Freezing Eggs: A New Way to Preserve Women’s Fertility
One of the newest advances in fertility treatment — retrieving and freezing eggs — allows women to preserve their ability to start a family later in life. “More and more women are asking about this option,” says Holly L. Thacker, MD, Director of Cleveland Clinic’s Center for Specialized Women’s Health. “Women are dedicated to their careers, yet they want to have families too. It’s important to realize that peak fertility is around age 24 — not age 34 or age 44.” Freezing eggs not only helps women who want to postpone having children until their life circumstances are more settled. It also helps women facing medical treatment that impacts fertility — such as chemotherapy — to preserve a dream they thought they’d have to sacrifice.
Not an Experimental Procedure
Freezing women’s unfertilized eggs has been an investigative procedure since 2003. Patients needed to sign a consent form acknowledging the procedure was experimental. Last fall, the American Society for Reproductive Medicine declared egg freezing a first-line fertility treatment, clearing the way for more women and couples to pursue it. Prior to freezing eggs, freezing embryos was the only option available. But it wasn’t a good choice for all women.
Why Freeze Eggs Instead of Embryos?
Embryo freezing requires that an egg be fertilized with a sperm. Thus, this is an option for women who are married, who have a committed partner or who are willing to use donor sperm to become pregnant. “The benefit of freezing eggs is that they are not yet fertilized,” says Cynthia Austin, MD, Director of Cleveland Clinic’s IVF Program. “This can be appealing to women in their early 30s who don’t have a partner and want to delay childbearing.” While freezing eggs can be controversial, she believes that it can help women avoid more intensive fertility treatment later on. “As women get older, their pregnancy rates decrease and their risks of chromosomal anomalies increase,” says Dr. Austin. “With this procedure, their pregnancy rates and risks of abnormalities remain constant — the same as they were the day the eggs were frozen.”
In Vitro Fertilization Paved the Way
Egg freezing came to light as an option for postponing pregnancy due to its success in IVF. Studies showed that the rates of pregnancy and the number of healthy babies born through IVF were similar whether frozen or newly obtained eggs were used. Much of the credit goes to a recent advance in cryobiology called vitrification. Vitrification is a flash-freezing technique that doesn’t cause damaging ice crystals to build up inside egg cells, which was more likely with slower conventional freezing. Cleveland Clinic’s IVF laboratory was a pioneer in using vitrification to rapidly freeze six- to eight-cell embryos and now uses it for freezing all embryos.
Target Ages: 32 to 34
Women’s biological clocks are ticking when it comes to freezing eggs. According to Dr. Austin, the best time to freeze eggs is between ages 32 and 34. Younger women typically have no reason to freeze eggs because they still have time to pursue pregnancy without IVF. “As women get older, the quantity and quality of their eggs decrease,” says Dr. Austin. “By age 40, IVF doesn’t work as well. By age 43, there’s very little we can do to increase a woman’s fertility.”
How Cancer Patients Benefit
For women facing life-saving but fertility-damaging cancer treatments, eggs can be frozen and banked in the same way that sperm are for male cancer patients. The woman receives fertility shots to increase egg production. The eggs are retrieved and frozen before chemotherapy begins. The process of freezing both eggs and embryos takes two to six weeks. Frozen eggs and embryos can be stored indefinitely. Freezing eggs does not guarantee that a woman will be able to get pregnant later on, cautions Dr. Austin. “Out of eight eggs, we may only get three or four embryos,” she says. Eggs don’t have the same potential that embryos do. Some may not survive the freeze. Some may not fertilize, because not all eggs do. Some eggs make better quality embryos than others.
Sidestepping Ethical Issues
As with frozen embryos, some frozen eggs may be left over after fertility treatment. Deciding what to do with frozen eggs doesn’t pose the same ethical dilemma for women or couples as deciding what to do frozen embryos, says Dr. Austin. “Some couples who would not be comfortable donating their embryo, may find donating unfertilized eggs acceptable,” she notes.
An Ever-Changing Field
Dr. Austin says that new technologies such as egg freezing are providing women with more options and better outcomes in every area of fertility care. “There’s no reason why women can’t ‘have it all’ — career, family and a full, fantastic life,” says Dr. Thacker. “The advances that we see in medicine are paralleling the strides that women are making year after year, decade after decade. Our future has never looked brighter!”
To schedule a consult at one of our six Cleveland Clinic Fertility Center locations, please call 216.444.6601. To schedule an appointment with a women’s health specialist in Cleveland Clinic’s Center for Specialized Women’s Health, call 216.444.4HER or visit clevelandclinic.org/womenshealth.