Online Health Chat with Cynthia Austin, MD and Nina Desai, PhD, HCLD
August 23, 2017
Fertility rates begin to decline as women age, starting at age 30 and dropping rapidly in their late 30s and 40. At the same time, the risk of miscarriage and birth defects may rise. This is due to the effects of older eggs on reproduction.
Given these facts, what can be done to hold on to fertility potential? Egg freezing may be an option. A process called egg cryopreservation allows the egg to be frozen or preserved in its current fertility capability. Eggs that are obtained at a younger age can actually provide the similar potential for pregnancy later in life for a woman.
During this web chat, Dr. Austin and Dr. Desai will discuss egg cryopreservation and answer questions concerning:
- The egg retrieval and freezing process
- The risks and benefits associated with egg freezing
- The qualifications of the ideal candidate for this process
- What happens when you’re ready to use your banked, frozen eggs.
About the Speakers
Cynthia Austin, MD, is board certified in obstetrics and gynecology with subspecialty certification in reproductive endocrinology. She is the current medical director of in vitro fertilization for Cleveland Clinic.
Dr. Austin earned her medical degree from George Washington University School of Medicine in Washington, D.C. She completed a residency in obstetrics and gynecology at University Hospitals of Cleveland and Cleveland Metropolitan General Hospital, including a year as executive chief resident. Dr. Austin completed a fellowship in reproductive endocrinology at Case Western Reserve University School of Medicine. Also at CWRU, she served as an associate professor in the Department of Reproductive Endocrinology and as chairperson of the core curriculum for reproductive biology. Prior to joining Cleveland Clinic, Dr. Austin served as co-director of in vitro fertilization at University Hospitals of Cleveland.
Nina Desai, PhD, HCLD, earned her doctorate in microbiology/cell biology from the University of Medicine and Dentistry of New Jersey in Piscataway. She is board certified as a high complexity laboratory director (HCLD) in both andrology and embryology. She trained as a research fellow at the University of Massachusetts Medical Center in Worcester and later completed a postdoctoral fellowship in infertility at The Ohio State University in Columbus. She later served as an assistant professor at Case Western Reserve University and directed the in infertility laboratories at University Hospitals.
Let’s Chat About Fertility and Egg Freezing
balance: Can you explain what egg freezing means? Are there different methods of freezing? I have read something about “vitrification.”
Cynthia_Austin,_MD: Eggs can be cryopreserved/frozen for future use. Vitrification is the name of the freezing technique that is used to freeze the eggs.
Taryn: Why do women opt to freeze their eggs?
Cynthia_Austin,_MD: Women elect to freeze eggs for future use because eggs become less and less likely to result in a successful pregnancy as the woman ages. Eggs from a woman in her early 30s have a pregnancy rate of about 50 percent to 60 percent after transfer of one embryo. Embryos formed from eggs from a woman in her early 40s have less than a 10 percent chance of successful pregnancy. In other words, if a woman freezes her eggs when she is her early 30s and uses them in her 40s, she will have the same pregnancy rate she had when she was in her 30s.
robbin: What is the first step if I am interested in pursuing egg freezing as an option?
Cynthia_Austin,_MD: Women interested in egg freezing should schedule a consultation to discuss the egg freezing process and statistics for success based on their specific information. It is best to freeze eggs by age 37.
simple: How many eggs should be harvested and frozen?
Nina_Desai,_PhD,_HCLD: Generally, women under 38 need to have at least 20 eggs frozen to have the best chance for having at least one baby. For older patients, the recommendation is to have at least 40 eggs frozen.
Sal: What is the average number of eggs that are retrieved during a cycle? How many are recommended to freeze?
Cynthia_Austin,_MD: Egg freezing is not a guarantee of future pregnancy. The number of eggs to freeze in order to have a high chance of achieving one pregnancy is 20.
BB10: Does the age of the woman affect the success rate of live birth when using the frozen egg versus a fresh egg?
Cynthia_Austin,_MD: The age of the woman at the time she made the eggs determines the pregnancy rate. The age she is when she transfers the embryos has only a small effect.
JQ8920: What is the success rate for IVF when using frozen eggs? Is one more desirable than the other?
Cynthia_Austin,_MD: Fresh eggs work better than frozen. Some frozen eggs will not survive the freeze/thaw process.
Roghan: How long can eggs be kept frozen? What happens to frozen eggs once they are no longer needed?
Nina_Desai,_PhD,_HCLD: Eggs can be frozen indefinitely. They are stored at -196 C in large tanks. These tanks are monitored 365 days a year by an embryologist. The eggs will be discarded at the patient’s request.
Pippin: Does egg harvesting damage the ovary or the immature eggs in any way?
Cynthia_Austin,_MD: Egg retrieval does not appear to have a negative effect on future function of the ovaries.
Tina: What is the cost? Can it be covered by insurance? Are there storage fees?
Cynthia_Austin,_MD: The prepayment for egg freezing is $6,974.00. This includes the cost of egg retrieval and freezing, but does not include the cost of the ovarian stimulation. The total cost is approximately $11,000. Some insurance plans do cover egg freezing, but most do not. Women freezing eggs in anticipation of treatment for cancer are eligible for significant discounts.
curious: Will this process remove all of my current eggs?
Cynthia_Austin,_MD: Neither freezing eggs or doing IVF uses up eggs. At the beginning of every menstrual (ovulation) cycle, a group of eggs begins to mature. One of those eggs becomes the dominant egg that will continue to develop and ovulate. The remainder of the initial group will stop developing and degenerate. When we do an ovarian stimulation for egg freezing or IVF, we encourage a larger number of that initial group to continue to develop to maturity.
That is all the time we have for questions today. Thank you, Dr. Austin and Dr. Desai, for taking time to talk to us about egg freezing as a fertility option.
On behalf of Cleveland Clinic, we want to thank you for attending our online health chat. We hope you found it to be helpful and informative. If you would like to learn more about the benefits of choosing Cleveland Clinic for your health concerns, please visit us online at http://my.clevelandclinic.org.
To make an appointment with a specialist at Cleveland Clinic’s Fertility Center or any of the other specialists in Cleveland Clinic’s Women’s Health Institute, please call 216.839.3100, toll-free at 800.223.2273 (extension 46601) or visit us at clevelandclinic.org/fertility for more information.
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