Everything we know about freezing eggs and not

Everything we know about freezing eggs and not

Alicia Trapini is now 30, "but my eggs will always be 29," she likes to say.

Last year, Alicia decided to spend thousands of dollars freezing her eggs to protect her chances of having children if she was ready.

She is one of about 20,000 women in the US who have decided to freeze their eggs or embryos – and their numbers are rising daily.

It's been 40 years since the first child of IVF was born. And now countless frozen eggs and embryos are forming future generations of babies made possible by medical technology.

Since the introduction of rapid freezing at extremely low temperatures in 2012 was widespread, the freezing process itself is a largely standardized, low-risk process.

But as technology stabilizes and more and more women use thousands for IVF treatments, egg retrieval and freezing, questions and misunderstandings are still spinning around the cryogenic technique.

However, the reality is that freezing your eggs, even without unforeseen armor failure, is more like hedging your bets than buying a fail-safe insurance policy.

After hormone therapy and egg retrieval, eggs are frozen and stored in cryogenic tanks like this for up to 25 years, costing about $ 100 a year in storage

After hormone therapy and egg retrieval, eggs are frozen and stored in cryogenic tanks like this for up to 25 years, costing about $ 100 a year in storage

After hormone therapy and egg retrieval, eggs are frozen and stored in cryogenic tanks like this for up to 25 years, costing about $ 100 a year in storage

WHAT WE KNOW: RETRIEVAL IS SAFE (IF PAINFULING) AND 90 PERCENTAGE OF EGGS SURVIVE THE THAWING

Alicia's six frozen eggs in a cryogenic tank in New York are not her only hope for children. They are more like a plan B.

Recent cryogenic accidents in fertility clinics in Cleveland, Ohio, and San Francisco, California cost more than 1,000 families some of their most valuable assets by thawing and destroying their frozen eggs and embryos.

Alicia Trapini, 30, decided last year to freeze her eggs at the age of 29, but hopes that they will only be a plan for a future pregnancy

Alicia Trapini, 30, decided last year to freeze her eggs at the age of 29, but hopes that they will only be a plan for a future pregnancy

Alicia Trapini, 30, decided last year to freeze her eggs at the age of 29, but hopes that they will only be a plan for a future pregnancy

For these families, the technology that had seemed to serve as a protective mechanism instead became a devastating setback.

When egg freezing was first commercialized, it was still mostly offered to women suffering from a disease, especially women diagnosed with cancer who had to undergo chemotherapy that damaged or destroyed their eggs and left them infertile could do.

But Alicia is part of a recent wave of women who know two things for sure: They want to have the opportunity to become mothers one day, but they do not want children yet.

Earlier in the history of cryopreservation technology, embryos seemed to be much more resistant to freezing and thawing.

Many women either had to choose fertilization of their eggs with their current partner or donor sperm without knowing what future (or who) their future would be at the time of implantation of the embryo.

"I'm single and hoping to someday have a husband to make embryos with," says Alicia, but she does not know who that person will be.

I was young [when I decided to do it] and I did not know anyone who had frozen their eggs in their twenties, except people with health problems. "

I'm single and I hope to one day have a husband to make embryos with

Alicia Trapini, patient for freezing the egg

Fortunately for Alicia and single women like her, the survival rates for unfertilized eggs are now almost as good as for fertilized embryos (90 percent versus 95 percent).

The improved resistance of frozen eggs has been evoked by the advent of vitrification, a rapid freezing process in which the temperature of an egg or embryo decreases by thousands of degrees per minute.

Cells frozen in this way assume a smooth, glassy structure instead of developing the crystalline structure of the ice, which is less stable and brittle. Until 2012, glazing was the preferred method for freezing eggs and embryos.

WHAT TO EXPECT: MONTHS OF INJECTIONS AND DOCTOR VISITS ARE NOT FOR THE HEART

Her eggs might have frozen extremely quickly, but the preparation process that Alicia had to go through was long and tedious.

When Alicia was ready to pull the trigger, Dr. John Zhang and his team from the New Hope Fertility Center immediately monitor their hormones and health status.

"They use hormones to stimulate your body, produce more eggs, take blood almost daily and start to watch you closely," she says.

HOW ARE EGGS FROZEN?

The freezing of eggs dates back to 1986, when the Lancet Journal described the first pregnancy of a frozen egg.

The collected eggs were stored in deep-freeze tanks after being frozen "slowly" for many years.

In the early 2000s, scientists began to experiment with an "ultrafast" freezing technique called vitrification.

In this method, the temperature of an egg drops by thousands of degrees per minute, resulting in a glassy cell structure that is stronger than other crystalline ice forms.

They are then stored in cryotanks for up to 25 years.

To prepare for taking their eggs, a woman must undergo the first stage of an IVF cycle using hormones to bring more eggs to maturity and then another set of hormones to trigger the release of the eggs ,

Patients inject these medicines at home and are usually monitored closely by their doctors.

There are many different forms of these hormone treatments that cost between $ 800 and $ 6,000 per cycle and last between six and ten weeks.

Subsequently, the eggs are surgically retrieved in a minimally invasive procedure.

"It's exhausting, it takes a lot of time and it's important that you take your medication on time. They give you explicit information about what you need to do every day and you go to the pharmacy constantly. "

All these medicines are expensive. Depending on the treatment and the level of monitoring, the price may range between $ 800 and $ 6,000 per treatment cycle.

