Hi everyone. I’ve been in Boston, Massachusetts, my own stopping grounds attending the annual meeting of the American Society for Reproductive Medicine. There was some really interesting information from researchers around the world and I want to share it with you now.
I have known Dr. Tan for probably 25 years. He’s one of the world’s authorities in the area of in vitro fertilization and reproduction. He has started working on a new approach to help women not lose their fertility as they enter menopause. In this interview he talked to me about this concept.
Mache: Tell us a little bit about your new approach.
Dr. Tan: As we know, women do not produce new eggs after they are born. Therefore, as they get older, the number of eggs and the quality of the eggs rapidly decline. A woman’s peak fertility occurs in their mid 20’s. As a result of which, as women get older, the chances of her getting pregnant reduces significantly, the risk of miscarriage increases tremendously, and the risk of giving birth to abnormal babies like those who have down syndrome, also increases significantly.
Mache: At what age does the big change start to happen mostly?
Dr. Tan: Sometime in the mid 20’s, around 27, 28. Clinically, to be relevant, it probably happens in the mid 30’s.
Mache: One who’s 35 might want, if she’s not in the position to have her family at that time, may want to consider options for preserving her fertility or if she’s going through cancer treatment and might lose her fertility.
Dr. Tan: You’re perfectly right, okay. Basically, we develop the idea of fertility preservation primarily to help women who are at risk of premature ovarian failure, either because they are going through chemotherapy or real therapy. Similarly, if women were having other treatments for autoimmune disorders, multiple sclerosis and a host of other diseases, I think they should ask their doctor whether those medications they are taking will reduce their fertility potential.
Mache: For women who are at risk for losing their fertility potential to medications, to treatments for malignancy, or through a situation where they simple don’t have a current partner and they don’t want to lose their fertility option, you have come up with a technique to help them. Tell us about that.
Dr. Tan: Basically, as we know, freezing sperm has been around now for ages. Freezing embryos has been used now for more than 30 years. Freezing eggs was not very successful until recently. The traditional way of freezing eggs is by lowering the temperature of the eggs slowly, but then because ice crystals form within the egg cells, 50% of the eggs do not survive freezing.
We’ve developed a method called Rapid Egg Freezing or Flesh Freezing. The medical term is vitrification. With vitrification, we plunge the eggs that we collect into liquid nitrogen directly, freeze the eggs at minus 100 and at 96 degrees centigrade. This can be stocked for years and years.
Mache: What you are doing is giving these women, who are not necessarily infertile at this time, fertility drugs. Then, at the time the eggs are mature or ripe, you are retrieving them as though it were going to be in vitro fertilization?
Dr. Tan: That is perfectly right but because these ladies are still fertile and they are generally relatively young, the treatment protocols are quite simple. At the beginning of their treatment cycle, we perform an optional scan to make sure everything is fine. We get them hormone injections, which will teach them how to treat themselves at home by injections for roughly ten days. During which, they carry on their normal working life. They come in for two or three ultrasound scans where the follicles containing eggs are about 18 millimeters in diameter. We then collect the eggs under a shot deep sedation, general anesthesia so that it’s painless. The procedure lasts about 15 to 30 minutes. They go home two hours later. They can go back to work the next day.
Mache: Then, you take the eggs that you’ve gotten and instead of fertilizing them, you simply freeze them for later thawing when the woman is in the position to find the right partner or have a baby.
Dr. Tan: Using the technique that we have developed for the rapid egg freezing, there have been more than 200 babies born now from around the world. The percentage of problems in those babies is the same as a women getting pregnant naturally.
Mache: If a woman goes through this, what is the ultimate change she’s going to end up having a baby?
Dr. Tan: That depends on at what age she freezes her eggs and how many eggs she freezes because I would emphasize that freezing eggs is the second best option. The best option would be if they have a baby right now. Technology should never be seen to replace what is done naturally.
Mache: Absolutely. Anyway, it’s not a hundred percent but somewhere in the range of what would be the successful in vitro fertilization today? Would that be permanent?
Dr. Tan: That’s right. In women who are under 35, for example, if we freeze eggs for them and then we thaw it out, they have about 60% chance of getting pregnant each time that we use the eggs. If they store, for example, 30 eggs, they’ll have over a 90% chance of having a successful pregnancy.
Mache: In order to get enough eggs, you suggest that women may have to go through it more than one time.
Dr. Tan: That’s right. Because of this, we offer, for example, in my center, The Montreal Reproductive Center, a package of three treatments, which are generally advised to be used within six months or a year for a price, for a cost of about $14,000.
Mache: Great. Anything else you’d like to add?
Dr. Tan: I ultimately think every woman in the world should freeze her eggs and I don’t want to sound too evangelical about it. I honestly believe so and the reason is that, every woman loses her fertility sooner or later. As we know, unfortunately, more than 50% of marriages or couples separate. When that happens, the gentleman in question will start a new family but the lady, if she decides to start a new family and then she’s not in her 40’s, she has much greater risks to conceive a child. This is almost like preventative medicine like buying fertility insurance.
Are you considering freezing your eggs? What concerns you about egg freezing? Please share your thoughts in the comment section!
Until next time,
Dr. Mache Seibel, Professor, University of Massachusetts Medical School
And Founder of My Menopause Magazine http://bit.ly/MyMenoMag
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Professor, University of Massachusetts Medical School