We sat down with Dr. Maureen Kelly to discuss the benefits and potential challenges one may encounter when considering egg freezing.
Dr. Kelly is the Medical Director of Society Hill Reproductive Medicine, a Board Certified Reproductive Endocrinologist, OB-GYN, and leader in the field of egg freezing.
BINTO: First, can you give us a quick overview of egg freezing?
Dr. Maureen Kelly: Egg freezing is considered a procedure to help with preserving fertility. We obtain a group of matured eggs for egg retrieval, and we can keep them frozen until they’re needed.
There are a couple different parts that are necessary: First, we use a medicine to mature the group of eggs simultaneously. The second part is when we actually retrieve those eggs, which is a procedure done under a little bit of IV sedation using a needle to aspirate the eggs out of the ovaries. It takes about 10-15 minutes. Then, the eggs are placed in the freezer by an embryologist where they can stay in the cryogenic tanks for quite a long time.
BINTO: How has science the science of egg freezing changed in the past 10-20 years to make the outcome “better”?
Dr. Maureen Kelly: One of the biggest breakthroughs that occurred in the world of IVF was the development of different techniques in freezing and thawing. Initially, it was utilized for embryos and was tested to see if it was helpful for eggs. We learned through a process called vitrification that the eggs tolerate the freezing and thawing much more than they did with older techniques, which often damaged them in the process.
Eggs are challenging because they are a large cell with a very high water content. The challenge was taking a cell that was going to collapse and re-expand and making sure everything contained in that water is protected during those time periods. Now, over 90% of the eggs survive that freezing and thawing, and can function well after the process.
BINTO: Why would you encourage women to look into egg freezing as an option?
Dr. Maureen Kelly: We know that, with age, egg quality and fertility decline, and miscarriage rates go up. The time that begins is quite young- starting at about age 26- and many women are not prepared, at that time, to attempt conception.
In our field (reproductive endocrinology and infertility), we don’t have a very effective way of treating infertility caused by egg quality issues. So, when someone has trouble getting pregnant because of egg quality, there are really no dependable ways of treating that right now. Culturally, not a lot of women are prepared to start a family when they are at the peak of their fertile ages. Now that we can freeze eggs successfully, I would encourage women to at least consider it.
BINTO: We often hear the term “insurance” used when talking about egg freezing- do you think this is an accurate term?
Dr. Maureen Kelly: It’s definitely not a guarantee that if you freeze eggs they will lead to a successful pregnancy. The biggest reason is that women make a lot of eggs that are abnormal throughout their lives. The percentage of abnormal eggs produced increases with age, and we don’t have a way of testing them before we freeze them. We really don’t know about their likelihood of creating a pregnancy for an individual until the eggs are thawed and fertilized. Because of this, I don’t think someone should consider it a guarantee- but it certainly is a good step.
BINTO: Can you tell us a bit about using age versus hormonal tests as a predictor of fertility?
Dr. Maureen Kelly: Age is the number one predictor of fertility. That is something that needs to be very strongly emphasized. It’s not really the fault of a lot of people for trying to interpret these hormonal tests as being a predictor of fertility because we didn’t really understand their meaning for a long time as a society. More research needed to be done, more things needed to be published. Even within the past year we’ve learned a lot about tests like AMH and their lack of ability to predict fertility or how long it would take someone to conceive. They’re useful for certain things, but you don’t want to extrapolate beyond what they’re useful for.
BINTO: What advice do you have for women choosing a clinic- especially in light of the recent tank failures that have been in the news? Are tank failures something we need to worry about?
Dr. Maureen Kelly: Those cases were highly unusual in the history of freezing, which has been going on long before egg freezing, with embryo and sperm freezing. Both of these centers had really good reputations- it’s not as if someone choose something they shouldn’t have upon going to those centers. It’s one those things where you have to remember things like this, as rare as they are, can happen in even the best centers.
A person who is considering working with any clinic or IVF center can speak with the head embryologist or lab director to find out what kind of backup they have to alert them if something is not going well in the laboratory. There is always routine testing- back alerts if the incubator temperature or different gas levels are off. If you’re talking about the cryogenic tanks, there are alarms that should go off, or if they’re on an automatic system, it should be checked on a regular basis by the staff. If staff members are manually checking the tanks, it needs to be recorded and reviewed.
In my 25 year career, I have not heard something occurring at the level it did in the Ohio and California centers.
BINTO: Is there anything else you’d like to share with our readers regarding egg freezing?
Dr. Maureen Kelly: I think the advent of contraception was an incredible breakthrough for women, ultimately allowing them to decide when or if they wanted to conceive. Yet, it had its downside- after decades we realized there was a set reproductive lifespan for each woman, and delaying could have an impact on her ability to conceive.
Egg freezing is equally as powerful in that it allows a woman to have more control in deciding if and when she wants to conceive, and also allows her to freeze her eggs in a time that she may be more fertile.