Elective egg freezing (or social egg freezing) is a medical procedure that allows women to preserve their eggs for the future. This fertility preservation process involves extracting and freezing eggs from the ovaries, which can then be used for artificial insemination at a later date.[1] Through egg preservation , women can postpone having children until they are ready or when they find the right partner. Elective egg freezing also provides a possible solution for women who are unable to conceive naturally due to age or health issues, such as cancer. Egg banking allows women to take control of their reproductive goals and plan ahead for their future. Whatever you choose, it is important to understand the process, as well as benefits and risks by visiting your preferred health care professional.
Elective egg freezing, medically known as oocyte cryopreservation, involves controlled ovarian stimulation, which is followed by an egg retrieval procedure.[2] As of 2012, this process was no longer viewed as experimental[3], and it has been gaining popularity since, especially with recent world events. The elective egg freezing process involves several steps, from the initial consultation with a fertility specialist, to the egg retrieval and also storage of the eggs. The following guide will provide a step-by-step overview of the elective egg freezing process so that you can make an informed decision about whether this option is the right choice for you.
The complete egg freezing process takes up to 8 weeks and includes the following steps:[4]
Step 1: Preparation
Before getting started, your health care professional may perform a number of tests on you.
Step 2: Hormonal Stimulation[7]
Ovaries typically release one egg per month. During the egg freezing procedure, it is optimal to collect as many eggs as possible. You will typically begin hormone therapy at home and will need to administer hormone injections into your body in order to stimulate the ovaries. This helps develop multiple mature eggs in both ovaries and is a similar process to IVF (in-vitro fertilization) treatment. This process takes between 10 to 14 days. In this same period, another medication will also be prescribed to prevent you from ovulating early and releasing your eggs before the retrieval. Patients will need to visit their fertility expert 3-4 times during this period to do ultrasounds and blood tests, so that they can keep track of their egg development.
Step 3: Ovulation induction
A specialized drug is administered to start ovulation after the ovarian follicles have matured enough to allow for egg retrieval. At this stage, timing is crucial for the egg retrieval’s success.
Step 4: Egg retrieval
The egg retrieval process commences approximately 35-36 hours after ovulation induction. A needle is used to remove eggs from the ovarian follicles and this is usually done under intravenous sedation. Generally a painless procedure, some patients noted feeling sore and experiencing some bloating.
Step 5: Egg vitrification
Following the retrieval, the eggs are assessed,ensuring that only mature eggs are stored in the freezer. Although more eggs are developed during the stimulation process, compared to a regular cycle, some of these recovered eggs may not be mature, thus rendering them unsuitable for freezing. This is normal and expected
There are two significant advantages to women who anticipate becoming pregnant at a later stage of her life.
The medical risk most significantly related to egg freezing is ovarian hyperstimulation syndrome, which may result from ovarian stimulation. This could lead you to have symptoms such as
fatigue, nausea, headaches, abdomen pain, breast tenderness and irritability,[11] but these adverse effects can usually be well-controlled. However, a very low number ( 0.1% – 2%) of women may have severe ovarian hyperstimulation syndrome,[12] which can include blood clots, breathing difficulties, abdominal pain, dehydration and vomiting that may need medical attention.[13]
It is also important to note the emotional risks of the procedure. It is crucial to get the right counselling in regards to the realistic success rates of egg freezing as every person is different. Preserving eggs does not represent a full-proof insurance policy against age-related fertility decline[14].
This information can be substantial to take in so it is best for you to visit a healthcare professional or fertility specialist (there are several fertility specialists and fertility clinics in Malaysia and Singapore) to discuss your options.
As always, we encourage you to take our questionnaire to assess your fertility status.
References
[1]Mayo Foundation for Medical Education and Research. (2021, April 23). Egg freezing. Mayo Clinic. Retrieved January 17, 2023, from https://www.mayoclinic.org/tests-procedures/egg-freezing/about/pac-20384556
[2] Gale, J., Clancy, A. A., & Claman, P. (2020). Elective egg freezing for age-related fertility decline. Canadian Medical Association Journal, 192(6). https://doi.org/10.1503/cmaj.191191
[3] Petropanagos, A., Cattapan, A., Baylis, F., & Leader, A. (2015). Social egg freezing: risk, benefits and other considerations. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 187(9), 666–669. https://doi.org/10.1503/cmaj.141605
[4] Cryosinternational.com. (n.d.). The process of egg freezing – step by step. Cryos. Retrieved January 17, 2023, from https://www.cryosinternational.com/en-gb/cy-shop/private/fertility-preservation/egg-freezing-at-cryos/the-process-of-egg-freezing/
[5] Jirge P. R. (2011). Ovarian reserve tests. Journal of human reproductive sciences, 4(3), 108–113. https://doi.org/10.4103/0974-1208.92283
[6] Egg freezing. (2021, April 23). Retrieved February 1, 2023, from https://www.mayoclinic.org/tests-procedures/egg-freezing/about/pac-20384556
[7] Gale, J., Clancy, A. A., & Claman, P. (2020). Elective egg freezing for age-related fertility decline. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 192(6), E142. https://doi.org/10.1503/cmaj.191191
[8] Liu K, Case A. Advanced reproductive age and fertility. J Obstet Gynaecol Can 2011;33:1165–75. [PubMed] [Google Scholar]
[9] Thomas, C., Cavazza, T., & Schuh, M. (2021). Aneuploidy in human eggs: contributions of the meiotic spindle. Biochemical Society transactions, 49(1), 107–118. https://doi.org/10.1042/BST20200043
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467930/
[11] Al-Azawi T, Tavukcuoglu S, Khaki AA, et al. Cryopreservation of human oocytes, zygotes, embryos and blastocysts: a comparison study between slow freezing and ultra rapid (vitrification) methods. Middle East Fertil Soc J 2013;18:223–32. [Google Scholar]
[12] Joint Society of Obstetricians and Gynaecologists of Canada and Canadian Fertility and Andrology Society. The diagnosis and management of ovarian hypestimulation syndrome. J Obstet Gynaecol Can 2011;268:1156–62. [Google Scholar]
[13] Fact sheet: Ovarian hyperstimulation syndrome (OHSS). Birmingham (AL): American Society for Reproductive Medicine; 2014. Available: www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/OHSS_final_1-5-12.pdf (accessed 2015 Mar. 1). [Google Scholar]
[14] Alteri, A., Pisaturo, V., Nogueira, D., & D’Angelo, A. (2019). Elective egg freezing without medical indications [Abstract]. Acta Obstetricia Et Gynecologica Scandinavica, 98(5), 647-652. doi:10.1111/aogs.13573
SG-NONF-00259 | 12 June 2023
