About Egg Freezing: Why It's Relevant and What It Means
Lately there is a lot of talk about egg freezing and fertility preservation. If this does not pertain to you, please read on anyway. This is a topic that I would ask you to share, with friends, family members and children of friends. It's a conversation that is relevant to women of all ages and it's one that needs to be brought up. We need to make sure that we understand how to protect our fertility and sharing that information is crucial so that other women don't end up with less choices than they should have.
Oocyte cryopreservation or egg freezing is an assisted reproductive technology (ART) for women who want or need to delay motherhood. Oocyte cryopreservation can be the answer for a number of specific family planning and fertility preservation issues. For example, egg freezing may be a viable option for women who face surgery, radiation or chemotherapy that could leave their ovaries at risk, for single women who want to extend or postpone their reproductive options or by couples who are undergoing in vitro fertilization (IVF) but who have moral or religious objections to freezing embryos that may never be used.
For fertility preservation, elective egg freezing is now more commonplace. Some women have chosen to freeze and store their eggs because they want to postpone pregnancy and are concerned about fertility preservation. These eggs can be thawed and combined with sperm at a later date for embryo transfer.
We have patients who are about to start chemotherapy treatment for cancer. Prior to their chemotherapy regimen, we can stimulate their ovaries and retrieve eggs for freezing. This process can move quickly, sometimes taking only a few short weeks, allowing the patient time to store eggs and providing them with reproductive options in the future.
Oocyte Freezing or Freezing Your Eggs
The oocyte cryopreservation cycle--freezing and then thawing human eggs--is a complicated process. The egg is relatively large and made mostly of water. Managing the process so that ice crystals do not form and damage the egg is a major challenge. The procedure used to freeze eggs at RMACT is called vitrification. Vitrification involves cooling eggs to a very cold temperature for a brief period of time (minutes) with sugar based cryoprotectants that protect the inner workings of the egg while at the same time allowing them to be frozen.
The oocyte cryopreservation cycle (egg freezing) follows the same protocol as in vitro fertilization (IVF), including the use of self-administered hormone injections to stimulate the ovaries followed by an egg retrieval. The eggs are placed in a protective medium, frozen immediately and stored until the patient is ready to use them. The eggs are then thawed and each is injected with a single sperm to achieve fertilization. The resulting embryos are transferred into the woman’s uterus for implantation.
Egg Freezing in New York & Connecticut
Egg freezing is available at only a few major centers for reproductive technology, and the number of live births worldwide from frozen eggs is fairly small. For more information on freezing your eggs, contact RMACT. We are here to answer questions.
Lisa Rosenthal's Google+
ASRM Responds to NY Times Op-Ed on Fertility Treatment
Today is supposed to be medical Monday, but there’s been so much buzzing around in the media these days that it’s hard to know where to even start.
Since it is medical Monday, I think I’ll start a little backwards.
Linda Guidice is the president of ASRM; here’s her response to an op-ed piece in the New York Times:
Photo: Adam Kinney, Flickr Creative Commons
We believe that "Selling the Fantasy of Fertility" (September 12) paints an incomplete picture of the likely success of infertility treatments.
Despite the dramatic advances in medicine of the last 30 years, it is true not every infertility patient will get pregnant, but patients and the public deserve to have all the facts. Among those facts the authors failed to mention are that ART treatments alone have resulted in the birth of more than 5 million babies around the world, and while it sometimes takes more than one attempt, more than 60% of women who undergo ART treatments eventually end up with a baby.
We, like the authors, recognize the tremendous emotional distress that can result for patients whose treatments are not successful, and hence the need to have transparency and full disclosure of available data for decision making in infertility therapy and coping with the emotional aspects that accompany it.
Linda C. Giudice, MD, PhD
American Society for Reproductive Medicine
Truth in the Op-Ed "Selling the Fantasy of Fertility"
Jumping back to the op-ed piece itself ("Selling the Fantasy of Fertility"), the final paragraph was the part that spoke eloquently and rang with truth, with no judgment. Much of the rest of the op-ed was subjective, to say the least. It spoke of the authors' experiences and they should be applauded for bringing to light the issue of when to end treatment and that, in fact, ending treatment is as brave and strong as continuing. I certainly agree.
Being unable to bear children is a painful enough burden to carry, without society’s shaming and condemning those who recognize that their fertility fantasy is over. It is time to rein in the hype and take a more realistic look at the taboos and myths surrounding infertility and science’s ability to “cure” it.
Miriam Zoll is the author of the memoir “Cracked Open: Liberty, Fertility and the Pursuit of High-Tech Babies.” Pamela Tsigdinos is the author of the memoir “Silent Sorority: A Barren Woman Gets Busy, Angry, Lost and Found.”
Finding Our Own Journey During Infertility
Still, we all find our own journey and each of us does have to find our own ending.
Having been a patient myself, worked with not-for-profit patient organizations for decades, run peer support groups and more, my experience is that giving up the dreams of a lifetime is a painful struggle that is more internal than external. Yes, society brings pressure to bear in terms of family but not nearly the pressure we put on ourselves. Acknowledging that there is marketing that goes on around infertility and fertility treatment, I understand the author’s point that there’s pressure there as well.
And while the “industry” is here to help create families, I hear more frequently that doctors will gently try to convince patients to give up treatment and that patients are resistant to that rather than the other way around. Maybe that proves the authors' point?
Or perhaps giving up the dream of a biological child, magical thinking or not, is something that takes time and effort.
