The current trend is as follows: childbirth, including the first, began to be postponed to a later age. We see this in Europe, and in America, and in Russia. There are several reasons for this. First, women get an education, build a career and are more careful in choosing a partner.
Secondly, health care has reached a new level. Women feel young longer, they have a lot of energy and plans. It seems that there is an eternity ahead and they still have time to give birth. But with an improvement in general health and an increase in life expectancy after 35 years, reproductive potential still inevitably deteriorates. This is due to a decrease in the number of eggs and a decrease in their quality, that is, the ability to create a good embryo for a successful pregnancy. Can time be stopped? In terms of reproductive health, yes. For this, technology of deferred motherhood is used.
Who is Delayed Motherhood for?
This service began to be widely offered about 10 years ago. It is in greatest demand in Europe, slightly less in the USA. In Russia, we see a growing interest: more and more patients are turning to delayed motherhood.
In the fall of 2021, the results of a study that was conducted in Jerusalem and concerned the preservation of oocytes – female gametocytes, or germ cells involved in reproduction, were published. 70 women had their eggs frozen from 2011 to 2014. Five years later, a telephone survey was conducted among them and the following was found out: the main reason for participating in the program was the absence of a partner (59 people). Three women had no plans to have children at the time of their participation in the study, but were married. Occupational reasons were in one, and four patients were planning repeated pregnancies in the future.
Over five years, 44 women attempted to conceive, either naturally or through assisted reproductive technology using fresh or cryopreserved oocytes. 28 respondents gave birth as a result of a pregnancy obtained naturally or with the help of a new IVF program (without the use of already frozen eggs), 14 reported using their cryopreserved oocytes (three of them had a childbirth, another 11 pregnancy or progressed at the time of the survey , or there was an unsuccessful attempt). 26 women did not try to get pregnant.
Thus, we can say that the service of delayed motherhood is treated as a kind of insurance. Maybe you need it, maybe not, but it’s better to let it be.
There are also medical indications for stocking up on eggs. This may be relevant if radiation or chemotherapy is planned in the presence of malignant tumors. Such treatment reduces the ovarian reserve (the number of eggs that are ready for fertilization at the moment) and increases the risk of infertility.
In addition, it is recommended to resort to delayed motherhood if surgical treatment is required in connection with an ovarian disease, because with such an intervention, the existing reserve of eggs is somehow affected. In addition, when in a family, for example, the mother and older sisters stopped menstruating before the age of 40, there is a risk of early menopause. Then you should either not delay childbearing, or think about freezing eggs.
If we talk about the age when women should turn to the delayed motherhood program, then this is 34 years. After 35 years, the reproductive situation begins to deteriorate quite quickly.
What is the essence of the procedure and how it goes
At the time of birth, a girl has about a million eggs in her body. By puberty, about 350-400 thousand remain. Every month, a few pieces come out of this “reserve” and begin to grow. As a result, only one ripens, the rest die. This process does not stop: it occurs during pregnancy, lactation, and when taking oral contraceptives.
Each menstrual cycle, several follicles begin to grow – usually from 8 to 20, but only one of them eventually matures, and an egg is released from it. The technology of delayed motherhood is aimed at saving those follicles that begin to grow in the menstrual cycle, but do not have time to ripen. After extraction, these cells are frozen. Technically, the procedure is similar to IVF – in that part of it, which includes stimulation and puncture.
Follicles grow under the influence of follicle-stimulating hormone (FSH). Normally, its concentration is such that one follicle matures, but if this concentration is increased, then all other follicles growing nearby will also be able to ripen. Thus, we will get not one egg, but 10, 15, 20. And they can be extracted and stored. FSH is given as an injection, usually for 10 days. Then a puncture is performed through the wall of the vagina: with the help of an ultrasound machine, a special needle is inserted into each follicle and a liquid is extracted from there (it just contains the eggs that will be frozen).
After retrieval, the eggs are placed on thin plastic tubes (straws). Then they are marked: indicate the individual number and name of the patient. Next, the straws are placed in liquid nitrogen, which is located in a special large thermos – a Dewar vessel. Inside it, a constant temperature of -196 ° C is maintained and liquid nitrogen is periodically added, as it evaporates.
The process of cryopreservation, that is, freezing, has its own nuances. The problem of cryobiology is that living tissues contain water: when it freezes, ice crystals form, including at the cell level. These small crystals damage the structure, the cells die. For about 10 years, specialists have been using the so-called vitrification, in which tissue is frozen very quickly without the formation of ice crystals. But, alas, this technology is not quite perfect: losses are about 10-15%. That is, out of 100 frozen cells, 85–90 will survive.
Cost of the procedure
There is a stereotype that egg freezing is very expensive and available only to a few. However, it is not. The Delayed Motherhood Stage I program includes the following steps:
- stimulation — 39,500 rubles,
- puncture – 30,000 rubles,
- anesthesia – 15,000 rubles,
- vitrification (depending on quantity): 1–4 oocytes — 35,000 rubles, 5–8 oocytes — 40,000 rubles.
After that, the annual storage of cells is paid (12 months – 18,000 rubles). Storage is carried out until the woman decides to become a mother, and can last for years.
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