Egg freezing

Oocyte cryopreservation

Egg freezing is a relatively new and developing technology. The first baby born using a frozen egg was in 1986. However, high failure rates and concerns that freezing would damage the egg chromosomes and cause birth defects, has kept egg freezing on the sidelines for over a decade. Recent advances in the freezing programme and the introduction of ICSI has lead to renewed interest in egg freezing.

Who would benefit from egg freezing?

Several groups may potentially benefit from egg freezing:

  • Preservation of fertility before a young single cancer patient receives radiotherapy or chemotherapy
  • Women who need to have their ovaries removed
  • As a way to salvage an IVF cycle when the partner is unable to produce a semen sample on the day of egg collection
  • Alternative to embryo freezing especially in countries where embryo freezing is outlawed.
  • For couples for whom embryo freezing presents a moral or ethical dilemma
  • Women in their early 30s and career oriented women thinking of delaying motherhood. Although there are no guarantees, a woman is more likely to get pregnant at 40 with one of her eggs frozen in her early 30s than with her 40-year-old eggs
  • Women with a family history of premature ovarian failure wishing to preserve their fertility. Some women wish to freeze eggs for their daughters who have recently been diagnosed as having Turner's syndrome.

How are the eggs frozen?

Egg freezing entails a costly and invasive IVF treatment. After the eggs are collected they are frozen. The human egg is the largest cell in the human body. It contains huge amounts of water and its outer layer is fairly water-resistant. Problems occur during freezing as this water will turn to ice crystals, which disrupt the egg’s DNA and membrane structure. Therefore cryoprotectants (antifreeze solutions) are used to replace this water to reduce ice formation. There are two techniques for freezing eggs:

  • The traditional “slow freeze” method where the eggs are frozen slowly using cryoprotectants, placed in a vial or straw and cooled gradually. At -32degree C the straw is put into liquid nitrogen (-196degree C) this technique results in one baby per 100 eggs.
  • Vitrification “ultrarapid freezing”. This is a new method where the vial or straw is plunged directly into liquid nitrogen, the cooling rates are so rapid that ice crystals does not have a chance to form, and the mixture of cryoprotectant and egg forms a “glass-like” solidification of cells. Vitrifaction method appears to be associated with a significantly higher survival rates compared to slow freezing. Results appear promising – approximately 10 babies are born per 100 eggs and it is much simpler technique (Petracco et al ESHRE 2007).

The usual period for storing eggs in the UK is 10 years, however it is possible to store the eggs for longer if the woman was under 45 when the eggs were collected. Regardless of the method of freezing used the outer coat of the egg (zona pelluicida) becomes hardened. Hence, after thawing the eggs, they would then have to be fertilized by ICSI.

How safe is egg freezing?

Egg freezing is a new procedure and may involve unrecognised risks, i.e., an increased risk of a congenitally abnormal baby. However, based on current data, egg freezing appears to be safe. Fortunately, to date, no abnormalities have been reported from the 200 babies born worldwide so far.

How successful is egg freezing?

Antinori and co-workers from Italy (ESHRE 2007) reported very high rates of egg survival (99Percentage), fertilization rates (92Percentage), pregnancy rates (32Percentage) and healthy babies using virtification technique. Todate, around 200 babies have been born from frozen eggs worldwide.

How much does egg freezing cost?

Around Pound2,500 (in the UK) in addition to annual cost for storage.


(Embryo cryopreservation)

Embryo freezing is a well-established form of assisted conception treatment. An increasing number of IVF clinics worldwide are now able to freeze spare embryos for later transfer. The first frozen embryo baby was born in 1984. Embryo cryopreservation allows multiple embryo transfers from a single egg collection and improves the chances of livebirth.

Advantages of embryo cryopreservation

Allow maximizing the potential for conception for IVF and prevent wastage of viable normal spare embryos. Perhaps this is the most important advantage of cryopreservation. Approximately 50Percentage of women may have spare embryos available for freezing. In some clinics, the pregnancy and live birth rates with frozen-thawed embryo transfer is as high as those achieved with fresh embryo transfer.
  • Freezing all embryos for subsequent transfer may be advised for women who are at a high risk of developing severe ovarian hyperstimulation syndromefollowing ovarian stimulation for in-vitro fertilization (IVF).
  • When embryo implantation may be compromised in cases such as the presence of endometrial polyps, poor endometrial development, break through bleeding near the time of embryo transfer or illness.
  • Difficulty encountered at fresh embryo transfer e.g. cervical stenosis (inability to pass through the cervical canal because the cervix is narrowed or scarred, etc).
  • Cryopreservation of embryos is very important to be incorporated in the egg donation programs. It is not always possible to synchronize the recipient’s cycle with that of the egg donor. In some countries, it is mandatory to freeze all embryos created from donated eggs, quarantined for a period of six months and until the donor have a repeat negative screening tests.
  • As a result of successful cryopreservation programs, frozen embryos have also become available for donation to infertile couples.
Before cancer chemotherapy or radiotherapy.
 

Male Infertility

 

Female Infertility

 

Diagnosis Male

 

Diagnosis Female