The essence of oocyte cryopreservation
Now in the world there is a pronounced tendency to shift childbirth to a later age, 30+, as modern women have become more focused on career success and personal growth.
But the older the woman, the fewer eggs are formed in the ovaries and their quality suffers, especially over 35 years. Of course, in each case, changes in reproductive function occur differently. Egg cryopreservation has greatly expanded the capabilities of reproductive medicine and allowed women to outwit their biological clock. Thanks to oocyte freezing, a woman has the opportunity to postpone the birth of a baby until the future, without worrying that the quality of her eggs will deteriorate with age.
Cryopreservation is the freezing of eggs in a laboratory. When a woman of young reproductive age freezes her biological material, she can store it indefinitely and return to the issue of pregnancy when she sees fit. At the same time, she does not need to worry about the quality of the oocytes. When frozen, the eggs remain young, morphologically good and suitable for fertilization.
Prices for egg freezing
Today, a service that gives a woman freedom of choice - egg freezing - is very popular. This is an opportunity to give birth to a child at a time that she chooses herself, and not dictated by the biological clock. How much it will cost the expectant mother depends on how long the oocytes are stored. It should be taken into account that the cost of cryopreservation is less than repeated ovulation stimulation and puncture to obtain oocytes. Moreover, cryopreservation of eggs eliminates the risk of complications and preserves the woman’s health.
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Bibliography
- Abakushina E.V., Otoy T. A promising method for preserving the fertility of cancer patients is cryopreservation of ovarian tissue. In: Parokonnaya A.A., editor. Cancer and reproduction. M.: Galleon; 2011.
- Abakushina E.V., Otoy T. Experimental substantiation of the use of the method of cryopreservation of ovarian tissue in clinical practice. In: Postgenomic methods of analysis in biology, laboratory and clinical medicine. Materials of the IV scientific and practical conference; 2014 Oct. 29 – Nov. 1; Kazan, Russia; 2014.
- Bystrova O.V., Dinikina Yu.V., Tapilskaya N.I., Lisyanskaya A.S., Manikhas G.M. Cryopreservation of ovarian tissue in patients with malignant and benign neoplasms of the reproductive system // Journal of Obstetrics and Women's Diseases. – 2006.
Indications for egg cryopreservation
Freezing biomaterial is recommended for all women under the age of 35 who want children, but for some reason do not plan a pregnancy in the near future.
Cryopreservation is also indicated if a woman has a tendency to decrease ovarian reserve at any age or has a family history of early menopause.
The program is also suitable for a woman who has children, but would like to have another child. At the same time, she postpones pregnancy indefinitely.
How is oocyte cryopreservation performed?
Cryopreservation of oocytes is a well-established procedure with its own characteristics, consisting of several stages.
In order for freezing to be successful and the quality of oocytes not to change during storage, cryopreservation must be carried out under certain laboratory conditions using special equipment. Therefore, not all clinics that perform IVF freeze oocytes due to the lack of necessary technical equipment. EMC has its own cryobank of oocytes, embryos and sperm.
Before freezing, a woman usually undergoes hyperovulation stimulation. This is due to the fact that for cryopreservation specialists must obtain not 1-2 follicles, but much more. However, if a woman has contraindications to stimulation, the protocol can be carried out in a natural cycle. After hormonal stimulation, follicle puncture is performed under ultrasound control. After the oocytes are punctured, they are given to embryologists, who evaluate the resulting cells under a microscope. Eggs with morphological abnormalities are not selected; only good oocytes are frozen.
Then comes the freezing stage. There are two types of cryopreservation. The first, cheaper one, is slow freezing. But this method has a huge drawback - a large percentage of oocytes are destroyed and become unsuitable for fertilization.
Currently, the safest and most effective option for cryopreservation is almost instant freezing, vitrification. For vitrification, special solutions are used that do not form crystals and prevent oocytes from being damaged. At EMC, specialists use exactly this freezing method.
