- I'm thinking of freezing my eggs.
How long can I wait?
My name's Michelle Kwik, I am a fertility specialist
and clinical director at IVF Australia.
We are seeing increasingly
more women coming in asking about egg freezing.
Primarily because they haven't met the right person yet,
they're worried about running out of time.
They've got other priorities in life
that they're trying to get done first,
like going up the corporate ladder,
or they wanna get some travel done first.
They want to be financially secure
before they start having a family,
and they're worried about their egg reserve
and how much time they have to try and have family.
And I guess in the first instance,
getting a measure
of your ovarian reserve would be important.
And there's a couple of different ways
in which we do that.
One way is by getting a blood test,
which is called an AMH test,
this is a blood test that can be done
at any point in your menstrual cycle.
You don't need to be fasted to have the blood test done,
it'll cost about $80 to get the blood test done
because there's no Medicare rebate number
for the blood test.
But this gives you a level of hormone in your system,
and this hormone is made by the eggs in the ovary.
So someone who has lots of eggs will have lots of hormones,
whereas someone who's used all their eggs up,
there's nothing to make the hormones
so hormone levels are low.
And for each age group over the age of 24 years of age,
we know how much hormone should be in your system.
So by doing this test it gives us a gauge
as to whether your ovarian reserve is normal for your age,
or whether you're low for your age.
A pelvic ultrasound scan can also help,
this one needs to be timed to your cycles.
So the best time to do a pelvic ultrasound
is just after period's finished
because at that point in your cycle,
when you do an ultrasound and look at the ovaries,
you can actually see
how many eggs are sitting in the ovaries,
waiting to be chosen to grow for that cycle.
And by looking at how many eggs there are,
that also gives you an idea of how many eggs
someone has left in their ovaries.
And this is important because we're born
with all of our eggs already in the ovaries,
and what we do is we use our eggs up as we get older
and we don't know how to make new eggs.
So that's why the older we get,
the harder it is for us to get pregnant.
And then we run out by our 50s,
and that's when our period stop and we go through menopause.
Now, added to that,
there's the issue with egg quality.
These tests that I've mentioned so far will tell you
about the number of eggs that someone has,
but it doesn't say anything about the quality of your eggs.
The quality of eggs is best correlated
to the age of the woman.
And we know this as well,
up until about 35 years of age,
it's relatively easy to get pregnant.
Between 35 and 38 it starts to get harder to get pregnant,
and then from 38 onwards really quickly
the fertility drops off.
And that's because the eggs have been in the body for longer
they're not as nice as younger eggs,
and so the quality of the eggs change as women get older.
When you talk about freezing eggs, yes,
the number of eggs you have is important,
but so is your age because that then gives you
the quality of the eggs,
and the likelihood that these eggs are gonna create
a pregnancy down the track.
Even though we still have eggs at 38, 39,
you need to freeze loads more eggs
in order to get that chance of pregnancy at the end,
because of the quality of those eggs.
The best time to freeze eggs
would be when the woman's in their early 30s,
because that's a good balance
between we should have good number of eggs still in reserve,
but also the quality of the eggs should be quite good.
And doing it in your early 30s
has also given you some time to meet the right person,
and avoid doing the process altogether,
so early 30s is about the right timeframe
that most women will consider doing this.
And freezing eggs would be an IVF cycle.
With an IVF cycle what we're trying to do,
we're trying to manipulate the woman's normal,
natural menstrual cycle.
At the beginning part of each,
at the beginning of each cycle,
there'll be a bunch of eggs sitting there.
And the woman will choose one egg to grow,
because humans we only have one baby at a time.
So when the woman grows that one egg,
the remaining eggs they die for the month.
This is how we finish all our eggs
by time the we're 50s,
every month we're wasting eggs.
When you do IVF what you're trying to do
is supplement the natural hormones,
so instead of the woman just choosing one egg to grow,
now we can get more eggs to grow.
So if we take those eggs out,
then that month she would lose fewer eggs
than if we weren't stimulating the ovaries.
