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IVF labs have been routinely freezing sperm and embryos for many years. However, freezing eggs has always been a challenge. This is because the egg is the largest cell in the body and contains a large quantity of water. Using conventional slow freezing techniques meant that this intracellular water would often form ice crystals while the egg was frozen, resulting in the egg being damaged.
However, using a new technique called vitrification (vitros = glass) or flash freezing, we can now reliably freeze eggs as well.
How does vitrification work ? The principle is simple. This new method of cryopreservation allows ultra-rapid freezing. We put the eggs in very small droplets of vitrification solution in special straws, and plunge them directly in liquid nitrogen. This means the egg is cooled from 37 C to -196 C in a few seconds , so that the water does not get a chance to crystallize ! Vitrification uses a very high concentration of antifreeze solution (DMSO and ethylene glycol), allowing instant super-cooling into solid with no ice crystal formation at all.
Of course, it is not quite as simple as it might sound. Such high concentrations of antifreeze could be toxic to cells. This is why technical skill, experience and expertise is critically important !
Using this vitrification technique for freezing, we can reliably preserve eggs as well as embryos so that the pregnancy rate is as good as with fresh eggs.
This breakthrough will now allow us to offer the following additional services to our patients
- Formation of donor egg banks to facilitate and lessen the cost of oocyte donation. We can ship these frozen oocyte anywhere in the world. However, it is critically important that the receiving IVF lab have enough expertise in vitrification, to be able to thaw these properly
- Provision of egg cryostorage for women who wish to pursue their career and want to postpone childbearing.
This is our standard egg vitrification treatment protocol.
Treatment starts from Day 1 (the day the bleeding starts) of your cycle. At this time, we start your downregulation using Lupride, a GnRH analog mfr by Sun Pharma, 0.2 ml sc daily . On Day 3, you need to do an ultrasound scan to confirm there is no ovarian cyst, after which we start your superovulation with 4 ampoules of HMG (Menogon) daily. The dose of HMG will depend upon your ovarian morphology and your antral follicle count.
We do the next scan on Day 10, after which you would have to be in Bombay for about 10 days. All the treatment is performed at our clinic, which means you never have to go elsewhere.
This is what the daily schedule would look like.Day 1. Inj Lupride 0.2 ml sc. (Downregulation starts)
Day 2. Inj Lupride 0.2 ml sc.
Day 3. Inj Lupride 0.2 ml sc. Vaginal ultrasound scan to confirm there is no ovarian cyst. If there is no cyst, we can commence superovulation.
If there is a cyst, we aspirate/ puncture it under ultrasound guidance and continue with the treatment.Day 4 Inj Lupride 0.2 ml sc. Inj Menogon (75 IU), 4 amp IM. Superovulation starts.
Day 5 Inj Lupride 0.2 ml sc. Inj Menogon (75 IU), 4 amp IM
Day 6 Inj Lupride 0.2 ml sc. Inj Menogon (75 IU), 4 amp IM
Day 7 Inj Lupride 0.2 ml sc. Inj Menogon (75 IU), 4 amp IM
Day 8 Inj Lupride 0.2 ml sc. Inj Menogon (75 IU), 4 amp IM
Day 9 Inj Lupride 0.2 ml sc. Inj Menogon (75 IU), 4 amp IM
Day 10. Inj Lupride 0.2 ml sc. Inj Menogon (75 IU), 4 amp IM.
Vaginal ultrasound scan to monitor follicular growth
The Lupride and Menogon injections will continue on a daily basis; and scans will be performed every alternate day, until the follicles are mature. This is usually Day 14- Day 16 for most patients. At this time, an HCG injection will be given, and eggs retrieved 36 hours after this.
The eggs will then be vitrified.
You can travel back 3 days after the egg collection.
Lots of women have many questions about egg freezing. Here are some common questions we are asked - and their answers !
How do you check that the eggs are normal? Do you do that before freezing or before / after fertilisation? I've heard of a higher rate of problems in babies born to older women. Is it possible to 'check' eggs for that?
No, sorry, we still cannot check if the eggs are genetically normal.
What are the possible side effects of the egg retrieval treatment - long-term and short-term? What is the likelihood of getting these side-effects?
There are no long term effects at all ! We use hormonal medication to superovulate you, but these are natural hormones which get excreted promptly. The treatment will not cause you to run out of eggs either - it just allows us to save the eggs which would have died ( undergone atresia) anyway
Have any babies been born from frozen eggs in your clinic? How many women have frozen their eggs? Can I possibly talk to anyone who's gone through this procedure? What is the success rate for IVF and for egg freezing in your clinic?
Our patients want us to protect their confidentiality ! However , this is now a pretty standard procedure used by clinics all over the world. We are not using you as a guinea pig !
What are the general chances of success - having a baby someday - with this procedure?
This is a complex question and the answer depends upon how many eggs you grow
If I do want to have a baby at say, age 45, would I be having it myself, or need to use a surrogate?
You can have it yourself - your uterus remains young forever ! Even after the menopause, your uterus is able to sdupport a pregnancy !
What would be the process of egg freezing? How would the eggs be retrieved? Would it hurt?
Retrieval is done under general anesthesia. It takes about 15 min. There is no pain.
Is it necessary to get screened for sexually transmitted diseases before doing the procedure?
Yes - this is routine
How many years would the eggs remain viable after freezing?
As long as you want - we store them in liquid nitrogen
How much would the procedure cost? What would be the approximate cost of the medicines required? What would the cost be for keeping the eggs frozen per year?
Our charges for freezing eggs and storing eggs for the first year is US $ 4000 only. This includes all medical treatments and procedures. Medicines would cost about US $ 1000 more. Storage after the first year costs US $ 1000 per year
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