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Give Birth to Healthy Babies at Age 42, through Oocyte Preservation

oocyte-preservationInfertility is a common issue among both men & women nowadays & there are several treatments available in India. Normally, it is very difficult to conceive children when women are above 35 years of age. Egg-Freezing or Oocyte Preservation is an ideal technique which is available to women who are planning to have children at a later point of time in their lives. 10 – 20 eggs are usually harvested so as to ensure proper pregnancy in future. These eggs can be fertilized & embryos emplanted into womb using IVF cycles, whenever women are ready to conceive. At least 8 eggs are required in each of the 2 – 3 IVF cycles in order to ensure high rates of success as it is found that only 70 – 80 percent of the eggs survive the freezing procedure. However, extra eggs can always be preserved for a second pregnancy.

What is Oocyte Cryopreservation?

Also known as Mature Oocyte Cryopreservation, this is a egg-freezing method which is used to preserve reproductive potential in women. Eggs for this purpose are harvested from ovaries, frozen & stored unfertilized so as to be used later in time. Frozen eggs can eventually be thawed over time & combined with sperm in a laboratory & implanted in uterus through in vitro fertilization Assisted Reproductive Techniques. Doctors during initial consultation for oocyte preservation will help patients understand how egg freezing will work, potential risks & whether this technique of fertility preservation is good for the patient based upon their personal reproductive history.

Why Undergo Oocyte Cryopreservation?

Egg freezing is an ideal option for women who are not yet ready to become pregnant at this point of time but would like to try & ensure ability for pregnancy or having a biological child in future course of time. Unlike embryo cryopreservation or fertilized egg freezing, oocyte preservation does not require any sperm just because eggs will not be fertilized before they are frozen. However, like with embryo freezing women will need to use fertility medications to induce ovulation so that they can produce multiple eggs for retrieval.

Women May Consider Egg Freezing in the Following Circumstances

  • Women about to Undergo Treatment for Cancer – Or other illnesses which may affect potential for fertility in future. Certain medical treatments like chemotherapy or radiation therapy can harm fertility in women. Oocyte preservation prior to such treatments can allow women to have biological children at a later point of time.
  • Women Undergoing In Vitro Fertilization. Egg freezing may be needed in case the partner is not able to produce sufficient sperm on the day of egg retrieval. Some people prefer egg freezing to embryo freezing for ethical or religious reasons while undergoing in-vitro fertilization.
  • Women Wishing to Preserve Younger Eggs for Use in Future – Freezing of eggs at a younger age will eventually help women preserve their ability to reproduce when time is right at a later date.

Women can conveniently use their frozen eggs to conceive biological children with sperm from a partner or sperm donor. Donors can either be known or anonymous. Women can also take services of a gestational carrier by implanting embryos in uterus of another woman.

Good Candidates for Oocyte Preservation

Good candidates are generally women who have not yet found an ideal partner or those who have certain goals to achieve before opting for motherhood. Other than these, women who are down with cancer & are opting for cancer treatments which may damage their ovaries in the process. It would be ideal for them to go for egg-freezing procedure before undergoing treatments like chemotherapy. 32 – 33 years is a good age for women who are choosing to freeze eggs for social reasons.

Preparing for Oocyte Preservation

Women considering freezing eggs should look for fertility clinics having expertise in this field. Commonly known as reproductive endocrinologists, these experts are most likely to undertake blood screening tests before beginning the egg freezing procedure. Some of these tests are listed below.

  • Ovarian Reserve Testing – This test is required so as to determine quantity & quality of eggs. Doctors for this purpose may test the concentration of follicle-stimulating hormone (FSH) & estradiol in blood on the third day of menstrual cycle. Results obtained from these tests will help predict how ovaries would respond to fertility medication. Ultrasound & other blood tests of ovaries may also be recommended in order to make complete assessment of functioning of the ovaries.
  • Infectious Disease Screening – Egg freezing patients will be screened for certain infectious diseases like HIV. Eggs that are potentially infectious are stored differently than other normal eggs which are not infectious.

