Egg freezing, also known as oocyte cryopreservation, involves stimulating a woman's ovaries to produce multiple eggs, which are then extracted and frozen for future use through in vitro fertilization (IVF). The success rates of egg freezing depend on the woman's age, with younger women having higher success rates. While egg freezing is now considered a standard fertility preservation option, it does not guarantee future fertility and may require multiple cycles to obtain enough eggs. The document discusses the egg freezing process, impact of age on fertility, success rates based on age, pros and cons of egg freezing, and options for preserving fertility.

1. Egg Freezing
Can it Stop Your Biological Clock?
FPNC (c) 2012

2. Agenda
 Update on egg freezing
 The process
 How age impacts fertility
 The success rates
 The pros & cons
 Best options
 Your questions
FPNC (c) 2012

3. Egg Freezing Before
 Considered experimental treatment
 Not enough data to determine the outcome
for children born from frozen eggs
 Pregnancy rates after IVF using slow-frozen
oocytes have traditionally been poor
– IR/Egg thawed 4.6% (Boldt, April 2005)
 ASRM says not to be offered for fertility
preservation
FPNC (c) 2012

4. Egg Freezing Now
 No longer considered experimental treatment
 Data suggest children born from frozen eggs
are fine
 Pregnancy rates seem similar to those of IVF
 ASRM: Still not officially recommended for
“social” fertility preservation, due to limited
data
FPNC (c) 2012

5. The Process of Egg Freezing
FPNC (c) 2012

6. Egg Freezing – Gathering the Eggs
 (Egg Freezing A.K.A Oocyte Cryopreservation or
“OC”)
 Basically the first part of an IVF cycle
 Stimulate multiple egg production with injectable
hormones
 Measure progress of stimulation with blood
samples and transvaginal ultrasounds
 Extract eggs from the ovaries (light IV sedation,
needle extraction through vaginal wall)
FPNC (c) 2012

7. Egg Freezing – Freezing & Storage
 Freeze (cryopreservation)
using Vitrification technique
 Store eggs in computer
controlled tanks
 Storage estimated to be
safe for about 10 years;
perhaps indefinitely
FPNC (c) 2012

8. Egg Freezing – Fertilizing the Eggs
 Thaw eggs
 Effects of freezing and
thawing require ICSI for
fertilization
 Embryology lab monitors
embryo progress
 Embryo transferred to
uterus via catheter
 Pregnancy test in 2 weeks ICSI (Intracytoplasmic
Sperm Injection)
FPNC (c) 2012

9. Can Egg Freezing Insure Against
Age-Related Infertility?
FPNC (c) 2012

10. Effects of Age on Female Fertility:
Chance of Conceiving Each Month
22
20
18
16
14
12
% 10
8
6
4
2
0
20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50
Age FPNC (c) 2012

11. Percentage Of Recently Married Couples
Who Delivered A Living Child By Age Of
Marriage – Ten Populations 1600-1930
100
94 91 85
80
70
Percent
60
40 48 36
43 40 35
20
17
0 4
20-24 25-29 30-34 35-39 40-44 45-49
Age Group
Eventually Pregnant Pregnant The First Year
FPNC (c) 2012
Adapted using data from Menken J. Science. 1986; 23:1389.

12. Spontaneous Abortion Following
Documentation Of Fetal Cardiac Activity
Percent Spontaneous Abortion
30
20
20
15
10
4
0
0
<31 31-35 36-39 >39
Age
KE Smith. F&S. 1996; 65:35
FPNC (c) 2012

13. Maternal Age And Chromosomal
Abnormalities (Live Births)
Age Risk
20 1/526
25 1/476
30 1/384
35 1/204
40 1/65
45 1/20
Table adapted from Obstetrics: normal and problem pregnancies, third
edition. Edited by SG Gabbe, JR Niebyl, JL Simpson.
Churchill Livingstone, NY, NY. 1996, data from page 221. (c) 2012
FPNC

14. Increased Female Age Contributes to:
 Lower rates of conception
 Higher rates of miscarriage
 Higher rates of chromosomal
abnormalities
FPNC (c) 2012

15. Success Rates with Frozen Eggs
are Age Dependent
 Success rates with oocyte
cryopreservation via either slow-freeze or
vitrification appear to decline with
maternal age
 This is consistent with the clinical
experience with fresh oocytes
FPNC (c) 2012

16. (BTW, Male Fertility Declines
with Age Too)
 Instudies controlling for female age,
men older than 50 have pregnancy rates
23-38% lower than men under age 30.
Kidd SA. Fert Steril. 2001; 75:237.
 Some studies suggest a correlation
between advancing male age and
increasing miscarriage rates.
FPNC (c) 2012

17. The Pros and Cons of Egg
Freezing
FPNC (c) 2012

18. Egg Freezing – Considered Safe
 Considered very safe with proper monitoring by
specialist (reproductive endocrinologist)
 Possibly some discomfort, bloating during
stimulation
 Mild to Moderate ovarian hyperstimulation
– ~8.5% (ASRM 2008), monitoring helps avoid this
 Less than 1% experience any serious
complications, such as:
– Severe ovarian hyperstimulation
– Intraperitoneal bleeding
– Ovarian torsion
– Ruptured ovarian cyst
– Infection
FPNC (c) 2012

