One Woman's Egg Freezing Story & Hope for Brighter Futures

As discussed in October, the American Society for Reproductive Medicine no longer considers egg freezing experimental. The topic was big news, covered by everything from national to local media affiliates.

This interview show on NPR offered an opportunity to hear the patient's perspective of oocyte cryopreservation, as told by well-known New York Times blogger, Suleika Jaoaud. She's the young woman who shares her experience with leukemia in “Life, Interrupted”, including her need to confront the possibility of infertility after life-saving chemotherapy. In this interview, Suleika describes how she learned about the option of oocyte cryopreservation on her own, not from her oncology physicians, and what it was like to go through the egg freezing process just prior to her initial treatments.

Also speaking is Dr. Samantha Pfeifer, one of the physicians on the ASRM committee that made the decision which should result in more expedient coordination of treatment for such patients. I and my Houston Fertility Center staff look forward to continuing teamwork with physicians who are helping save lives, so that our patients can have the brightest futures possible.

~ Dr. Sonja Kristiansen M.D.

Image: FreeDigitalPhotos.net

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

Speaking of Fertility Preservation: Frozen Eggs Do Well

In Malta, there's a legislative proposal that might decrease the ability of some citizens to resolve their infertility with IVF. While political and social pundits wrestle with the questions of which patients can access which treatment and even specifics on which treatment protocols can be used, one expert shed some positive light on one option in particular.

Image: FreeDigitalPhotos.net

Dr. Eleonora Porcu is possibly the most experienced reproductive specialist in the world when it comes to the use of frozen eggs with IVF. Because of Italy's highly restrictive assisted reproductive technology laws, Dr. Porcu has been very active in the pursuit of technique advancements that make oocyte cryopreservation a viable option when frozen embryos are not available. She was called on by the Maltese government recently to testify about the success she has seen over the past 15 years.

The Times of Malta published this interview with Dr. Porcu, who reports she and her medical team have produced "some 500 births of children conceived using frozen eggs."

In the United States, we are so fortunate to be free of extreme governmental restrictions mandating which individuals may access ART and which forms of ART they can use to resolve their fertility issues. My Houston Fertility Center staff and I have offered egg freezing to patients for several years now, believing it to be an optimal fertility preservation technique for unmarried women who are about to undergo cancer treatment, as well as others who are without partners and do not want to use donor sperm.

~ Dr. Sonja Kristiansen MD

Saving Your Nest Eggs For A Rainy Day

Chances are good you've heard of oocyte cryopreservation – in plain language, egg freezing – as a way for women with cancer to preserve their fertility just prior to undergoing chemotherapy or radiation treatments. But did you know that women without cancer can also choose to freeze their egg cells?

It's becoming more common for women – who are now far more savvy about fertility than past generations – to make use of their highly-informed foresight in family planning and opt for freezing their eggs, well in advance of when they plan to conceive.

Image:FreeDigitalPhotos.net

The technology used to freeze and thaw oocytes has rapidly advanced to be more reliable and effective, resulting in greater success rates. So more fertility centers are offering this option to women whose goals are simply to “freeze in place” their fertility. For example, women in their 20's who are super-busy with academic and career goal tasks might envision motherhood for their 30's. These same well-informed women also know that their chances at natural conception decrease with age. So far, it appears that freezing an egg cell now – in its healthiest condition – can result in thaw, conception, and pregnancy success several years down the road.

Many specialists -- including my own lab staff at Houston Fertility Center -- see the greater possibilities for use of egg freezing in this way, to preserve the family-building options for fertile women. I can't tell you how many times I've heard in my office, “Dr. Kristiansen, I cannot believe I spent all those years using contraceptives and trying NOT to get pregnant – and now when I want to, I can't!” For some of these patients, if egg freezing had been available, they could've continued with their contraceptive efforts until the time was right – as late as their 30's or 40's – and their eggs, frozen while still young, would be ready and waiting to be used to create embryos.

Perhaps egg freezing will eventually become just part of the normal course of reproductive health care management that young women learn about and use for wise family-planning.


~Dr. Sonja Kristiansen MD

Tis the Season For Donor Eggs: Fresh or Frozen Work

In our minds, the concepts of fertility and eggs go hand-in-hand -- especially this time of year. Now, there's some very good news for those who want to either preserve their fertility for the future or otherwise have a Plan B in the freezer for subsequent treatment cycles.

Research performed in the nation of Cyprus has concluded that frozen donor eggs are just as likely as fresh to have a pregnant outcome.

Freezing sperm for later use is almost fool-proof, it's been done for so many years. Likewise, freezing embryos has become a far smoother process that ends in success more often than not. Freezing eggs, on the other hand, has been a challenge.

I've spoken often about the use of egg cryopreservation technology -- the tricky nature of the egg cell that makes the freeze-thaw processes so tenuous, and the hope that comes with improvements on the technique. In 2008, I was interviewed by Houston Business Journal about the intersection of related advanced reproductive technology and society. The ASRM has long been pleased to hear of frozen eggs being used for women prior to cancer treatment, but they've been slow to agree on the technique's use for women who aren't preserving fertility in the face of life-threatening illness.

Now, a new subset of patients are given hope by frozen eggs -- women who must use a donor's eggs to conceive a child.

Arriving at "Honey, I think we need to use donor egg to get pregnant" comes only after some serious thought about very tough topics. Women who've gone through menopause prematurely in life -- a huge psychological burden itself -- and older women who've deferred pregnancy find themselves giving thought to what most people don't have to: "I can either have a child who isn't genetically related to me, or not at all."

Using donor egg to get pregnant also adds to the financial burden of these patients, since they are required to meet the donor's compensation needs.

Among other benefits, documentation of frozen donor egg success increases the possibility of egg banks, similar to long-standing sperm banks, which might then make the entire process cost less. More directly for patients, knowing that subsequent cycles using their donor's frozen eggs can be just as likely to help them get pregnant as that first fresh cycle -- that's a huge load of stress taken from the patients' shoulders.


Any bit of hope we can offer to donor egg recipients is a good thing in my book. The news that frozen donor eggs can be just as successful in rendering a pregnancy is very good.

European Women Happy to Freeze Eggs for Future

According to two studies presented at the annual meeting of the European Society of Human Reproduction & Embryology (ESHRE), European women are embracing the idea of egg freezing as a means of having more reproductive control over their lives.

A small Belgian study of women average age 38 years found that half of them planned to freeze their eggs to lessen the pressure they feel to find the best parenting partner. Most foresaw using their eggs for conception after age 40.

A larger study in the UK saw eight in 10 medical students would be willing to freeze their eggs so that career growth could continue to take a front seat.

Women in the U.S. are also warming up to the idea of using assisted reproductive technology even when infertility isn't an issue in their life. Advances in the technology have made egg freezing with IVF more affordable and even covered by some women's insurance plans.

http://www.bioedge.org/index.php/bioethics/bioethics_article/9085/