Medical Contribution by Gilbert L. Mottla, M.D.
Studies have shown that chemotherapy, especially those using alkaline agents, can severely diminish a woman’s ovarian reserve. With some chemotherapies of longer duration, the sensitive egg cells will not survive, rendering the patient infertile and unable to conceive in the future. Woman now have the ability, though, to freeze their eggs prior to beginning chemotherapy, due to recent advancements in freezing technology. This option allows patients to safeguard their fertility for the future.
A: Egg freezing is a process in which the ovaries are stimulated to produce several mature eggs. These eggs are then retrieved; frozen using vitrification technology; and stored for future use. Since frozen eggs are suspended in time, their quality remains unchanged from the point of freezing.
Q: Who Should Consider Egg Freezing for Fertility Preservation?
A: Women with a recent cancer diagnosis who are planning to have children in the future should consider egg freezing at the time of diagnosis. The best outcome relative to both egg thaw survival rate and future pregnancy is achieved in women under the age of 40.
Q: What does the Process Entail?
A: When a patient with a recent cancer diagnosis is referred to Shady Grove Fertility, a specially-trained team guides them through the entire treatment process. This team helps to navigate patients through each step, from finding ways to afford treatment to the actual medical procedure. Due to the time-sensitive nature of treatment, oncology patients can expect an expedited treatment plan and to see a physician for consultation as soon as possible.
Once a patient decides to move forward with treatment, it generally takes 2-3 weeks to complete stimulation of the ovaries. During this time patients will take injectible medications administered subcutaneously (under the skin.) Egg development is monitored 4-5 times during the 10-12 days of stimulation. Monitoring appointments consist of a transvaginal ultrasound and bloodwork, both used to monitor egg development. These appointments help your physician to adjust medications as needed and identify the ideal time for the egg retrieval. Once the follicles reach 20mm in size, an egg retrieval is scheduled in one of our ambulatory surgery centers in either Rockville or Towson, MD or Chesterbrook, PA. The retrieval is performed under light sedation, with normal activity resuming the next day.
Q: What are my Future Options?
A: Once eggs are frozen, they are available for when the patient has completed their cancer treatment and been cleared to move forward with attempting pregnancy. A back-up plan is now in place should a patient need to use their eggs in the future. Use of these eggs in the future involves thawing, inseminating with sperm, and transferring a healthy embryo into the uterus. Once eggs are frozen, a woman’s success at achieving pregnancy is related to her age at the time of freeze – not at the time when she plans to use her eggs to achieve pregnancy. At Shady Grove Fertility, eggs may be used to achieve pregnancy before a patient’s 51st birthday. Beyond this age, other medical conditions impact safe pregnancy and delivery.
Q: How Long Can My Eggs Remain Frozen?
A: While long-term data on egg freezing is not available, our experience and research leads us to believe frozen eggs can remain viable indefinitely. Since the start of elective egg freezing using vitrification over 200 babies have been born as a result.
We hope this summary is helpful as you consider egg freezing as a possibility for protecting your fertility. Most importantly, we recommend discussing your particular situation with your medical team, so that we can individualize your care and coordinate with your oncology team.
If you would like to schedule an appointment with a fertility specialist, please speak with one of our New Patient Liaisons at 877-971-7755.