The total cost of the procedure varies depending on the type of IVF a woman chooses to prepare the egg retrieval, but Alicia says she is willing to spend several thousand dollars, plus $ 100 a year to store her eggs.

Alicia opted for mini-IVF, a form of treatment that uses lower hormone doses but must be given over a longer period – 10 weeks instead of the traditional IVF of six weeks.

All this time, "you have to inject yourself with drugs every day, or in my case, my sister had to do it," says Alicia.

"I'm not someone who is familiar with needles, but it's less a big deal than you think you get used to it, and I think that keeps a lot of people from thinking about it, but if I can get used to it Anyone can do that. "

When her body and hormones were otherwise ready, Alicia got one last dose of medication for her ovaries to release the carefully bred batch of eggs that were to be extracted.

With all the medical interventions they use to promote the development of these eggs, doctors still have only so much control over when they will come, so that the egg deliveries do not exactly correspond to nine to five work schedules.

"It happens in a very specific time window. It could be midnight. My was on a Sunday, "Alicia says.

The retrial procedures are short and take only about 20 to 30 minutes. Patients may opt for the procedure or general anesthesia.

Alicia decided to stay awake so she would not have to worry about finding someone to drive her home and "was an independent woman about it," she says.

"It was not so great, it was quite painful and uncomfortable, and I wish I'd opted for sleep."

If I'm a single woman and I'm young and I have the money, then you do it, the younger the better

Dr. Zhaher Merhi, New Hope Fertility Center

Since she had a mini-IVF instead of the traditional form, Alicia could assume she would have a relatively small crop of eggs, but of a higher quality.

Nevertheless, "first" [the surgeons] They only had four eggs, they could not bring out the other two, and you are in the room, as they tell you. It was very emotional, "Alicia recalls.

In the end, her team got all six. Alicia even plans another cycle next year before the quality of her eggs worsens, which usually begins at the age of 35.

"One of the reasons I'm more involved with New Hope," says Alicia, who now talks about freezing eggs at the clinic's regular information sessions. "Just because you do not have this decline yet does not mean it's not you. You should not freeze your eggs while your life is not focused on finding someone to have children with."

In general, 35 is the anxious age, as Alicia says, the number and quality of her eggs varies from woman to woman.

There is a 90 percent chance that each of their eggs will survive thawing, and they can remain frozen for about 25 years. But beyond that, there is no guarantee that the eggs will bring children to Alicia, and there is no good way to appreciate the odds.

What we do not know: How to accurately determine the fertility of an egg without fertilizing it?

WHAT WE DO NOT KNOW: IF A FROZEN EGG WILL NOT LEAD TO A SUCCESSFUL PREGNANCY

Doctors test fertility by measuring two hormones: anti-Muller hormone (AMH) and follicle stimulating hormone (FSH).

These help to estimate the number of eggs a woman has in her ovarian reserve, but say nothing about the quality of these eggs.

Sperm can be examined under the microscope for mobility or how well they swim, which gives a good indication of their quality.

"We use donor sperm to sort the test eggs," says Dr. Zaher Merhi, who works at the New Hope Fertility Center but has not treated Alicia.

But that means you need to fertilize precious eggs, and some women are unwilling to make that commitment.

The best doctors like Dr. Merhi can examine the extracted eggs under a microscope for very obvious and basic imperfections, such as a "cracked shell," he says.

If the eggs do not look good, they are disposed of.

"If we could find a marker that tells us whether an egg is good or not, by testing the liquid or something, it would greatly increase the freezing of eggs compared to IVF." This is still the infertile treatment, he says.

Many women do not seem to know that a frozen egg is not a guarantee of pregnancy.

If we could find a marker that tells us by testing the liquid or something, if an egg is good or not, it would greatly increase egg freezing compared to IVF

Earlier this month, the journal Fertility and Sterility published a study on the perception of women freezing eggs. It turned out that many people thought that their frozen eggs could lead to 100 percent of a child.

To date, more than 5,000 babies have been born from frozen eggs, but there is no national registry that counts the number of frozen eggs, and therefore it can not be determined how many percent were successfully or not successfully fertilized.

Dr. Merhi says that this uncertainty should not stop young women from doing so in any way: "If I'm a single woman and I'm young and I have the money, you go for it, the younger the better. Once a patient starts to think about it, he should do it, but at the age of 35 you should not wait any longer. "

Women may not even know that freezing their eggs is an option.

Alicia learned about freezing eggs through her work selling medical products for a fertility business. She learned Dr. Zhang, who told her, "You should definitely do it now if you have no concrete plans to have children and a meaningful relationship with someone you want to have children with over the next five years," she recalls yourself.

Alicia agreed and continued to freeze the eggs, but her own obstetrics had never mentioned the option.

"I had an appointment with her for a few months after I started the process, and I let her know about it. She was like, "Oh, that's a good, good call," Alicia says.

Now that she has frozen her eggs, she gives me the rest, she adds.

"I still do not have to use them. Honestly, my plan is to donate them to science and have kids in an old-fashioned way."

"But I think many women end up saying," I wish I knew when they were 40, "and Alicia is relieved not to be one of them.

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