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A delayed decision of IVF and other ART treatments can often lead to unfavourable treatment outcomes, which can further lead to feelings of depression, anxiety, isolation, and loss of control.
By Dr Apurva Satish Amarnath
It is wonderful how technology can play a huge role in making all our lives comfortable and blissful. And the same technology has also proved to be a blessing in disguise for women — who want to postpone pregnancies — via egg freezing. In the current scenario, where women have proved their excellence in all fields, and with their eyes firmly fixed on their careers, they have the option of freezing time through the egg freezing technology, which is slowly making inroads among woman in the upwardly mobile urban set up.
Who would have imagined that egg freezing could now turn even the biological clock back in time, which is a path-breaking technology in the field of assisted reproduction? It is an empowering option that women have, a choice that they can make, and it offers them flexibility to embrace motherhood whenever they are ready. To keep pace with evolving role of women, some companies have even included egg freezing as part of their insurance/compensation package.
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What is it?
Egg freezing involves multiple steps right from doctor consultations to begin with, and followed by other steps like stimulating the ovaries to produce eggs, extracting, freezing, and storing a woman’s eggs (oocytes). The procedure of extracting eggs is known as oocyte retrieval and they are frozen at – 196 degrees and preserved in nitrogen cryocan. The eggs can be thawed months, or even years, later and fertilized with the partner’s sperms, creating embryos. These embryos then can be transferred to the uterus in an attempt to achieve a successful pregnancy.
Long-term storage of frozen eggs though does not really affect the quality and can be preserved for at least 10 – 13 years. However, experts highly recommend storing 6 – 8 eggs for each pregnancy attempt. The number of eggs required for a successful pregnancy increases with increasing age, hence the older the age at the time of egg freezing, the more the number of eggs required for successful pregnancy.
Though egg freezing provides flexibility in terms of planning/postponing pregnancies, but ensuring eggs are banked at the right time has great advantages and positive outcomes as then women need not worry about depleting ovarian reserves. Normally, women between 28 years to 32 years can opt for egg freezing, as this is clearly gives an advantage of premium egg quality and quantity.
The ‘take home baby’ statistic is of greatest interest to women. The age at which a woman freezes her eggs remains an important predictor of success.
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Some of the reported success rates are:
– ‘Take home baby’ rates range from 61-77 per cent for women aged 30-35
– A far greater range for women over 35 years of age at freezing, that is 18-62 per cent.
Thus, freezing eggs in her late 30s may not offer women the security they seek.
While a woman is born with all of the eggs she will ever need for becoming a mother, yet with time they diminish in number and cellular integrity. This decline explains why a woman in her 40s has only five per cent chance for becoming pregnant each month. We do have some pros and cons of egg freezing, which we all must consider to enable the woman to make an informed choice.
Pros of egg freezing
Women undergoing cancer treatments: Egg freezing is also a boon for women who are undergoing medical treatments. For example, in treatments for diseases like cancer, radiation and chemotherapy that can put a woman’s fertility at risk as they can inadvertently damage or destroy the woman’s eggs along with the cancer treatment, preserving eggs prior to the treatment can give women the opportunity to postpone pregnancy until they completely recover.
Women who have endometriosis: When surgical removal of your ovaries is needed, fertility preservation can give you a chance to have a biological link to a future child.
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Women who would want to delay child bearing in order to pursue educational, career or other personal goals: Since the biological clock ticking is a reality and fertility is known to decline with age, freezing your eggs at an early reproductive age will enhance chances of future pregnancy. Unlike the ovary and oocytes (eggs), the uterus does not age and can carry a pregnancy well in to the 40s and 50s.
Family history of early menopause: Some forms of early menopause (premature ovarian failure) are genetically linked. Egg freezing offers a chance to preserve eggs before they are all depleted thus proving a ray of hope to such woman.
Chronic conditions: Autoimmune conditions like SLE and women who are undergoing bone marrow transplantation for any reason like thalassemia, would be put on immunosuppressant. Egg freezing would benefit in these cases, so that the women can embark on pregnancy when medically feasible to carry a pregnancy.
In addition, in case of single women, egg freezing gives them the time to find the right partner they want to raise their children with, and they do not have to settle down in a hurry.
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Cons of egg freezing
The surgical procedure involved in egg freezing is mostly safe but the hormone shots carry a risk of Ovarian Hyperstimulation Syndrome or OHSS. Sometimes, women respond too aggressively to the hormone shots which could make them ill and cause nausea, vomiting and abdominal pain which is temporary and can be resolved in a couple of days. The risk of this is low, and the preventive practices in place are effective in avoiding development of OHSS. It may also cause mood swings and bloating.
With fertility freezing, one also needs to continue to focus on leading a healthy lifestyle. Just because your eggs are frozen, doesn’t guarantee a chance at conceiving. An individual also needs to strive to lead a well-balanced lifestyle and visit the doctor regularly, so that there are no further lifestyle-related complications or illnesses. These health issues can include diabetes, fibroids, high blood pressure, endometriosis and more.
Comes at a cost: Since egg freezing entails a lengthy procedure and requires state-of-art laboratory and experienced fertility expert, the cost of the undergoing the procedure can definitely be an expensive affair. It would be better to get yourself acquainted with the costs involved before deciding to go ahead with the decision.
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IVF is a time sensitive technology
Women must consider the fact that IVF, too, has its own limitations; that it is a time sensitive disease, and any delay can have implications on treatment outcomes. According to WHO, infertility has been defined as a ‘disease of the reproductive system’, and is a time-sensitive issue, which can result in disability if timely measures are not taken. Many countries put a restriction on age limit of woman undergoing IVF treatments, as the same cannot be done at any stage of life. In fact, it can be quite risky to go for IVF treatments for women over 45 years of age, and thus, it can be a wakeup call for woman who have been postponing motherhood.
A delayed decision of IVF and other ART treatments can often lead to unfavourable treatment outcomes, which can further lead to feelings of depression, anxiety, isolation, and loss of control. If a couple wishes to opt for assisted reproductive treatment to fulfill their dream of parenthood, they can surely go ahead without delaying it further.
(Dr Amarnath is a Fertility Consultant at Nova IVF Fertility in Bengaluru)
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