Although the technology for freezing an embryo – also known as oocyte cryopreservation – was developed in the 1980s to help women suffering with serious medical conditions improve their chances of having a baby post-treatment, the idea of egg preservation in healthy women has emerged recently.
In the US, the number of people who have frozen their eggs rose by more than 400 per cent, to over 13,000 in 2020 from just over 2,500 in 2012, according to data from the Society of Assisted Reproductive Technology.
Similarly, in the UK there were 11 times more egg freeze cycles in 2021 than in 2011, with the number of embryo freeze cycles increasing from around 230 cycles in 2011 to 10,719 in 2021.
But even as egg freezing has grown more popular over the last decade, the process can seem intense and overwhelming. Here’s what you need to know.
What is egg freezing?
Egg freezing is a way of preserving a woman’s fertility so she can try to have a family in the future. It involves collecting a woman’s eggs, freezing them and then thawing them later on so they can be used in fertility treatment.
A woman’s chances of conceiving naturally fall as she gets older because the quality and number of her eggs drops.
According to HFEA, egg freezing can be an attempt to preserve fertility by freezing the eggs when the woman is young and the eggs are of the highest quality.
What does egg freezing involve?
Firstly, you’ll need to be tested for any infectious diseases like HIV and hepatitis. This has no bearing on whether you can freeze your eggs or not, but is to ensure that affected egg samples are stored separately to prevent contamination of other samples.
You’ll then start the IVF process, which usually takes around two to three weeks to complete. Normally this will involve taking drugs to boost your egg production and help the eggs mature. When they’re ready, they’ll be collected whilst you’re under general anaesthetic or sedation.
At this point, instead of mixing the eggs with sperm, as in conventional IVF, a freezing solution will be added to protect the eggs.
The eggs will then be frozen either by cooling them slowly or by vitrification, a practice of freezing an egg or embryo with extremely rapid cooling. They will then be stored in tanks of liquid nitrogen.
Most patients under 38 years of age will have on around 7-14 eggs collected, although this isn’t always possible for patients with low ovarian reserves.
When you want to use them, the eggs will be thawed and those that have survived intact will be injected with your partner’s or donor’s sperm.
How safe is egg freezing?
The UK’s Human Fertilisation & Embryology Authority says IVF is mostly very safe, although some women do experience side effects from their fertility drugs. These are usually mild, but in extreme cases women can develop ovarian hyperstimulation syndrome (OHSS).
How much does egg freezing cost?
The average cost of having your eggs collected and frozen in the UK is £3,350, with medication being an added £500-£1,500. Storage costs are extra and tend to be between £125 and £350 per year.
Thawing eggs and transferring them to the womb costs an average of £2,500. So, the whole process for egg freezing and thawing costs an average of £7,000-£8,000.
What are the benefits of egg freezing?
The clearest benefit is that it allows women to “freeze” the biological age of their eggs, increasing the chances of successful pregnancy if they use those eggs at a later time, says Professor Assaf Ben-Meir, head of IVF at Hadassah Medical Center and chief medical officer at Fairtility.
“This is especially advantageous when done at a younger age, as it typically yields more eggs per retrieval with higher quality which is the main benefit, enhancing the chances of a successful live birth.
“While women may not ultimately need these eggs, the procedure provides peace of mind.”
What are the downsides of egg freezing?
While freezing eggs does “freeze time” in terms of the biological age of the eggs, Ben-Meir says some women don’t take into account that their bodies do keep aging.
“Women will freeze eggs but then might put off family planning for longer. If a person waits until their early 40s, they might find that they cannot get pregnant with their fresh eggs. In this situation, they will count on their frozen eggs – and there is no 100 per cent guarantee for success.”
The potential of frozen eggs can vary significantly too, Ben-Meir says, adding that current methods of assessing egg quality are not highly reliable.
“Embryologists make estimations solely based on some morphological characteristics of each oocyte. Most studies show that the predictability of an egg’s potential to result in a live birth based on these parameters alone are low and non-personalised.
“This means that when a patient ultimately wants to use frozen eggs to start a family, she may find that what she initially froze is not enough for her personal plans.”
What does the rise in egg freezing suggest?
Overall, it means that women are becoming aware of and proactive about their fertility earlier in their lives, says Dr Luca Sabatini, consultant gynaecologist and obstetrician and chief medical officer at Apricity.
