HERE’S WHAT YOU NEED TO KNOW. Women today encounter myriad life opportunities and choices, some which allow for parenthood at an early age and others that do not. While many of us have dreamed of becoming mothers, life circumstances often make finding the right time for parenthood a challenge.
Unlike our parents’ generation, nearly one out of five women now wait until after age 35 to have a child, according to the Centers for Disease Control and Prevention. As a physician, I can certainly relate to this since academics and job training were often the focal points of my life. This is true for many women who continue to make personal sacrifices in order to advance their careers and life goals. For them, as for me, the question has never been, “Should I have a child?” but rather, “When is the right time to have a child?” Other women have had to postpone childbearing due to medical conditions, such as cancer or lupus, only to discover after treatment that their chances for parenthood are greatly decreased, due to the medications they have received. Egg freezing is a technology that can extend a woman’s fertility potential, enabling her to conceive at a later time in her life, depending on her social or medical circumstances. In naturally occurring pregnancies the female egg is fertilized by sperm from the male and the resulting embryo grows into a baby. Egg freezing (referred to medically as “oocyte cryopreservation”) is a process performed on eggs prior to fertilization. This technology was initially developed in European countries for patients with religious concerns regarding the creation of too many fertilized embryos. Its use has since been extended as a way of preserving fertility and reproductive autonomy for women who do not yet have a partner as well as for those who are undergoing medical treatments that would risk their fertility. The process involves the extraction of eggs from the ovaries following hormonal stimulation (similar to the in vitro fertilization process), freezing them and storing for later use. While there is no guarantee that future pregnancy will result, egg freezing serves as a way of increasing the possibility of having children in the future. The first child born from a frozen egg occurred over 25 years ago, but the technology has vastly improved in the past five years; success rates approach those of in-vitro fertilization. Egg freezing involves the “flash freezing” (referred to as vitrification) of eggs. The eggs can be thawed at a later date and fertilized to create an embryo for subsequent implantation and birth. There is limited information on how long eggs can remain viable once frozen. However, with the data that is available, we understand that the eggs are usable for at least four years, if not indefinitely. Undergoing this procedure does not increase the risk of genetic or birth defects. Because every woman is born with a finite number of eggs, her fertility potential is best when she is in her twenties and starts to decline in the mid-thirties. With this in mind, the best time to consider egg freezing is by the mid-thirties. This is also because the risk for miscarriage rises after the mid-thirties due to genetic changes that happen in the eggs with aging. Unfortunately, the biological clock keeps ticking even for women living very healthy lifestyles. For women who are considering egg freezing, we recommend a consultation sooner rather than later. While women have conceived from eggs frozen at later ages (early forties), the chances of pregnancy are lower. On the flip side, we generally do not recommend elective egg freezing for women who are still in their twenties. This is because egg freezing is a considerable financial investment, and many women who freeze eggs at this age will not need to use them. Patients with a cancer diagnosis that threatens their fertility are strongly advised to consider egg freezing if medically possible, regardless of how young they may be. If you are reading this article and think that egg freezing might be for you, I encourage you to speak with your OB/GYN or to see a fertility specialist that offers patients this opportunity. To be a woman today is to encounter a world of opportunities; your chance at parenthood need not be sacrificed in order to experience them.