Understanding Fertility Preservation

Fertility preservation is the process by which eggs, sperm, or embryos are cryopreserved and stored for a patient’s future use, thereby allowing a person or couple to have a child when the timing is right for them and removing the effects of the proverbial “biological clock.”.

Who Should Preserve Their Fertility?

• Patients who have conditions that may worsen over time or can affect future fertility.  Patients who have chronic medical conditions such as endometriosis, auto-immune disorders, a cancer diagnosis, or a genetic disease that can affect fertility are ideal candidates for medically indicated fertility preservation. Patients can focus on the treatment of their condition knowing that their eggs/sperm/embryos are being safely stored for future use.
• Young, healthy women. Fertility declines over time, especially after age 35. Women are born with all the eggs they will ever have, and they will continue to lose eggs every month.  Many women choose to delay motherhood for various reasons, including furthering their education, progressing in their career, not finding a suitable partner, among others. Having the choice to electively freeze their eggs, essentially “pausing” time, affords them the option to create embryos many years later with their younger eggs.  While eggs can be frozen for as long as you have a substantial reserve, the process is ideally performed when the age of the woman is 35 years or younger, when her eggs are younger and are of a better quality.

What does the fertility preservation/egg freezing process look like?

During an egg freezing cycle, the patient administers injectable hormone medications to herself for a period of about 10 days, while being closely monitored via ultrasound and blood work. These injectable hormones encourage her ovaries to produce many follicles, each of which contains fluid and an egg. Every few days the patient comes into the office for “cycle monitoring;” we scan her ovaries via ultrasound and document the follicle sizes, as well as run blood work which will reveal her hormone levels. The physician can choose to titrate the medication doses accordingly for the optimal cycle outcome.

Once the follicles are of an appropriate size, the eggs should be mature and ready to be retrieved. Egg retrieval is performed here in our procedure room with the patient under a light sedation so she’s comfortable and relaxed. The egg retrieval usually takes 15 minutes or less, and the patient rests comfortably in the recovery area while her vitals are monitored. The eggs are transferred to the lab, which is adjacent to the procedure room, where they are counted, and prepared for cryopreservation. If any are immature, they are allowed to sit in a special culture in the incubator to see if they will mature. If they meet cryopreservation standards, they are frozen and stored with the others. The eggs will remain, indefinitely, in a glass-like state of cryopreservation until the patient chooses to thaw and inseminate or discard her eggs.

At some point the patient may choose to create embryos using her eggs. This involves thawing the eggs in the lab and injecting each egg with a singular sperm via a procedure called ICSI (Intracytoplasmic Sperm Injection). The resulting embryos are allowed to grow in an incubator in the lab for approximately 5 days before being PGT biopsied and frozen, while we await the results of the genetic testing (PGT) Once the genetic testing report is received the patient discusses the results with their clinician, and a subsequent (FET) cycle can begin at any point thereafter.

Our team of fertility experts would welcome the opportunity to help you on your journey towards preserving your fertility, or parenthood! Contact the team at the Fertility Institute of New Jersey & New York today!