Conceiving with frozen eggs as effective as with fresh, but scientists still warn women not to delay childbirth

Conceiving with frozen eggs as effective as with fresh, but scientists still warn women not to delay childbirth

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UPDATED:

17:53 GMT, 19 October 2012

Freezing human eggs can be successful in treating infertility – but
U.S. guidelines issued today still urge caution for women hoping to
pause a ticking biological clock.

Egg freezing had long been
labeled experimental, but the American Society for Reproductive Medicine
declared that is no longer the case.

The group cited studies that found
younger women are about as likely to get pregnant if they used
frozen-and-thawed eggs for their infertility treatment as if they used
fresh ones.

Hot topic: Egg freezing should no longer be considered 'experimental', according a new report

Hot topic: Egg freezing should no longer be considered 'experimental', according a new report

The move is expected to help cancer patients preserve
their fertility, by pushing more insurers to pay for their procedure,
and to boost banking of donated eggs, similar to sperm banking.

Here
is the controversy: Should otherwise healthy women freeze their eggs as
sort of an insurance policy against infertility in case they do not
meet Mr Right – or just are not ready for motherhood – until their late
30s or beyond, when the childbearing window is closing fast

The pricey technology, which insurance does not cover for elective reasons, is being marketed aggressively for just that use.

Yet
the society that represents doctors who treat infertility stopped short
of endorsing egg freezing solely for deferring childbearing until women
are older.

The conclusion: It's not at all clear who's a good
candidate, or if women who store their eggs are being given a false
sense of security.

'The bottom line is there is no guarantee,'
said Dr. Samantha Pfeifer of the University of Pennsylvania, who chaired
the society's guideline committee.

There is no guarantee. Women interested in using this technology are in their late 30s, early 40s, and they may have the
worst success of anybody.

'A lot of women interested in using
this technology are in their late 30s, early 40s, and they may have the
worst success of anybody.'

Anyone considering egg freezing needs
careful counseling about their age and the odds of success if they want
to later thaw those eggs for use in in vitro fertilization, the
guidelines stress.

'It's an insurance policy that many of those
women may never need to turn in,' added Dr. Eric Widra of Georgetown
University, who co-authored the guideline.

But proponents of egg
freezing, known medically as oocyte cryopreservation, say lifting the
experimental label will encourage more women to check out the option,
and they'll make an educated choice.

'It's none of our business to
tell someone, 'No, you shouldn't delay childbearing if you choose for
whatever reason,' said Dr. James Grifo of New York University, whose
center has frozen more than 1,100 batches of eggs, mostly for elective
fertility preservation.

SEEKING TO PRESERVE: EGG FREEZING

In preparation for the procedure women inject high levels of hormones for a
week in order to ovulate as many eggs as possible.

Retrieving them is an
outpatient procedure that can cost $10,000 to $15,000, which sometimes does not
including the cost of the medication.

Clinics then charge patients to store their eggs,
until they decide to use them and undergo in vitro fertilization (IVF).

One of the early problems with egg freezing was that eggs contain lots of water, and
methods of freezing and thawing allowed ice crystals to form that
destroyed or damaged them.

However in the past decade, scientists created a
flash-freezing method called vitrification that appears to overcome that
challenge

There are no estimates of how many
women have had their eggs frozen.

'It's not a promise. It's hope and insurance.'

For
Brigitte Adams of San Francisco, that hope of a future pregnancy was
worth paying about $15,000 to freeze 11 eggs, especially when her
parents covered half the bill.

'I'm glad I did it when I did it. I
wish I had done it a few years earlier,' said Adams, who had the
procedure about a year ago at age 39.

Her doctor estimated she'd have a
30per cent chance of pregnancy using those eggs later on, 'and I thought a 30per cent
chance was better than a zero chance.'

Adams started a website,
eggsurance.com, to spread word of women's experiences with egg freezing.
She says one of the most-asked questions is how to learn about clinics'
success rates using frozen eggs.

Specialists say lifting the
experimental label means more clinics will start publicly reporting that
information like they do now for other infertility procedures.

Sperm
routinely are frozen. So are the extra embryos of couples undergoing
infertility treatment, in case they want to use them for later pregnancy
attempts.

But eggs proved more delicate and difficult to freeze
than sperm or embryos.

The problem: Eggs contain lots of water, and
early methods of freezing and thawing allowed ice crystals to form that
could destroy or damage them. In the past decade, scientists created a
flash-freezing method called vitrification that appears to overcome that
challenge.

For a number of years, egg-freezing has been offered
experimentally for young women or girls who are diagnosed with cancer or
other serious illnesses that would destroy their ovaries.

Then
there's age-related infertility: About one in five U.S. women now have
their first child after age 35, according to the Centers for Disease
Control and Prevention.

'I'm glad I did it when I did it. I
wish I had done it a few years earlier'

Yet the ability to conceive begins dropping
around 35 and more rapidly as the 40s near. Women have fewer eggs left,
and these older remaining ones aren't as healthy, meaning even if the
woman can get pregnant she's more likely to miscarry.

What is
involved in freezing eggs: Women inject high levels of hormones for a
week in order to ovulate as many eggs as possible.

Retrieving them is an
outpatient procedure that can cost $10,000 to $15,000, sometimes not
including the cost of the medication.

Clinics also charge a storage fee,
and then women who wind up using their eggs will pay thousands more to
undergo in vitro fertilization.

There are no estimates of how many
women have had their eggs frozen.

But Pfeifer's committee cited four
well-controlled European studies that compared IVF using either fresh
eggs or ones that had been frozen from younger women, and found the
chances of pregnancy were comparable.

What about birth defects
There are only about 1,500 known live births resulting from frozen eggs
worldwide, compared with about 1 million IVF births using fresh eggs.

But a recent review of nearly 1,000 of the births from frozen eggs found
no increased risk of birth defects, Pfeifer said.