Egg Freezing
ivf.com.au | 1800 111 IVF
While embryo and sperm
freezing are well-recognised
infertility treatments, with
many thousands of babies
born as result, egg freezing
is a relatively new option for
fertility preservation.
Egg freezing is a method of storing a woman’s unfertilised
eggs, with a view to them being used in the future. It may
be seen as a way of preserving the potential for fertility, in
women who are not in a position to become pregnant, or
whose fertility is at risk.
Recent work by Australian and international scientists
has resulted in improved techniques for egg freezing and
thawing and there have now been over 5,000 babies born
(worldwide) following egg freezing.
Frozen eggs may be stored for many years. When the woman
is ready to use her eggs, they are warmed, and then fertilised
with sperm. The aim is for a healthy fertilised egg to develop
into an embryo, which may then be transferred to the
woman’s uterus, with a subsequent chance of pregnancy.
Ovarian function, fertility and age
During a woman’s reproductive years, the ovary contains hundreds
of thousands of immature eggs.
Usually, one ripe, mature egg is released each month, and many
hundreds of eggs die off naturally. As a woman grows older, the
number of eggs available to go through the maturing process
becomes less, until by the age of 50 or so no eggs remain
(menopause).
A woman’s most fertile years are when she is in her 20’s and early
30’s, when the ovaries still contain a large number of healthy eggs.
For the 10 – 15 years prior to menopause, despite a woman having
regular ovulatory cycles (monthly periods), the ovarian function
deteriorates.
1000,000
Egg Number
Optimal
Fertility
Decreased
Fertility
100,000
A woman’s most fertile years
are when she is aged in her
20’s and early 30’s
End of
Fertility
10,000
Irregular
Cycles
1000
Birth
13
18
31
37
41
Maternal Age (years)
45
51
Menopause
Egg freezing preparation
To obtain eggs for freezing, a woman will usually undergo hormonal
stimulation over 10 – 12 days enabling a number of eggs (usually
10 – 15) to mature. There are a variety of stimulation techniques,
and your fertility specialist will decide, in discussion with you,
which is the most appropriate for your treatment. The stimulation
medications are a self administered injection using a tiny needle
under the skin. Patients are taught how to do this in an instructive,
introductory consultation. The injections may make the woman feel
a little bloated but she can carry out all normal activities up until the
day of the egg retrieval.
Procedure to collect the eggs
The eggs are collected from the ovaries using an ultrasound guided
probe. Attached to the ultrasound probe is a needle. The fine needle
passes through the vaginal wall into the ovary and draws the fluid
(and egg) from the ovary.
Patients can go home about one hour after the procedure and are
advised to rest for the remainder of the day.
55%
50%
45%
40%


10 eggs frozen
6 eggs survive
thaw process
3 embryos once
fertilised
Egg freezing procedure
The eggs undergo a freezing procedure in the IVF laboratory called
vitrification. This involves freezing the eggs by a rapid process that
extracts the fluid from the eggs to prevent crystal formation. Once
vitrified, eggs may be stored for many years.
Success rates
As the technique for egg freezing is relatively new, it is not possible to
give precise figures for the chance of pregnancy after freezing, future
thawing and fertilisation.
Currently we would expect that:
• A stimulated cycle would result in the collection of 10 – 12 eggs of
which 7-9 would be suitable for vitrification & storage
• Approximately 60 – 70% of eggs would survive warming in the future
• Approximately 50 – 80% of surviving eggs would fertilise
• Approximately 90% of fertilised eggs would develop into embryos
• A single embryo would have a 15% -35% chance of developing into
a pregnancy.
Considerations when thinking about egg
freezing
Egg freezing is a very good option for a young woman who is facing
the prospect of cancer treatment or other treatment that may harm her
eggs.
The issues are, however, more complex for other women, who are
considering freezing their eggs because they are not yet in a position
to have a family.
As with IVF itself, the success rate of egg freezing is closely related to
the age of the eggs and there is only limited data about the success
rates of vitrified eggs from older women. Despite the technical
advances in freezing, vitrified eggs have a lower success rate than
fresh eggs in achieving fertilization and development of embryos. Eggs
that have been vitrified then warmed are thought to be the equivalent
of using eggs from a woman 3-5 years older.
Given this effect and the lower egg number in older women, there is
really no value at all in egg freezing for a woman who is already over
the age of 38. For younger women with low AMH levels, egg freezing
is a very reasonable option for them to consider. This is because egg
quality is dependent on age, and they will most likely run out of eggs
sooner.
There is also the important issue that egg freezing is only a partial
insurance and that you will not know the outcome for many years of
how your stored frozen eggs will fertilise.
This leads to a dilemma, of when to actually use your frozen eggs.
Are you planning to postpone your family to your late forties, with all
the health and social consequences that that will involve for you. Or
are you planning to use your stored eggs when you are in your late
thirties, at which time your own ovaries may still work just as well as
the stored oocytes?
Finally, cost is a serious consideration. In Australia, Medicare and
other government subsidies are only payable for fertility treatment
when there is a medical indication present, and out-of-pocket
costs are much higher where there is no medical indication. For an
explanation of costs call our Public Liaison Coordinator on 1800 111
IVF.
You need to give careful thought to all of this in considering egg
freezing.
Other possible risks
Serious side-effects of the stimulation process used to collect a
woman’s eggs are very rare nowadays. Possible problems may
include bloating at one extreme and rarely, failure to obtain eggs, at
the other extreme. Egg pick up may be complicated by bleeding or
pelvic infections, although this is very uncommon.
Other risks of egg freezing relate to the possible failure of the
treatment: the eggs may not survive the thawing procedure, may not
fertilise or develop into embryos, or may not result in pregnancy after
embryo transfer.
A woman contemplating egg freezing should have counselling to
consider other options which may be available to her, such as donor
insemination (for more immediate rather than delayed treatment) or
the possible future use of donor eggs if her own ovarian function is
likely to be lost.
How to access our egg freezing program
You can be referred by your local doctor or another medical
specialist, directly to an IVFAustralia fertility specialist. The fertility
specialist will take a medical history, arrange any necessary
investigations including blood tests and ultrasound assessment of
the ovaries, and offer a counselling referral. If you choose to have
egg freezing, the fertility specialist will then manage your care
through the stimulation and egg collection procedure.
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COMM-PI-089 | 8MAY2015
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