Ask these questions before moving forward with the egg freezing procedure.

  • When are you planning to become pregnant? Patients must weigh the probability of time as to when they would like to become pregnant & probability of a successful pregnancy at that age by using eggs that have been frozen for the purpose.
  • How many eggs will you like to freeze? Fertility experts recommend freezing at least a total of 20 – 30 eggs & thawing about 6 – 8 eggs for every pregnancy attempt depending upon the age & egg quality of patient. Doctors may as a result often recommend that patients undergo ovarian stimulation more than once. Ovarian stimulation is a process of injecting medication meant to stimulate ovaries & thereby increase egg production.
  • What would you do with unused eggs? Patients may also consider donating unused frozen eggs to childless couples or to a research facility. However, they can choose to discard unused eggs if they are not inclined to any type of donation.
  • What is the maximum period of preservation? Official cut-off date for egg freezing is not yet set as technology of vitrification is relatively new. However, women can check with the oocyte cryopreservation facility if they have any time frame.
  • What are the success rates of pregnancy following oocyte cryopreservation? Chances of a single frozen egg leading to live birth are 2 – 12 percent as per guidelines of the American Society of Reproductive Medicine. However, this probability will go up with higher number of eggs. Moreover, quality of the sperm will also influence the rate of success.
  • What are the side effects of oocyte cryopreservation procedure? Bloating & mood swings are commonly observed among women undergoing egg freezing procedure. There can also be nausea & abdominal pain among women where higher doses of drugs were used for egg retrieval.

Oocyte Preservation Procedure

Egg freezing procedure involves multiple steps which include ovulation induction, egg retrieval & egg freezing. Women are treated with stimulating hormones at the beginning of menstruation cycle for a week or more in order to stimulate ovaries so as to produce multiple eggs, rather than producing a single egg which they do every month. Several different types of medications are required for this purpose including some of the following.

  • Medications for Ovarian Stimulation Follicle-stimulating hormone (FSH) medications like Bravelle, Gonal-f, Flooistim AQ or human menopausal gonadotropins like Menopur may be injected in women in order to stimulate ovaries to produce multiple eggs.
  • Medications for Preventing Premature Ovulation Medications like gonadotropin-releasing hormone antagonist – Cetrotide or gonadotropin-releasing hormone agonist – Lupron may be injected in order to prevent premature ovulation among women producing multiple eggs for egg freezing procedure.

Doctors will ask patients to return for follow-up visits during egg retrieval process of egg freezing treatment. These visits are utilized for undergoing vaginal ultrasound procedure where sound waves are used to create images of inside of ovaries so as to monitor development of fluid-filled ovarian cysts or follicles where eggs mature. Blood tests are also conducted during these visits so as to measure response to ovarian stimulation medications. Estrogen levels within patients typically increase as these follicles develop alongside progesterone levels which remain low until after ovulation. Injections of human chorionic gonadotropin like Ovidrel or Pregnyl or other medications are given to patients, which help in maturing of eggs when follicles are ready for egg retrieval & which is generally after 8 – 14 days of time.

  • Egg Retrieval – Process of egg retrieval is typically done under sedation at the doctor’s clinic. Transvaginal ultrasound aspiration is the most common approach applied for this purpose. An ultrasound probe is inserted into vagina during this procedure so as to identify follicles. A needle is subsequently guided through vagina into the follicle & the suction device which is connected to the needle is used for removing eggs from the follicle. Multiple eggs from this procedure can be removed in about 15 – 20 minutes of time. Patients may at times experience cramping after egg retrieval procedure. Moreover, as ovaries remain enlarged feelings of pressure or fullness may also continue for weeks.
  • Egg Freezing – Shortly after unfertilized eggs are harvested, they are cooled to subzero temperatures in order to stop biological activity & preserve them for use in future. The structure of unfertilized egg is more difficult to freeze & subsequently lead to successful pregnancies than the makeup of an embryo or a fertilized egg. Fertility healthcare experts often use substances known as cryoprotectants in order to help prevent formation of ice crystals during the process of egg freezing.

