Elective Fertility Preservation
Egg freezing allows a woman to preserve her fertility in order to increase her chances of being able to start a family when she is ready. If a woman in her peak years of fertility is not in a position to conceive because of life circumstances or not finding the right partner, she is able to be proactive in preserving the option of childbearing for her future.
Women are born with all the eggs they will ever have and there is a significant decrease in the quality and quantity of a woman’s eggs over the course of her life. This effect becomes more dramatic in the late thirties and beyond, which is why older women often have more difficulty becoming pregnant and are also more prone to miscarriage. The advantage to having frozen eggs is that they will retain the genetic quality of the age at which they were frozen.
When to Freeze Your Eggs
The best candidate for egg freezing is a woman under the age of 40 who has an adequate ovarian reserve of eggs. Women in this age group are more likely to have a good response to ovarian stimulation and a higher percentage of genetically normal eggs. Ovarian reserve can be assessed by taking a blood sample and measuring the levels of follicle stimulating hormone (FSH) and anti-mullerian hormone. In addition, a vaginal ultrasound can be performed to count the number of baseline follicles in the ovaries. While this testing provides insight into the ovarian reserve, the true test of ovarian reserve is a stimulated cycle where the woman takes injections of FSH.
Egg Freezing Steps
To begin an egg freezing cycle, daily follicle stimulating hormone injections are begun soon after the menstrual period starts or may follow a short course of oral contraceptive pills. This medication is a synthetic version of the natural hormone that the body makes to stimulate follicular development within the ovaries. The daily injections are self-administered with a small needle for a period of 7-10 days and during this time the response is monitored with blood tests and vaginal ultrasound exams to follow the growth of the follicles. All monitoring takes place at our Greenwich or Tuckahoe locations.
When the follicles are ready, the egg retrieval is scheduled. This brief procedure takes place at Greenwich Hospital under sedation provided by an anesthesiologist. Under vaginal ultrasound guidance, a needle is inserted through the vaginal wall and into the follicles of the ovary, and the fluid inside them is removed. Our embryologists examine the fluid to identify the eggs under the microscope. Later that day, all of the eggs are frozen using the vitrification technique and then stored in liquid nitrogen tanks. Depending on the number of eggs available to freeze after the first cycle, some women elect to undergo another cycle to freeze additional eggs. Eggs may be stored for an indefinite period of time without any apparent damage as a result of long term storage.
Estrogen and progesterone supplements are used to prepare your uterus to receive the embryo. The eggs are then thawed. Surviving eggs are inseminated with a technique called intra-cytoplasmic sperm injection (ICSI), in which a single sperm is injected into each egg. The resulting embryo or embryos are then transferred into the uterus during a simple procedure in which no anesthesia is required. Any remaining good quality embryos can then be frozen for future use.
It should be understood that freezing eggs does not guarantee a future pregnancy, and it is not recommended that egg freezing be used as a reason to delay childbearing. The eggs that are frozen might never be used if the woman has no difficulty in successfully conceiving on her own in the future.
Recently, some employers have begun to subsidize egg freezing, but in general, insurance coverage is often limited for both the egg freezing and egg thaw transfer cycles. The procedure may otherwise be considered by insurance standards as not medically necessary when performed electively. Visit our Affording Treatment section from more info.