Egg freezing, also known as oocyte cryopreservation, involves harvesting a woman’s eggs and freezing them so she can attempt pregnancy later through in vitro fertilization (IVF). Egg freezing therefore acts as a safeguard against the natural decline in fertility that all women experience as they age.
Having the option to freeze eggs can be a valuable, life-changing one for some women, such as those suffering with diseases such as cancer, severe endometriosis, or for those with a family history of early menopause. Egg freezing treatment was originally designed for such women, for whom medical treatment that would harm fertility. However, amidst a general trend for women to have children later in life, egg freezing has now broadened its use to ‘social’ application.
Social egg freezing:
Social egg freezing, also known as elective or non-medical egg freezing, is a procedure where a woman’s eggs are harvested and cryopreserved (frozen) for future use, typically for non-medical reasons. It has gained popularity as a means for women to preserve their fertility and gain more control over their reproductive choices.
Rise in Popularity:
Social egg freezing has gained significant attention and popularity in recent years. Factors contributing to its increased adoption include:
- Advancements in Technology: Improvements in cryopreservation techniques, particularly vitrification, have increased the success rates of egg freezing and subsequent thawing and fertilization.
- Removal of “Experimental” Label: In 2012, the American Society for Reproductive Medicine (ASRM) removed the “experimental” label from egg freezing procedures, which contributed to a shift in public perception and increased acceptance of social egg freezing.
- Awareness and Education: Greater awareness and education about the procedure, its success rates, and the availability of fertility preservation options have led more women to consider social egg freezing.
Women may choose social egg freezing for various reasons:
- Delaying Parenthood: Some women choose to freeze their eggs to delay childbearing and extend the window of opportunity for having biological children. This can be due to personal or professional reasons, such as pursuing education, career advancement, or finding the right partner.
- Medical Conditions or Treatments: Women facing medical conditions or treatments that could potentially affect their fertility, such as cancer treatments, may opt for egg freezing to preserve their eggs before undergoing medical interventions that may compromise their fertility.
- Uncertain Future Fertility: Women who are unsure about their future fertility, whether due to medical conditions, family history, or other factors, may choose to freeze their eggs as a precautionary measure.
- Choice and Autonomy: Social egg freezing offers women the opportunity to take control of their reproductive choices and gain more autonomy over their family planning.
Considerations and Limitations:
While social egg freezing offers women more options and flexibility, there are some important considerations:
- Success Rates: While advances in technology have improved success rates, the chances of a successful pregnancy with frozen eggs still depend on various factors, such as the age of the woman at the time of egg freezing, the number of eggs frozen, and the quality of the eggs.
- No Guarantee of Future Pregnancy: Freezing eggs does not guarantee a future successful pregnancy. Other factors, such as the quality of sperm, the viability of embryos formed from the thawed eggs, and the woman’s overall reproductive health, also play a role.
- Financial Costs: Social egg freezing can be expensive, involving costs for the initial egg retrieval procedure, storage fees, and potential costs for subsequent IVF procedures when the frozen eggs are eventually used.
- Emotional Considerations: It is important for women considering social egg freezing to be aware of the emotional and psychological implications of the process. It can involve complex decision-making, potential disappointment if pregnancy attempts are unsuccessful, and the need for ongoing storage and decision-making about the fate of the frozen eggs.
Egg freezing in the UAE:
Egg freezing has been slower to be adopted in the GCC due to cultural beliefs and religious regulations. However, the trend has now picked up, especially in the UAE, driven in part by a new IVF law that came into effect in January 2020. This new IVF law allows fertility centres in Dubai to freeze human embryos and unfertilized eggs and sperm. Under the Old IVF Law, it was illegal to freeze human embryos. Only unfertilized eggs could be frozen. According to reporting from Arabian Business, clinics in Dubai experienced a 2,000% surge in egg freezing since the law came into effect. Around 20 times more women requested egg freezing procedures in 2023 than in 2021.