Doing IVF doesn't speed up menopause,
or use the eggs up any quicker than normal.
Every month those eggs are there,
and if we don't take them they're gonna go anyway.
How we supplement the hormones to get extra eggs to grow?
We give injections and they're like a pen,
and the woman will click into the tummy
every day for about 11, 12 days.
This will make the extra eggs grow,
we then have to take the eggs out,
and taking the eggs out literally
it's a 20-minute procedure.
You're sleeping,
you don't feel what we're doing at the time,
and from the vagina we take the eggs out,
so there's no cuts on the tummy.
Women goes home that day,
most are back to work again the next day,
so it's quite a minor procedure really.
And once we have the eggs, we freeze those eggs.
The woman will then get a period about seven days later,
and then the hormones reset from there.
And the eggs can be frozen for years, and years, and years,
until the woman's ready to use the eggs down the track.
And it may not be for the first child,
because you might freeze your eggs
when you're in your early thirties,
but meet someone when you're 35, 36.
Start having children 37, 38,
it might be your second child where now,
or your third when you're now in your 40s,
and this is when you want to use the frozen eggs.
There is a bit of a lag
between when women freeze their eggs initially,
and when they actually
come back for their eggs down the track.
Bearing in mind that's what the IVF process involves,
there's also costs associated with that, and risks.
And in terms of costs,
Medicare doesn't fund fertility treatment
if there's no medical reason for you to need to do it.
So in most situations egg freezing just in case,
Medicare doesn't fund that kind of treatment.
Added to that you've got ongoing storage costs,
which most women can cope with every six months,
it's about $200 to keep the eggs frozen,
that bit's okay.
But your third cost is using the eggs down the track,
because at that point we need to finish the IVF process.
At that time,
the partner would have to give us sperm,
we defrost the eggs, fertilize the eggs,
create the embryos to then make the woman pregnant.
And there's a cost associated with that.
There's also risks when you do IVF,
and that's primarily
to do with the egg collection procedure,
because even though it's not a massive procedure
to take the eggs out,
all medical procedures have risks.
And the risks would be infection,
which is small 'cause we clean before we do anything.
But inside the tummy next to the ovaries,
there's a bladder in there, there's bowel in there,
there's blood vessels.
So whenever we take the eggs out,
we've always got an ultrasound machine there
so those things we can see them,
so the risks of damaging anything
they're really, really small.
But as a woman who's freezing eggs electively,
you need to be aware the risk is there,
because if something like that were to happen to you,
it could be a massive deal.
For example, you've got an infection in the ovary.
0.1% but you've got an infection ovary, lost the ovary.
Or you've got an infection in your pelvis
and it meant down the track,
you couldn't get pregnant naturally when you wanted to.
You wouldn't be in that position
if you didn't freeze eggs and do IVF in the first place,
so you just need to balance up.
Yes we're young,
yes we want to do this to protect ourselves
and give ourselves some insurance for down the track,
versus the cost and the risks
of putting yourself through that process.
The other risk that you need to be aware of
is also the follow-up of people
who have been born from frozen eggs,
because whilst we've been trying to freeze eggs
for a good 30, 35 years,
we've been rubbish at doing it
until about seven, eight years ago.
So now when you look at people who have been born
from frozen eggs,
there's about 50,000 people around the world.
They're all about seven, eight years old,
so their children.
So far they're healthy,
but this is the information we've got.
And then the final risk with going
through the egg-freezing process is
that there's also no guarantee
that freezing eggs will result
in a pregnancy down the track.
You can freeze 100 eggs,
and it won't become 100% chance of pregnancy.
And the chance of pregnancy
from frozen eggs are very much linked
to the age of the woman.
The age at the time you freeze the eggs
because that correlates with the quality of the eggs
that we frozen.
So the younger you are,
the higher the chance that you will have a baby
down the track using the frozen eggs.
But you've got to balance up your age,
versus the costs and risks,
and avoiding the process unless you really have to do it.
Thanks for watching,
don't forget to hit the subscribe button
for All Things Fertility, see you later.
(gentle music)