19. Egg Freezing – Considered Safe
A study of 200 infants born from 165 vitrified
oocyte pregnancies revealed no difference
in birth weight or congenital anomalies
among those born from vitrified oocytes
compared to children conceived after fresh
IVF.
FPNC (c) 2012

20. Egg Freezing – Considered Safe
 A recent review of over 900 live births derived
from cryopreserved oocytes, principally using
slow-freeze, suggests there is no increased risk
of congenital anomalies compared to the general
US population.
 Only about 1500 babies born worldwide from
frozen eggs – development of children must be
studied further to determine true outcomes
FPNC (c) 2012

21. Egg Freezing – Challenges
 Not all eggs survive the freezing or thawing
– Eggs have high water content
– Freezing can damage the cell membrane
– Vitrification (rapid freezing) has reduced this
problem
– Requires high concentrations of cryoprotectant
 Not all eggs will be likely to fertilize
 Not all transplanted embryos will continue to
develop
FPNC (c) 2012

22. Egg Freezing – Challenges
 Delayed pregnancy (40s)
– Patients in their 40s have a higher chance of
complications
 More difficult for frozen eggs to fertilize;
ICSI required
 ICSI may not deter transmission of
genetic abnormalities from sperm
 Not enough data about storing frozen
eggs
FPNC (c) 2012

23. Egg Freezing – Cost Efficient?
 Costs are similar to IVF:
– $9,850 for medical care and lab services
– Another $2,000-$6,000 for medication
– Long term cryopreservation about $600/year
 Eggfreezing for “social” reasons is not
covered by insurance
FPNC (c) 2012

24. Drawbacks to Egg Freezing
 No guarantee that fertility is safeguarded
 May require several cycles to obtain
enough eggs for best chances
 Short and long-term costs
 Estimated that most women will never use
their frozen eggs
 May increase the number of much older
parents
FPNC (c) 2012

25. In Support of Egg Freezing
 Offers some control over reproductive
destiny
 Can provide women ‘a backup plan’
 Younger eggs have lower rates of
abnormalities
 Considered as safe as IVF
 Estimated success rates similar to IVF
FPNC (c) 2012

26. Success Rates for Egg Freezing
FPNC (c) 2012

27. ART Pregnancy Rates Using Fresh Eggs
70
60
50
Percent
40
30
20
10
0
5
7
26
30
32
34
36
42
44
46
28
38
40
<2
>4
Patient Age
Art Cycles Live Births National Data
Own Eggs Donor Eggs FPNC (c) 2012
Per Transfer CDC 2006

28. Egg Freezing – Success Rates
 Slow freezing – 2-10% per embryo transferred
 Vitrification – data suggest that:
– 85% will survive thawing
– Success rates similar to IVF
 45% pregnancy rate if eggs frozen before age 36
 More data needed to determine with certainty
 “There is good evidence that fertilization and
pregnancy rates are similar to IVF/ICSI with fresh
oocytes when vitrified/warmed oocytes are used
as part of IVF/ICSI in young infertility patients
and oocyte donors.” (ASRM 2012)
FPNC (c) 2012

29. FPNC 2010 Ongoing Pregnancy per
Embryo Transfer Procedure
PER PROCEDURE
2010 Ongoing Pregnancy per <35 35-37 38-40 41-42
Embryo Transfer Procedure Years Years Years Years
Fresh IVF with Own Eggs
(n=323) 44% 34% 34% 28%
Frozen Embryo Transfer (FET)
with Own Eggs (n=148) 41% 37% 36% 2/11
Fresh IVF with Donor Eggs All Ages
(n=29) 55%
This data showing ongoing pregnancy rates is not final, and has not yet been
reported to SART/CDC. Final “Live Birth” rates will be reported when the
outcomes for all ongoing pregnancies are known. FPNC (c) 2012

30. Egg Freezing – Success Rates
 Best chance of success for one pregnancy:
– Women under 35
– 20 eggs frozen (may require multiple cycles)
– Still, NO guarantee of successful thaw,
fertilization, implantation, or live birth
FPNC (c) 2012

31. Your Options
 Timelyand natural conception
 Frozen eggs
 IVF
 Frozen embryos
 Donor eggs
FPNC (c) 2012

32. Can ART Make Up For Babies Lost By
Delaying Attempts to Conceive?
Begins Pregnant Not ART Total
Attempt % Preg Pregnant
At Age
30 91 9 - 91
35 82 18 4 86
40 57 43 7 64
Assume attempt 4 yr if <35, 3 yr if 35-40, 2 yr if >40;
2 cycles of IVF
Leridon. Hum Reprod 2004;19(7):1548-53.
FPNC (c) 2012

33. Best Defense Against Infertility:
Follow a Healthy Lifestyle
 Maintain a healthy diet and weight
 Moderate, regular exercise
 Prenatal vitamins
 Minimize caffeine
 Avoid smoking and alcohol
 Avoid / treat sexually transmitted diseases
FPNC (c) 2012

34. Key Messages
 Prevent infertility by appropriate life choices
 Plan your career AND your family
 Don’t wait for perfection—there is never a
perfect time to start a family
 Test your ovarian reserve
 Seek expert help if any risk factors are
present
 Know the facts about your reproductive life
FPNC (c) 2012

35. We appreciate your feedback.
Please use the evaluation form to share
your thoughts with us. Thank you!
Questions & Answers
FPNC (c) 2012