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Elective Egg Freezing
You may want children but the time isn't quite right. Find out about egg freezing from Dr. Mary Ramie Hinckley.
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Learn more about Mary Ramie Hinckley, MD
Mary Ramie Hinckley, MD
Mary Ramie Hinckley, MD is a board certified Reproductive Endocrinologist who completed her training at Stanford University Medical Center. She says her greatest joy is helping patients to realize their dreams in creating a family, but she also enjoys participation in clinical and laboratory studies.Learn more about Mary Ramie Hinckley, MD
Transcription:
Bill Klaproth (Host): So, why would you consider freezing your eggs? Maybe you want to buy some time. Maybe you’re not ready for babies yet. Finances, relationship status. There’s a bunch of reasons. So, if you’re considering elective egg freezing, what do you need to know? Let’s find out with Dr. Mary Hinckley a physician at Reproductive Science Center of San Francisco Bay. I’m Bill Klaproth and this is Fertility Matters. Dr. Hinckley, great to talk with you.
Mary Ramie Hinckley, MD, REI (Guest): Hi Bill. It’s a pleasure to be speaking with you as well.
Host: Oh, well thank you so much. So, let’s jump into this. Dr. Hinckley, egg freezing, this seems to be a hot topic. Why is everyone talking about egg freezing?
Dr. Hinckley: Well it is a hot topic and it’s a hot topic because it’s something new and something that really has the ability to change the way we’ve thought about fertility. Up to this point in time, there has been people that are infertility doctors that deal with the problems as most doctors do. But we’ve entered a new era and this new era is one in which we can be proactive about our fertility. We can take charge of it and we can then be able hopefully to create in the future the family that we dream for.
Host: So, this is a real thing now. So, who is the best candidate for this?
Dr. Hinckley: Well that’s a great question and I think it still remains to be seen which people may benefit that are at the extremes from the very young to the quite – pushing the edge of their fertility. But we do know without a doubt, that women in their mid-30s are great candidates for this. As women near their 40s and even get into 42, 43; we find that we can freeze many fewer eggs and the quality is less. And that makes the procedure less successful.
So, if you want to be able to get the most success out of a single procedure; then usually coming to see us in your early to mid-30s is going to be best.
Host: That’s really good. So, mid-30s is kind of the benchmark area you want to be in. So, speaking of the procedure Dr. Hinckley, what can someone expect during the egg freezing process?
Dr. Hinckley: So, the egg freezing process it self is not that difficult. I mean, most of the time, people have heard about in vitro fertilization. They’ve heard about the hormone swings, the ups and downs, the painful shots and while some of that is true; I think for a woman who is freezing their eggs, they come in in a different place. They come in ready to take charge and ready to spend a shorter period of time for that ability for the future.
And so, while they do do about two weeks of shots; and we teach women how to do shots in their tummy with a little tiny needle. Generally they can tolerate these symptoms very well. They come in for maybe four to five visits to the office in total over that two week period and of course one of those is the actual egg retrieval surgery which is a very minor surgery.
So, most people can tolerate this. They may feel a little more fatigued than normal. They may feel a little more bloated, almost gassy, but other than that, they are able to go to their jobs, lead a normal life and even exercise. Although we don’t like them to be doing a lot of bouncing and jumping; cardiovascular exercise is just fine during this two week process.
Host: And Dr. Hinckley, how many eggs should a woman aim to freeze?
Dr. Hinckley: Well the number of eggs really depends on the age of a woman. And there has been some great studies out there looking at what the ideal number of eggs is depending on how many children you are and how old you are. This study was done by a doctor named Dr. Dole and it allows us to be able to advise women to give them an idea of what number of eggs would be ideal.
Now, for many women, they may only produce ten to twenty eggs in a single cycle, in a single two week process. And so therefore, if they felt that they needed more eggs or were counseled to harvest more eggs; then they might have to do another cycle. But for the vast majority of people, freezing somewhere around 15 or 16 eggs will give them very good chances of having a baby in the future. So, maybe a 34-year-old, freezing 16 eggs would give them about a 75-80% chance of at least having one child and maybe a 50% chance of having two and that would hopefully come from a single egg freezing cycle.
