Egg Freezing Is No Longer Experimental

I spent part of the past week at the annual meeting of the American Society for Reproductive Medicine. Each year, thousands of individuals from all realms related to fertility come together to share research news and camaraderie. This year, as always, the days were filled with hopeful ideas and grounded conclusions about how best to help men and women with their reproductive medical needs. One of the big announcements this year was not about a brand new technique; rather, an announcement was made about a change in perspective toward techniques that have been in limited use for several years now.

Oocyte cryopreservation, or egg freezing, has been offered by several clinics in the world since the early 2000's. Specialists in Italy, especially, charged ahead with making egg freezing a viable option, because of that country's stringent laws regarding freezing embryos. It took reproductive lab experts a long time to finally “get it right” – specifically, egg cells (the human body's largest cells) were easy to freeze but often did not survive the thaw. When the science began closing in on successful freeze-thaw methods, many fertility specialists started offering the service to women for the deferment of conception.

In 2008, the ASRM published “Ovarian Tissue and Oocyte Cryopreservation” (Fertil Steril 2008;90:S241-6) which stated egg freezing, while not harmful, should still be considered experimental because of the unknown efficacy of the process. In that same year, I published a website called BabyLater introducing Houston Fertility Center's egg freezing services for women who wanted to preserve their fertile potential for later use with IVF. I joined many fertility providers around the country who saw the enormous need for cancer patients (and others who undergo sterility-causing chemotherapy or radiation treatments) to be able to “put their eggs on ice” before undergoing life-saving therapy, in hopes of parenthood later.

At this year's ASRM meeting, the announcement was made that egg freezing is no longer considered experimental. Enough data now exists to demonstrate that the science and clinical techniques behind the process is solid enough to present acceptable success rates. The committee continues to strongly advise that patients interested in egg freezing must be fully informed about the limitations of the technique, which primarily include the age factor: As always, eggs from younger women survive the process and result in pregnancy more often than eggs from older women.

I expect far more fertility providers to start offering egg freezing, and as with any “new” technique, tenure of experience can have an impact in treatment success. I'm happy to respond to related inquiries about how oocyte cryopreservation can be part of a reasonable family-building plan.

You can read the new guidelines from the Practice Committee of the ASRM here.

Image: FreeDigitalPhotos.net

Cancer & Infertility: The Good Part of the Bad News

We've known for a long time now that cancer treatment can save lives but also render survivors infertile, even completely sterile. Young people who were surviving cancer more often found their new lives had a huge gap: little to no chance of being a parent in the future.

Spurred by organizations like Fertile Hope and the Young Survivors Coalition, researchers began focusing on fertility preservation techniques and their usefulness for this population. We've come a long way with what we can offer both men and women who want a chance at family-building after they're cancer-free. (At Houston Fertility Center, we offer a number of these techniques and even have a site devoted just to deferring conception by way of preserving fertility.)

Now, it appears as though the numbers of women with infertility resulting from cancer treatment is bigger than we thought. A large survey study by the University of California, San Francisco (UCSF) has concluded that our previous understanding may have given women "unrealistically low assessments of their risks" for infertility.

Some of the salient points of this study:

*Acute ovarian failure (no longer having a menstrual period after chemotherapy) increases significantly with age at cancer diagnosis.

*For women who did not experience loss of menses, incidence of infertility increased significantly with age.

*The younger the woman was when diagnosed with cancer, the higher her chances of early menopause.

Learning that the impact of chemotherapy on fertility is greater than we assumed -- that's the bad news.

The good news? That we now have that knowledge and can let women and their oncologists know that the need for fertility preservation is more prevalent than we used to think.