The new frontier of egg freezing and delayed motherhood for women in India

Aastha GuptaJan 05, 2019 19:45:04 IST

Five years ago, if someone in India said the words "egg freezing" out loud, people would open their eyes wide.

The social stigma around freezing eggs for the future still exists but, in its slow journey over the years, people have become a little more receptive aren't as shocked or scandalised.

The credit for this goes to a few significant changes like openness in society, awareness about the changing trends, and importantly, women themselves. With more women choosing to have careers, we're seeing more of them consciously adopting egg freezing as a welcomed lifestyle choice – as a need of the hour.

Another reason that has led to the reception of this process is the involvement of celebrities and many other prominent personalities. Though most choose to stay anonymous, the fact is that some of Bollywood's leading women, best-selling authors and journalists have secured their motherhood using egg freezing.

Of these, former Miss World and Miss India World of 1997 Diana Hayden has been vocal about giving birth to a baby at the age of 42 through this process. Diana froze her eggs when she was 32 because of her career and waiting to find the right man. Her reasons will surely be relatable to many other women her age.

Internationally, Sofia Vergara and Kim Kardashian too are promoters of this new modern science that is giving women the option to be able to take control of their lives. Companies like Apple and Facebook announced way back in 2014 that paying for the procedure has helped more women take egg-freezing seriously to stay in the workplace as long as they desired.

An illustration of the steps in egg freezing. Image credit: The Centre for Reproductive & Genetic Health

The basics of egg freezing

It is a fact that a woman's biological clock ticks with age and this might result in difficulty during the process of conceiving and complications during birth. Sometimes, late pregnancy can even result in various abnormalities in the baby and increased chances of the child born with Down syndrome. Thus, oocyte cryopreservation (more commonly known as egg-freezing) is a method to preserve re-productivity of a woman so that she may choose to have her own biological child with sperm from a partner or a sperm donor whenever she desires to.

For this, the eggs are harvested from a woman’s ovaries by injecting hormones. This enables the ovaries to produce multiple eggs which are then extracted under a short anaesthetic procedure called egg retrieval. These eggs are later taken to the lab wherein they are cooled down and frozen unfertilized to be used later.

To use, the frozen eggs need to be then defrosted, united with sperms in a laboratory and implanted in the uterus (in vitro fertilization) of a female.

It is important to understand that IVF and oocyte cryopreservation are two different processes that aim for the same result. In IVF, unlike freezing, the eggs and sperms and combined immediately in a laboratory to create an embryo. These are then injected back into the uterus in an attempt to get the patient pregnant right away. Egg-freezing, on the other hand, is an effective way of delaying motherhood.

Egg freezing and IVF are far from the same procedures but are carried out to achieve the same ultimate result: pregnancy.

The "right" time

For better results, it is preferred that a woman should freeze her eggs between 32-36 years though, there is no upper age but up to 40 years is considered optimal for it. There are studies that state that the results of egg freezing are best until the age of 38.

While the viability of eggs is dependent on the age of a woman, every human body is different and positive results can happen anytime. In the case of egg freezing, sooner really is better.

Egg banking as it is also called is primarily done for medical and social reasons. Under medical, patients especially those suffering from cancer can use this method to preserve their future fertility. As cancer involves treatments like chemotherapy and radiation, both of which might damage the ovaries and impair fertility thus, if permissible in her treatment plan, a woman should undergo ovarian stimulation and egg retrieval before her therapy.

Any of many reasons to put your eggs on ice

Women who have a family history of premature ovarian failure or early menopause i.e. prior to turning age 40 should consider this procedure. It usually occurs as a result of genetic abnormalities that affect the ovaries, or due to family history. Endometriosis, where the tissue lining the inside of the uterus grows outside of the uterine cavity has a negative impact on fertility is another reason to evaluate egg freezing.

In case of social or elective freezing, the more popular of the two reasons, the intent to delay having a baby vary from finding a suitable partner, a failed marriage, advancing age, focus on a career, etc.

Once the motive is clear, the method of post-injection usually takes anywhere from 10 days to two weeks. All through this time, the ovaries are constantly supervised by vaginal ultrasound. After this, eggs retrieval is done within a couple of weeks. It requires a day of rest after which women are back to living their normal life. In some cases, Ovarian Hyper Stimulation Syndrome can develop but with the latest hormonal protocol, these incidences are rare. The hormonal injections, however, may cause Occasional bloating and sometimes mood swings. But these symptoms are mostly mild and temporary for most people.

Before coming to the success rate of this process, some advice you ought to hear from any doctor you might be consulting is, if age permits, to try conceiving naturally.

Egg freezing storage in done using liquid nitrogen in tanks. Image courtesy: Oceanis Filyra

Only a backup plan

The frozen eggs are like a backup plan that would come to your rescue if required. The chances of retrieving healthy eggs using vitrification are almost 95-99%. Five eggs retrieved can give approximately a 15% chance, whereas 10 give you a 61% and 15 eggs give you an 85% chance. The health of the eggs, implantation rate, sperm quality are a few factors that play a crucial role in the success of this process and all these are age-dependent.

To conclude, 1986 marked the year of the first baby to be conceived from a frozen egg. Since then, over two thousand more babies have come into the world in this way. This number shows acceptability of the form of producing babies across the world. Rightly so too, with aspects like lifestyle, stress, and pollution leading to a decline in fertility the option of egg-freezing is a new-age reproductive technology that enables women to lead a life without having to worry about the biological time bomb again. In fact, over the years, of the 10-15 inquiries received, the conversion is as high as 50-60%.

Though, 3-4% of these cases are those women who already know of this process, are well-educated and well-travelled. It might be considered to be an expensive process (up to ₹1.5 to ₹2 lacs and preservation cost is about ₹10,000 to ₹40,000 per year) but with EMI options, with no interest available, it’s worth the money. After all, it’s an insurance and the most likeable assurance of your biological clock.

The author is a gynaecologist, advanced fertility & IVF consultant at the Delhi IVF and Fertility Centre