Host: And how long will frozen eggs keep? What’s the window of opportunity?
Dr. Hinckley: Well the shelf life is forever. They are frozen in liquid nitrogen and so long as the tank in intact and is filled with liquid nitrogen; they do not get freezer burned. Freezing eggs is very complicated. It requires a highly skilled lab to be able to perform this well, but once they are frozen; they can stay frozen for a very long time. In addition, they could even be shipped from one facility to another and then at that point in time, they are thawed.
Now one of the issues is we don’t know how good the eggs are until they are thawed. And once they are thawed that we find out what the survival is and how well they fertilized and so that in essence, is one of the biggest challenges in this field. It’s determining how good are these eggs you’ve frozen, and will they truly be able to help you in the future.
Host: So, let me shift the conversation a little bit. What do the detractors say about egg freezing?
Dr. Hinckley: Well more and more insurances are starting to cover this and that is why we are starting to see an increase in women coming into our clinics asking about it. Many detractors feel that this might backfire on the very women who the procedure is intended to help; that women who freeze their eggs at a younger age may think that they are perfectly fertile and delay getting married or having children and then come to find out that the eggs aren’t good enough to help them have a baby.
And so the detractors warn these women don’t be fooled in thinking that this is a guarantee and I actually agree with that. I do try to educate patients that this is not a guarantee. That this is another option that they may have to help accomplish their goals.
Some of the other detractors think that we just haven’t really thawed enough eggs and fertilized them to see how successful this will be. And that is true. Many, many clinics are popping up and offering egg freezing without any data on how well their procedure works when it comes to thawing the eggs. And this might be quite disappointing to patients. Their pop up clinic may not even exist in the future to be able to thaw their eggs. There are different devices that are used. Like I said, the skill set is incredibly intense and complicated and so, freezing eggs it is important to understand can the clinic do it well and can they thaw these eggs well to result in a healthy pregnancy.
Now, the good news is, is the detractors are not allowed to say or should not be saying that we don’t know if it’s safe. We have lot’s of data on the safety of this. the babies that are born are quite healthy. They are very similar to the babies that are born when we do IVF and so we are not feeling that in any way this increases the incidence of birth defects or problems to the children.
Host: You brought up a really good point Dr. Hinckley when you said egg clinics are popping up all over. So, I take it every clinic is not the same in terms of success rates and the ability to use them in the future. Is that right?
Dr. Hinckley: Well we just don’t know. And while this procedure itself can be done at many IVF clinics and even at independent clinics that are only egg freezing clinics; we just don’t know what that success rate is going to be. And so, there is a little bit of education that needs to happen to the patient to have them really understand that if they are going to trust their future, these eggs and they are going to undergo a surgery to be able to freeze eggs for the future; they want to go to a clinic that they know has a good track record.
They want to go to a clinic that maybe has done this already, thawed the eggs, seen the fertilization rates, so that they can say with certainty what the outcome data is. And I think if patients are made aware that that’s an option; then they are able to ask the right questions and get the right information to make the best decision for where they would freeze their eggs.
Host: And that’s what we are looking for an informed consumer. So look for that clinic that’s got the experience. And Dr. Hinckley, if you could wrap this up for us. Is there anything else we should know about egg freezing that I didn’t ask you?
Dr. Hinckley: Well I think just in general, as a reminder, that women should not try to get on the internet and figure it out for themselves. They should use that as a starting point, a launching pad to then go talk to a physician, maybe even do some fertility labs and our clinic offers something called a fertility check where without even being a patient, you can check your fertility hormones to see if you would be a good candidate and then come in, sit down and have a conversation.
You owe that to yourself to have a conversation with a physician who can help educate you to make the best decision for being able to have the family that you wish in the future or at least have the option to have the family that you wish in the future.
