Dear Eggsperts—I have a request for information about egg preservation. My 33-year-old daughter hasn’t found her forever mate yet. I wanted to give her info about fertility and egg preservation to help her decrease her worry about having a baby later in life. Could you talk about reasons why some women choose to preserve their eggs? Patient education that explains decreased fertility and increased chance of birth defects. It would be much appreciated.–Mama in Maryland
Dear Mama–The Eggsperts appreciate your concern for your daughter’s ability to grow her family (and give you grandchildren) in the future. You are not alone in this concern, as many hopeful grandparents also share this same worry for their adult children. Because of all that you have enjoyed in parenthood, you wish these same joys for your own daughter. We get it!
Before approaching your daughter about her fertility options in the future, I would first recommend finding out what she wishes for her future and her desires for growing a family. Many women may choose a non-traditional family.
- Single parenthood by choice
- Having “furkids”
- Adoption or Foster Parenting
- Child-free living, either single or with a partner
It is important to remember that any decision regarding your daughter’s fertility, does, and should, remain entirely up to her. That said, we do have a few points that she may want to consider if she wants to preserve her ability to conceive a biological child in the future.
Let’s talk about eggs.
Numbers first: A girl is born with all of her eggs. Pretty cool, right? But, by the time a girl reaches puberty, she has already had a substantial loss of eggs. Bummer. Every monthly cycle, a follicle grows (it may look like a “cyst” on ultrasound) where an egg is maturing. But, a single egg or follicle can’t do it alone. Many more follicles (with eggs) use their cells to provide some hormone support to the “dominant” follicle. All of those follicles are used up when the 1 egg ovulates; the other eggs in the support follicles are lost. [SIDE NOTE: Fraternal twins are the result of 2 eggs being released, fertilized and implant.] Even women who are not ovulating (birth control, PCOS, etc.) continue to lose eggs every month. So, over time, there are fewer and fewer eggs available.
Some small print here. There is ongoing research that suggests that there may be a small number of newly developing eggs, but right now, we have no idea how to make more eggs grow.
Next, let’s talk about quality: Since a girl is born with all of her eggs and over time, there is a reduction in the quality of the remaining eggs, it may be that the “best” eggs, most likely to make a baby, are used first. We also know that the longer the egg sits, the more likely the genetic material in the egg is to become fragile and break in the wrong places during cell division while an embryo is developing, and therefore causing abnormalities in the DNA of the embryo. Additionally, we see the energy production ability of cells degrades over time. This may also limit the ability of a fertilized egg to properly divide and ultimately implant into the uterus.
Bottom Line: There is a progressive loss of egg quantity and quality that occurs with female aging. Infertility, pregnancy loss, and chromosome abnormalities increase steadily as a woman nears age 35, and even more rapidly in her late 30s and 40s.
Egg freezing may allow a young woman to save a moderate number of her high quality eggs.
OK, now that we have reviewed eggs, let’s talk about oocyte (egg) cryopreservation (freezing).
The first baby from frozen eggs was born in 1986, and technology has improved since then. Egg freezing does increase reproductive options for women by decreasing the ever-looming pressure of the “biologic clock.” Women choose to freeze eggs for a number of reasons, including:
- Reproductive autonomy
- Allowing postponement of childbearing while
- Waiting to find the right partner
- Advancing an education or career
- Control over gametes without requiring “consent” of a partner for future use (frozen embryos may require partner “consent” for later use)
- Allowing postponement of childbearing while
- Before undergoing cancer treatment
- Before undergoing surgery that may lead to a loss of ovaries (endometriosis, benign cysts, etc.)
- Religious reasons when a more common approach to IVF with embryo freezing may not be accepted
Sounds great, right? “Freeze your eggs,” they say. “Use them when you’re ready,” they say.
Well, unfortunately, that isn’t the whole story.
- The live birth rate from frozen eggs is about 2-12% per frozen egg and may be lower for women age 38 and up
- It can take sometimes 20 (or more) eggs to have a reasonable chance of having a baby and this may mean multiple ovarian stimulation, egg retrieval cycles
- Having eggs frozen is no “guarantee” of a baby later
- A woman may be able to have a baby later without needing fertility treatment, or using her frozen eggs
- The process to collect, freeze, store eggs is expensive, emotional, has medical risks, and requires a time-commitment
- Although short-term data suggests no harm to the resulting babies, we don’t have long-term data on the impact of egg freeze/thaw on children
Bottom Line: Freezing eggs is an option for women who hope to have a baby, one day, but not right now. There still is NO guarantee. AND, there are a lot of things to consider before starting the process.
Because egg freezing or oocyte preservation technology is relatively new, much of the information available to the public is commercially biased. The best advice and counseling will come from a reproductive specialist who has the ability to do the procedure. But, beware of marketing schemes that may provide false hopes.
If your daughter wishes to learn more, we recommend she speak to a reproductive endocrinologist, here are a few questions she may want to consider before jumping in:
- Why does she want to freeze eggs?
- What is her long-term goal for her fertility and any frozen eggs?
- What is the clinic’s success rate with using frozen eggs?
- What is the estimated success for her and her specific situation (age, medical factors, test results)?
Now, if your daughter is ready to make that phone call to the clinic, here is some information to help her prepare for the first phone call. https://askaneggspert.com/the-phone-call/
We hope we met your Eggspectations—An Eggspert
To stay up to date with our content, please bookmark our page www.askaneggspert.com and follow-us on social media. We welcome questions and will answer them in our posts as soon as possible. Please email us at questions@askaneggspert.com
- Facebook.com/askaneggspert
- Twitter.com/ask_an_Eggspert
- Linkedin.com/in/askaneggspert-a-team-of-2-195956199
- Instragram @ask_an_eggspert
Disclaimer: All of the comments on this page are for basic information only. They are based on the opinions and expertise of the authors and are not meant to provide a substitute for medical care or specific treatment recommendations. Each person is unique and requires individualized diagnosis and treatment plans. Any specific questions should be directed to your personal healthcare provider.