Freezing your dreams

FOR LATER

There is hope for women who wish to put off pregnancy for a later date, due to personal or professional reasons. Dr Nandita Palshetkar sheds light on the promise of egg freezing

 What do stars like Kim Kardashian, Jennifer Aniston and Sofia Vergara have in common? All these Hollywood A-listers have come out in the open to talk about their fertility choice – egg freezing. If you think this is another Hollywood fad, think again. Even Silicon Valley giants like Facebook and Apple are telling their women employees to freeze their eggs. In fact, both companies cover the procedure under their insurance plan.

A combination of science and technology have now made this medical marvel possible. Women waiting for their Mr Right, or in pursuit of a high-flying career, have the option of freezing their eggs. If you are a woman in your 30s and plan on having a baby sometime in the future, you should be considering the option, too. The biological clock is relentless. A woman’s fertility – her probability of getting pregnant during a year – falls from 86 percent at age 20 to 52 percent at age 35. Thereafter, it drops ever more steeply to 36 percent by age 40 and 5 percent by 45.

 Egg freezing or human oocyte cryopreservation is a novel technology in which a woman’s eggs are extracted, frozen and stored. Later, when the woman is ready to become pregnant, the eggs will be thawed, fertilised, and transferred to her uterus as embryos. In many ways, something as simple as freezing your eggs, can be a life-changing experience. Most importantly, it offers women the option to postpone motherhood, giving them the ability to control the timing of their career growth and family.

As you age, the quality of eggs declines. By freezing your eggs in your twenties or early thirties, you can reduce the chances of conceiving a baby with birth defects. The technology is also a boon for women diagnosed with cancer, who have to go through cycles of chemotherapy and radiation, which are toxic for oocytes, leaving few, if any, viable eggs.

How does it work?

Hormonal injections are given to stimulate the ovaries to produce more eggs. The eggs are then harvested in a surgical procedure and kept in a cryogenic state. The eggs are frozen using either a slow-freeze method or a flash-freezing process known as vitrification. In order to retrieve eggs for freezing, the patient undergoes hormone-injection treatment for approximately four-six weeks. It will also involve two-four weeks of self-administered hormone injections.

Once the eggs have matured, they are removed with a needle placed through the vagina under ultrasound guidance. This procedure is not painful. The eggs are then frozen, and whenever the patient is ready, the eggs are thawed, injected with a sperm to achieve fertilisation and then transferred to the uterus. The healing period post delivery is the same, at around three months, regardless of whether the baby has been conceived naturally or via egg freezing.

Some misconceptions about egg freezing such as hormonal imbalance and mood swings persist. But the hormonal injection ensures that there is no hormonal imbalance,and as for mood swings, they do exist, but it varies for every woman and is manageable.

There is no additional stress on the reproductive system. Yet another common misconception about the process is that women going through egg freezing treatment tend to be depressed – which is not true. Egg freezing comes as a ray of hope for women, giving them more control over their reproductive decision.

If despite freezing her eggs, the woman realises she may not be ready to be a mother, she can take a call on whether she wants to use her frozen eggs or not. The decision is entirely up to her.

(The author is a gynaecology & infertility specialist at Lilavati & DY Patil Hospitals, Mumbai and Fortis hospitals, Delhi)