Who needs Egg Freezing? Procedure Cost and Risks A Woman Must Know
Fertility of women comes with an expiration date or say way early than of men’s. This is because they are bound by biological cycle and their eggs will not wait until they decide to become pregnant. The risk of infertility rises as women age.
As there is no way to stop the aging process, there is no way to stop the aging process of eggs. However, with egg freezing technique, the eggs which were frozen in the 20s or 30s, can be used 10 years later. Let’s know all about egg freezing.
Also called as mature oocyte cryopreservation, egg freezing (low-temperature freezing) technique preserves the reproductive potential of a woman so that she can become pregnant later in life. Eggs are collected from the ovaries, frozen and stored to be used for in-vitro fertilization later.
Reasons - Why egg freezing is done?
For women who want to become pregnant or have a biological child later in life, egg freezing can be an option. This could be due to career or relationships. It is not to be confused with embryo freezing (embryo cryopreservation), which requires sperm for fertilization. However, like the embryo freezing, you will need fertility drugs to trigger ovulation for the production of multiple eggs.
Other reasons for egg freezing may include:
- A woman might choose this option if she is about to undergo cancer treatment or other such illness which can affect her fertility potential in future.
- If a woman is donating her eggs, she might preserve some eggs for herself.
- If a woman is undergoing IVF treatment and the male is unable to produce enough sperm on the day of egg retrieval, frozen eggs can be used. This is because the fresh produced egg cannot survive for long in the body.
Ideal age for egg freezing
As woman age, the number of egg production also declines. By puberty, 3-5 lakhs eggs are left and out of this number, hardly 300-500 eggs become mature. Experts agree on one thing that younger is better. If a woman decides to go for the procedure (harvesting and freezing) in her 20s, she might get around 15-25 eggs.
For a single pregnancy, 4-5 eggs are needed at a time. If a woman is in her 40s, she would hardly be able to produce 8-10 mature eggs. Out of these, some may not survive the thawing (melting) process or some may not fertilize. So, one can easily comprehend the importance of egg freezing at a younger age. The maximum the number of eggs, maximum the chances of becoming pregnant in future.
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How long frozen eggs last?
This is the important aspect of this technique. Freezing of eggs also freezes the aging process of the eggs. An egg frozen a few years back will be healthier than the fresh egg of an older woman. It is exactly unknown how long the eggs can survive freezing, but there cases where the live birth occurred after 10-12 years of freezing.
Side effects - Are there any risks and complications of egg freezing?
There are risks associated with egg freezing but they rarely occur and are not severe in nature. These include:
- Using fertility drugs can result in ovarian hyperstimulation syndrome (OHSS) which causes swelling in the ovaries after ovulation or egg retrieval. It can cause bloating, mild abdominal pain, nausea or vomiting.
- Infection in the bladder, bowels or blood vessels.
- Risk of miscarriage
There hasn’t been extensive research done on risks. Experts have not found any link between birth defects among child born with frozen eggs. So, long-term risks aren’t fully known yet.
Preparation before egg freezing
If you are serious about egg freezing, consider finding out people who are expert in dealing with reproductive endocrinology. Learn about each step of the procedure as well as the cost of storage. Before you undergo the procedure, the doctor would conduct some blood tests which include:
- Ovarian reserve testing – This blood test will determine the current quality and quantity of your eggs. For this, the doctor would check the levels of follicle stimulating hormone and estradiol in the blood on the third day of your menstrual cycle. The doctor will also check Anti-Mullerian Hormone (AMH) level in the blood. Normal AMH levels are in the range of 2-6 nanogram/ml.
- Ultrasound of the ovaries – This is to get the complete picture of ovarian functioning.
- Screening for infectious disease – You might also be tested for some infectious diseases. If the eggs are infectious, they might be stored through a different procedure.
Procedure of egg freezing
The process of egg freezing goes through several stages. These are:
You will be given synthetic hormones and other medications to stimulate your ovaries for producing more than one egg. This will be done at the start of your menstrual periods. You might have to visit your doctor regularly for ultrasounds and blood tests to check the response.
As soon as the follicles (sac containing egg) are ready to retrieve eggs, typically after 2 weeks, you will be given human chorionic gonadotropin to mature the eggs.
Once the doctor becomes certain that eggs are matured, the egg retrieval process begins. It is typically done through transvaginal ultrasound aspiration. The doctor will insert an ultrasound camera into the vagina to check for follicles. Through a fine needle with a suction device attached, the eggs will be removed from the follicles.