The egg freezing process:
Whilst many people consider egg collection as ‘easy’, the process involves regular medication, injections and scanning, and it is not a guarantee to get pregnant. It is also costly in terms of finances, time and emotional energy. Therefore, any egg collection treatment should not be undertaken without careful consideration.
- Daily, multiple injections: the daily, multiple injections are a big part of egg collection and the needle, and the stinging of the hormones entering the body can be painful. We recommend that patients try to get as much practice as possible with a nurse before attempting injections at home. Make sure to try to relax as much as possible, and if helpful, enslit a supportive partner, relative or friend to help until confident.
- Blood collection: The egg colleciton process includes blood collection and testing to ensure hormones are on track.
- Trans vaginal scans: Egg freezing involves regular intravaginal scanning, which can be uncomfortable.
- Ovarian stimulation: As the ovaries get larger, they can feel uncomfortable and swollen. Patients can report bloating, breast tenderness and mood swings. Again, please don’t minimize these symptoms and if overwhelmed, speak to your medical advisor.
- Egg retrieval: The retrieval involves a mild sedataion before the doctor retrives the eggs. This will involve a needle where the anaesthesia is administered. If patients are uncomfortable with the needle site (often in the back of your hand), they can ask the nurse to try a different location, such as the wrist or forearm.
- Egg assesment and freezing: The embryology team then asses the maturity of the eggs and select those viable for freezing. All mature eggs are selected and frozen using an advanced cryopreservation technique, allowing them to be stored for extended periods of time. Since becoming widely used circa 2005, vitrification has boosted the success rate for people who try to get pregnant using eggs they’ve frozen. When the patient is ready to use the eggs, the eggs are fertilized in a lab, and the embryo is implanted into the uterus.
- Afterwards: Afterwards, patients will feel groggy and tired, but can resume light activity for the rest of the day. Patients also might feel sore, with cramping or spotting immediately following the procedure. This is usually treatable with rest and over the counter painkillers.
Egg freezing medication:
All cycles are different, and the precise type of medication offered will depend on each patient. However, typically, patients can expect to be given a combination of the below:
- A synthetic FSH (follicle stimulating hormone) or combination of FSH and LH (luteinizing hormone) that stimualte the ovaries into creating extra eggs.
- An antagonist hormone that will prevent ovulation before the retrieval procedure takes place.
- A “trigger,” timed to be injected 36 hours before the retrieval, that tells your body to go ahead and release the eggs.
Success rates:
It is worth noting that there are many different studies from different fertility centres offering differing success rates. In a recent research paper, a team of experts fro NYU’s Grossman School of Medicine and Langone Fertility Center said the proportion of patients who ultimately had a baby after going through the whole process of freezing and using their eggs was 39%, and the success rate was heavily influenced by the patient’s age. Only around one in three of those who choose to freeze their eggs will result in a live birth after going through the entire process, the study finds, and that success rate drops as the patients age increases.
The main factor behind the success rates is the age that the female chose to freeze her eggs, and not the age when she chose to undergo the IVF procedure. Younger eggs greatly influence positive outcomes. However, more data is needed on safety, efficacy, ethics, emotional risks and cost effectiveness.
Risks:
- PMS side effects: The hormones shots can cause symptoms similar to PMS, that include moodiness, hot and cold flashes, cramping or bloating.
- Ovarian hyperstimulation syndrome (OHSS): This can occur as an exaggerated, adverse response to the hormone stimulation. The hyperstimulation causes the ovaries to swell and leak fluids into the abdomen. OHSS is more common in people with PCOS who are going through fertility treatments. New IVF protocols and strategies have made OHSS common, although mild cases still occur from time to time.
- Anesthesia risks: All anesthesia procedures carry a risk, but it is worth noting that the risks are very low for the type of sedation used in egg freezing.
- Needle punctures: There is minimal risk of injury to the bowel, bladder, uterus, cervix or a blood vessel from the needle used to retrieve the eggs.
FAQs:
What is the best age to freeze my eggs?
