1. What do you exactly mean by fertility preservation?

Fertility preservation is use of advanced technology to retain an individual’s ability to procreate or reproduce an offspring in the future.

In this we cryopreserve (freeze) eggs also known as oocytes, embryos, sperms, and ovarian tissue. With the help of these frozen gametes and tissues it is possible for the couple to conceive in later ages whenever they take the decision of starting their own family.

2. Why is fertility preservation a best option for you?

• If you are not ready for a family– Not everyone feels ready for parenthood at the same time. There are times when couples want to attain their financial stability before starting a family in such cases freezing your embryos at a young age to focus on your career, finances, and emotional well-being to prevent yourself from regretting the decision in future.

• You have not met the right partner – For women who are still in their late 20’s or early 30’s and still haven’t found the right partner, they can opt for freezing their eggs. With increasing age, the quality and number of eggs (oocytes) goes on declining. For some women the decline is more rapid than the others of the same age. Egg freezing in such instances will help these women to rewind their biological clocks and focus on their life goals and give them the authority to take charge of their own future.

• If you are a transgender or non-binary person- You may want to preserve your fertility if you are starting hormone therapy or are planning to have reconstructive surgery (operations for change of sex). Both treatments can lead to total or partial loss of your fertility.

• If you are undergoing treatments for cancer- Chemotherapy and Radiotherapy are cancer related treatments that can lead to toxic effects on your gonads. Some drugs used in chemotherapy in high doses can cause infertility. Also, evidence suggests that certain genomic alterations may be present in the children conceived from gametes after exposure to such treatments for cancer. Hence it is wise to freeze (cryopreserve) gametes sperms, oocytes(eggs) or embryos prior to undergoing such treatments for cancer.

3. What is social egg freezing or elective egg freezing?

Women today are choosing to have children later in life than ever before, Egg freezing can help woman to delay pregnancy until a later stage in life.

Egg freezing is a process where multiple oocytes or eggs are extracted from your ovaries and stored or frozen using advanced techniques in the cryo-tanks.

Once the women desire pregnancy, these eggs are then thawed and used to make babies by the process of IVF.

4. Is egg freezing a viable option for me?

• Social Reasons For Egg Freezing- If you are a woman who wishes to postpone her pregnancy for reasons such as financial stability, or achieving certain life goals with regards to your career or in cases where you haven’t found the right match egg freezing at a younger age is your knight in shining armor.
• Medical Reasons For Egg Freezing- Women who are having medical conditions like auto-immune diseases or detected with certain types of cancers such women or young girls can freeze their eggs before undergoing treatments like chemotherapy /radiotherapy which have a hazardous effect on your fertility.
• Confused Regarding Child Bearing- Women who are unsure about their decision whether they want to have children in future or not. Such women can freeze their eggs or embryos (for married women) until they decide to have children.

• In A Toxic Relationship Or Marriage – Women who are in a toxic relationship or marriage can explore the option of egg freezing to not regret their decision of postponing pregnancy.

• Underwent an ovarian surgery at a very young age– Women or young girls who have undergone ovarian surgery in their teenage years due to ovarian torsion, dermoid cysts in their ovaries, removal of ovarian cysts or removal of one of the ovaries such woman or girls can opt for egg freezing for preserving their future ability to bear children after testing their ovarian reserve.

5. Why is egg freezing so important?

With increasing age there is decline in the fertility potential of women because of

• Decrease in the quality of oocytes (eggs). Increase risk of oocyte aneuploidy or genetic(chromosomal) abnormality.
• Decrease in the number of oocytes(eggs).
• Increased risk of miscarriages.
• Less chances of getting pregnant with increase in age.
• Female eggs or ovarian reserve starts declining after the age of 32 years and declines rapidly after 35 years of age with increased risk of fetal abnormalities.
• For example:

A woman decides at the age of 30 years to freeze her eggs as she has not found the right partner or for reasons of her financial stability.

When at the age of 37 years she decides to conceive using the eggs frozen at the age of 30 years the risk of fetal abnormalities, miscarriages are less and chances of conceiving and having genetically healthy offspring are high and similar to the age group at which she froze her eggs.

