Dr Tallon's Blog

Dr Niamh Tallon MB BCh BAO, FRCSC

Egg Freezing during the Pandemic

Who would have known, that a pandemic would spur women to consider egg freezing? Over this last year, we have seen more women pursuing this fertility preserving intervention, to pause the effects of time on their eggs. Perhaps, these months have given us all the space to consider and focus more on what we want. The slower pace of a pandemic, shifting to working from home, medical appointments offered with ease from your own computer or telephone, culminating in greater access to advice and action.

There is no question that today’s women are more aware of their own biological capabilities. My eleven year old daughter has declared her egg number has started to decline, not knowledge bestowed from an intense fertility specialist mother, but from the basic education offered today in our schools. We also learn from the stories around us; Janet Jackson had a successful pregnancy through the use of donated younger and more robust eggs, allowing her the opportunity to carry a pregnancy at the age of 49yrs, when the natural odds were slim to none. This story highlights how our eggs quality and capability for pregnancy diminishes with time but, the female uterus can continue to support a healthy pregnancy, if given a healthy embryo, from a younger healthier egg.

More recently, Naomi Campbell showed the world her son, achieved from thawing her own younger eggs- she pro-actively safe-guarded some of her younger eggs. The time of empowered reproductive decision making isn't just upon us, it started a few years ago. The concept to try and make the best of our biology is not new. What is new, how openly we are talking about our reproductive options with friends, mothers, sisters and partners; all wanting to safe-guard the same thing, a plausible chance for future biological pregnancy and family.

And it is not just women who are looking to harness the advantages of today's freezing technology. An ever growing number of couples are interested in planning their family lives together, acknowledging and balancing their desires and ideal timelines, whilst taking any protection on offer with fertility treatments such as embryo freezing. The goal is the same as egg freezing, set aside your best quality embryos of today; assets with greater returning value as time passes. Decision making as to whether eggs or embryos are frozen can be complicated, as the reproductive effect of time is primarily a female issue yet, committing your eggs to a partners sperm means they have influence on how you can use those embryos later in life. I see women and individuals defining how strongly they want to autonomously own their eggs, gaining full decision making rights around their reproductive lives, even when a partner is present. Not uncommon ground in a prenuptial agreement.

Today’s freezing technology, known as vitrification, allows for high survival rates (>90%) for both eggs or embryo and the best pregnancy rates are achieved, when the eggs are harvested in your prime ( late 20s- early 30’s). The arguments against freezing include the possibility of one not ever using or needing them, and for the lack of a guarantee for success. Well, I have yet to meet a woman who froze her eggs and regretted natural pregnancy. If anything, the frozen eggs become more valuable, when she decides to try for another child at a more advanced age. Egg and embryo freezing will likely contribute to couples achieving bigger family sizes in the future, with these added natural successes. For the individual who doesn’t meet a partner, they still have options to consider using donor sperm and consider parentage as a single person. Some split the difference- commit some eggs to donor sperm for pregnancy now and keep some eggs for later, holding out in the hopes of finding their partner.

It is true, there is no guarantee that your set of eggs or embryos will definitively bring you a future live birth. But, you can try to get close to it. There are educated guesses, based on valid statistics, that project if your frozen material will bring you success. We can take this a step further with egg freezing using AI technology, Violet imaging, to gain you a better insight as to your eggs likelihood to make embryos. Embryos can be screened for chromosomal age related issues using PGT-A, pre- implantation genetic testing for aneuploidy, which helps determine the best embryos for future use. When looking to achieve your best possible outcome, you need an experienced fertility clinic, with supporting outcomes and real measures of success.

The literature from patients freezing their eggs before sterilizing chemotherapy or surgery, certainly supports fertility preservation treatments as bringing relief and hope for the future. Given the technology and tools of today, I can see the ever growing interest for all.