Social egg freezing, or oocyte cryopreservation for non-medical reasons, is gaining popularity among younger women. However, there is some dispute as to whether fertility clinics should offer this service. Educating your patients about the risks and benefits of egg freezing can help them make the right choice for their bodies and lifestyles.
The Case for Social Egg Freezing
Women opt to freeze their eggs primarily to delay childbearing, and often consider this decision in their late 20s to mid-30s. Some research suggests that being without a partner is the primary reason women freeze their eggs, but it's not the only reason. Many women choose to have children later in life in order to pursue an advanced degree or a demanding career path.
Frozen Eggs and IVF
The success rate of egg freezing and ensuing in vitro fertilization (IVF) treatments is higher than it once was. The American Society for Reproductive Medicine no longer designates egg freezing as an experimental treatment, and research in the BC Medical Journal found that vitrification, a relatively newer egg freezing method, had an egg survival rate of 90.4 percent.
The live birth rate of frozen eggs is even comparable to that of fresh oocytes. The Royal College of Obstetrics and Gynaecologists urged caution over egg freezing, but found pregnancy rates of 27 percent using frozen eggs for women aged 35 to 37, compared to the average IVF success rate of 23 percent.
Limitations for Patients
Social egg freezing is a big undertaking both physically and financially. It is critical that your patients understand the risks as well as the benefits. The BC Medical Journal reports that many women overestimate their chances of pregnancy at any age; your patients may need to be told that no number of eggs will guarantee a pregnancy.
If a patient asks you about social egg freezing, be sure to talk about:
- Age at egg retrieval. The earlier a person undergoes egg retrieval, the fewer eggs they may need and the better their chances of success. Women younger than 36 who banked eight to 10 eggs had the highest live birth rates, according to the BC Medical Journal.
- Cycles needed. An initial ultrasound evaluation will reveal how many eggs remain and how many can be retrieved. Emphasize to your patients that more than one cycle may be needed to retrieve enough eggs.
- Length of storage. Some clinics may have a time limit or annual fee for egg storage.
- Risks of pregnancy at a later age. Your patients need to understand the inherent risks of being pregnant at a later age, including miscarriages and chromosomal abnormalities.
Understanding the Social Egg Freezing Process
Rather than go to a fertility clinic or hospital, some prospective parents seek out a less clinical environment. Social egg freezing clinics with a spa-like atmosphere are popping up in some regions. No matter the environment, the physical demands of the process, including oocyte assessment and courses of ovary-stimulating hormones, are often the same.
A gynecology practice will be more adept than an egg freezing spa at using transvaginal ultrasound to obtain an initial antral follicle count (AFC). 3D ultrasound tools like SonoAVC™ antral and SonoAVC™ follicle automatically calculate the AFC and number and volume of stimulated follicles, respectively. This level of clarity allows you to effectively monitor stimulation and pinpoint the optimal time for oocyte retrieval.
Follicles can be counted and measured accurately with SonoAVC™(Sonography based Automated Volume Count) follicle.
"We need to have precise measurements so we can interrupt stimulation at the right time," says Dr. Angela Palumbo of the Centro de Fecundación In Vitro Angela Palumbo (FIVAP) in Tenerife, Spain. "More important than the number of follicles is the size. If a follicle is smaller than what you measured, you cannot use the egg to be fertilized. On the other hand, if it becomes too big, the egg might not be suitable for fertilization." For this reason, the care team at FIVAP uses SonoAVCfollicle rather than taking a manual count.
"It's a better way" that enhances the patient experience and improves a patient's chances of a healthy pregnancy. "We get more good follicles with mature eggs—which is what we want. That improves the IVF result."
Social egg freezing may be appropriate for some of your patients. Educating them to make a well-informed decision and start the process at an appropriate time will set them up for the best chances of success.
