What You Should Know About Social Egg Freezing

What is Social Egg Freezing?

Social Egg Freezing is a medical treatment for well women who wish to harvest some of her existing eggs to be frozen (in liquid nitrogen), as a form of fertility preservation. This utilises current knowledge and technology of assisted reproduction techniques (used in IVF), to stimulate, mature and harvest eggs for freezing. In time to come, when the woman is ready to conceive, these eggs may be used in IVF, to create embryos for transfer into her womb.

Why freeze eggs?

Unlike men, who continue to produce sperm throughout most of their adult life, women are born with a finite amount of eggs, which will only last them about 20-25 years of their reproductive life. As the quantity reduces with advancing age, the quality of these eggs deteriorate too. Eggs stored in the ovaries cannot be fertilised unless they split and divide their genetic contents into 2 equal portions. With advancing age, this “splitting mechanism” of the egg cells become more prone to errors, resulting in unequal division of the genetic contents, hence the resultant (fertilisable) eggs are more likely to be genetically abnormal. The natural decline in quantity and quality becomes accelerated from the age of 35-37 years onwards. In some women, certain disease processes and medical treatment (including surgery near or on the ovaries) may cause extra insult on the eggs, leading to a steep decline regardless of age. Therefore, to safeguard the fertility of a woman, the most important factor to “preserve” would be her eggs.

As we embrace the societal norm of delaying marriage and childbirth, age-related female infertility is inevitable. An older woman is less likely to give birth to a healthy child, as the chances of conceiving is lower with less eggs. The risk of abnormal eggs resulting in miscarriage also increases drastically with advanced age. Hence the treatment for age-related female infertility is to freeze eggs when they are plenty and of better quality.

How to freeze your eggs?

Social/elective egg freezing should only be performed by accredited fertility specialists, experienced in the techniques of IVF treatment. As it is performed on otherwise healthy women, additional care must taken to minimise complications. Egg maturation treatment, mirrored from IVF regimes, are tailored to suit the profile of the woman (taking into account the age, egg reserve and existing disease states), to strike a balance between optimal yield of eggs, minimal risk and cost-efficiency.

Once the eggs are mature, they can be harvested in accredited IVF Centres for storage in liquid nitrogen. In the frozen state, the eggs do not deteriorate, but the process of thawing them for IVF use has a certain attrition rate, therefore you will have to be prepared to have less usable eggs than the number obtained for freezing.

Who should freeze her eggs?

Biologically, the young woman in her late twenties- early thirties will be the best candidate to freeze her eggs, as she has large quantities of good quality eggs. However, the lack of awareness, financial prioritisation and focus on other aspects of life (such as studies and career) means most women in these age group will not be considering egg freezing as a priority. Ironically, it may be the older woman, after failing to conceive for years, or upon diagnosis of disease affecting fertility, who will then actively seek out this preventive treatment.

Even though the number of eggs to be banked is less at a latter age/state and of lower quality than when she was younger, it is invariably better than less or none. Therefore, the best woman to freeze her eggs is one who still has eggs and desires to start a family later (not currently).

What happens after your eggs are frozen?

Once the mature eggs are retrieved from the ovaries via a simple procedure under anaesthesia, they are then processed and cryopreserved (frozen) for future use. These eggs are kept frozen in liquid nitrogen at the fertility centre, until you are ready to thaw them for use. There is no need for long term follow up treatment pertaining to the frozen eggs, after recovery from procedure.

Women who froze their eggs may not eventually use these banked eggs to conceive, unless they only try to conceive after their egg reserves have been depleted by advanced age or disease.

The current advent in IVF technology has allowed frozen eggs to be cryopreserved as per when they were collected and not proven to deteriorate over the years of freezing. However, upon thawing, some women may experience some attrition of these eggs.

What are the risks and drawbacks of social egg freezing?

Regardless of the objective of the treatment, be it preventive in a well woman, or therapeutic for a subfertile woman, the egg preparation/maturation still requires the use of stimulatory hormones and depending on the profile of the woman, some may have excessive response leading to Ovarian Hyper Stimulation Syndrome, while some may have poor response requiring cancellation. The procedure of egg retrieval, although is a quick and simple procedure, is still an invasive undertaking with small risks of causing bleeding, injuries, infection and discomfort.

The perennial concern with egg freezing is to have a (false) sense of security from having banked eggs for future use; this may lead to even longer deferment of pregnancy, giving rise to other medical complications during pregnancy in women of advanced age, invariably with poorer outcomes.

Will you have significantly less eggs or infertility after egg freezing procedure?

The answer is no. Biologically, every woman undergo ~50-200 egg atresia(natural death) every month. When a woman does hormonal stimulation, it is to stimulate these that are meant to undergo atresia anyway. And these will be collected to freeze rather than allowed to undergo atresia. Short of the rare catastrophic complications during the egg retrieval procedure, causing severe damage/infection to the ovaries, egg freezing in the heathy young woman should not contribute to any appreciable decrease in egg reserve, nor is it going to lead to infertility.

Should YOU bank your eggs?

This question is much easier to answer for the older woman, who is planning to defer her childbearing endeavour – yes, please do consider social/elective egg freezing.

But for the young women who are seemingly healthy, a good start would be to consider getting a fertility screen done with an experienced fertility specialist/fertility surgeon. This is to ensure that you are indeed healthy from the fertility perspective. If you do not intend to conceive before 35 years old, egg freezing might be a good idea. It serves as an alternative/option for the future.