“They know other women who have been tested and chosen to freeze their eggs, and as a result social egg freezing is becoming more acceptable and routine.”
However, Professor Ben-Meir says if this trend continues, the industry must consider the future implications of storing thousands of unused eggs.
“Healthcare providers will need to make decisions about the management and potential donation of thousands of unused, but viable eggs in the coming years,” he warns.
Have celebrities and social media influencers led to more women freezing their eggs?
While there is no clear data on this, experts believe celebrities and internet personalities have been somewhat responsible for egg freezing’s growing popularity.
“Celebrities and social media figures have likely helped reduce the stigma around fertility care, and encouraged people to be proactive about fertility preservation and care,” says Sabatini.
“Their stories might have brought awareness to the option of egg freezing, which some people may not have considered or even known about previously.”
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Paris Hilton has frozen 20 embryos, revealing that she is “waiting” for a daughter
Ben-Meir says an unintended consequence of these stories may be additional pressure for women in their reproductive years.
However, he thinks greater awareness means that women are talking about this earlier and they are better assessing their options.
What should women consider before freezing their eggs?
Dr Lisa Stradiotto, consultant in obstetrics and reproductive medicine at Apricity, says one of the biggest factors women need to consider is the financial cost of freezing and storage. For some women multiple cycles may be required to achieve a enough eggs to give them a good chance of pregnancy later.
“The literature suggests that it would be ideal to freeze around 15-20 eggs to give an 80 per cent chance of successfully yielding a pregnancy.”
However, egg freezing is not a guarantee of future fertility like it is sometimes portrayed, cautions Stradiotto.
“It should rather be viewed as a potential ‘back-up plan’, as life doesn’t always go according to plan.”
Professor Ben-Meir encourages women to consider the reputation of the clinic they are choosing.
“Research and choose a reputable facility for egg freezing. Ask if the facility is using AI in its egg and embryo assessment processes, as these technologies are making egg freezing and IVF processes more accurate and personalised to each patient.”
How we can address the gender imbalance in fertility testing
Everyone has heard of the female biological clock, but not many people know that male fertility declines throughout adulthood too
Although one in six couples globally have difficulty conceiving, infertility remains a woman’s social burden. We need to address male infertility, says Lily Elsner.
Infertility affects 186 million people worldwide and, despite everything society has led us to believe, one-third of infertility cases are caused by male reproductive issues.
Male infertility can be caused by low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Some men may also experience fertility issues due to chronic health problems, illnesses and lifestyle choices.
How come no one talks about it? To date, fertility has been firmly cast as a “woman’s issue”, irrespective of men being half of the fertility equation.
Everyone has heard of the female biological clock, but not many people realise that male fertility declines throughout adulthood too. Research shows that men will generally see a 52 per cent decrease in fertility rate between their early 30s and their mid-to-late 30s.
“Male infertility, although often treatable, is a very taboo subject,” says Lily Elsner, co-founder and CEO of Jack Fertility.
“Because men don’t have the same relationship with their physicians as women do, they often don’t know they could do something about it.”
Culturally, it can also be hard for men to talk about having trouble conceiving as this can be seen as a lack of masculinity.
Research shows that the majority of men (73 per cent) are unlikely to talk about their infertility with others. In fact, 39 per cent are not likely to talk about their infertility at all.
Elsner, however, thinks we can change that. As the woman behind Jack Fertility’s at-home sperm test kit, she thinks talking openly about male infertility could go a long way towards addressing the gender imbalance in fertility testing.
“The whole point of femtech is to ensure women’s health is prioritised. By opening up the conversation around reproductive health and making it easy to assess male fertility, we can take some of the pressure off of women.
“Some men may not want to talk about their infertility still, but it’s an essential component of creating an equal world for all genders. I am tired of watching women shoulder the majority of infertility’s physical and emotional burden, and seeing men and non traditional families completely neglected in the medical and societal discourse surrounding fertility.”
A test like Jack, Elsner says, could give people that empowerment of having access to their health data and provide them with the tools to be able to make the right decision for them.
“A lot of men think of fertility as static, when really the male body is constantly creating sperm. With Jack, what we are trying to say is, ‘Actually, your fertility massively depends on your current health and chronic illnesses’.