I am 36 years old, and I, like millions of women, want to get married. For the last 2.5 years I have been dating a man who could not decide whether he needed a family. Having finally decided to have a serious conversation with him about marriage, I realized that I had little chance, he was not ready to get married yet. But I, too, was not ready to wait any longer and left him. Now I am left “without a permanent partner.” Leaving aside the suffering over the lost two years of life, I understand that it will take me another couple of years to meet the next man and start a family with him, and I will already be 38 - a critical age for pregnancy. And then I remembered cryopreservation. There are a lot of myths and scary articles on the Internet on this topic, so I decided to talk to a doctor who has been doing this for many years. This is how I ended up with Natalya Anatolyevna Kalinina, MD, obstetrician-gynecologist of the highest qualification category, reproductive specialist at the SM-Clinic Reproductive Health Center. Kalinina helped more than 3,000 children be born. Incredibly, two thirds of them were born from frozen eggs.
Cryopreservation (from Greek κρύος - cold and Lat. conservo - save) is low-temperature storage of living biological objects with the possibility of restoring their biological functions after thawing.
– Before we move on to the details, please tell us a little about the hardware, how long has cryopreservation been carried out?
– In Russia, cryopreservation of eggs has been carried out for more than 20 years. The first scientific work on fertilization of a human egg was carried out in the USSR. Ph.D. Petrov published a report at the Crimean Medical Institute three years before Edwards (the “father” of the first test tube baby, Louise Brown (England)). Cryopreservation technology has developed and improved in recent years thanks to the Japanese embryologist Kuwayama. Egg freezing, or, in scientific terms, vitrification, has achieved excellent results - more than 95% of eggs are now thawed. In general, cryopreservation is part of the IVF protocol, which is used all over the world, including Russia.
Even if a woman is doing well, she is young, and she has a family, cryopreservation is such an insurance for the future, your personal egg bank.
– I’m already 36, is it late or normal? At what age is it best to freeze eggs?
– The ideal age for freezing is a young age up to 35 years, when the number of follicles is greatest and the quality of oocytes (ovum - ed.) is still high. After 35 years, the quality of the biomaterial decreases, but the chances are still high, it all depends on the body and the number of follicles. From the age of 38, and if possible earlier, if there is a permanent partner, we strongly recommend freezing embryos, that is, eggs fertilized with the sperm of a partner. But in your case, the situation is optimistic - on the ultrasound we saw 8 follicles, this is an average chance for 1-2 healthy embryos. Even if a woman is doing well, she is young and has a family, cryopreservation is such an insurance for the future, your personal egg bank, because you never know how life will change. Therefore, even at 25 years old, egg freezing would be a very smart decision. Unfortunately, at this age, few people think about it.
Frozen eggs can be stored for an indefinite number of years.
– How long can you store an egg? And why is it better to freeze embryos?
– An infinite number of years. The technology is designed in such a way that air is released from the cell and it is frozen with liquid nitrogen, in this state it can be stored forever. An embryo is a more durable structure. Cryopreservation of embryos is more profitable, since after thawing the eggs, up to 5-7% of the material for fertilization can be lost. And embryos are the result of fertilization of an egg by a sperm, and during defrosting, the percentage of loss of biomaterial is much less.
– Could you explain using my example?
– Look, you have 8 eggs in the follicles. We will find out the number of eggs in them after puncture (their number is 7-8). When freezing mature eggs, we plan to defrost an average of 5-7 cells; when they are fertilized, we will get 2 embryos. And if we immediately fertilize 7-8 eggs, we will get 4 embryos. By defrosting them, the chances of success will be twice as great.
Contraindications to IVF include viral hepatitis, tuberculosis, HIV and other diseases.
– Tell us how the process itself works, how long does it take? Are there any contraindications?
– First of all, you undergo an examination to exclude contraindications for stimulating ovulation. Contraindications to the drugs are strictly stipulated by Order No. 107N of the Ministry of Health of the Russian Federation; they do not differ from the IVF protocol. This is a rather impressive list, but you can do some of it at the clinic at your place of residence or through your insurance. Contraindications include viral hepatitis, tuberculosis, HIV and other diseases. If contraindications are excluded, then there will be no negative consequences from stimulation.
