Freeze time by freezing your eggs!
Today, more and more women decide to have children in older age groups. It is common nowadays for many women to postpone marriage and children after the age of 35-40, mainly due to work commitments. Considering that a woman’s fertility gradually declines after 35 and rapidly after 40, many women who try to procreate at these ages find it quite difficult and eventually they choose, after several IVF attempts, the option of egg donation.
What kind of tests should a woman take to check her fertility, and in what age?
Most women assume they will be able to have kids if they do it at a young age, ignoring the obvious: they have no idea if their bodies will permit it. Prevention is the best way to face possible fertility problems and ensure the conception of a child. Nowadays, it is possible to diagnose issues related to fertility by some simple fertility tests, that, according to most doctors, women should start having at an early age (before their 30s and not later than the age of 35). By knowing how fertile she is, she is also able to plan her future.
Fertility tests should include hormone testing (FSH, LH, and AMH anti mullerhian hormone) and a transvaginal ultrasound scan that checks the size and quality of the ovaries as well as if there are many small follicles. Those tests can estimate a woman’s potential of pregnancy and thus help the fertility specialist recommend the appropriate treatment plan.
What affects most a woman’s fertility?
Knowing that the advanced reproductive age of a woman is the most aggravating factor for having a child, either naturally or with an assisted reproductive method (IUI or IVF) due to the poor number and quality of eggs, older women find it very difficult to get pregnant and fail easily when they try IVF. This means that they produce both a small number and low-quality eggs, resulting in the creation of poor-quality embryos, which inevitably lead to failure and increase the risk of miscarriage, even in the case of a successful attempt.
How can we ensure a successful pregnancy at older ages?
The results from the use of cryopreserved human sperm and embryos have been particularly good the last decades. Egg cryopreservation techniques have improved dramatically nowadays and at the same time pregnancy rates from embryos from cryopreserved eggs have increased.
The modern method of vitrification for cryopreservation of oocytes significantly increases both survival and fertilization rates.
An important prerequisite in the ‘survival’ of the oocytes, fertilisation and the creation of embryos suitable for pregnancy is the quality of the frozen oocytes. Therefore, the younger is the woman who decides to freeze her eggs, the higher chances she gets for pregnancy in the future. Pregnancy rates with embryos from frozen eggs are slightly lower than with fresh eggs. As far as the decision to freeze her eggs is concerned, it is a decision any woman can make upon reaching adulthood.
The best way to pursue egg freezing, or oocyte cryopreservation is in the prime reproductive years—a woman’s 20s and early 30s— in order to get the premium quality and quantity of eggs. Therefore, the younger a woman freezing her eggs, the higher the success rates for pregnancy in the future she gets. Pregnancy rates for in vitro fertilization (IVF) cycles using frozen oocytes appear to be slightly lower than for those using fresh ones.
Why should a woman choose cryopreservation of her eggs?
Normal infertility at older ages is clearly a very important reason for a woman to act proactively and cryopreserve her eggs. However, this method is mainly recommended in cases of:
- women with an established predisposition to premature menopause (usually hereditary)
- women whose priority is a career.
- women without a partner, with thoughts about starting a single-parent family.
- women who have cancer and are about to undergo chemotherapy or radiation, which causes damage to their ovaries and eggs and therefore infertility.
- women with significant and chronic health problems.
- women who refuse, on ethical or religious grounds, to consent to the cryopreservation or destruction of surplus embryos created during the application of assisted reproduction methods to which they have had recourse on grounds of infertility.
What is Ovum Cryopreservation, and which is the process?
Obtaining and cryopreserving the oocytes initially requires the stimulation of the woman’s ovaries by administering gonadotropins and simultaneous ultrasound monitoring. The oocytes are then collected under anesthesia using a vaginal ultrasound scanner. The number of eggs retrieved is usually large and therefore satisfactory in younger women, but it is lower in older women and more than one ovulation may be required.
Once the eggs have been retrieved, they are frozen at a very low temperature (vitrification method), achieving this way very good survival rates after thawing and, at the same time, high pregnancy rates.
The oocytes are then placed in solutions with special cryoprotective agents, frozen, and stored in liquid nitrogen at -196°C. Under these conditions, the eggs can be kept initially for 5 years according to current law (practically they could be kept forever), while the percentage of cryopreserved eggs that are suitable for treatment after thawing varies according to the age of the woman and their quality.
In spite of possible difficulties, these techniques have given hopes for the birth of a child to many women. Ovum Cryopreservation gives women the chance to freeze their eggs while younger, preserve their fertility, and, when older (after their 40th year), reduce the chances of miscarriage and birth defects associated with “egg age.” Why would a woman consider preserving her eggs? To preserve her options. She might not be ready for babies right now (because of her relationship status, career, finances, etc.), but knows she will or might want kids later. Or she really has no idea whatsoever, but she wants to keep that option open. Freezing her eggs buys a woman time and can give her more choices in the future.
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