By Joanne Pounder
The chance to prolong fertility until you're ready for a baby - or you've met Mr Right - is now possible through egg freezing. Jennifer Aniston and a host of other celebrities have done it. Should you?
At my book club recently we had a lively debate about baby names because one of the women in the group was about to have her first baby. Everyone joined in with their favourites, including one of the women who excitedly told the group she knows exactly what all three of her babies will be called.
I was a little taken aback by her conviction for one simple reason: this woman is fast approaching 40 and doesn't have a boyfriend, let alone a life partner with whom she wants to have a baby.
She is, of course, like so many women you and I know, very attractive, incredibly successful and thoroughly independent. Like most privileged women of our generation, she was encouraged by her parents to get an education, to travel and to pursue a career. She's done all of those things.
What our parents didn't encourage us to do was pursue a man, a life partner. That, our parents and we assumed, would simply fall into place sometime along the way, and children would come soon after - the life puzzle complete.
Yet my friend's life, like so many of our generation, has that last piece of puzzle
missing. It is - it may not be politic to mention - a really dark blank for so many women. You can meet a man at any age but once you get to 40-plus you are at great risk of being too old to have your own biological child.
But now there is some real hope that, by freezing a cycle of eggs (cryopreservation), a woman can have a baby later in life, allowing her to extend her fertility until Mr Right walks into view or, in the case of a woman who has the man and the career, until she feels the time is right to have a baby. When she finds a partner or is in a position to take a career break, she can have her eggs thawed and use routine IVF procedures to get pregnant.
What makes egg freezing so exciting is it doesn't pose the same moral and ethical dilemmas that embryo freezing does. While some couples have no problem with the concept of embryo freezing, others find it ethically confusing. For those who believe life begins at the moment of conception, each frozen embryo represents a life, and if unused, a life left unfulfilled. Egg freezing, like sperm freezing, presents us with the opportunity to extend ones fertility without these issues. If the eggs are not used, they are simply destroyed, or donated.
The main way in which age affects fertility is its impact on the quality of a woman's eggs. A woman is born with her lifetime's supply of eggs. Each month, when her period starts, she sheds one or so of those eggs. As time passes, age takes its toll on the remaining eggs and their quality deteriorates, making them less likely to be fertilised by a sperm to create a healthy baby.
This is also why the risk of a baby being born with a chromosomal defect rises with age.
Before the age of 35, the odds of a woman falling pregnant naturally each cycle is around 25 percent if she has intercourse at the right time and her partner has healthy sperm. When she reaches 35, that figure begins to drop off so that by the time a woman is 40, the chance of her falling pregnant with each cycle drops to 10 percent and, by the time she hits 45, that percentage is close to zero.
Of course, these percentages are only statistics; we all know women who have fallen pregnant naturally during their 40s. Lifestyle also influences fertility. A woman who has looked after herself physically is far more likely to have a baby at a later age than someone who has neglected or abused her health.
Book club didn't feel the right time to do it, but I really wanted to suggest to my friend that she considers freezing her eggs. Of course, such a procedure can seem drastic (as well as expensive), something for the Jennifer Anistons of the world. It is fraught with fear, confusion and misinformation.
So we asked Professor Thinus Kruger, head of the Fertility Clinic at Tygerberg Hospital and the Institute for Reproductive Medicine at Life Healthcare's Vincent Pallotti hospital in Cape Town, to answer some of the most pertinent questions.
Do you think women should freeze their eggs to prolong their fertility?
Yes I do. I would not be against it if someone aged between 25 and 35 wanted to freeze her eggs. I would definitely advise it, ideally before the age of 35. Freeze your eggs and get that burden off your shoulders.
What does the procedure entail?
During the first consultation, the procedure is explained and discussed. A blood sample is taken so the patient can be screened . Then the patient returns at the correct time in her cycle to receive hormones to stimulate her ovaries to produce more eggs than usual. This is known as superovulation. About three weeks later, the patient returns for harvesting. The patient is lightly sedated and the eggs retrieved trans-vaginally using a hollow needle that is guided using ultrasound. .
How much does the procedure cost?
It costs around R12 000 to R15 000, depending on the clinic.
What are the success rates?
It's so new but, based on international literature, I think you can say a fair rate is about 20 percent per cycle. If you attempt three thawing cycles, that's a cumulative rate of 60 percent. We've successfully frozen eggs, we've thawed them and we've fertilised the eggs - we have one in culture this week - but we have not yet had our first baby from a frozen egg. It is such a new procedure but I know technically that it is working.
Are there any risks?
The risks to the woman are minimal. Superovulation can trigger ovarian hyperstimulation syndrome, but you don't get it when you don't transfer embryos, so that risk is small. There is a theoretical risk of infection in the ovary but I have never seen it. Also, the ovary can swell, causing pain and discomfort, but very few people complain about that.
For how long can eggs be frozen?
Usually 10 years.
- Meet two of SA's top fertility specialists and find out all you need to know about having a baby at the Fit Pregnancy Fertility Workshop on Saturday 9 August, 2008 at The Vineyard Hotel, Colinton Road, Newlands in Cape Town and in Johannesburg: Saturday 23 August, 2008 at The Indaba Hotel, William Nicol Drive, Bryanston
- Registration is at 8.30am. The Workshop starts at 9am and finishes at 12noon. To book contact Kaylynn Walker at 021-408-1249 or email [email protected]. Cost is R320 p/p and R550 p/couple.
For the full article, get the latest issue of Fit Pregnancy.