As the authors pointed out.
Lisa Rosenthal's Google+
Facing Infertility Frustration
Infertility is associated with a lot of feelings.
Thank goodness for hope. It is the feeling that allows us to go on and try, in or out of fertility treatment.
I'm going to focus on just one of those feelings today.
Probably the best way of describing the way we feel when we can't get answers. When the answers are standardized and predictable and aren't necessarily the absolute answers, there is an even higher level of frustration that occurs.
And we can't always get answers. We can't always identify the problems or reasons why we can't conceive. We can't always know why a growing embryo stops growing or doesn't implant or even why a miscarriage occurs.
Sometimes we know absolutely and sometimes we know maybe and sometimes we simply don't know at all.
We think that knowing the answer will help. And often it will or it could. It could help if something could be changed for the next attempt at IUI (intrauterine insemination) or IVF (in vitro fertilization). Maybe the protocol would be changed or medications altered.
Often those things are shifted and modified with or without an answer.
Given the intricate and minute details of what has to occur to create and sustain a healthy pregnancy, it is often not possible to know definitively why the attempt to conceive hasn't worked.
We start there and come back, full circle. No answers that are definitive.
Asking Infertility Questions
Does it meant that your fertility specialists (board-certified reproductive endocrinologists, I hope!) don't know what they're doing? Aren't good enough? Should quit their jobs and find something they're actually good at?
Nope. It means that we don't know what we don't know. Science and ART (assisted reproductive technology) is amazing. What we know fills textbooks and is expanding every day. It's a field of medicine that is truly creating miracles and at lightning speed.
At the same time, we don't know what we don't know. We don't know all the intricacies of each step that is necessary for conception to occur and progress to a healthy baby.
So frustration remains. Answers are elusive. Infertility questions are unanswered or unsatisfactorily answered.
That is part of it. And perhaps it always will be. Perhaps even with knowing more and more, it will turn out that there are questions we don’t even know to ask yet. We will find more answers and that will generate further questions.
And so we will still end up with unanswered questions.
And frustration will remain a feeling closely associated with understanding infertility.
Perhaps the frustration comes more from the fear of being and staying unsuccessful in our quest to create our families. Isn’t that really the question? Will we be able to have the family we are striving for?
And for that, you will have an answer. Not as quickly as you might like. But you will have an answer.
May your answer be the one for which you are hoping. And may you find that answer quickly.
Lisa Rosenthal's Google+
There may come a time in your fertility treatment that the subject of egg donation is brought up; either by you or by your board certified reproductive endocrinologist (infertility doctor). This topic can stir up many strong feelings that would be best looked at before seriously considering this option.
Many of us have mixed feelings about being at a fertility program. While we may be very grateful that treatment is available to help us conceive when it's not happening the old fashioned way, we may also experience feelings of loss as well. Loss of privacy, loss of intimacy with our partner, loss of self esteem about our bodies not functioning properly, loss of having a baby at all (much less on the timetable we were hoping for), and so on. There are other losses, some smaller, yet just as poignant, that we feel intensely. It may be a loss of a friend who simply cannot be supportive or understanding. Or feeling left out of the "mommy" club. Or the feeling of dread when being invited to a baby shower.
Then the subject of egg donation comes up. And a whole other world opens up. The incredible positive aspects of this option are the ability to conceive, carry a pregnancy, give birth and nurse a child, where those things might not be possible otherwise. Egg donation can open up those possibilities when you and your doctor start to see that a viable pregnancy is unlikely any other way. How incredible that the fertility path that you are on can extend in this way instead of ending without a pregnancy.
While the loss of strict biological connection through DNA is something that we all experience as a loss with sadness, frustration and often anger, becoming pregnant, nourishing and carrying a baby and giving birth is an option that also allows us to feel a deep physical and emotional connection to our child.
Acknowledging feelings that are less than positive has become almost taboo in our society these days. We are encouraged by many sources to "manifest what we desire or need in our lives", "visualize the outcome "that we want for ourselves. And yes, I watched Lindsey Vonn go through her pre-Olympic ritual of closing her eyes and taking herself through the Giant Slalom course. I particularly love the story about Julia Mancuso (who won 2 silver medals in this Olympics alone) who drew a picture of herself winning Olympic medals when she was 8.
My own spiritual, emotional belief system rests on a version of these ideals. I know that when I visualize what I want for myself that achieving it is more possible. Helps to put the work into it, though, doesn't it? Julia Mancuso's lovely picture of herself would be just a dream without all the training, hard work and many sacrifices and choices along the way. Some of the choices that we make when we have a goal are truly difficult, giving up things, including privacy, to achieve something else.
There also has to be an outlet for the anger, sadness and frustration that invariably comes up when we are working hard and sacrificing for a goal. I believe, with much support from my yoga training and personal reading and study that allowing our "negative" feelings out, offers comfort and release. That choosing to say them out loud or writing them down, gives us an opportunity to let some of it go, even if only momentarily. Lastly, I believe that allowing those feelings to see the light of day makes them less scary to feel and experience. You are not a bad person because you are jealous of your friends' pregnancy. You are also not the only one who has these feelings.
Consider this the first blog in a four part series this week on egg donation, third party reproduction, and assisted reproductive technology (ART) and, just as importantly, our reactions and responses to the subject. These are complicated options to consider and I want to see if we can help this week with seeing them more clearly.
I know that my over riding feeling is of immense relief and joy that these technologies are options for us; that we have fertility programs that can offer them in medically responsible ways.