Host: Absolutely and that’s what it’s all about. Dr. Hinckley, thank you so much for your time today. I’ve really enjoyed talking with you. And for more information, and to get your questions answered please visit www.rscbayarea.com, that’s www.rscbayarea.com. This is Fertility Matters by Reproductive Science Center of San Francisco Bay. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): So, why would you consider freezing your eggs? Maybe you want to buy some time. Maybe you’re not ready for babies yet. Finances, relationship status. There’s a bunch of reasons. So, if you’re considering elective egg freezing, what do you need to know? Let’s find out with Dr. Mary Hinckley a physician at Reproductive Science Center of San Francisco Bay. I’m Bill Klaproth and this is Fertility Matters. Dr. Hinckley, great to talk with you.
Mary Ramie Hinckley, MD, REI (Guest): Hi Bill. It’s a pleasure to be speaking with you as well.
Host: Oh, well thank you so much. So, let’s jump into this. Dr. Hinckley, egg freezing, this seems to be a hot topic. Why is everyone talking about egg freezing?
Dr. Hinckley: Well it is a hot topic and it’s a hot topic because it’s something new and something that really has the ability to change the way we’ve thought about fertility. Up to this point in time, there has been people that are infertility doctors that deal with the problems as most doctors do. But we’ve entered a new era and this new era is one in which we can be proactive about our fertility. We can take charge of it and we can then be able hopefully to create in the future the family that we dream for.
Host: So, this is a real thing now. So, who is the best candidate for this?
Dr. Hinckley: Well that’s a great question and I think it still remains to be seen which people may benefit that are at the extremes from the very young to the quite – pushing the edge of their fertility. But we do know without a doubt, that women in their mid-30s are great candidates for this. As women near their 40s and even get into 42, 43; we find that we can freeze many fewer eggs and the quality is less. And that makes the procedure less successful.
So, if you want to be able to get the most success out of a single procedure; then usually coming to see us in your early to mid-30s is going to be best.
Host: That’s really good. So, mid-30s is kind of the benchmark area you want to be in. So, speaking of the procedure Dr. Hinckley, what can someone expect during the egg freezing process?
Dr. Hinckley: So, the egg freezing process it self is not that difficult. I mean, most of the time, people have heard about in vitro fertilization. They’ve heard about the hormone swings, the ups and downs, the painful shots and while some of that is true; I think for a woman who is freezing their eggs, they come in in a different place. They come in ready to take charge and ready to spend a shorter period of time for that ability for the future.
And so, while they do do about two weeks of shots; and we teach women how to do shots in their tummy with a little tiny needle. Generally they can tolerate these symptoms very well. They come in for maybe four to five visits to the office in total over that two week period and of course one of those is the actual egg retrieval surgery which is a very minor surgery.
So, most people can tolerate this. They may feel a little more fatigued than normal. They may feel a little more bloated, almost gassy, but other than that, they are able to go to their jobs, lead a normal life and even exercise. Although we don’t like them to be doing a lot of bouncing and jumping; cardiovascular exercise is just fine during this two week process.
Host: And Dr. Hinckley, how many eggs should a woman aim to freeze?
Dr. Hinckley: Well the number of eggs really depends on the age of a woman. And there has been some great studies out there looking at what the ideal number of eggs is depending on how many children you are and how old you are. This study was done by a doctor named Dr. Dole and it allows us to be able to advise women to give them an idea of what number of eggs would be ideal.
Now, for many women, they may only produce ten to twenty eggs in a single cycle, in a single two week process. And so therefore, if they felt that they needed more eggs or were counseled to harvest more eggs; then they might have to do another cycle. But for the vast majority of people, freezing somewhere around 15 or 16 eggs will give them very good chances of having a baby in the future. So, maybe a 34-year-old, freezing 16 eggs would give them about a 75-80% chance of at least having one child and maybe a 50% chance of having two and that would hopefully come from a single egg freezing cycle.
Host: And how long will frozen eggs keep? What’s the window of opportunity?
