Preservation of fertility

egg and sperm freezing

Have you ever thought of freezing your gametes? You may not know it, but the technique preservation of fertility (freezing of egg or sperm cells) is one of the great medical advances in reproductive medicine, as it allows a person to decide when is the best time to start a family.

Delayed maternity due to the socio-economic situation

 The current health and economic crisis due to the coronavirus pandemic has obligated millions of women and men around the world to postpone family planning indefinitely.

Due to the economic situation in which we find ourselves makes it hard for young people to be financially independent. For this reason, people have children at a later age and the number of children per family is steadily decreasing. According to the National Institute of Statistics (INE), the average age at which a woman has her first child is over 30.

It is well known that the most fertile age of a woman is between 20 and 35 years old, so that it hard to get pregnant naturally for women beyond that age (a decrease of about 5% per year) due to the reduction in quality and number of eggs. According to data from IVF-Spain, around 70% of couples consult a fertility specialist because of their age.

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However, very few people are aware of this and contact a fertility clinic in time (i.e. in the most fertile years) to freeze their eggs.

The main thing about fertility preservation

To be able to freeze your gaments (eggs or sperm cells)  is one of the great medical advances in the field of reproductive medicine, as it allows people to decide when is the best time to start a family and, having frozen their gametes previously,  have the chance to do so at any time with their own gametes.

The treatment for egg freezing consists in obtaining and freezing of eggs. Prior to this, the woman undergoes controlled ovarian stimulation, after which her eggs are retrieved and frozen. The egg retrieval  is a quick and non-invasive procedure under slight sedation.

The eggs are frozen at -196ºC  and can be stored indefinitely without affecting their properties. Thanks to advances in assisted reproduction, it is possible to increase the survival rate of frozen eggs or embryos which can be stored frozen as long as the patient wishes, without any time limit.

Concerning sperm freezing, the main difference is in how male gametes are obtained as it is much easier as in women. These are the steps of fertility preservation in both sexes:

Phases of egg freezing

 First of all, a series of tests are carried out to determine the fertility of the person concerned. Among other things, this will determine how high the woman’s egg reserves are.

The steps for fertility treatment for egg freezing are as follows:

  1. Stimulation of the ovaries >> The aim is to obtain a sufficient number of eggs. For this purpose, the patient injects herself medicines every day and the growth of follicles is checked by means of regular ultrasounds.
  2. Follicle puncture and follicle aspiration >> When the follicles are the optimum size for extraction, ovulation is induced and follicle puncture and follicle aspiration are programmed by vaginal ultrasound under anaesthesia so that the patient is not disturbed.
  3. Vitrification of oocytes >> The retrieved oocytes are frozen in liquid nitrogen at a temperature of -196º C Protective agents are used to protect the eggs from possible damage. From the moment of freezing, the eggs no longer age.

The test mentioned above are necessary to determine the quality of semen, as the freezing process requires a minimum quality. Although the sperm quality is also decreases with age, it is less drastic than in women and as a result there is little awareness in this regard. In most cases, male fertility is preserved for medical reasons that may endanger their fertility, as is the case with cancer.

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Preservation of male fertility

 The first step in maintaining a man’s fertility is to carry out a sperm analysis in which the concentration, the number of motile sperm cells and the morphology of the sperm are analysed.

After these results have been evaluated, there is the option of a more thorough examination:

– The fragmentation of the DNA of sperm cells.

– The presence of abnormally high concentrations of apoptotic spermatozoa.

– The Y chromosome.

– The immature germ cells.

– The balance between ROS production and antioxidant activity.

The test mentioned above are necessary to determine the quality of semen, as the freezing process requires a minimum quality. Although the sperm quality is also decreases with age, it is less drastic than in women and as a result there is little awareness in this regard. In most cases, male fertility is preserved for medical reasons that may endanger their fertility, as is the case with cancer.

What are success rates of egg freezing?

 Despite all the advances, it is not possible to say how many eggs are required to guarantee a pregnancy. Fertility experts usually recommend to have between 15-20 eggs  in order to have an 80% chance of getting pregnant with these eggs.

The good news is that the freezing does not affect the quality of eggs, so that after thawing, the gametes have the same quality as when they were frozen.

For this reason, it is extremely important to carry out egg vitrification up to the age of 35 (but the earlier the better) in order to have the best possible egg quality and a good number of eggs.

It is important to be aware of the fact, that preservation of fertility does not guarantee future pregnancy, but a chance of achieving it by means of IVF cycle, having the same chances to succeed with frozen eggs as with fresh ones (at the time of freezing).

With this article we want to raise awareness of the fact that, due to the age-related decrease in the ovarian reserve in women and some serious pathologies such as cancer, which affects both men and women, both should consider maintaining their fertility as this will allow them to choose the best time to start a family.

Now you know what fertility maintenance is all about. If you would like more information on this subject, please contact us using the form below.