“Our aim is to make it easy and convenient for all men to get reliable results about the status of their fertility, even if they are not considering starting a family. That’s part of why we named the company Jack – it’s cheeky and relatable.”
There are many fertility test on the market, but Elsner doesn’t see that as a bad thing.
“The rise of companies providing at-home sperm testing suggests a growing interest in male reproductive health, but it also signals a shift in attitudes, with fertility being recognised as an issue that affects both men and women equally,” she says.
“There are so many amazing companies out there working on fertility tests, but I think most of them are targeted a little bit further down the funnel. For us, it’s about getting men to take that first important step of getting tested. We just want them to have a chat with Jack.”
Jack Fertility is expected to launch later this year. To find out more, visit jackfertility.co.uk.
Partnership to pilot ‘cutting-edge’ embryo selection tool
The partnership is hoped to streamline laboratory operations with the potential future benefit of optimising the embryo selection process
The US fertility technology company Alife Health has teamed up with a network of laboratories to pilot an AI technology for embryo image capture and cataloguing.
The company’s partnership with Ovation Fertility aims to focus on streamlining laboratory operations with the potential future benefit of optimising the embryo selection process.
The technology could enable future “AI-powered” embryo selection.
Alife’s Embryo Assist software promises to help embryologists to create digital records of every embryo, with the added benefit of using the start-up’s clinical decision support algorithm to determine the best embryo for transfer.
Paxton Maeder-York, founder and CEO of Alife, said: “We are thrilled to join forces with Ovation, a leading laboratory network in the country, to showcase the transformative impact of Alife’s technology.
“Through this partnership, we aim to demonstrate how Alife’s advanced technology, powered by AI, can not only optimise clinic workflow, but also set a new standard in the precision and consistency of embryo selection.
“We look forward to contributing to Ovation’s commitment to excellence in fertility care.”
Matthew VerMilyea, vice president of scientific advancement at Ovation, added: “At Ovation, we strive to discover and leverage the most state-of-the-art technologies available to us in order to better improve patient outcomes.
“The Alife Embryo Assist software provides our laboratories with a structured digital approach to a rather manual and cumbersome process.
“I believe that by implementing Alife’s technology, we will see an improvement in lab efficiency and performance, which ultimately will help our network provide the best possible outcomes for every individual hoping to grow their family.”
The Embryo Assist software claims to allow embryologists to capture images of each embryo and streamline the embryo reporting process by eliminating the need to manually transcribe information between systems.
Alife expects the tool to “elevate” laboratory quality-control measures by providing an activity and audit trail for every embryo, viewable in real time.
Kitazato and IVF2.0 forge groundbreaking collaboration to revolutionise IVF with AI solutions
The collaboration aims to advance real-time sperm selection for intracytoplasmic sperm injection (ICSI) and embryo ranking
Kitazato, a trailblazing Japanese corporation specialising in assisted reproduction products, and IVF2.0, a leader in AI software for assisted reproductive technology (ART), have joined forces in a strategic collaboration.
The partnership aims to advance real-time sperm selection for intracytoplasmic sperm injection (ICSI), and embryo ranking based on ploidy prediction, ushering in a new era for the IVF market.
Under this agreement, Kitazato will leverage its multi-national distribution network to introduce standardised reproducible data-driven decision-making to IVF laboratories in many regions of the world through IVF2.0’s software.
IVF2.0’s suite of AI tools, including sperm selection (SiD) and embryo selection (ERiCA), assists embryologists in making critical choices to optimize fertility outcomes.
Mr Futoshi Inoue, president and CEO of Kitazato, expresses enthusiasm, stating: “Partnering with IVF2.0 demonstrates our commitment to innovation. We embrace technologies that aim to boost success rates, standardize procedures, and democratize fertility treatment for all.”
Professor Andrew Drakeley, co-founder and board chair of IVF2.0, emphasises the significance of the collaboration.
He said: “Our bond with Kitazato, a prestigious company with world-class products, underscores the growing need for implementing AI tools in IVF clinics globally. This marks a substantial step in the right direction.”
Kitazato, Kitazato – Quality Results for Life (kitazato-ivf.com), renowned for delivering quality products in assisted reproduction, aligns with IVF2.0’s mission to enhance IVF outcomes through AI.
IVF2.0’s innovative software platform employs AI and computer vision technology to elevate key steps in the IVF process.
Learn more at IVF 2.0 (ivf20.ai)
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