Egg Freezing Process
The process of egg freezing involves the following steps
Deciding to freeze eggs
This step may sound obvious, but for many patients the decision to freeze eggs can be the hardest part of the entire process. Considering the conflicting pressures of work, family, relationships, finances, society and more, it is not surprising that many modern women would rather not think about their reproductive abilities. With this in mind, the doctors at Los Angeles Reproductive Center are committed to thoughtful and thorough counseling for all of their egg freezing patients. Drs. Winkler and Kalan not only guide their patients through the technical aspects of treatment, but also engage in the critical emotional and spiritual side of care.
Stimulating egg growth
Drs. Kalan and Winkler design specific medication protocols for each individual patient. Usually this involves 2-3 injections per day beginning on the third day of the menstrual period and lasting for 8-11 days. During this time, the doctors closely monitor egg growth through regular visits with trans-vaginal ultrasound and blood work.
Retrieving the eggs
Once the doctors determine that the eggs are ready, a retrieval procedure is performed. This procedure occurs under anesthesia, with transvaginal ultrasound guidance. Each egg is carefully aspirated from the ovary and transferred to the waiting embryologist.
Freezing the eggs
Eggs are collected in specially designed containers and handed to a waiting embryologist. The embryologist evaluates the eggs for maturity, and then gently loads them into specifically designed, clearly labeled, egg freezing tubes. Following a precise protocol, eggs are rapidly cooled through a freezing technique known as “vitrification,” and placed in environmentally controlled, securely monitored storage receptacles. Once frozen, the eggs remain usable for years to come.
Following the egg retrieval procedure, the recovery is usually very quick with most women returning to their regular routine the following day. Sometimes there is some bloating or discomfort that may last for 5-7 days.
Second and/ or third cycles.
One cannot determine the quality of an egg until it is fertilized, therefore, when freezing eggs, more is generally considered better. For this reason, many women elect to undergo a second or third cycle of egg freezing depending on the number of eggs produced in the first cycle (as well as their age). In anticipation of a subsequent cycle, Dr. Winkler or Kalan will review the initial cycle to determine if there are adjustments that can be made to improve the number and maturity of the eggs. A second cycle can begin as soon as the next period, however for many women the ovaries need to recover a full month before a second cycle can begin.
Using the eggs
- Once a patient who has frozen her eggs decides that she wants to become pregnant, the first step is often to try with her current egg supply (through timed intercourse, intrauterine insemination with her partner’s or donor sperm, or IVF). If conception with her current egg supply is unsuccessful, then the patient begins a frozen oocyte embryo transfer (FOET). Depending on the patient’s desires, the FOET can proceed in a number of different ways.
PGS (preimplantation genetic screening)
- If the patient wants, her fertilized eggs (embryos) can be tested to determine which are chromosomally healthy. In addition, the gender will be revealed through this method. PGS usually requires that the eggs are thawed, fertilized and grown for 5 days in the laboratory. On the fifth day, the embryos are biopsied and then either transferred on day 6 or frozen. If a day 6 transfer is planned, the uterus is prepared ahead of time for implantation and the result of the biopsy is available within 24 hours. If the embryos are frozen the results of the biopsy return approximately 5 days later. Once the results are known, the patient can prepare for an embryo transfer just like a normal FET (frozen embryo transfer).
Frozen embryo transfer without PGS:
- Some patients might elect not to test their embryo’s chromosome prior to implantation. During a FOET without PGS, the patient begins taking estrogen pills on the third day of her period and her uterine lining is monitored with ultrasound over the next 2 weeks. Once the lining is ready, the patient begins taking progesterone in preparation for the embryo transfer. The eggs are thawed and fertilized with the desired sperm. The fertilized eggs (embryos) then grow for 5 days at which time, the best 1-2 of them (depending on age, quality and patient desires) are selected and transferred into the patient’s uterus. Any extra embryos can be frozen for a second chance or (hopefully) more kids in the future.
Natural Frozen embryo transfer:
- For some patients who desire to avoid the use of medication, preparation of the uterus can be also done naturally by following the women’s own ovulation.
Intracytoplasmic sperm injection (ICSI):
- It is important to mention that ICSI is commonly utilized to fertilize previously frozen eggs. During this process, an embryologist identifies and isolates one normal appearing sperm per egg and precisely injects it into the egg. The fertilization rate is generally greater when ICSI is used with previously frozen eggs.
The process of egg freezing requires experience, expertise, organization and precision. At the Los Angeles Reproductive Center, we proud to help our patients preserve the eggs for the future. If you have questions about egg freezing and would like to talk with one of our board certified fertility specialists, Dr. Marc Kalan or Dr. Nurit Winkler, please give us a call (818) 946-805, we will be happy to speak with you.