics and in different patients and age groups.

The American Society for Reproductive Medicine (ASRM) no longer considers egg freezing for IVF to be an experimental procedure for certain patient populations. However, the ASRM does not currently recommend egg freezing for patients who wish to delay childbearing because there are insufficient data on the efficacy and safety of this procedure for these patients. The ASRM does not want to give women false hope by encouraging active promotion of egg freezing for the purpose of delaying childbearing. For more information from the ASRM, go to www.ASRM.org.

Only you and a Reproductive Endocrinologist can determine if egg freezing is right for you. So it’s important to learn all you can about this process. Call Fertility Lifelines at 1-866-538-7879 to find a fertility specialist in your area.

Egg Preservation Milestones

1940s Discovery that cryoprotectants, such as glycerol, could protect sperm from damage during the freezing and thawing process.21
1953 First reported human birth from frozen sperm.22
1970s Identification of other cryoprotectants to minimize cell damage during the freezing and thawing process; programmable freezers were also developed to allow for a more controlled slow-freezing process.23
1984 First successful IVF pregnancy in an infertility patient using a frozen embryo resulting in a human birth.24
1986 First successful IVF pregnancy in an infertility patient using a frozen oocyte (egg) resulting in a human birth25
2010 The largest study examining pregnancies from frozen eggs was published, stating that survival rates of eggs preserved using the oocyte vitrification process (ultra-fast freezing) were in the 90 percent range.26
2012 The American Society for Reproductive Medicine lifts "experimental" label from the oocyte vitrification process for use in IVF in certain patient populations. However, the ASRM does not currently recommend egg freezing for patients who wish to delay childbearing because there is insufficient data on the efficacy and safety of this procedure for these patients.27

Here’s what you may expect if you decide to freeze your eggs.

While individual patient experiences may vary, the process of freezing eggs and using them at a later time generally includes:

Phase 1:
Egg Freezing and Storage:

Consultation and Workup
Ovarian Stimulation
Egg Retrieval
Egg Freezing and Storage

Phase 2:
Egg Thawing and IVF:

In Vitro Fertilization
Embryo Transfer

 

Phase 1: Egg Freezing and Storage

Consultation and Workup

Your first step is to make an appointment with a Reproductive Endocrinologist (RE). An RE can help you understand your fertility potential, the possible risks of delayed childbearing and the facts about egg freezing. Your appointment will likely involve several blood tests and an ultra-sound screening. Then you will discuss your results with your RE.

Please note, depending on the number of eggs your RE suggests you freeze, you may need to undergo more than one egg freezing cycle. 

Ovarian stimulation

Please note, depending on the number of eggs your RE suggests you freeze, you may need to undergo more than one egg freezing cycle.

Treatment usually begins with medications that will help your body produce the multiple eggs required for your freezing procedure.28 Each month a new set of eggs begin to develop. Usually one egg matures and is ovulated. The other eggs stop developing. The medicines you receive help these other eggs to develop into mature eggs.29 Therefore, freezing your eggs does not result in a net loss in your overall or future egg supply.

Your doctor will also prescribe other medications to help your body prepare, depending on your specific needs. During this time you will visit the doctor’s office regularly to monitor the growth of your eggs with blood work and ultrasound.30 This phase of the process can take from 8 to 14 days.31

The medications you receive during this process may cause some side effects, including but not limited to headache, bloating and gastrointestinal effects. Some side effect can be serious and require medical attention. Of course, your doctor and nurse will closely monitor your treatment and should be immediately informed of any symptoms you experience.

Egg Retrieval

At your doctor’s office or clinic, you may receive light sedation or pain medication. An ultrasound probe is inserted into your vagina to find the follicles, and a thin needle is guided into the follicles to draw out the eggs.32 The retrieval process usually takes fewer than 20 minutes.33

You may experience some pain during the procedure and mild cramping afterwards, and may experience a sense of fullness or pressure over the next 2 weeks.34

Your doctor can help manage any post-procedure symptoms. You should plan to take the whole day off from work and have someone drive you home from the appointment.

Please note, depending on the number of eggs your RE suggests you freeze, you may need to undergo more than one egg freezing cycle.

Egg Freezing and Storage

Finally, your eggs are frozen for future use. Frozen eggs are stored in tubes in a liquid nitrogen storage tank. Individual clinics vary as to the length of time they will store your eggs. At your initial meeting with the RE’s nurse, you may discuss storage and plans for your eggs should you elect not to use them.

The entire process from screening to freezing and storage takes approximately 2 months. However, for most of this period you will be able to continue your normal activities

Phase 2: Egg Thawing and IVF

In Vitro Fertilization

When you decide the time is right to try and have a baby, your RE may advise you to try getting pregnant on your own for 6 months or a year depending on your age.35 If this doesn’t work, you will visit your doctor and make sure you are healthy and ready to carry a pregnancy to term. Fertility tests will be done on you and on your male partner or, if needed, your sperm donor.

If you decide to use your frozen eggs, the process of IVF will begin. First, you will begin a cycle of medication to prepare your uterus for pregnancy. This cycle usually lasts no more than 10 days.

The first step is to thaw your eggs. This will be done by the laboratory team working with your RE. Some but not all of your frozen eggs may make it through the thawing process. Those that do, will then go through in vitro fertilization using sperm from your partner or donor. You and your RE will discuss the results and determine next steps, including whether the fertilized eggs (now embryos) are genetically normal and available for transfer.

Embryo Transfer

Generally, within a few days of thawing, one or more fertilized eggs (embryos) are implanted directly into the uterus. This procedure is usually brief and may cause some discomfort that is often compared with discomfort experienced during a routine pap smear and pelvic exam. Sedation is usually not required but a mild sedative may be given.36,37

You will continue to take hormones to support the early stages of your pregnancy. About 10 to 12 days after the embryo transfer, your doctor will know if you are pregnant.

Only you and your Reproductive Endocrinologist can determine if egg freezing is right for you. So it’s important to learn all you can about this process. Call Fertility Lifelines at 1-866-538-7879 to find a fertility specialist in your area.

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17-27. The Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. Mature Oocyte Cryopreservation: A Guideline. Fertil Steril. 2013; 99:37-43. 

28. Gonal-f® RFF Pen (follitropin alfa injection) full Prescribing Information. EMD Serono, Inc. 2011.

29, 30. American Society for Reproductive Medicine. Medications for Inducing Ovulation: A Guide for Patients. 2012. 

31-34, 36, 37. American Society for Reproductive Medicine. Assisted Reproductive Technologies: A Guide for Patients. 2011.

35. American Society for Reproductive Medicine. Age and Fertility: A Guide for Patients. 2012.