Dr Shruti Salampuria- Sawant, MBBS, MD (Obs & Gyn), Fellowship in Reproductive Medicine, Consulting Clinician, Aksigen IVF

Modern fertility treatments give women and couples new ways to plan for children. A female might delay pregnancy to focus on career goals, wait for the right partner or protect fertility before medical treatments like chemotherapy.

When is the right age to do egg freezing?

A woman is born with a fixed number of eggs since birth, that is called the egg or ovarian reserve. As the age increases, there is a constant decrease in this egg supply in terms of both quality as well as quantity. There is a rapid decline in female fertility after 35 years of age.

So the best age to freeze eggs would be the prime reproductive years, early 20s to early 30s.

There is a common misconception whether oocyte freezing is only for the older group, but-

Younger women usually produce higher-quality eggs which increases the chance of successful future fertilization. On the other end of the spectrum, if a woman in her late thirties also plans for egg freezing in absence of a partner. This can provide a way to preserve her fertility. The sooner it is done, the better.

Tests to be done before egg freezing

• Ultrasonography for Ovarian Reserve- Antral Follicle Count
  • Hormonal test for Ovarian Reserve- Anti-Mullerian Hormone AMH
  • Infectious Disease Screening.
  Procedure
• • Injectable Hormonal Injections are given to stimulate the ovaries in a controlled manner to produce multiple eggs.
  • Regular ultrasound guided monitoring is done and some blood test till the follicles (Fluid filled sacs which contain the egg) are ready for retrieval.
  • This usually requires 10-14 days.
  • Egg Retrieval is done under sedation.
  • It is done transvaginally under ultrasound guidance.
  • The eggs that are retrieved are assessed for their quality and then cryo-preserved and stored.
  The eggs are frozen with a technique called as vitrification. The eggs are placed in a special media that has cryoprotectants. This substance prevents formation of ice crystals that can damage the egg during cryopreservation. The eggs are then rapidly cooled using liquid nitrogen (-196 degree Celsius). This ultra-fast cooling transforms the water inside the egg into glass like state, thus preserving them from forming ice crystals. Once vitrified, the eggs can be stored for a long amount of time in the cryotanks under liquid nitrogen.

How long can these be frozen?

Eggs have the ability to last many years without losing their quality.

Any gamete (egg or sperm) or even Embryo can be frozen for a duration of 10 years.

Does this affect your natural fertility?

Egg freezing usually does not speed up menopause. It mainly matures and collects the eggs that were already recruited in that cycle. The long term ovarian function is not typically “used up” by the process.

Future of Stored Gametes

• In INDIA, the frozen eggs or sperm cannot be stored indefinitely. Clinics usually require periodic consent renewal and storage fees. If patient stops responding it can be considered as abandonment.
• Donation- Sale of gametes is illegal (Commercial trading). Any gamete donation must occur through registered ART banks.
• Research- Stored gametes can be handed over for research purposes to institutes registered under ART ACT after a valid written consent is taken.
• Perish- If the gametes are no longer needed, the clinic may allow them to perish or medical dispose them. If the owner chooses to discard or if the 10 years’ storage limit has expired.
• Posthumous use of gametes is allowed only if the concerned person has given a prior consent.z