By Joshua Berger, MD,PhD.
Today’s women face more challenges and demands than ever before. Society and popular media are constantly bombarding young women about the new definitions of what success means. In the past, an emphasis was placed on becoming a housewife, making a good home, and preparing for a husband and a family. Although these are all good goals in general, they were the end game for many.
Women of this generation have also added a different set of goals to those already held by their families and beliefs. Women are entering professional fields at higher rates, becoming more educated and spending more time in their chosen professions before focusing on starting a family.
Although this trend is wonderful on many levels, in terms of childbearing it has been detrimental. Women go to their OBGYN for regular visits and because they are having their monthly flows, they think that everything is ok, and that they have all the time in the world to start a family.
Many do not realize that no matter how healthy, how fit, or how centered they are, their eggs do not care. The longer a woman waits to have a family, the less likely she is to be able to achieve those goals, until at some point she may not be able to carry a child from her own eggs.
The number one factor in determining a woman’s ability to conceive is her age at the time of trying. The highest chances for success are throughout her 20s. In her 30s, a woman’s ability to conceive begins to decline. The rate of decline increases after the age of 35, and thus the likelihood of starting a family also declines.
These social trends and biological facts are what drove our fertility network’s founder, Dr. Kwang Yul Cha, to focus on research and development in fertility preservation. Out of his team’s efforts, CHA became a global leader with some of the technologies that made advanced egg freezing possible today.
Women today can now opt to freeze their eggs so that they can preserve their ability to have children for a later date. By freezing eggs prior to the age of 35, a woman preserves her potential for a healthy family when her chances are higher.
How Does Egg Freezing Work?
Overall, the process is very similar to the procedure a woman undergoes in order to conceive at that moment via IVF (in vitro fertilization) with a Fertility Specialist. After an initial consultation, pre-screening and testing is performed to determine the special needs and treatment plan for the woman.
The entire treatment is closely monitored with blood work and ultrasounds, usually taking less than one month in total time commitment. Birth control pills usually begin the treatment cycle, followed by up to 2 weeks of injections used to stimulate the ovaries to develop more eggs than they normally would in that cycle.
Although this process has been overly simplified for this article, it is not much more complex than this. At the right time, the Fertility Specialist will stimulate the eggs to mature, and then later retrieve them under direct ultrasound guidance. This outpatient procedure is typically done in less than 30 minutes.
After some processing in the embryology lab to prepare the eggs for freezing, they are rapidly frozen via a process called vitrification. Our Laboratory Director at CHA Fertility Center, Los Angeles, Dr. Simon Hong, was part of the team that developed this technique, which has become the gold standard in egg and embryo freezing.
Each egg is given a unique identifier, and once vitrified it is placed in a storage rod so there is no comingling. They are then placed into the liquid nitrogen storage tank, or “egg bank,” and catalogued for accessibility later. These frozen eggs can be stored indefinitely, and depending on the age at the time of thaw, one can expect greater than 80% successful thaw rate. This means that for every 10 eggs frozen a woman can reasonably expect to have 8 eggs for use!
What Happens After?
When a woman is ready to have children, she can have her frozen eggs thawed and fertilized with either her partner’s or a donor’s sperm. Her body is made ready for pregnancy with some simple medications and the uterus is made receptive to the embryo that will be placed inside. This step is essentially the latter part of IVF.
Is Egg Freezing Safe?
While long term data is not yet available, the largest study of over 900 children born from frozen eggs has shown no increase in birth defects, and other studies have shown no increase in genetic defects. For mothers, there has been no increased risk of pregnancy complications in comparison to women conceiving naturally at the same age level.
How Much Does Egg Freezing Cost?
Egg freezing can cost anywhere from $8000 to over $15,000. Costs depend on a variety of factors including which clinic is chosen, what medications are needed for the individual woman, and how many cycles she wants to do. Only when a woman has been evaluated can costs be determined more accurately.
