So you definitely want to be a mother someday, but you are in your 30’s and you are not ready to have a baby now. You are concerned about your fertility potential and you may have friends or relatives who are dealing with infertility and others who are considering oocyte cryopreservation (egg freezing). How do you decide if this is the right choice for you?
You are not alone. Generation X and Millennials are delaying child bearing to a greater extent than any generation in American history for a variety of reasons. While this decision is ideal for many aspects of their lives, it can make having a baby later more challenging because fertility potential in women declines with age. This is because women are born with all the eggs they will have and they lose a few thousand eggs each month up until menopause. Furthermore, the good eggs with the right genetic makeup are expended first and the chance of becoming pregnant decreases over time for all women as a result of the decline in egg quantity and quality.
Science has not figured out a way to arrest or slow down this process but it is possible to collect eggs from a woman with good fertility potential and save them for use at a time when she might have less potential to conceive. Egg freezing is a relatively new technology but it seems to be safe and effective particularly for younger women with a good number of eggs remaining.
Who are the best candidates for egg freezing?
- Women under the age of 35 in good general health
What are the advantages?
- It may allow women who otherwise may not have an opportunity to have a baby to conceive at an age of their choosing
- Peace of mind
What is the downside?
- Limited amount of information about long term success rates and safety
- Less successful than overall IVF
- Experience and success rates vary significantly among clinics due to complexity of process
IVF FLORIDA has been an industry leader in oocyte cryopreservation and has had a successful program for six years – a long time for a new technology. We would be delighted to meet you and review your situation and the opportunities that our fertility preservation program offers.
By
Dr. Steven Ory at 19 Aug 2016
Often times the IVF cycle is preceded by a 3-week course of oral contraceptives. Some literature has suggested that success rates are better following a 3-week course of ovarian suppression. The stimulation always begins at the start of the cycle in which the eggs will be retrieved and usually is between the second and fourth days of the cycle.
Typically a patient undergoing fertility treatment will be given instructions for injections for 4 days and then instructed to return to assess the response which we determine with an ultrasound to measure the size of the growing follicles, the small cysts which contain the eggs, and the blood estrogen level which is the primary byproduct of the developing cycles. Once we determine that the eggs are mature with the ultrasound measurements and estrogen levels, we use a different hormone to trigger ovulation.
The egg retrieval has to be precisely timed so that we can retrieve the eggs shortly before the ovaries would otherwise release them. Once they are released into the pelvis it becomes much more difficult to recover the eggs and the usual time interval from the injection to the planned time of the retrieval is approximately 34 hours, but we do allow a few hours grace period. The egg retrieval is done with IV sedation so you should be very comfortable through the procedure. You may experience some pelvic discomfort for a day or so after the procedure. Since it is surgery there are potential complications and these include bleeding, infection, damage to other organs, and problems with the anesthesia. In practice, all of these complications are extremely rare.
The eggs are removed using a vaginal ultrasound with a needle guide so that the ovary can be entered through the back wall of the vagina where it is very thin and the fluid within the follicles containing the eggs is then drawn through the needle, collected in a test tube, and given to the laboratory for identification of the eggs. On the same day of the retrieval, the eggs will be fertilized either by adding a predetermined concentration of sperm to the dish containing the egg or by injecting a single sperm directly into the egg, ICSI (intracytoplasmic sperm injection).
The following day we will be able to determine whether the eggs fertilized or not and they are then observed for 3 to 5 days after the egg retrieval. Depending on how they are developing they may be transferred either 3 or 5 days after the retrieval. The recommended number of embryos to be transferred depends on the patient's age and for most women, under the age of 35, we are recommending 1, or no more than 2 embryos be transferred. For women over the age of 39, we will transfer up to 5 embryos. This reflects the higher proportion of abnormal embryos in older women and even though more embryos are transferred, the pregnancy rates and multiple pregnancy rates are lower in older women. The most common reason an IVF cycle is unsuccessful is that the embryos produced have the wrong number of chromosomes to develop into a normal embryo.
Additional information on both the egg retrieval and embryo transfer process can be found on the IVF FLORIDA website.
If you have questions or would like to schedule an appointment, please contact us today.
By
Dr. Steven Ory at 28 Feb 2014