Cryopreservation Freezing Methods

  • Slow-Freeze Method – Low concentrations of cryoprotectants are initially used in the slow-freeze method. Higher concentrations of cryoprotectants are subsequently used as metabolic rates of eggs decline due to gradual reduction in temperature. Slow-freeze method can also ideally be used in order to protect eggs from potential exposure to toxins in cryoprotectants.
  • Vitrification Method – High initial concentration of cryoprotectants are used in combination with rapid cooling in vitrification method so that intracellular ice crystals have no time to form.

Following Egg Retrieval Procedure

Patients can typically resume normal activities within 7 days following egg retrieval procedure. They must however avoid unprotected sex so as to prevent unwanted pregnancy which can occur with remaining eggs. Women should also contact the fertility healthcare expert in case they experience the following symptoms.

  • Fever higher than 38.6 C (101.5 F)
  • Severe pain in abdomen
  • More than 0.9 kg (2 pounds) of weight gain in 24 hours
  • Heavy vaginal bleeding which fills more than 2 pads in an hour
  • Difficulty in urinating

Oocyte Preservation Risks & Complications

  • Egg Retrieval Procedure Complications – Although rare, use of aspirating needle for retrieving eggs can cause infection, bleeding or damage to bladder, bowel or blood vessel. Moreover, risks associated with general anesthesia which may be necessary in some egg retrieval cases may also pose concern.
  • Conditions Relating to Use of Fertility Drugs – It is quite rare that using injectable fertility drugs like synthetic follicle stimulating hormone or luteinizing hormone will cause ovarian hyper-stimulation syndrome. This is a condition in which ovaries become painful & swollen soon after ovulation or process of egg retrieval. Other signs & symptoms of ovarian hyper-stimulation syndrome include diarrhea, vomiting, nausea, bloating & mild abdominal pain. Still more rare is the possibility of egg retrieval patient developing a more severe form of ovarian hyper-stimulation syndrome which can cause fluid build-up in abdomen along with shortness of breath.
  • Emotional Risks Involved with Egg Freezing – Egg freezing procedure can sometimes prove to be a false hope for women. Although deciding to freeze eggs may empower & provide hope to patient for a future, it is still no sure-shot guarantee of success.

For patients looking forward to have biological children with frozen eggs, risk of miscarriage will primarily depend upon the age at which the eggs were frozen. Research as of date has never shown any increase in risk of birth defects among babies who have born as a result of egg freezing procedure. Nevertheless, further research is however needed so as to confirm safety of oocyte cryopreservation procedure.

Oocyte Cryopreservation Outcomes

Eggs will be thawed, fertilized with a sperm in the laboratory & subsequently implanted within the same woman’s womb or in a gestational carrier’s uterus when they choose to use frozen eggs. Fertility healthcare experts may recommend using a fertilization technique known as Intra Cytoplasmic sperm injection or ICSI in short. ICSI involves injecting a single healthy sperm directly into every mature frozen egg. Normally, about 90% of eggs survive the freezing & thawing procedure. Of these only 75% are found to be fertilized successfully. Subsequent chances of women getting pregnant after implantation are roughly 30 – 60 percent depending upon the age of patient at the time of freezing eggs. Lower the likelihood of women having live birth in future with increase in age at the time of freezing eggs. Women must keep in mind that pregnancy rates will be much lower when frozen eggs are being used in comparison with fresh eggs or frozen embryos.

Oocyte Cryopreservation in India

India is one of the most reputed medical tourism destinations in the world proving high quality affordable healthcare solutions including fertility treatments for both men & women. Healthcare infrastructure in the country is as per international standards along with constant upgrading of latest technologies. IndianMedTrip is the fastest growing medical tourism company in South Asia catering to international patients seeking a wide spectrum of medical treatments & surgeries. Associated with a number of accredited fertility clinics & hospitals in the subcontinent, IndianMedTrip healthcare experts will be delighted to combine an exotic recuperative vacation at reasonable costs to go along with your egg freezing procedure so as to make this a memorable experience.

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