Breaking the Biological Clock: How social egg freezing is helping women achieve their goals

Pune (Maharashtra) [India], March 7 (ANI/PNN): As she sipped her coffee on the balcony, staring at the sunset, she appeared quite worried. Her mother inquired about the dilemma she was facing. Her boss had recently offered her the opportunity to work on an international project that would require her to travel abroad, but it would also mean postponing plans to have a baby. She was aware of the age constraints involved with conceiving a child and was conflicted about whether to prioritize her professional growth or plan a family.
Over the past few decades, women have made significant strides in pursuing higher education and professional advancement, leading many to delay starting a family in order to achieve these goals. While it was once challenging to conceive at a financially stable age in one's early 40s, social egg freezing has made it scientifically possible to conceive at a more financially secure age. Societal changes have contributed to an overall delay in the process of motherhood, but the prevention of age-related infertility further encourages women to freeze their gametes, especially as 12% of Indian women face the challenge of early menopause.
Egg freezing is a scientific process that offers women reproductive freedom by allowing them to plan a baby at their preferred age while freezing their eggs at the optimal biological age. The process involves stimulating a woman's ovaries with hormones, retrieving viable eggs through transvaginal methods, and subsequently freezing and storing them.
Unfortunately, Indian society is largely unaware of the decrease in ovarian reserve and decreased chances of pregnancy as age advances. The unplanned postponement of pregnancy can increase the risk of infertility, adding to feelings of guilt, frustration, and agony. While sperm freezing and banking are parallel processes, egg-freezing science has lagged behind due to the large size, more fluid content, and specific chromosomal arrangement of eggs. However, since the first successful baby through egg freezing in 1986 by Dr. Chen from South Korea, the process has seen exponential growth. In 2012, the American Society of Reproductive Medicine removed the experimental label from egg freezing, and it has been widely used since then. Nevertheless, the split recommendation that egg freezing is allowed for medical reasons but not for non-medical reasons prompts an analysis of the moral distinction between medical and non-medical reasons for egg freezing.
There are certain medical and non-medical factors that need to be duly considered before one opts for egg freezing. A thorough breakdown of the crucial factors is as follows:
Social and medical egg freezing
Some women may opt for egg freezing for medical reasons such as having a low ovarian reserve, severe endometriosis prior to chemotherapy or suffering from rheumatoid disease. Other mothers may delay planning for a second child due to having a compromised first child with autism, birth defects, or mental subnormality. However, after a few years, they may want to have a second child, but by then, their egg reserve may have decreased or they may have crossed the age of 38, resulting in lower chances of pregnancy. Elective egg freezing not only allows for a first baby at a later age but may also allow for a second child. Women who are approaching the age of 35 and have not yet found an ideal partner can also consider egg freezing. Additionally, women who are at high risk of early menopause at 40 years, which may run in some families, can benefit the most from egg freezing.
Egg harvesting and freezing procedure
To ensure safety for the stimulation and local anesthesia, blood tests are conducted. These tests evaluate the ovarian reserve by measuring AMH, FSH, LH, and AFC. Depending on the age, ovarian reserve, and weight, women are given gonal F injections or Pergovaris for 10-12 days, following either the antgonist or PPOS protocol. Once the eggs reach 17-18 mm in size, a Lupride injection is given, and the egg retrieval process takes place 35-36 hours after Lupride.
The egg retrieval procedure takes 20-30 minutes and is performed under general anesthesia, allowing women to be discharged within four hours since there is no incision or suturing required. The eggs are then vitrified using vitrification media and stored at a temperature of -196 degrees Celsius in liquid nitrogen. Once labeling is verified by the patient, a cryopreservation certificate is issued.
Technological Advancements
Large studies conducted in Spain and Italy have shown that the live birth rate using frozen oocytes is equivalent to that of fresh IVF cycles. Additionally, the vitrification thaw procedure has a high success rate of 99-100%, while fertilization rates of 77-80% have been reported. Furthermore, international follow-up studies on children born using vitrified oocytes have not revealed any increased risk of congenital defects.
Ideal Age to freeze eggs
The highest quality and quantity of eggs are typically obtained between the ages of 20 and 30. While many women choose to freeze their eggs between the ages of 32 and 38, the chances of a successful pregnancy decrease if egg freezing is delayed beyond the age of 38. Without the use of previously frozen eggs, the likelihood of pregnancy after the age of 37 is only 22%, whereas it increases to 52% if eggs have been frozen. Indian law prohibits IVF treatment for women over 50 years of age, with age restrictions based on general health and cardiac status.
Requirements
To achieve a 75% pregnancy rate, it is recommended to freeze at least 10 mature eggs, which would allow for two IVF embryo transfers. However, the optimal number of eggs required for successful freezing may vary depending on several factors such as age, AMH levels, body weight, and any associated medical conditions. Additionally, the woman's reproductive goals also play a role in determining the number of eggs that should be frozen, whether it be for the purpose of having one or two children.
Cost involved
The main factor that affects the cost of egg freezing is the number of eggs required to achieve a reasonable chance of pregnancy. Unlike health insurance systems and smaller private entities, larger companies like Apple and Facebook have offered their female employees egg-freezing benefits worth up to $20,000.
Policy Decisions
Thorough informed consent should be obtained from both parents regarding the potential risks, side effects, expenses, and work absences associated with the procedure. It is also important to consider the efficacy of vitrification during thaw recovery, as well as a comprehensive understanding of embryo development and transfer and the costs involved.
For some women, egg freezing may serve as a form of reproductive insurance, providing them with the opportunity to have a child at a financially and emotionally stable time in their lives. This may be particularly relevant for those facing severe cancer, endometriosis, or impending ovarian failure. It can also be a viable option for those with autoimmune disorders that may lead to low ovarian reserve.
Originally developed to help cancer patients preserve their fertility before undergoing potentially damaging treatments, egg freezing has evolved into a valuable tool for anyone looking to become a parent at the right time, with the right mindset, and without compromising their physical well-being.
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