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Oocyte Cryopreservation

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As we know unlike in case of men a women’s reproductive life is limited by age. So if a decides to postpone getting pregnant either due to personal/professionals reasons or medical reasons. Oocytes Banking is exciting technology, it has really change a life of lots of women. The intention of the procedure is to secure future fertility by preserving their eggs just like Diana Hayden (Miss World) did.

Who should OPT for Egg Freezing

Girls who are suffering from cancer and have to undergo chemotherapy and radiotherapy. Over 50000 reproductive age women are diagnosed with cancer each year in US. This number is higher in India. As chemotherapy and radiotherapy are toxic for oocytes and in these therapies the ovary can be damaged so egg freezing offers women with cancer to preserve their eggs to utilise them in attempt to have children in the future.

A women with a family history of early menopause.

Career – Oriented women today and girls busy with their life opt for late marriages so some of these girls before the age of 35 do come forward and freeze the oocytes so than even if they wish to have a child in their 40’s these oocytes can be thawed and used for conception.

Social-Egg freezing: Egg freezing for the purpose of preserving fertility for delayed childbearing when natural conception becomes more problematic.

Steps of Egg Freezing

Step 1: Consultation

Before beginning the egg-freezing process, counselling of patient is done and screening blood test is advised like AMH(anti mullerian hormone) and viral markers (HIV, HBSAG, HCV, VDRL).

Step 2: Stimulation

During a normal menstrual cycle only one follicle is produced by ovaries but since we want to preserve as many eggs as possible. Ovaries are stimulated with injections( gonadotrophins) to produce multiple eggs. These are used in conjunction with drugs like antagonist for proper regulation of the cycle.

Step 3: Follicular Study

These scans are done regularly to assess follicular development. The size of the follicles indicates the degree of egg maturity, usually 10-15 follicles will develops in the ovaries during standard stimulation protocol.

Step 4: Egg Retrieval

All the instructions prior to the oocytes retrieval or egg pickup will be given on the day women receives trigger injection(usually GnRH agonist for final maturation of oocytes). The trigger injection is usually given late evening or in the night so as to schedule the pickup in morning around 34-36 hrs later. Aspiration of ovarian follicles under anaesthesia is done in OT adjacent to the IVF laboratory. This is done by trans-vaginal ultrasound technique. For this procedure a probe is inserted in to vagina and this project a picture into a monitor which enables the doctor to direct a needle into each follicle to retrieve the eggs. The fluid filled follicles are aspirated under slight suction in a test tube which is passed on to the embryologist.

Step 5: Egg Freezing

The embryologist locates the Egg and places them into culture media and then into the incubator. After the procedure the women will have to rest in hospital for 3-4 hours. It is a day care procedure.

Success Rates

In a 2013 meta-analysis of more than 2,200 cycles using frozen eggs, scientists found the probability of having a live birth after three cycles was 31.5 % for women who have frozen their eggs at age 25, 25.9 % at age 30,19.3 % at age 35 and 14.8 % at age 40.

Risks:

The risks for women undergoing egg freezing includes:

  1. Vaginal/Uterine bleeding from the oocyte recovery procedure
  2. Developing ovarian hyperstimulation syndrome (OHSS) as a reaction to the hormones used to induce hyper Ovulation (producing more than one egg). But now a days with avoidance of injection HCG for final maturation, OHSS can be completely avoided. Infact now we have OHSS free clinic.