If everything is fine with the tests, you are given a set of drugs in syringes that stimulate the ovaries. You can go to the clinic every day for injections, but many still prefer to inject themselves. There is a thin insulin needle and the injection is placed in the thigh. The injections contain hormonal drugs that stimulate the growth of follicles in the ovaries and the maturation of eggs in them. For all women, this number varies individually, from 1-2 to 25-30 follicles. Once the follicles have reached a certain size, a puncture is performed and the resulting eggs are cryopreserved.
How does the procedure work? In the clinic, under general anesthesia, the egg retrieval procedure is performed, which lasts 20 minutes. A small puncture of the ovary occurs under ultrasound supervision. The cells are collected, cryopreserved and sent to storage. This is not an operation, we do not injure the tissue, so after two hours you can go about your normal business.
– And if there are still contraindications, we can’t talk about any cryopreservation?
– If there are contraindications or serious illnesses (in particular, cancer), egg retrieval for freezing can be carried out without previous stimulation. That is, in each menstrual cycle, a woman normally grows 1 follicle and contains 1 egg. Before ovulation, this single follicle can be punctured and the resulting egg can be frozen. Similar punctures of the follicles are carried out in several menstrual cycles in order to accumulate a certain number of eggs for further use.
– What should I do if I have an ovarian cyst? Should she be operated on first?
– The issue of surgical treatment is decided individually, since part of the follicular apparatus is irretrievably lost with the ovarian tissue.
- Well, okay, these eggs are lying there, when can I use them? Until what age can you theoretically “pull”?
– It all depends on the woman’s body. By cryopreservation we have solved the problem of the “youth” of the egg, but we also need to understand that with age, a woman’s chronic diseases worsen and her ability to bear a child decreases. We put a lot of effort into preparing a woman for pregnancy and childbirth. This is a whole complex of gynecological procedures that improves the condition of the endometrium, which ensures embryo implantation.
Sperm donors are young healthy men under 35 years of age who have been examined, including those who are genetically healthy.
– Do I understand correctly that if I do cryopreservation now, I have at least another 5 years to start a family and have a child?
– Perhaps more. In the absence of a permanent partner, it is possible to fertilize your egg with donor sperm. We have been using a donor sperm bank for many years. Donors are young healthy men under 35 years of age, examined, including karyotyped (genetically healthy).
With IVF, it is possible to exclude the birth of children with developmental defects, because 24 of 46 chromosomes can be tested.
– By the way, about diseases. I have read all sorts of horror stories that children born after cryopreservation have a higher risk of developing genetic diseases, Down's disease. That they are developmentally delayed. What do you say about this?
– These are typical myths from the Internet, and it’s sad that there are so many of them. I’ll tell you even more - children born after IVF have a much lower likelihood of genetic diseases if they undergo PGD (preimplantation genetic diagnosis). In a natural pregnancy, 5 chromosomes can be checked using non-invasive genetic screening, and in IVF, 24 out of 46 chromosomes can be checked! This is more than half of the genome. We reject a large number of embryos that carry the wrong set of chromosomes, which makes it possible to exclude the birth of children with developmental defects.
– What is the price of the cryopreservation procedure?
– In our clinic it’s about 60,000 rubles, not counting tests that you can do anywhere. Storage costs 1,000 rubles per month if paid annually, that is, well within the budget for any city resident.
*** Questions: Lina Isetskaya We thank SM-Clinic for their help in preparing the material.
Advantages of contacting EMC
- Own large cryobank of eggs, embryos and sperm, including donor biological material.
- Modern international diagnostic and treatment protocols. Using the most modern, effective and safe techniques.
- Quality and safety of ART services: the IVF laboratory is created and equipped in accordance with the standards of the American Society for Reproductive Medicine (ASRM).
- A full range of medical services in the areas of reproduction, obstetrics and gynecology: preparation for pregnancy. Carrying out IVF, pregnancy and childbirth management.