Generally, female fertility begins to drop in the late 20s or early 30s. It tends to fall more rapidly after age 35 as female egg reserves become even more depleted. Therefore, the best age for egg freezing likely falls somewhere between 27 and 34.
Egg freezing, what’s the cost in Dubai?
In Dubai, the cost of egg freezing ranges upwards from 12,000 AED. Packages may or may not include tests, labs, ultrasounds and the procedure itself. It’s worth remembering that eggs will also incur an annual storage fee. When the time comes to use the eggs, an IVF package is likely to cost upwards from 20,000 AED.
Does my Dubai insurance cover egg freezing?
Some insurance plans cover medical or elective egg freezing, and some employers – famously Apple and Meta – cover some of the costs as an employee benefit. But typically, patients pay from their own pocket.
Will my company pay for my egg freezing?
In October 2014, Facebook (now Meta) and Apple announced that they would cover up to $20,000 in costs for female employees wanting to freeze their eggs.
Over the past ten years, some companies, mainly in the start-up tech sector, are providing egg freezing as a benefit to draw in the younger geneation and keep them working harder throughout their thirties. This means that generally, most women who are freezing their eggs are in a higher-income bracket.
We recommend that patients speak to their employer to understand if this is a benefit that can be offered.
Can I freeze my eggs if I’m not in a relationship?
Yes. Dubai’s legislation is increasingly lenient towards fertility preservation. The new IVF law in Dubai that officially came into effect on 1st January 2020, allows fertility centers to freeze human embryos and unfertilized eggs and sperm. Under the old IVF law, it was illegal to freeze human embryos. Only unfertilized eggs could be frozen. In a further update November 2023, non-Muslim unmarried couples can now undergo IVF treatment, reflecting the nation’s commitment to inclusivity and progressive values
Legislation elsewhere in the MENA region varies, though a main critical caveat is that egg freezing only allowed in the context of married couples. Saudi Arabia offers no limit on egg storage and allows IVF treatments, Egypt considers egg freezing permissible, though it cannot be fertilized and used after divorce or death. Bahrain allows an embryo to be for five years, again, only available to married couples, while in Oman, eggs can be stored for up to five years and are subject to annual renewal.
How long can my eggs stay frozen?
After they’ve been frozen (vitrified), eggs can be stored indefinitely until you want to use them. So essentially, they can be stored forever. Most people use their eggs within three to 10 years, and there are no concerns about the freezing process.
What happens if I no longer want my eggs?
If you don’t end up using eggs, they can be discarded, donated to research, or even to another couple.
How long does egg freezing take?
A round of egg freezing takes eight to 14 days from the start of the medication to the time the eggs retrieved. Typically, medication starts on day two of the menstrual cycle. However, many people wish to prepare their body for a few months before commiting to the hormone shots to ensure they are in the best possible health to create healthy eggs.
How many eggs do I need to freeze?
The short answer is as many as possible, but the limiting factors relate to the medical health and age of the female. A typical round yields between 10-12 eggs, but it’s likely that not all will survive the thawing process and others won’t fertilise. Others still may not be chromosonoall y normal, or ‘take’ in the uterus. Therefore, doctors recommend people consider multiple cycles of egg collection.
Is success guaranteed?
The short answer is no. Egg freezing does not guarantee a baby, but a shot at getting pregnant in the future. Not all frozen eggs survive the thawing process, and miscarraige is still a risk during pregnancy.
Will the hormone shots affect my ability to function?
Self administered hormone shots are not the most comfortable part of the egg freezing experience, and they can cause moodiness, cramping, hot and cold flashes and bloating. Patients can expect to feel swollen, as if they have eaten too much, or are experiencing PMS. This is because the hormones make the ovaries swell a little in order to make space to accommodate the multiple expanding folicles. The egg freezing process is also financially and emotionally stressful, and the number of eggs that will be harvested is unknown until the collection itself. Patients should focus on a stable mindset throughout the procedure, and ensure they have a strong network around them.