This is because the gametes (egg) used to make the baby were stored at a younger age hence the women were able to bypass the age-related fertility problems if she decided to conceive at the age of 37 years without use of egg freezing.

6. What is the optimal age for egg freezing?

For better success rates it is advised to freeze your eggs as early as before 35 years of age.

However, in certain cases due to delayed awareness or reasons such as social acceptance we do encourage women to undergo egg freezing whenever they are ready after assessing their ovarian reserve.

7. Is egg freezing safe?

• Egg freezing is a safe procedure when done under guidance and supervision of your fertility clinician or reproductive endocrinologist.
• Possibly some discomfort, bloating during the stimulation can be experienced.
• Less than 1% patients experience any serious complications.

8. What are the steps of egg freezing?

Egg freezing is like first half of your IVF cycle.

It takes place in 3 steps.

1. Ovarian stimulation – You will take synthetic hormone injections to stimulate your ovaries to produce multiple eggs.
2. Egg retrieval /Ovum pick up– Under light anesthesia a transvaginal probe is inserted in your vagina attached to a needle. A suction device connected to the needle is used to collect egg from the follicle.
3. Egg freezing- The collected eggs are scanned under the microscope and then cooled to subzero temperatures to preserve them for future use.

9. How will the eggs be used in future?

When the women decide to have a child, these frozen eggs are placed in warming solution and assessed.

Those eggs that survive the freezing process are fertilized with ICSI technique and the fertilized eggs are then grown in the culture medium until the embryos are ready to be transferred into the uterus.

Simultaneously we prepare the woman’s uterine environment so that it is most receptive during transfer.

10. For how long the eggs can be safely frozen or stored?

Storage is estimated to be safe for about 10 years according to the law but there is no expiry date on eggs and can be frozen indefinitely.

11. Does freezing eggs have any side effects on the quality of eggs?

No congenital or genetic abnormalities have been seen in children conceived from IVF after using frozen oocytes.

The risk of any congenital abnormality in children conceived through frozen eggs are the same as compared to those conceived in a conventional way.

More than 1500 babies have been born in the past decades using frozen eggs.

12. How many eggs do we need to freeze?

The number of eggs frozen depends on your ovarian reserve (AMH and Antral follicle count in both ovaries) and the ovarian response to the stimulation injections.

As ovarian reserve declines with age, age plays an important factor with respect to number of eggs frozen in a single cycle post ovarian stimulation.

For young patients who are 35 years and less we recommend freezing 14-20 oocytes as all oocytes do not survive freezing-thawing process.

13. Egg freezing how is it beneficial to women?

• It gives women control over their reproductive destiny (biological clock)
• It enables them to have a back-up plan in cases where they are indecisive or focusing on their career.
• No Guilt or Regrets of not starting their families early.
• Younger eggs have low rates of abnormalities.
• It is as safe as IVF.

14. What are the challenges with egg freezing?

• Lack of awareness amongst population.
• Not all eggs survive freezing some are lost while thawing. 75% of eggs will survive the thawing process.
• May require several cycles to obtain enough eggs for best chances mostly in cases where the ovarian reserve has declined rapidly.
• Not all eggs will fertilize.
• Obstetric complication due to advanced age cannot be prevented.

15. What are the success rates with egg freezing?

Success rates are like that of IVF cycles in the age group the gametes were frozen.

16. What are costs of egg freezing?

The cost of the stimulation injections alone ranges between INR 70,000 to INR 1,00,000 depending on the drugs used, its dose and your ovarian response.

The cost of the procedure goes up to INR 1,00,000 to INR 2,00,000.

However, every year renewal charges for the frozen eggs must be deposited at the fertility clinic until you decide to use or perish the eggs.

So, for all the women and young girls exploring their lives and wanting the freedom from social implications and pressures of bearing a child or getting married just because your biological  clock is ticking here is your opportunity to take charge of your own life with no regrets or guilt of delaying your pregnancy. Egg Freezing is Your Blessing in Disguise!