By Dr Radhika Sheth
Today’s career-oriented woman is often faced with the dilemma of choosing between her career and family life. Her career clock and biological clock are often in conflict with one another. A decision to delay pregnancy is often surrounded with the constant fear that her chances of conceiving may become lesser as she grows older.
With the advances in reproductive technology, women with career or academic goals now have an option to plan their pregnancy. Egg freezing can be considered a major development in the field of fertility, giving women an opportunity to slow down their biological clock by freezing their eggs till they are ready for conception.
The “biological clock” generally stops ticking for a woman in the late 30’s or early 40’s. A woman is born with a finite egg reserve, which is laid down in her ovaries when she is still her mother’s womb. After puberty, each month, only the few best eggs are selected to complete their journey towards ovulation, while the rest are discarded naturally. By the age of 37, there is a significant decline in the egg reserve and the number steeply declines till the age of 40.
Who can benefit?
- Women who have certain career or academic goals to achieve before motherhood.
- Women who have not yet found a partner.
- Women with cancer as its treatment may damage ovaries. Hence, egg freezing to attempt fertility preservation in cancer patients can be opted for use in the future, prior to starting cancer treatment.
Recommended age for freezing eggs
For those who choose to freeze eggs for social reasons, late twenties or early thirties is a good time to get healthy eggs. There is no upper age cut-off at which women should preserve their oocytes in order to achieve the best outcome from those cryo-preserved gametes. Studies have shown that the outcome of frozen eggs yielded results comparable to those of the fresh oocytes, being just relevant to the maternal age at which the oocytes were extracted, with higher success rates noted below 35 years of age.
Procedure for freezing eggs:
- The patient is given fertility drugs for around eight to 10 days to stimulate production of eggs.
- The egg development is monitored with ultrasound scans/hormone tests.
- When of appropriate size, the eggs are retrieved under anesthesia by a short procedure.
- The mature eggs are then frozen in the lab using skillful embryology techniques.
- These eggs are frozen in liquid nitrogen cans at -196 degrees celsius and can be preserved for five years or even more. The duration of storage does not hamper egg quality.
- At times, it may take two or more rounds of extraction to get an optimum number of eggs for freezing.
When the lady feels that it is the right time for her to plan a pregnancy, these eggs can be thawed and injected with a needle containing a single sperm, a procedure called ICSI. The eggs begin to develop into embryos, which can be transferred into the uterus using a catheter, often leading to a successful pregnancy.
Egg freezing appears to be most effective when at least eight to 10 eggs are banked before age 36 and most cost-effective when undertaken before age 37. Egg freezing, while it does not guarantee pregnancy, is like a reproductive insurance policy or backup plan that offers many women a chance of conceiving with their own eggs. It allows women to freeze time when they freeze their eggs, so that it is possible for them to pursue a career and have a healthy baby too.
(The writer is Consultant Fertility Specialist, Cloudnine Group of Hospitals, Mumbai, Malad and Vashi.)