The power of fertility is in your doctor’s hands.
I can’t imagine my life without my children, yet that’s the potential future of the more than four million infertile women in the country. But oocyte cryopreservation – the process of freezing human eggs – offers hope.
“Five years ago, this was barely possible,” says Lauren Streicher, MD, Gynecologic Specialists of Northwestern and assistant clinical professor of obstetrics and gynecology, Northwestern University Feinberg School of Medicine. “And we don’t know how long eggs will be viable once they’re frozen, since most women who’ve undergone the process aren’t yet ready to use them.”
The procedure itself is relatively easy. A woman is given a course of synthetic hormones to stimulate the ovaries into producing multiple eggs, rather than the single egg that normally develops each month. After 8-14 days, the egg retrieval is done under sedation in a doctor’s office and takes about 30 minutes.
So when is the best time to begin the process? Dr. Streicher says the younger the better. “Our bodies were created to bear children in our 20s. That’s when eggs are most fertile.” David Cohen, MD, professor of obstetrics/gynecology and chief of reproductive endocrinology and infertility, University of Chicago, agrees — especially since “70 percent of all embryos after 40 will be abnormal. After that age, a good egg is hard to find.”
Then there are women who might have had normal fertilizations and pregnancies until a different scenario unfolded – a diagnosis of cancer. Chemotherapy, radiation and surgery can destroy a woman’s reproductive capabilities. That’s what inspired Teresa Woodruff, PhD, director, Women’s Health Research Institute and chief of division of obstetrics and gynecology-fertility preservation, Northwestern University Feinberg School of Medicine, to coin the term ‘oncofertility’ – a field that bridges the worlds of oncology and fertility.
Doctors urge patients to preserve eggs as soon as possible after cancer diagnoses, before any treatment begins. They don’t often have to talk women into the procedure. “You need chemo,” Dr. Streicher tells her patients. “But guess what, we can save your eggs.”
Dr. Cohen presents egg freezing to his patients as an insurance policy. “In general, if a woman is young the actual likelihood that she’ll use the frozen eggs is small,” he observes. “But just as with any other insurance policy, she’ll have a fallback plan in case she loses ovarian functionality after cancer treatment. And I encourage women to freeze both embryos and eggs. For those who don’t have a partner with whom to create embryos, we use donor sperm.” Unused eggs and embryos can then be donated to other women with fertility issues.
Alice Crisci was diagnosed with cancer in 2008. “I went to a fertility clinic to discuss cryopreservation and was totally on board and then I heard the cost – $20,000.” Ms. Crisci was immediately on the phone to increase her American Express credit card limit, charged the whole thing and began the hormone shots. Just months ago, on the fifth anniversary of her cancer diagnosis, she heard her baby’s heartbeat for the first time.
But long before Ms. Crisci became pregnant, she recognized the need for all women to have the option of preserving eggs, regardless of their economic situation. She created Fertile Action, an organization that helps women touched by cancer become mothers through education, advocacy and financial assistance.
Doctors have become so proficient at harvesting/freezing eggs that the American Medical Association no longer considers it experimental. That’s especially good news as it opens up the possibility of insurance companies covering the procedure. That said, the technology surrounding oocyte cryopreservation is moving at lightning speed, and more research means more chances that all women will know the joys of motherhood.