What to Look for When Choosing an Egg Freezing Center
Success rates are dependent upon the skills and familiarity with egg freezing techniques techniques. With over 15 years of continuous operation, CHA Fertility Center, Los Angeles is the first and longest-running publicly accessible egg freezing center in the world. Also, the gold standard egg and embryo freezing technique used throughout the world was developed here, so we have extensive familiarity and experience with properly freezing and thawing frozen eggs.
Other items to look for include longevity of staff, on-site embryology lab and storage facilities, and continuously running laboratory facilities.
The Use of Egg Donors
While infertility affects 1 out of 7 women, the good news is that 3 out of 4 women can benefit from today’s treatments. For that 25% of couples that are not able to proceed with treatment using their own eggs for either medical or other situations, there is still the hope of carrying a pregnancy. Even women that are after menopause can successfully carry a pregnancy because the uterus itself is just the vessel that holds and maintains the pregnancy. Once pregnant, the ovaries have very little to do with the pregnancy, so even without ovaries women can get pregnant with the help of an egg donor. Who would deny that a woman who carries a baby in her womb for ten months, and changes its diapers, and gives milk from her own bosom is that child’s mother? Not a single person! So, even if life’s situations have left a woman without the chance of using her own eggs, there is always the possibility of being a mother and experiencing the same gift of life that other women have.
Another important fact to remember is that during the 10 months of pregnancy, the growing baby is exposed to all of the woman’s own hormones. This results in certain genes being turned off and turned on in a unique pattern that would never have happened in another person. So, the child that is born is unique to that mother and father, no one else could have made that child the way it is.
As a reproductive endocrinologist, I have the privilege of being present at very private moments for a couple. I will tell you that there is no difference between the intimacy and uniqueness of the event of embryo placement in the uterus following IVF treatments. Whether from a woman’s own egg or a donor’s egg, at the moment of embryo transfer all is forgotten and the focus is on the future of that child. It is the same anxiety that every expectant mother shares.
So, using an egg donor carries no shame, nor should it. For women with no option to use their own eggs for whatever reason, it is the gift of life that someone is giving to them and their loved ones.
ABOUT DR. JOSHUA BERGER
Joshua J. Berger, MD, PhD, FACOG, serves as the Medical Director of the Los Angeles branch of CHA Fertility Centers, the pioneer of now-standard egg and embryo freezing technologies.
Dr. Berger is a Reproductive Endocrinologist who was awarded the Clinical Research/Reproductive Scientist Training Scholarship (CREST) by the National Institutes of Health, Duke University and the American Society of Reproductive Medicine (ASRM).
A Los Angeles native, Dr. Berger returned home after his undergraduate studies at The Johns Hopkins University. He completed two doctorates concurrently at UCLA one in Physiological Science and the other in Medicine. His OBGYN training was at Tufts University in Boston, and his fellowship in Reproductive Endocrinology and Infertility at the University of Alabama at Birmingham. Dr. Berger has over 16 years experience in Women’s Reproductive Health.
ABOUT CHA FERTILITY CENTERS
Since 2001, CHA Fertility Center, Los Angeles, located near museum row at Wilshire and La Brea Boulevards, has helped fulfill the dreams of over 10,000 aspiring parents from Southern California and beyond in over 22 countries using the latest in Assisted Reproductive Technology (ART) such as in vitro fertilization (IVF), intrauterine insemination (IUI), genetic testing (PGD/PGS), and embryo and egg freezing (cryopreservation). CHA Fertility Centers is one of the largest fertility treatment networks in the world performing upwards of 15,000 cycles annually.
CHA Fertility Centers is part of CHA Health Systems, a global network of hospitals, clinics, research and academic institutions, and health and biomedical ventures. Since its founding in 1960, CHA Health Systems has touched and improved over 5 million lives across the globe.
CHA Fertility Center,
5455 Wilshire Blvd. #1904,
Los Angeles, CA 90036