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One of the most popular podcasts we have done so far is the one we hosted with our resident expert Harley Street consultant gynaecologist/obstetrician Mr Mahantesh Karoshi on egg freezing. Not surprising when you consider how our lifestyles have changed and the benefits of technological advances which now makes this a successful and relatively easy process. We looked at who it works for, how it works, what you should expect and the key things you need to know…..
Click here for podcast and here for the full article with lots of detail, but, for those of you tight on time (aren’t we all!) here are the ten quick things to know:
ONE: it IS happening more. Why? Lifestyle change, technological improvements and awareness are the main reasons. Mahantesh thinks this is a good thing. As our lifestyles have changed (but our biological clocks stay the same) and egg freezing gives the ‘insurance’ to continue to wait until you feel ready for a baby without worrying about decline in egg quality. Unfortunately, it remains a fact of life that as we get past 25 years old (on average) the quality gradually declines, with more rapid decline in quality from age 35 which is in many cases now the point a lot of us feel financially and mentally ready for a baby. He thinks the stigma around it is coming down now which is great.
TWO: age in this case really does matter: The ideal age for egg freezing is between 25 – 35 years old with an AMH (which measures your egg reserve) above 15. Click here for all you need to know about this important hormonal measure.
THREE: why does age (and AMH) matter so much? The simple objective from egg freezing is this: you want as many genetically normal eggs as possible. The more genetically normal eggs you collect, the higher the chances of your end goal = a viable pregnancy. Age here according to Mahantesh is the single most important factor and unfortunately as we age we get less genetically normal eggs.
FOUR: here are the stats as to why age matters so much: at 25 years old, on average, 80% of your eggs are genetically normal which means (given the drop off rate) that 50-60% of them could make it to a viable pregnancy. When you hit 35 years old, that drops to 50% genetically normal. Above 40 years old it drops to less than 20% on average. Sooner is better in this case.
FIVE: How can we tell what eggs are ‘genetically normal’? Well, nature’s way is simple: the ones that are not normal (aneuploidy) either won’t implant or will not survive into a viable pregnancy. However, we can now use something called Pre Implantation Genetic Diagnosis (or Screening) to test before implantation. This is where a couple of cells are taken and tested. The good news is that when you test and transfer a genetically normal embryo (uploidy), implantation success rate goes up to 90%! This is often something you have to pay more for, but, arguably this could save you more money down the line.
SIX: The aim is 10-20 eggs harvested. Why this number? Because the typical drop off rate is 40% as not all eggs we collect are genetically normal, so, you want at least 10 and ideally more to make the process worth the time and money. That is why having an AMH number +15 is prefereable. The lower your AMH lower the chances of having enough genetically normal eggs to collect and use towards a viable pregnancy. Click here once again to understand AMH better and why this number matters.
SEVEN: The first step therefore on your egg freezing journey is to test your AMH and also to scan your ovaries. Not only does this give the doctor your baseline position to judge your reaction to the drugs given, but it also allows the proper dosage of drugs to stimulate growth of follicles into eggs to be harvested. This is just a simple blood test and scan.
EIGHT: Next up – injection time! Mahantesh says that really the thought of self injecting is worse than the reality. Once your cycle has been taken hold of by the doctor (via birth control pills) it is time for injections to begin. What are you injecting? This is Follicle Stimulating Hormone (FSH) in order to make immature eggs (follicles) develop into eggs that are available for collection. This usually lasts seven days – the aim is 10-20 follicles that are between 14-18mm in length at that point they are ready for collection. You may even feel an extra burst of energy during this time from the FSH as naturally speaking at this point in your cycle you will have more energy (click here for more) – doesn’t work like this for everyone though with some people reporting bloating. Don’t worry though, it wont last forever!
NINE: Next up collection: what to expect? Once you have had a scan. Anti FSH will be given (to make sure your follicles dont grow bigger and ovulation occur naturally leaving no eggs left to collect!) within 36hrs collection will then happen. This is a process lasting between 30-45 minutes where your eggs will be collected through a specialised vaginal scan.
TEN: into the freezer and settling back down: once you’ve had your eggs collected, they are banked and ‘fast frozen’ (a new process which means that freezing unfertilised eggs is now essentially as good as freezing fertilised eggs or ‘embryos’). It should take around 6 weeks for your own cycle to settle down and after this point its up to you when you would like to fertilise and implant. In the UK there is no limit age wise that you can have them put back in, but Mahantesh thinks the upper limit realistic cannot go above 50 years old. Are these unnatural doses of hormones and intervention damaging? The research shows that the risks are low for 1-2 cycles which given the advances in modern technology is now all most people need. More than that the risks do appear to rise.
How much does this all cost? On average one cycle will be around £5000 plus storage costs (which are usually between £500-800 per year). The consultation should be free. If you want to check out the right place for you the best resource to consult is the Human Fertilisation and Embryology Authority in the UK which gives a full breakdown of clinics who have to disclose their success/failure rates and all other information which should help you find the right place for you. Click the link to find out more on clinics near you.
This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The information on this website has been developed following years of personal research and from referenced and sourced medical research. Before making any changes we strongly recommend you consult a healthcare professional before you begin.
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