Fertility Treatments

Egg cryopreservation

Egg cryopreservation is a method of freezing and preserving a woman’s eggs in order to give her the chance to conceive and bear a child in the future.

Introduction

Egg cryopreservation, also known as oocyte cryopreservation, is a technique to freeze and preserve a woman’s eggs to provide her with a chance to get pregnant and bear a child in the future. 

After being harvested or retrieved from your ovaries, your eggs are frozen for future use instead of being fertilised. Then, the egg can be thawed (gently warmed), fertilised with the sperm in a petri dish in a fertility lab, and placed in your uterus for implantation. This process is known as in vitro fertilisation with frozen eggs. 

During the initial consultation, the doctor will provide you with the details about this fertility preservation technique and its potential risks. They will also tell you if it is beneficial for you based on your personal medical and reproductive history. 

During your reproductive age, this process is conducted before the step of fertilisation. The first successful birth through this procedure was carried out in 1986. But in the past three decades, the technology has improved massively, improving its success rate and bringing down the risks associated with it, to the point of it no longer being considered an experimental procedure. 

Thanks to the latest technological advancements in this technique, women can now have a much better hold on autonomy, along with enhanced egg survival, improved fertilisation and birth rates.

Why Is It Done?

Egg cryopreservation can be an excellent option if you are not ready to be pregnant and become a parent at the moment but want to ensure you do at some point of time in the future. 

With embryo cryopreservation, the doctor will first fertilise your eggs with your male partner’s sperm to create embryos, which will then be frozen for preservation. But with egg cryopreservation, the doctor will freeze your eggs right after retrieval, before they are fertilised with the sperm. 

But just like with embryo cryopreservation, the doctor will provide you with ovarian stimulation or ovulation drugs to increase the production of eggs in your ovaries. They want to ensure that multiple eggs are retrieved for the preservation procedure, as not every egg may survive the process. 

Here are a few cases in which you may consider egg cryopreservation: 

  • You may need to undergo treatment for cancer or some other severe illness that may affect your fertility

Cancer is one of the most severe illnesses worldwide, and a few of its treatments are chemotherapy and radiation therapy. Unfortunately, these treatments may have adverse effects on your fertility. That’s why the doctor may advise you to preserve your oocytes for future pregnancy. 

  • You want younger eggs for pregnancy in the future.

Older eggs may not always result in a successful pregnancy. So you wish to preserve the eggs at a younger age to have a chance of conceiving a child in the future.

  • You have been diagnosed with a medical condition that may affect your fertility.

There are several medical conditions that may affect your fertility, including sickle cells anaemia, degenerative or autoimmune diseases like lupus, and even gender replacement to become a transgender. In that case, you may wish to freeze some oocytes to have a shot at becoming a parent in the future.

  • Undergoing IVF or in vitro fertilisation

While going for in vitro fertilisation, you may opt for egg cryopreservation instead of embryo cryopreservation for any reason. 

  • After being frozen, these eggs will be thawed (gently warmed) at the time of IVF or other reproductive techniques for fertilisation with your male partner’s or an anonymous donor sperm. Then, the resultant embryo will be placed in the uterus for implantation. It can be placed in your uterus or a gestational carrier’s uterus (in the case of surrogacy).

Are There Any Risks?

As with most other medical procedures, there are a few risks associated with egg cryopreservation. These risks are as follows:

  • Complications during the process of eggs retrieval

The eggs are retrieved from the ovaries with the help of a fine aspiration needle. Although it is pretty rare, this needle may lead to issues like bowel damage, damage to your urinary bladder and blood vessels, bleeding, infections, etc. 

  • Complications associated with fertility or ovarian stimulation drugs

Sometimes, the doctor may provide you with ovarian stimulation or fertility drugs, such as HCG or human chorionic gonadotropin to increase egg production in your ovaries. But in rare cases, these drugs may result in a condition called ovarian hyperstimulation syndrome, due to which your ovaries may become swollen and painful after the process of egg retrieval. A few signs and symptoms that may indicate ovarian hyperstimulation syndrome are nausea, abdominal pains, diarrhoea, bloating and vomiting. 

