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At 29, Mumbai-based Reshma was pursuing her career in banking, and a couple of years later she had to relocate to Chennai. At 34, she settled down after marriage and began thinking about starting a family. Like many others, she wasn’t sure, though. Was it the right decision? Was it the right time? Her case is just one among hundreds; her reality is that of umpteen women who have to juggle their careers and family lives. Life hardly follows a linear path these days.
Financial independence, career, relationships, and personal objectives are all parallel priorities that a woman must consider before deciding to have children. It’s in this context that fertility preservation becomes an important topic of discussion. Egg freezing and embryo freezing are the most popular forms of preservation choices. Both processes involve retrieving and freezing eggs, but the difference lies in the steps taken before freezing.
Egg freezing, or oocyte cryopreservation, involves stimulating the ovaries with medications to develop multiple eggs. These eggs are then collected through a short procedure and then frozen using a process known as vitrification. The eggs are then stored suitably. When a woman is ready to attempt pregnancy, the eggs may be thawed, fertilised with sperm in a laboratory and then developed into embryos for possible transfer to the uterus.
Egg freezing allows a woman to preserve her eggs without having to decide on a sperm source. This is ideal for women who are not yet ready to start a family. It may also be considered by women who are likely to undergo medical treatments that could affect ovarian function. But please note that egg freezing does not absolutely guarantee a pregnancy. The age at which the eggs are frozen and the number of mature eggs retrieved are among the factors that can affect the outcome. The success rates for egg freezing decrease significantly with age, and optimal outcomes happen when the eggs are frozen before age 35.
Initially, embryo freezing also follows a similar process. The ovaries are stimulated, eggs are retrieved, and they are then fertilised with sperm in the lab. The resulting embryos are then frozen for potential future use. For those couples who are ready to create embryos, this is an established method of fertility preservation.
However, unlike egg freezing, it requires a decision about the source of sperm at the time of treatment. Embryo freezing is also commonly used during IVF treatment. For instance, embryos may be frozen for a transfer at a later stage when a fresh transfer is not recommended, or even when additional embryos are available after an IVF cycle.
That decision is based on several variables. It depends on the age of the woman, the ovarian reserve, medical history, reproductive goals, relationship status and whether she is ready to make decisions about creating embryos. A woman who wants to preserve her reproductive options without deciding on a sperm source may consider egg freezing. A couple who have already decided to create embryos may consider freezing their embryos. Tests such as AMH may provide information about ovarian reserve.
Still, it is important to remember that AMH alone cannot predict the chances of pregnancy. It’s a proven fact that as women grow older, the number of eggs available declines, and the proportion of eggs with chromosomal abnormalities tends to increase. Your eggs age with you, but they don’t degenerate like other cells. This is one reason why the age at which eggs or embryos are frozen can be relevant to future pregnancy success.
Fertility preservation is not a passport or a guarantee of a future pregnancy. The eventual outcome can depend on the age at which eggs or embryos were frozen, the number and quality preserved, the response to treatment and other factors. The goal is not to encourage every woman to freeze her eggs or embryos, but to ensure that every woman understands her options early enough.
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