DR. PRITIMALA GANGURDE. MBBS. DNB OBS & GYN, CONSULTANT IVF SPECIALIST AT APOLLO FERTILITY BORIVALI, MUMBAI explains why egg freezing need not be feared or shamed. It is a technological marvel that has given millions of infertile or cancer-stricken women around the world a chance to have a baby.
Egg freezing is an important and historical development in the field of reproductive medicine. It sounds like magic to have direct control over the biological clock, which always makes women feel under pressure. It is an absolute boon for women who want to preserve their fertility potential when they are younger and choose to conceive after a few years.
The female fertility potential is highest between the age of 20 year to 30 years, after which it slowly starts diminishing in quantity as well as quality.
It is not only about getting pregnant, but also about having a healthy child.
As women are increasingly taking on professions which are highly responsible, demanding and time consuming, egg freezing is the need of the hour. It is definitely like an insurance policy for those ladies who need to postpone their childbearing for various reasons.
The indications are many.
We can majorly classify those as medical indications and social egg freezing. Women who are diagnosed with malignancies, and need to go for cytotoxic chemotherapies, which may damage their reproductive potential, are the ones who will largely benefit from this fantastic technique.
How does it work?
The procedure of ovarian stimulation can be started randomly, irrespective of the day of menstrual cycle, which will avoid delays in therapeutic treatment of the malignancies. This provides them a positive hope to retain their possibility of pregnancy and fulfilling the dream of motherhood.
Women who want to postpone their childbearing, either due to their careers or for finding a perfect match, are the ones who can also benefit.
This is known as social egg freezing.
In the case of couples, where the wife has poor ovarian reserve and the husband is suffering from obstructive azoospermia, it is a blessing. In such cases oocyte freezing-pooling is done with multiple cycles of ovarian stimulation - a testicular biopsy is planned when sufficient numbers of oocytes are available for ICSI with [TESA] testicular sperms.
Oocyte freezing is beneficial for donor oocyte banking. It gives the advantage of having more donor oocyte profiles available, while negating the need for synchronisation of donor-recipient cycles. It allows quarantine of donor oocytes, giving time for genetic infection screening. It also works as a fantastic back up for fresh donor oocyte programmes.
Is it safe?
Egg freezing is a safe procedure, and considering its success rate on the basis of available evidence, the American Society of Reproductive Medicine has stated that oocyte freezing should no longer be considered as experimental for women with medical indications.
It is not a hectic or painful process anymore, with the availability of newer recombinant subcutaneous injectable hormones. The injections are very patient friendly, good for self-administration, without any paramedical help. The process of oocyte retrieval is a day care procedure, which may be done even under local anaesthesia and does not involve any bed rest.
What is the success rate?
The possibility of a successful pregnancy after oocyte freezing, depends upon multiple factors. The age of the woman is one of the most important determinants, as age related decline in the success rate is reported in multiple studies.
The technique used for oocyte freezing is another important factor. The newer technique of verification is supposed to provide better success, though very limited evidence is available for the same.
The number of oocytes is also a factor to be taken into consideration. The available evidence supports the concept of needing at least 8 to 10 metaphase II oocytes for getting a reasonable success rate, though it might not be 100 %.
Oocyte freezing procedure does not carry any risk of decreased ovarian reserve or infertility in the future. Frozen eggs are equally good to ensure a successful conception when desired. It is a good alternative to embryo freezing, in cases where there are ethical and legal issues.
In conclusion, oocyte freezing has opened a new era in the field of infertility, and the safety of the procedure has expanded its role and indications.