  • Emotional complications

Because of its reported success rates, this technique may leave you with false hopes of pregnancy. The success of IVF may get curbed when combined with egg cryopreservation. Depending on your age during the egg retrieval, you may suffer a miscarriage in case of child conception with the help of the egg cryopreservation technique. 

  • Due to anaesthesia

You may be put under anaesthesia during the egg retrieval process. You may experience a few problems like vomiting, dizziness, feelings of cold and shivering, nausea, uneasiness, and a temporary state of confusion. 

But, to put your mind at ease, there is little to no research to date showing an increased risk of congenital disabilities in babies born through IVF with egg cryopreservation. But there is still a requirement for more research depicting the safety of the egg freezing process.

What To Expect From Egg Cryopreservation Procedure?

If you are looking for egg cryopreservation, you may want to look for a fertility clinic and a doctor with expertise in this field. These experts are commonly referred to as reproductive endocrinologists. 

Prior to the cryopreservation process, the doctor will perform a mandatory screening, which will include the following:

  • Screening for infectious diseases: You will be screened to determine the presence of infectious illnesses like Hepatitis B, Hepatitis C, HIV 122, etc. The eggs at risk of these infections will be stored separately. 
  • Ovarian reserve testing: This test will be performed to examine the overall quantity and quality of the eggs produced by you. For it, the doctor will perform a test for AMH level with the AFC test. The aim of ovarian reserve testing is to analyse the response of your ovaries to ovarian stimulation or fertility drugs. 

 

These tests are followed by egg cryopreservation, which has multiple steps, as mentioned below.

Ovulation stimulation

At the start of your menstrual cycle, the doctor will begin the treatment by administering gonadotropin hormones to stimulate the increased production of eggs, other than that single egg produced monthly. In addition, the doctor will provide you with the following drugs:

  • Ovarian stimulation drugs: These drugs, including human menopausal gonadotropin or follicle-stimulating hormones (FSH), will help stimulate the production of eggs in your ovaries.
  • Drugs for preventing premature ovulation: Then, the doctor will inject gonadotropin-releasing hormone agonist or gonadotropin-releasing hormone antagonist. 

 

After that, blood tests will be performed to analyse the response to the ovarian stimulation drugs. The estrogen level should increase due to the development of follicles, and the progesterone will stay low until the completion of ovulation. 

Once your follicles are ready (it may take around 9 to 12 days), the doctor will administer HCG to help with final maturation and ovulation. 

Retrieval Of Eggs

The doctor usually performs the retrieval procedure under anaesthesia, usually through transvaginal ultrasound aspiration. First, a small ultrasound probe will locate the follicles and then guide them further into the follicles. Then the eggs are retrieved with the help of a suction device. This whole process is completed in around 20 to 30 minutes.

After the retrieval, you may experience some pressure, fullness and cramping for a few weeks due to some of the eggs being affected by ovarian hyperstimulation. 

If there is an issue with the transvaginal ultrasound approach, the doctor will go for the laparoscopy technique through a tiny incision. 

Cryoprotection

After the retrieval, the eggs will be stored in sub-zero temperatures to stop all biological activity in the egg, preserving for the future. The doctor will use a few specialised methods to freeze the eggs successfully, like using cryoprotectants, slow-freezing and vitrification (flash-freezing). 

After the procedure, you will be able to return to your daily routine within a week of egg retrieval. You may want to use protection during sexual intercourse to prevent pregnancy. But you may contact the doctor immediately if you have difficulty urinating, have a fever of more than 101 F, profuse vaginal bleeding, abdominal pain, sudden weight gain, etc.

What To Expect From The Results?

The doctor may suggest an ART (artificial reproductive technique) called ICSI, in which a single sperm is injected into your egg. Depending on your age, the rate of implantation is around 30 to 40%.

Conclusion

Egg cryoprotection is considered to be a safe procedure for preserving an egg with the help of freezing. It provides you with a chance to get pregnant and bear a child in the future. In addition, the doctor will provide you with ovulation stimulation drugs to increase egg production. 

Although it is a great technique, the doctors don’t suggest it to older women with age-related fertility issues, as their eggs may not be of suitable quality.

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