Egg freezing – do you need reproductive insurance?

Egg freezing has been hailed as a game changer for women, an “insurance policy” to revitalise waning fertility, a breakthrough as revoluationary as the birth control pill. If you’re reading this, you probably already know all the facts about how egg quality and quantity deteriorate with age, which is why some women consider freezing their eggs until they’re ready to use them.

Over the past several decades the average age of a woman’s first birth has increased to an all-time high of 28.4 years. By 2006, 1 in 12 women were having their first birth at age 25 years o older, compared with only 1 in 100 in 1970. He cause of the delay in attempted childbearing in Western societies is thought to be multifactorial, stemming from both social and economic factors. In Australia, the age of first marriage has increased since 1950; in 2009 the mean age of first marriage was 26 years for women. Now there are ramifications of this with the delay in attempted child-bearing incurring the cost of an increase in age-related infertility.

Unfortunately standard fertility treatments can only partially overcome the fertility decline associated with ageing. However, egg freezing or in technical terms oocyte cryopreservation (OC) can be used as a method of fertility preservation for single women who are not ready to conceive. OC “freezes-in-time” egg quality, protecting the higher pregnancy rates that are seen in IVF treatment with the use of “younger” eggs.  Egg freezing has been shown to achieve live birth rates consistent with those of fresh oocytes in egg donation cycles suggesting that the technique is a viable option. After the American Society of Reproductive Medicine state that “oocyte cryopreservation to improve prospects of future child bearing should be available for non-medical reasons,” two of the world’s largest technology frimed, Apple and Facebook announced that they will provide a $20,000 employee benefit to fund OC. 

In the United States in 2009 only about 500 women froze their eggs. In 2013, almost 5,000 did and it is estimatedt hat 76,000 women will be freezing their eggs by 2018. 

While egg freezing may offer a viable option for single women wanting to protect against the age-related decline in fertility, women and doctors must face several questions regarding it. These are worth asking and include:

  • What is the live birth rates following OC for an individual woman?
  • What is the “best” age for eggs to be frozen?
  • What is my financial cost of banking eggs that may never be used?

Demeter Fertility views egg freezing for women that are characterised in two main groups. These groups are:

  • Women who have some degree of ovarian impairment and are not in the position to have a child and
  • Women who are not planning children currently, but have “normal” fertility

In the first group, other medical diagnoses such as the requirement to undertake some form of treatment that may kill eggs (eg cancer treatments) or surgical approaches requiring significant removal of parts or all of ovaries e.g. endometriosis, and serious consideration is appropriately paid to women who are looking for mechanisms to preserve the possibility of future conception.

Those women without partners or those who wish to delay childbearing often do not know when they may decide to try to conceive.

Unfortunately, how humans produce eggs that can make babies is going to get in the way of the desired outcome for many women. In their early 20s, women will likely release an egg that is good enough to make a baby every couple of months, and if hormones are given to produce extra eggs in a month, often there will be more than one egg that can make a baby. By 35 however, women may well only be making an egg that can make a baby every 3-6 months, and her chances of having a second egg that can also do this in one month is around 1 in 20. And in their early 40s, eggs making a baby is only produced around once a year. 

So this means, collecting eggs for maximising the chances of having a baby from them, may entail collecting eggs on a number of different occasions. In the end its the number of best eggs a cycle that are collected, rather than the number of eggs in one cycle. How many eggs from how many cycles is obviously going to depend on the individual person and their age at collection. 

And this is where the trade off comes. The earlier the eggs are collected, the better the chance of these eggs making a baby. But conversely, younger women are more likely to not need the “egg insurance” as most will form relationships and conceive spontaneously. As women get into their 30s and remain single, there is a lower chance of conceiving, but also a lower chance of forming a relationship, meaning that frozen eggs are more likely to be utilised. 

Even young women have a high percentage of eggs with chromosomal abnormalities which is why most don’t get pregnant every month. This means women won’t know if their eggs are genetically healthy until they’re thawed and fertilised and grow into a baby, which means they could be freezing, and pinning their hopes on eggs that in the end don’t have the ability to make a baby.

At Demeter Fertility, our experience suggests that it is not egg numbers that determine the chance to generate a single pregnancy, but the number of best eggs from an egg collection cycle. The number of eggs expected to be required to produce a pregnancy is reported to be higher in other units, with some suggesting 30 or more eggs, often resulting in hyperstimulation syndrome, and more eggs that are abnormal. Your Demeter Fertility specialist will discuss how many egg collections they recommend you freeze depending on your individual circumstances.

Egg freezing can be performed at Demeter Fertility from as little as $2000 out of pocket. Individual circumstances may vary, and you must discuss your case with our specialist before fees can be confirmed.

Oocyte cryopreservation can be of great benefit to specific women and has the highest chance of success when performed at an earlier age. For social egg freezing, the ages 35 - 37 years show the largest benefit over no action and appears to be most cost-effective in women who do not have any ovarian impairment.

Demeter Fertility is a Sydney-based fertility and IVF clinic with locations in Hurstville and Liverpool. To find out more about egg freezing phone Demeter Fertility on 1300 899 850.

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