by Lauren Streicher, MD
If pregnancy is years away, the perfect solution would seem to be to simply store your eggs until you are ready to use them. Every day I have patients that inquire about freezing eggs in order to increase the possibility of conceiving if life circumstances put pregnancy on hold.
While freezing embryos (an egg that has been fertilized with sperm and is at an early stage of development) is very successful, and has been an option for years, the technique of cryopreservation of unfertilized eggs, until recently was not routinely recommended since in many cases a thawed egg was not always a viable egg . In the last few years however, the technology of egg freezing (and thawing) has dramatically improved, and while not always a guaranteed success, is the best option for someone who doesn’t have sperm in their life, and would like to increase the chances of a biologic baby down the road. The big question is always timing. Most women are not thinking about freezing their eggs when they are in their twenties. By the time someone is considering it (usually in their late thirties or early forties), egg quality is already sub-optimal.
A 2013 Belgium survey asked women one year after they froze their eggs, if they were glad they did, and if they intended to use them.
In this study,
75% of women said they believed they were less likely to use the frozen eggs than at the time they had them retrieved.
34% said they were unlikely to use their frozen eggs.
96.2% said they were glad they froze eggs,would recommend it to others and would do it again.
70.6% however wished they had done it at a younger age when there was a better chance of a healthy egg.
So back to timing. While the number one predictor of fertility is age, there is a significant variability in ovarian aging which make some women infertile at 35, and others still going strong at 40.
Anti-Mullerian Hormone, (AMH) isprobably the best way, way to evaluate someone for ovarian reserve…essentially how good your eggs are, and how long they will be functional.
AMH is secreted by cells from follicles in the ovary. Follicles are only present if healthy eggs are still around. AMH declines with age as the “good” egg pool declines and is completely gone after menopause. Unlike other hormones used to measure fertility, AMH doesn’t vary through the cycle and can even be measured by a blood test even in women who are taking birth control pills. While AMH is considered to be a reasonably reliable way to know what ovarian reserve is there, there is not consensus as to what the lowest “OK” level is. In general, if AMH is above 0.5, there is good ovarian reserve.
So even if you are not going to use it, a little money in the bank can be a good idea. If you have the money, your AMH is still high, and youdon’t mind going through hormonal stimulation and egg retrieval, egg freezing is currently the best option to stop the clock. The best time to consider it, however, it is long before you will likely, if ever, need it.
Originally published Jul 10, 2013 EverydayHealth. Edited Sept 2, 2015