Egg freezing: Should you consider it?
A recently published study brings hope to women faced with fertility issues. The study has found that the combination of four drugs can contribute to the growth of new eggs.
More specifically, an article in Human Reproduction journal suggests that researchers from the University of Edinburgh, led by professor Evelyn Telfer, noticed that women with Hodgkin’s lymphoma, who underwent chemotherapy with a drug called ABVD (adriamycin, bleomycin, vinblastine and dacarbazine), had up to ten times more eggs compared to healthy women.
“Basically, the ovarian tissue in patients taking ABVD appeared healthy and its condition was similar to that of healthy women. Although the extra eggs were still at the ovarian follicle stage, scientists are trying to understand the mechanism responsible for their growth and maturation. However, it is still unclear whether eggs at the current phase are functional and able to become fertilized”, says Dr Harry C. Hiniadis, Obstetrician –Gynaecologist specialised in IVF and Laparoscopy, associate in the IVF unit at MITERA Maternity Hospital (http://www.hiniadis.com/).
He adds that “although the study is conveying a promising message it is still far from being implemented in everyday clinical application, both for women with a history of cancer who wish to preserve their fertility, and for those who wish to extend it for various reasons”.
“Today, vitrification, a method that prevents the formation of harmful crystals after thawing, allows us to extend a woman’s fertility for as long as she wishes. A woman may freeze her eggs (or even part of her ovaries) and when these are thawed they can be fertilized with donor sperm or sperm from her partner or husband. After that, resulting embryos are transferred to the uterus with significantly high chances of successful gestation, compared to methods used in the past. This means that while previous technology had a success rate of less than 10%, this new method reaches 30-35%. A key prerequisite for high success rates is the all along good quality of the eggs. In other words, the youngest the woman who decides to freeze her genetic material, the highest her chances of success in the future. The potentials of cryopreservation technology are also better exploited if the genetic material comes from a younger individual” explains the doctor.
It is known that while sperm production in men continues throughout their life, women are born with a specific number of eggs, which in part defines their reproductive age. At menarche, ovaries contain approximately 250,000 follicles, each one of which can potentially release one ovum (egg) per month. When a woman reaches her late thirties, her reproductive capacity gradually diminishes due to the depleted quality of the remaining eggs and the fact that ovulation may not happen each month. When she finally reaches the age of 50, a woman is left with only a few follicles which are not able to respond to the hormones that trigger egg maturation and thus the woman is led to menopause.
Which women are eligible for egg freezing?
According to Dr Harry Hiniadis women who can or should take advantage of the egg freezing option are:
• Those who are scheduled to undergo chemotherapy or radiation. “These treatments may cause significant harm to both egg production and egg quality. Therefore, we can freeze a good number of healthy eggs and use them in the future, when ovaries will probably not be able to function”, says the doctor.
• Women with serious health conditions. Because of severe health conditions and/ or long-term medication many women are advised to postpone childbearing for many years. With cryopreservation, particularly if a woman is over the age of 35, fertility can be extended until the end of her treatment.
• Women who give their career a priority. An ever increasing number of women is opting to promote their career leaving childbearing aside. Egg freezing is the only way that these women can extend their reproductive years and preserve their fertility for the future.
• Women who are not in a long-term relationship or haven’t found the right partner. In countries like Greece where the decision to start a family is almost inseparable from marriage, the number of single-parent families is significantly lower compared to Western Europe. Egg freezing allows women to preserve their fertility for when they decide to have children, either on their own or with a partner.
• Women on early menopause or family history of early menopause. In this case, the gynaecologist must let the patient know that the time she has left for childbearing is coming to an end. The doctor must also inform the patient about all available options. If the woman is not on a long-term relationship or not yet planning of having children, the only way to preserve her fertility is egg freezing.
How is egg freezing performed?
“The procedure is relevantly simple and painless. After a few necessary tests (ultrasound, hormonal and virology screening), we begin ovarian stimulation, just as a simple IVF procedure. After 10-12 days, when the eggs have become mature we administer a hormone that causes their release into the fluid of the follicles. Egg retrieval is done approximately 36 hours after the final injection. With appropriate medication, the patient is put under light general anaesthesia – sedation that allows for a painless procedure. The fluid from the follicle is suctioned through a fine needle and is handed to the embryologist, who isolates the eggs under the microscope. He then freezes the eggs in extremely low temperature. The patient may return home approximately an hour after the procedure”, says Dr Hiniadis.
Based on Greek legislation, frozen eggs may be preserved for ten years. Technically, though, they can remain frozen for an unlimited period of time.
“When a woman decides to have children, we can thaw the eggs and fertilize them with sperm from her partner or a donor. This way, we may produce embryos and transfer them to the uterus 2-3 days after. A hormonal preparation of the uterus is carried out prior to the transfer” adds the doctor.
If the patient has had her uterus removed for health reasons, these embryos can be transferred to the uterus of a surrogate mother, who will carry the baby to term and then hand it to its biological parents.
Finally, it should be noted that relevant Greek legislation allows single mothers to use their eggs, fertilize them with donor sperm and become pregnant.
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