Claudio Benadiva, MD
“Doctor, should I freeze my eggs”? asked my patient last week. She is 38 years old, single, professional, and still looking for “Mr Right”. She realizes her fertility is declining, and is afraid when the day comes to try to have a baby, it may be too late. Is it a better option for her to try to get pregnant now, using donor sperm, and become a single mom? What if she does find the man of her dreams after she has already made that decision? Will she be able to have a child with her partner, or it may be too late by then? I see many women who are facing similar dilemmas. Some for personal reasons like my patient, but others unfortunately are facing possible sterilization due to chemotherapy or radiation after being diagnosed with cancer, or other medical conditions, and wish to preserve their fertility.
The need to freeze human eggs successfully, with the goal of achieving live births at rates equivalent to those obtained with fresh eggs has been receiving increasing attention. Although we have been able to freeze embryos (fertilized eggs) very successfully for many years, freezing the unfertilized eggs has been much more challenging until recently. Fortunately, a new technique called “vitrification” where the eggs are frozen very fast has been gaining popularity as a very effective method.
Despite very promising advances in egg freezing, the American Society for Reproductive Medicine (ASRM) still defines oocyte cryopreservation as an experimental procedure. Since the eggs may remain in storage for several years before they are utilized, we wanted to find a way to provide our patients with reliable outcome data regarding the success of this new technique. For this reason, our Center conducted a study to assess our results. We were able to demonstrate excellent egg survival and live births after the frozen eggs were warmed, fertilized, and the resulting embryos were transferred back to the patients.
In contrast with their male partners, women are faced with a rapid decline in their fertility starting in their mid thirties, and sometimes even earlier. We now have a way to preserve their fertility much longer. Still many questions need to be answered: when is the best time to do it? How many eggs is a good number to have in storage? Who should pay for it? We certainly don’t want women to wait until it’s already too late to think about their fertility. We also don’t want them to get a false sense of security, and then continue delaying motherhood just because they have some eggs frozen.
Although we still can’t stop the biological clock, at least we have now more options to offer to our patients.