Shortly after retrieval, the eggs are then cooled under zero temperature in order to stop all the biological activities. The doctor might use cryoprotectants, a substance that would prevent the formation of ice crystals during the procedure. This would be either through slow-freezing technique or through vitrification (rapid freezing).
After the procedure, you might experience fever, heavy vaginal bleeding or may feel problem in urinating. Normally, you should be back to your normal activities within a week.
Success Rates of egg freezing
When you decide to go for a child, the frozen eggs will first be thawed and then fertilized with the sperm using ICSI or other technique. As per success rates, around 90 percent of the frozen eggs survive the freezing and thawing process while 75 percent of them will be able to pass through fertilization process successfully.
Then comes the phase of pregnancy. After implantation, about 30-60 percent women can become pregnant. And out of this, around 20 percent will be able to successfully give live birth.
Egg freezing in India
The desire to freeze eggs is fast catching up among career-oriented urban women. According to fertility specialists who appeared in a meeting organized by Indian Fertility Specialists, there has been a 10-fold increase in women seeking help of Assisted Reproductive Technology (ART) centers for egg freezing.
As per fertility specialist Dr. Jatin Shah, who helped celebrities like Karan Johar and Shahrukh Khan in having children through IVF, every month 3-4 women are moving to fertility centers for egg freezing. Earlier, this was 3-4 cases annually. Yet, compared to advanced countries, the egg freezing in India is in the infant stage.
Without any doubt, the age of having babies, especially in countries like India has shot up due to late marriages and other lifestyle factors. Still, if you want to freeze your eggs, it’s a good option as eggs can stay in cold storage for years. However, once you have made up your mind to have a baby, you would first like to try naturally, without the frozen eggs. This will also depend on how old you are. If you are under 35, you may like to try getting pregnant for 6 months via sexual intercourse.
If you fail to get pregnant naturally, then only you may want to consider using frozen eggs. The doctor would then evaluate your fertility. Your male partner might also be suggested to undergo semen analysis. Then only the further course of action is decided with your doctor like which type of treatment you would like to do; ICSI, intrauterine insemination or some other. But before going with any kind of treatment, you would like to think about below questions.
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Q & A
What is the cost of egg freezing in India?
First thing first, the cost will depend on your age and overall fertility status. The doctor will confirm this through the Anti-Mullerian Hormonal test. The comfort of egg freezing and becoming mother years later comes at a price. The cost of vitrification (a method which prevents ice crystals forming on the eggs) is approximately Rs. 50,000. Add it to the cost of fertility medicines and other tests, then the overall procedure will cost between Rs. 1 lakh to Rs. 1.5 lakh.
Now include the storage charge which could be around Rs. 20,000 per annum. This is the cost of egg freezing, if you want to get pregnant you will have to undergo IVF treatment for fertilization or transfer of the embryo, which will cost you additionally.
Does egg freezing mean I will not be able to produce eggs in future?
As mentioned above, woman’s fertility decreases with age. The early you freeze your egg, the more you have chances of producing matured eggs in future. After the age of 40, you will hardly produce a few matured eggs if you plan to conceive naturally (via sexual intercourse). So, even if God forbids something happens to the preserved eggs, you will still have chances of becoming pregnant in future.
How much time does the procedure of egg freezing take?
The timeline begins with the first appointment and start of your first periods. Typically, in the first month, you will go through ultrasounds and blood tests to evaluate if you are an eligible candidate for egg freezing. The first two weeks of the second month you will spend taking medicine (to stimulate ovaries) before your eggs are retrieved. The procedure of egg retrieval hardly takes 15-20 minutes.
Egg freezing vs embryo freezing – which is the best?
It depends on case to case. Cost, age, and other personal issues are subjective things. The primary difference between egg freezing and embryo freezing is that latter requires sperm. But what is important to remember is that neither of the procedure is a ‘surety’.
However, if you already have a male partner and aren’t ready for children as of now, you might choose embryo freezing over egg freezing. Secondly, eggs are delicate things and might not survive the thawing process as compared to thawing frozen embryo. Contrary to this, after thawing eggs, it has to be fertilized by sperm before transferring it to the uterus. So in this case, embryo freezing has an upper edge. By mixing your male partner’s sperm with the egg, you have crossed one stage (fertilization) of the overall process.