Dr. Hinckley: Well the shelf life is forever. They are frozen in liquid nitrogen and so long as the tank in intact and is filled with liquid nitrogen; they do not get freezer burned. Freezing eggs is very complicated. It requires a highly skilled lab to be able to perform this well, but once they are frozen; they can stay frozen for a very long time. In addition, they could even be shipped from one facility to another and then at that point in time, they are thawed.
Now one of the issues is we don’t know how good the eggs are until they are thawed. And once they are thawed that we find out what the survival is and how well they fertilized and so that in essence, is one of the biggest challenges in this field. It’s determining how good are these eggs you’ve frozen, and will they truly be able to help you in the future.
Host: So, let me shift the conversation a little bit. What do the detractors say about egg freezing?
Dr. Hinckley: Well more and more insurances are starting to cover this and that is why we are starting to see an increase in women coming into our clinics asking about it. Many detractors feel that this might backfire on the very women who the procedure is intended to help; that women who freeze their eggs at a younger age may think that they are perfectly fertile and delay getting married or having children and then come to find out that the eggs aren’t good enough to help them have a baby.
And so the detractors warn these women don’t be fooled in thinking that this is a guarantee and I actually agree with that. I do try to educate patients that this is not a guarantee. That this is another option that they may have to help accomplish their goals.
Some of the other detractors think that we just haven’t really thawed enough eggs and fertilized them to see how successful this will be. And that is true. Many, many clinics are popping up and offering egg freezing without any data on how well their procedure works when it comes to thawing the eggs. And this might be quite disappointing to patients. Their pop up clinic may not even exist in the future to be able to thaw their eggs. There are different devices that are used. Like I said, the skill set is incredibly intense and complicated and so, freezing eggs it is important to understand can the clinic do it well and can they thaw these eggs well to result in a healthy pregnancy.
Now, the good news is, is the detractors are not allowed to say or should not be saying that we don’t know if it’s safe. We have lot’s of data on the safety of this. the babies that are born are quite healthy. They are very similar to the babies that are born when we do IVF and so we are not feeling that in any way this increases the incidence of birth defects or problems to the children.
Host: You brought up a really good point Dr. Hinckley when you said egg clinics are popping up all over. So, I take it every clinic is not the same in terms of success rates and the ability to use them in the future. Is that right?
Dr. Hinckley: Well we just don’t know. And while this procedure itself can be done at many IVF clinics and even at independent clinics that are only egg freezing clinics; we just don’t know what that success rate is going to be. And so, there is a little bit of education that needs to happen to the patient to have them really understand that if they are going to trust their future, these eggs and they are going to undergo a surgery to be able to freeze eggs for the future; they want to go to a clinic that they know has a good track record.
They want to go to a clinic that maybe has done this already, thawed the eggs, seen the fertilization rates, so that they can say with certainty what the outcome data is. And I think if patients are made aware that that’s an option; then they are able to ask the right questions and get the right information to make the best decision for where they would freeze their eggs.
Host: And that’s what we are looking for an informed consumer. So look for that clinic that’s got the experience. And Dr. Hinckley, if you could wrap this up for us. Is there anything else we should know about egg freezing that I didn’t ask you?
Dr. Hinckley: Well I think just in general, as a reminder, that women should not try to get on the internet and figure it out for themselves. They should use that as a starting point, a launching pad to then go talk to a physician, maybe even do some fertility labs and our clinic offers something called a fertility check where without even being a patient, you can check your fertility hormones to see if you would be a good candidate and then come in, sit down and have a conversation.
You owe that to yourself to have a conversation with a physician who can help educate you to make the best decision for being able to have the family that you wish in the future or at least have the option to have the family that you wish in the future.
Host: Absolutely and that’s what it’s all about. Dr. Hinckley, thank you so much for your time today. I’ve really enjoyed talking with you. And for more information, and to get your questions answered please visit www.rscbayarea.com, that’s www.rscbayarea.com. This is Fertility Matters by Reproductive Science Center of San Francisco Bay. I’m Bill Klaproth. Thanks for listening.