With so many women putting off having children till much later in life, Dr Johannes van Waart, a fertility specialist who works with Mediclinic Stellenbosch, helps us explore the option of egg harvesting and freezing as a solution to potential infertility issues as we age.
Can all women freeze their eggs?
Potentially, yes. The only exclusions for egg harvesting and freezing are women who’ve already been medically diagnosed as unable to conceive, as well as those women who have already gone through menopause. IVF and egg freezing can cost between R25 000 and R40 000 per cycle – it’s not covered by medical aid at the moment, so it may be cost-prohibitive to many.
What IVF freezing options are currently available to women?
There are three main options. The first is basic ovum (egg) freezing, which we often recommend for young patients who, for whatever reason – from having cancer to societal reasons like not being in a relationship – are delaying having a family. Then there’s ‘egg pooling’ where we’d gather the patient’s eggs in more than one cycle, put them all together to get a total number of between eight and 10 eggs to be fertilised in one go to offer a reasonably good chance of a baby later on. The final option is ovarian freezing, where we remove an entire ovary or freeze strips of ovarian tissue for re-implantation later.
What tests are done beforehand?
It’s important to remember that whatever age you are when your eggs are harvested and frozen is the age they’ll stay. For example, if you harvest your eggs when you’re 28 but only use an egg at 40 – those eggs remain in the same genetic state they were when you harvested them 12 years prior. There’s no real age window for harvesting but the older the woman is, the more difficult it may be to conceive from a frozen egg. To determine this, a fertility specialist will take a few factors into account to see whether the woman is a good candidate for this procedure. These factors include her chronological age, as well as the results of an anti-Müllerian hormone (AMH) test and an antral follicle count, which will basically determine her ovarian reserves or fertility potential. When you look at all these things together, they will determine how fertile she is. In the test results, we’re looking for an ideal average value of one in older women. The younger you are when your eggs are harvested, the higher this numerical value will be and the higher the chance of success.
What’s the preparation procedure?
The woman will go through the same stimulation process as if we were doing IVF immediately, but after egg pick-up we’d proceed straight to the freezing stage instead of the embryo-transfer stage. Then, when the woman is ready, she can return for the fertilisation process in the lab and embryo transfer.
Look out for more on IVF in our upcoming issue of Mediclinic Family from the beginning of June.
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