Talking Egg Freezing with IRMS

Serena Chen

One option for women in New Jersey seeking egg freezing for fertility preservation is the Institute for Reproductive Medicine and Science (IRMS) at Saint Barnabas, a New Jersey fertility clinic with four locations in Livingston, Hoboken, Clark and Westfield. Serena H. Chen, M.D., Director of the Division of Reproductive Endocrinology in the Department of Obstetrics and Gynecology at Saint Barnabas Medical Center and Director of the Ovum Donation Program at IRMS recently answered questions about freezing oocytes for fertility.

How long has IRMS been performing egg freezing?  

Since 1995.  Our lab director, Dr John Garrisi, is an expert in the field of Reproductive Cryobiology.  Since arriving here at IRMS at Saint Barnabas, Dr Garrisi has worked diligently on improving and perfecting egg freezing techniques. Up until October of this year, egg freezing has been considered experimental due to previously low pregnancy rates. 

IRMS has always performed egg freezing for cancer patients wanting to preserve their eggs prior to undergoing chemotherapy or radiation.  In addition, IRMS has had a long-standing research study that has led to significant improvements in pregnancy rates after egg freeze and thaw in recent years.  After reaching pregnancy rates similar to fresh pregnancy rates in this ongoing study, IRMS made the decision two years ago to begin offering egg freezing for fertility preservation to non-cancer patients.

Who are you offering egg freezing services to?

Any women who wants to preserve her fertility through egg freezing after a thorough evaluation and counseling about the pros and cons and limitations of egg freezing. This includes patients with cancer who must undergo egg-destroying chemotherapy or radiation, or women who want to conceive but are not ready to and yet are concerned about the effects of advancing age upon their fertility.

What does your clinic consider the optimal age or criteria for egg freezing?  Do you have a cut-off age? 

At this point we have no cut-offs or strict guidelines.  We believe that all women who are interested in egg freezing deserve an evaluation and a detailed conversation with a physician about the technology and what it might or might not be able to do for them.  Egg freezing is not for everyone, but the rapid improvements in technology and the wide variety of individual circumstances mean that rigid cut-offs or criteria based upon numbers, rather than an individual patient situation, may not make sense. 

For example, in our experience, we find that the consult itself is often a very positive and hopeful experience for cancer patients. The fact that a cancer patient is proactively taking steps to plan for a future as a survivor is in some ways therapeutic. Only about half of the cancer patients who see us for a consult will ultimately decide that egg freezing is for them.  However 100 percent of these patients feel very positive about sitting down with the doctor to discuss her fertility preservation options.  It can also be a very positive experience for a woman who feels a loss of control that her biological clock is ticking – that she does have options, that she can take steps to give herself a better chance of having the family she wants someday. 

Once eggs are frozen, where are they stored? 

In liquid nitrogen – at negative 320 degrees Farenheit — a temperature so low that molecules cannot move and thus decay is theoretically non-existent.  The liquid nitrogen storage tanks are checked daily and filled manually, and are not dependent on an electrical supply to maintain optimum temperature.

How long do you feel eggs can be stored safely? 

Theoretically forever, although we do not have the data to prove that. The record for the longest an embryo has been frozen and resulted in a healthy baby is 14 years.

Is there a cut-off age that you recommend for women to have the eggs thawed, fertilized and transferred in a cycle?

At this point, the American Society for Reproductive Medicine (ASRM) recommends that women do not consider childbearing beyond the natural age of menopause — around 50 years of age.  However, risks from childbirth increase before then with women over 40 having increased risks for pregnancy complications.

How many live births from frozen eggs has IRMS had? 

15.

What are the reasons a woman would NOT be a good candidate for freezing her eggs? 

Any medical reasons that might make ovarian stimulation dangerous would make egg freezing dangerous since this is very similar to in vitro fertilization (IVF).  Egg freezing involves taking injections of fertility drugs to stimulate multi-follicular development so multiple eggs can be obtained and hopefully frozen.  If a woman has diminished ovarian reserve she may not respond to the medications, making it difficult to freeze her eggs. 

Ideally we would like to freeze multiple eggs because not all eggs will survive the freeze thaw, not all that survive will fertilize, not all eggs that fertilize will develop into normal embryos, and not all embryos will result in a pregnancy.

How much does egg freezing cost at IRMS?

About $8,000 for the cycle including anesthesia, but not including medications, which can run from $2,000 to over $5,000 depending upon the dose of the drugs.

What is the most exciting aspect of ASRM lifting the experimental label? How do you think this will change the face of fertility treatment?

This reflects a huge advance in technology and more choices for women and their physicians. More options is always a good thing.

What should a woman look for in a fertility clinic that does egg freezing?

Experience and data. With the relatively recent development of highly efficient cryopreservation techniques that can be technically demanding, it is important to identify a clinic with capability that can be demonstrated with a substantial live birth rate.

If you are interested in egg freezing, CLICK HERE and we will will put you in contact with IRMS or a fertility clinic near you! 

November 13, 2012 

Posted by Leigh Ann Woodruff
 

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