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Dr. Amelia Warshaw is a pediatric resident at Columbia University’s New York Presbyterian Children’s Hospital (CHONY). She is a graduate of the Alpert Medical School of Brown University (MD’21).

She has written for numerous media outlets including AAMC News, Medscape, The Daily Beast, and AOA’s The Pharos and Princeton University’s Innovation Journal of Science and Technology.

Dr. Warshaw is committed to disseminating science, health, and medical information to a diverse audience, and empowering children, adolescents, and families through health literacy.

Freezing Your Eggs: How, Why, and When?

Freezing Your Eggs: How, Why, and When?

University newspapers often feature advertisements from “happy couples looking to grow their family” looking for an egg donor with “an Ivy League degree, blonde hair, blue eyes, and athletic ability.” Egg donation has been a topic of popular culture for a few years now, with movies such as Tina Fey’s Baby Mama, but the opportunity to freeze one’s eggs to “fight the biological clock” holds a greater deal of uncertainty.

How does the process of freezing eggs work?

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The process of freezing an egg is probably not that much different from what one would expect: at the University of Southern California (USC) Fertility Center, they cool the eggs or embryos to a freezing temperature of -196 degrees Celsius (around -320˚F) through either a slow-freeze method or a flash-freezing process (called vitrification) and store them in their facilities for up to ten years.

There are some modifications, however, that must be made to the egg before they can undergo the freezing process. Since the egg contains a great deal of water, which can produce ice crystals that will destroy the cell, eggs are typically dehydrated before being frozen. The water is then replaced with “an ‘anti-freeze’ prior to freezing in order to prevent ice crystal formation.”

How are the eggs generated in preparation for freezing?

In order to produce multiple eggs for freezing, a woman must undergo the same hormone-injection process as someone preparing for in-vitro fertilization (IVF). It takes approximately 4-6 weeks to prepare the oocytes for egg harvesting and requires “2-4 weeks of self-administered hormone injections and birth control pills to temporarily turn off natural hormones,” followed by nearly two weeks of “hormone injections to stimulate the ovaries and ripen multiple eggs.” According to fertility studies, “most women 38 years of age and under can expect to harvest 10-20 eggs per cycle.”

The eggs are then removed from the body under ultrasound guidance and immediately frozen.

While most college students probably aren’t currently thinking about freezing their eggs, the fact remains that this is an option used by millions of women, requires informed decision-making, and may not be something that can be put on the back burner for that much longer.

According to a DailyMail.com article published in May of 2015, “egg freezing is the most popular fertility treatment in the UK, with demand up 407 percent in the past 12 months.” Furthermore, among those in the UK seeking egg freezing treatment in the past year, “43 percent were aged 25 to 34, and 13 percent were under the age of 24.”

Why are women deciding to freeze their eggs so early?

Since the likelihood of chromosomal abnormalities and risk of miscarriage, birth defects, and certain disorders increases with age, many view freezing their eggs as a way to extend their best reproductive years. There is some evidence suggesting that egg freezing may help to “preserve the younger, possibly healthier eggs.”

While there is still limited clinical evidence regarding how age affects the viability of frozen eggs, there is some evidence to suggest that the process is more successful for women under 38 years of age. The USC fertility clinic, for example, predicts that “the chance of future pregnancy in women older than 38 at the time of freezing is likely to be lower than that seen for younger women.”

According to Sarah Elizabeth Richards, author of Motherhood Rescheduled: The New Frontier of Egg Freezing, “The average age at which a woman freezes her eggs is now 36.”

Since the announcement that Facebook and Apple will pay for their female employees to freeze their eggs, Richards reports that “we’re seeing women freeze their eggs younger and younger, and the public narrative around it is changing. Women are doing it for work now, which is very different from the first wave of freezers.”

It is important to remember that egg freezing is first and foremost a personal choice; it should be based on an informed decision regarding the individual’s fertility, long-term plans, religious beliefs, and understanding that families can come in a variety of shapes and sizes.

Articles cited

http://www.pbs.org/newshour/updates/freeze-eggs/

http://uscfertility.org/egg-freezing-faqs/

http://www.nbcnews.com/news/us-news/perk-facebook-apple-now-pay-women-freeze-eggs-n225011

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Too Much Emphasis on Procedures and Pills?

Too Much Emphasis on Procedures and Pills?