The Future of Egg Freezing: From The Perspective of a Reproductive Endocrinologist

A lot of us have simple questions about our fertility, but it can seem like a big step to make an appointment with a fertility doc just to get a few basic answers. Lucky for you, we interviewed a prominent fertility doc for you to get answers to the most pressing questions about fertility and egg freezing. You can thank us later :)

Meet Dr. Mark Denker! He is a Reproductive Endocrinologist - an OBGYN who specializes in alternative reproductive technologies like egg freezing and IVF. He is an expert in women’s fertility and has experience with a wide range of reproductive health issues - from birth control in teens to hormone replacement in menopausal women. In vitro fertilization (IVF) and egg freezing are of particular interest to those in between puberty and menopause – 20-somethings and 30-somethings, especially.

The first thing Dr. Denker clarified for us is that “egg freezing is a misnomer.” Post-harvesting, eggs go through a procedure called vitrification, which is a fancy term involving dehydration and solidifying in a glass -like state. According to Dr. Denker, during vitrification all water is removed from the eggs, which is important because ice crystals are prickly and can puncture the egg cell’s delicate membrane. The dehydrated eggs are then suspended in organic “antifreeze” prior to being stored in liquid nitrogen. Eggs can remain “frozen” for several years because the cold temperature (-196 degrees Celsius) makes them have virtually no expiration date. They just hang out in the freezer where they sit like tiny glass marbles.

Dr. Denker believes that egg freezing is underserved in the young female population. “Young women that are just starting careers may be smart enough to start actively planning for retirement, but if they know that they want to someday be a mother, they should also start planning for their families,” explains Dr. Denker.

He further emphasizes why family planning is so important by pointing out that, “regardless of whether an egg is frozen or ‘fresh’, if they are from a woman in her 20s, the risk of abnormalities is about 20-30%. Alternatively, eggs from a woman in her 40s may have a 60% risk of genetic defects.”

Unfortunately, most employers and health insurance plans don’t even offer IVF benefits for women who are infertile, let alone egg freezing for women who want to be proactive about preserving their fertility. There is also a lack of education about egg freezing that is a significant societal obstacle to widespread adoption of the procedure. For example, Dr. Denker clarifies one of the common myths that he hears: “Women in their 20s may be afraid that egg freezing uses up eggs, which is not at all true. Each month, a woman ovulates over 100 eggs. However, only one of them reaches maturity that month and actually ovulates from the ovary. The other 99+ eggs that don’t reach maturity die inside the ovary. So every woman loses hundreds to thousands of eggs per year whether or not she freezes them. By freezing them, she is just rescuing them from death.”

It is important to point out that just because a woman gets her eggs frozen, that does not mean she has to ever use them, or even plan to use them. Freezing eggs provides her with a kind of insurance policy in that it is a way of preserving her fertility in case there are problems if and when she is ready to start a family. Many women who have frozen their eggs still plan to conceive the natural way, if their biology allows it when they are ready. But, for example, if a woman doesn’t end up being ready for kids until 38, she reduces chances of a natural conception and increases the risk of genetic defects. If she had the foresight at 25 to freeze eggs, all doctors would have to do is warm them up and mix them with sperm of her choice to cause fertilization. Voila!

Even in mid to late 30s, egg freezing can be a viable option. Older eggs are still eggs and thus have the potential to be fertilized and grow into an embryo. But, for eggs that are fertilized in vitro (including all eggs that are used after egg freezing), they have the added benefit of being able to go through a process called pre-implantation genetic testing, or PGT, prior to being implanted into the uterus. According to Dr. Denker, PGT uses a microscopic laser to remove some cells from the outer layer of the embryo in order to do genetic tests on the sample to identify any abnormalities. Abnormal embryos (e.g., if there is a genetic defect that will cause a complication for the baby) are discarded and not used for implantation. So if a 38 year old woman chooses to freeze her eggs, even though they are at greater risk of abnormalities, there is the potential for screening later on in the process, which may increase her chances of having a healthy baby when she’s ready.

While egg freezing is not at center stage in the fertility field right now, there are other forward-thinking clinics like Dr. Denker’s that place an emphasis on fertility preservation. Though these progressive clinics may not be easy to find, Dr. Denker envisions that they will grow in prominence in the next 5 to 10 years, because of platforms like Freeze which are educating about the benefits of the procedure and making it easier for women to find clinics that perform it. He strongly believes egg freezing will have a much larger spot in the conversation about family planning.

Curious about what clinics in your city offer egg freezing, and what it would cost? Check out the Freeze database for all the info you need to start your search. Start here -->

 

Of course, it’s important for all women - regardless of age - to remember that even if she freezes her eggs, it’s not a guarantee that she’ll have a successful pregnancy from the eggs later on. There are also risks (as with any medical procedure) that your doctor will review with you if you decide to explore egg freezing as an option.