Why should I consider egg freezing? Fertility for Cancer Patients

Why should I consider egg freezing? | Podcast with Dr Bruno Radesic

Infertility has increased dramatically in the last decade.

In fact it rose 860% between 2010 – 2018.

So, why do so many women consider the egg freezing procedure and what does freezing your egg involve?

This podcast with Dr Bruno Radesic, Fertility SA Medical Director explains.

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Why should I consider egg freezing?

Dr Bruno Radesic, Fertility SA Medical Director, explains, in this podcast that the “biggest reason can be simply because there is no suitable partner and they know the time for child bearing is limited.”

Age-related infertility in women is one of the most common issues presented to fertility specialists each day when trying to help patients become pregnant.

At Fertility SA, we encourage all initiatives which can educate and improve social support so that women can optimise their chances of having a family before the natural decline of ovarian function. However, we recognise that for some women, child-bearing for a variety of reasons has been or will be unavoidably delayed.

Scientists have been at the forefront of infertility-related research and scientific work since the development of IVF treatment options. With these advancements in scientific techniques, we are able to offer egg freezing to enable more patients to explore all their reproductive options whatever their unique situation.

Egg freezing can be undertaken for two primary reasons.

Egg freezing is acknowledged as a potentially helpful option with good survival rates and similar outcomes to standard IVF.

  1. Medical egg freezing relates to women whose fertility is affected or likely to be affected by conditions such as cancer requiring, chemotherapy or radiotherapy and/or other medical indications.
  2. Elective egg freezing relates to women who wish to have a child or children in the future, but for their own unique reasons either elect to delay this decision or have not found a partner during their most fertile years, egg freezing is a way of reducing the risk of future infertility.

 

Research Recap: Elective Egg Freezers Disposition Decisions

It is also known that many women have surplus frozen eggs at the end of the process because they did not return to use their eggs or only used some of their eggs. When this occurs, women have to decide what to do with their surplus eggs; this is called a disposition decision. In Australia, women/couples can choose to: donate their eggs to research, donate their eggs to known or unknown people, or discard them. Past research has informed us that these decisions can be stressful, complex, and morally challenging. Read more: https://fertilitysa.com.au/2021/11/18/elective-egg-freezers-disposition-decisions-study/

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Ovarian function, fertility and age

During a woman’s reproductive years, the ovary contains hundreds of thousands of immature eggs.

Usually, over the course of a few weeks, multiple immature eggs start to develop in a wave and then most stop growing, while one ripe (“mature”) egg continues to develop and is released each cycle.

As a woman gets older, the number of eggs available to go through the maturing process becomes less, until by the age of 50 or so, no healthy eggs remain.

A woman’s most fertile years are when she is aged in her 20s and early 30s, 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. This is especially so in women in their forties who have less chance of producing a healthy pregnancy because of the age-related decline in egg quality.

Technique: hormonal stimulation

To produce the eggs for freezing, a woman will usually undergo hormonal stimulation over 10–12 days enabling a group of eggs to mature, under the guidance of a fertility specialist and our nursing team. The number of eggs retrieved will relate to each woman’s individual circumstance.

There are a variety of stimulation techniques, and your doctor will decide, in discussion with you, which is the most appropriate for your treatment.

The stimulation medications are usually self-administered by injection and are very easy to administer.

Patients are taught how to do this in an instructive introductory session with a member of our nursing team who will provide support throughout the stimulation phase of treatment.

Procedure to remove the eggs

The eggs are removed from the ovaries in a minor procedure performed under anaesthetic at St Andrews Hospital, which takes about 15 to 20 minutes.

This procedure is performed by the fertility specialist using an ultrasound guided probe.

Egg freezing procedure

The eggs undergo a freezing procedure at our laboratory located at St Andrews Hospital, using the latest scientific technology, called vitrification (fast freezing).

Eggs may be stored safely for many years.

When the woman is ready to use her eggs to create an embryo, they will be thawed, and then fertilised with sperm.

How many eggs should I freeze?

It is very hard to accurately predict the number of eggs that will be retrieved and the number of viable embryos which will ultimately be created. The expected success of the procedure can be partly indicated from an initial assessment of the ovarian reserve via an anti-müllerian hormone (AMH) test and an ultrasound.

The AMH test can provide an insight into the remaining quantity of eggs although it does not give any information about the quality of the eggs.

Success rates

The live birth rates using frozen eggs depend heavily on the age of the woman when the eggs were collected and frozen, irrespective of the age at attempted pregnancy.

On average a woman under the age of 35 will have 10 mature eggs collected in a single procedure, but this number reduces by approximately one egg per year above 35.

How to access our egg freezing program

You may be referred by your local doctor or medical specialist directly to a fertility specialist. The fertility specialist will take a medical history, arrange any necessary investigations including blood tests and ultrasound assessment of the ovaries, explain the process and its implications, inform you about success rates for your specific situation, and arrange a counselling referral if appropriate.

If you choose to have egg freezing, the fertility specialist will then manage your care throughout the stimulation and egg collection process.

Costs

The cost for an egg freezing cycle varies depending on the patient’s individual circumstances. If you are freezing your eggs for a specific medical reason, Medicare may provide a rebate on your treatment. Where there is no medical indication for treatment, Medicare do not provide a rebate for your treatment.

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