1. Cryopreservation is applicable only for IVF as part of infertility treatment
Cryopreservation is indeed used in IVF. But not only. This is just one side of it. Egg cryopreservation is increasingly being used by modern young women who are postponing their motherhood for personal reasons – someone is actively pursuing a career, while someone else does not have a reliable partner nearby. “Delayed motherhood” is a new trend of our time. Today, any woman aged 18 to 38 can freeze her eggs and be calm about her future. This was made possible thanks to a new freezing technology – vitrification, in which the egg instantly turns into a glass structure, and after defrosting it completely retains its viability.
2. Egg cryopreservation is maternity insurance
It really is insurance. And not just for those who voluntarily put off motherhood because of their careers. Cryopreservation can be relevant for any woman. The ovarian reserve is not durable – we lose a few eggs every month, and this is a natural process. But there are factors that can accelerate the decline in natural fertility. The number and quality of eggs are affected by disturbed hormonal levels, endometriosis, ovarian surgery, abortion, smoking, long-term use of potent drugs, radiation or chemotherapy, overweight or underweight, constant stress. For women at risk, cryopreservation is a sure way to preserve their own reproductive potential and avoid the need to use donor eggs in the future. In Spain, for example, cryopreservation is a normal thing. Most young women at 18 freeze their eggs.
3. This is a complex process, it takes a lot of time
The whole process consists of three stages – examination, stimulation of ovulation, egg collection – and, of course, takes some time. The examination program includes: ultrasound of the pelvic organs and mammary glands, blood tests and smears for viruses, infections, hormones, including anti-Mullerian hormone, which will answer the question of what kind of ovarian reserve a woman has now. General blood and urine tests, ECG, fluorography are also performed, and a therapist is examined. And if there are no contraindications, the reproductologist prescribes stimulation.
Absolute contraindications to cryopreservation for the purpose of delayed motherhood are acute inflammatory processes and severe therapeutic pathologies in which hormonal stimulation cannot be performed, problems with blood clotting, formations in the mammary glands, on the cervix, in the uterus and ovaries. Relative contraindications to egg cryopreservation are age over 40 years and low ovarian reserve, in which case it is better to freeze embryos.
With age, cells age, their reserve is depleted, and at a late reproductive age, not every thawed egg will be able to give an embryo. After forty years, cryopreservation of embryos within the IVF program gives more chances for pregnancy. The storage of frozen embryos is no different from the storage of eggs in a specialized cryo-storage facility (individual cells, bar-coding, cryotopes).
Stimulation of ovulation is short, takes 10 days on average, and does not require frequent visits to the doctor. Injections can be performed independently at home. They have a high safety profile (do not affect weight, do not bring menopause closer, do not provoke oncology). Before the egg retrieval procedure, you should limit physical activity and spend days in a relaxed mode.
Egg retrieval is carried out in the clinic under intravenous anesthesia and takes no more than 15 minutes. When cryopreserving eggs for the purpose of delayed motherhood, our task is to get as many follicles (eggs) as possible – 10-15-20 follicles. This is quite painful, technically there are difficulties. It is undesirable to carry out the procedure under local anesthesia, as this is associated with risks. Any involuntary movement of the patient can lead to injury to the internal organs. An increase in pressure due to stress is not excluded: even if the patient is psychologically tuned in to local anesthesia, is quite calm and has a normal pain threshold, she can “wind herself up” during the procedure. And against the background of high blood pressure, there is a risk of bleeding. Therefore, a short general anesthesia is the best option.
The doctor, under ultrasound control, makes a puncture (puncture) of the follicles in the ovaries with a special very thin needle. The resulting fluid (the contents of the follicles) is immediately examined by the embryologist under a microscope, reports how many eggs have been received, and sends them for cryopreservation. An hour or two after the procedure, you can leave the clinic and go about your business.