How does egg freezing work? Know about the benefits of egg freezing!

Parenthood is a dream for every couple. For most women who desire to be a mother, the journey seems easy, while it may not be that easy for some. Today a social trend is observed to delay having a baby. Due to their careers, people marry late and feel unprepared to have a baby in their twenties and early thirties. For women who are delaying their pregnancy for reasons like career, finances, or severe medical problems and decide to conceive sometime later in life, the process of egg freezing can help one weigh up one’s options and give more choices about the future. Egg freezing is one of the best options for women who wish to delay childbearing until later in life. Women are born with a finite number of eggs and are at the peak of their fertility in their twenties to early thirties; the delay in pregnancy can lead to infertility due to depletion in the egg reserve and the quality of the eggs. Certain serious medical illnesses, chemotherapy, and radiation to the pelvic region can lead to the degeneration of the ovarian follicles; egg freezing is a ray of hope for women suffering from ovarian insufficiency. Egg freezing or oocyte cryopreservation is a novel technology where a woman’s eggs are extracted, frozen, and stored where it can be used later whenever a woman plans her pregnancy. The stored eggs are warmed, fertilized, and transferred to the uterus. Egg freezing gives a chance for a woman to become a mother. Even though the biological clock is ticking, it has opened new doors to avoid age-related infertility.

An egg freezing cycle is similar to the first part of the IVF cycle. Oocyte cryopreservation is done after the fertility specialist assesses the ovarian reserve, then ovarian stimulation is done the same way as the IVF process using injectable hormones which stimulates the ovaries to produce a good number of eggs. The important factor is the age of the woman and her ovarian reserve, early reproductive age and good ovarian reserve give multiple eggs along with good results. After 10 – 12 doses of injections, eggs are removed through a 10-minute procedure, Oocytes together with the surrounding fluid are aspirated through the vagina under sedation. The maturity of the eggs is assessed under the microscope and only the mature ones are cryopreserved by a process called vitrification where the mature oocytes are cooled ultra rapidly into liquid nitrogen where they will be stored. Vitrification is an advanced and innovative technique of cryopreservation that involves the rapid freezing of eggs eliminating the problem of the formation of ice crystals that might be unfavourable. Sperm and embryos are easy to freeze than a human egg. Because human egg has more water which results in the formation of ice crystals during freezing which can damage the quality of eggs. However, with the advent of the new technology of vitrification, the formation of ice crystals is prevented along with the use of cryoprotectants which prevents damage caused by ice crystals during freezing. The extracted eggs are stored in liquid Nitrogen at -196 C and stored in the lab at a fertility centre, at a long term storage facility, or at a frozen egg bank. . Whenever the woman wants to get pregnant, the frozen eggs are thawed using warming solutions and these eggs are fertilized with their husband’s sperm or donor sperm through injection. These fertilized eggs or embryos are cultured for three to five days and assessed for their quality. A good-quality embryo is then transferred to the woman’s uterus through a catheter.

The late ’20s or early 30 are the most fertile years and are the best age to freeze eggs. The quality and quantity of eggs that are collected decide the success rate. As the age advances, the fertility potential decreases, the chances of chromosomal abnormalities also increase, and the eggs collected may not sustain the freezing and thawing procedures.

• Women with cancer who require chemotherapy and/or pelvic radiation therapy that may affect fertility.

• Surgeries that may damage the ovaries

• Family history of early menopause or Chromosomal abnormalities that may cause premature ovarian failure (e.g. Turner syndrome, fragile X syndrome)

• Ovarian diseases with the risk of damage to the ovaries.

• Genetic mutations require removing the ovaries e.g. BRCA mutation.

• To preserve fertility for social or personal reasons to delay childbearing.

Egg freezing was initially started for patients who suffered because of the harmful effect of chemotherapy and radiotherapy to treat cancer and other serious medical illnesses, which reduced the ovarian reserve. It gave hope to women who are receiving these treatments.

Economic instability, career opportunity, delay in getting a partner, or social pressures are reasons women postpone pregnancy can also benefit from egg freezing. Freezing eggs give options to women who are focused on their careers and want to have children in the future—storing a woman’s egg for purposes other than medical is called social egg freezing.

Today, a social trend in delaying marriages, motherhood is observed in women of reproductive age groups. This delay is because of various lifestyle factors like developing a professional career or the absence of the right partner. As a result, these women may have age-related infertility once they decide to conceive. Here comes the role of egg freezing for women. Usually, egg freezing was offered for only medical reasons. This medical innovation is now widely used worldwide by healthy fertile women who wish to postpone becoming a mother for various reasons.

Women with medical conditions like severe symptomatic endometriosis together with reduced fertility because of reduced ovarian reserve post-surgery, autoimmune diseases requiring gonadotoxic treatment are benefited from egg freezing work.

• Low responders: allowing the storage and accumulation of oocytes from multiple stimulations before IVF.

• Emergency egg freezing: can be a backup for patients with unexpectedly no sperm available on the day of oocyte retrieval for IVF.

Thus, egg freezing is an established technology with a wide range of benefits that may benefit several patients in the future. Egg retrieval, freezing, usage of the right CPA in freezing, thawing, fertilization in the laboratory, and transfer of the embryo to the uterus all need a lot of skill and expertise; therefore, one should be diligent in choosing the best IVF centre.