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Egg Freezing: Are Women Waiting Even Longer to Have Kids?
November 12, 2014
The recent media attention on egg freezing has many wondering how the timeline for patients pursuing fertility preservation or fertility treatment is impacted.
As it stands, many women are only beginning to think about their fertility in their late 30s and early 40s. In fact, NBC News reported earlier this year that there has been a 900% increase over the past four decades in women over 35 having their first child. Could this trend lead prospective patients to inquire about their ovarian reserve sooner, or will women who are waiting even longer to pursue family building find they missed the boat?
Dr. Jeffrey Russell of Delaware Institute for Reproductive Medicine has observed that while egg freezing patients are coming in for a consultation sooner than they had in the past, women are still waiting until their late 30s to talk about fertility preservation. “The trend used to be that (egg freezing) patients were older, in their early to mid-40s coming to freeze because they felt once they hit 40 and didn’t have a partner; they really needed to figure out their options. The trend now is that more patients are ages 35 to 40. This is largely due to education, the media, and publicity around egg freezing,” he says.
“As recent as four years ago, the majority of egg freezing patients were looking to freeze prior to cancer treatment or chemotherapy. Now, there are many more coming in for elective cryopreservation, including residents and physicians, who worry that it will be too late to have a baby once they finish their residency,” adds Dr. Scott Lucidi of Virginia Commonwealth University Health Systems.
Although professional women are still waiting to pursue fertility treatment, it seems the buzz around egg freezing has landed more proactive patients in the waiting room- at least to get some information about their fertility. Patients in their mid-to-late 20s are said to be the prime age for egg freezing, particularly if they have family history of infertility or early menopause that could impact future fertility.
Whether a woman is ready to have a child or not, the smartest thing she can do for herself is to go for a consultation with a Reproductive Endocrinologist to find out where she stands on the fertility timeline. In this consultation, she will have blood drawn to measure hormones predictive of ovarian reserve: Anti Mullerian Hormone (AMH) and Follicle Stimulating Hormone (FSH). She will also undergo a brief ultrasound to measure the size and shape of her ovaries as well as antral follicle count (AFC), or number of follicles expected to respond to a stimulation cycle. The results of these tests combined will tell the doctor if a patient is a candidate for egg freezing, if she should start considering her reproductive options now, or if she will need an egg donor when she is ready to conceive.
Dr. Russell explains that based on the “fertility workup” not every woman will be a candidate for egg freezing, regardless of her age. Multiple stimulation cycles may be recommended for a woman to bank enough eggs to increase her chances of conception. “We also talk to the patient about success rates of using an egg donor. We give them both scenarios - egg freezing and donor egg IVF- so they can decide which option is right for them,” Russell says. A woman in her early 40s has less than 5% chance of getting pregnant with her own eggs, even with advanced technologies like IVF so donor egg IVF may be the best option for her.
“It might be more successful and cost effective for a 42-year-old to save up for a donor egg IVF cycle rather than trying to conceive with her own frozen eggs,” Lucidi states. Fertility doctors strive to help patients make educated decisions about their reproductive future choosing the most successful and cost-effective option. Depending on a patient’s current relationship status or openness to donor sperm, the doctor might advise the egg freezing patient to also freeze one or two embryos for additional family building insurance down the road. Pregnancy success rates of fresh eggs and frozen eggs are comparable, though embryo freezing could give a patient one more option to build her family.
Given the detrimental effect of age on ovarian reserve, it is better to consider your fertility options sooner than later.