What is the Egg Freezing Process? To Whom Can It Be Done?

Egg freezing (oocyte cryopreservation) is the process of freezing and storing healthy eggs (oocytes) obtained from a woman's ovaries using high-tech methods in a laboratory environment in order to achieve pregnancy in the future. This procedure freezes the woman's biological clock, allowing her to carry her potential into the future when egg quality and quantity are at their highest.Assoc. Dr. Nazlı Korkmazemphasizes that egg freezing is not only a medical necessity, but also a "biological insurance" that protects a woman's reproductive freedom and her chance of becoming a future mother in the modern world.

The Biological Necessity of Egg Freezing

Women come into the world with a limited egg reserve and, unlike men, cannot produce new eggs throughout their lives. Starting from the age of 35, eggs begin to decrease rapidly both in terms of quantity (quantity) and genetic quality (quality). By the age of 40, the possibility of a healthy pregnancy drops significantly due to the increase in chromosomal disorders. Egg freezing preserves the quality of eggs at the age they were frozen; Thus, when a woman wants to use these eggs at the age of 40, the chance of pregnancy has the same success rate as the age when the eggs were frozen (for example, 30 years old).

In reproductive health evaluation, age, infertility duration, ovarian reserve, sperm parameters and uterine-tube factor should be considered together [1][3].

Thanks to the "vitrification" (fast freezing) technique applied in modern medicine, egg cells pass into the vitrification phase before the water inside turns into ice crystals. This method minimizes the risk of damage to the egg cell during the freezing and thawing stages and increases the viability rates to over 90%.

Who Can Have Egg Freezing?

Within the framework of legal regulations and medical requirements in Turkey, egg freezing is applied to the following groups:

Protocol selection in in vitro fertilization and assisted reproductive treatments should be individualized, taking into account ovarian response and safety risks [1][2].

1. Patients Who Will Receive Cancer Treatment:Treatments such as chemotherapy or radiotherapy can cause serious damage to egg cells (gonadotoxic effect). Freezing eggs before treatment preserves the chance of becoming a mother in the post-cancer period.

2. Women with Low Ovarian Reserve:Women who are not yet married but whose egg reserve is found to be decreasing regardless of age in clinical tests (AMH test or ultrasonography) have the legal right to freeze their eggs.

3. Those with a Family History of Early Menopause:The genetic risk is high in women whose mother or sister went through menopause at an early age. It is vital to take precautions before these people run out of reserves.

4. Before Surgical Intervention:Since chocolate cysts (endometrioma) or other ovarian operations may damage the ovarian tissue, freezing is recommended before the operation.

5. Social Causes:This procedure is the safest way out for women who want to postpone motherhood until after the age of 35 due to reasons such as career planning, not finding a suitable spouse candidate yet, or education process.

Egg Freezing Process: Step by Step Application

The process takes approximately 10-12 days and is the same as the first stages of a standard IVF treatment:

Prior attempts, comorbidities, and pregnancy goal should be evaluated in detail before starting treatment [1].

• Preliminary Evaluation:On the 2nd or 3rd day of menstruation, the condition of the ovaries is analyzed by ultrasound control and hormone tests.
• Stimulation of the Ovaries (Stimulation):With hormone medications specifically determined for the individual, the ovaries are enabled to produce more than one egg.
• Tracking Process:The growth rate of the follicles (egg sacs) is monitored with checks every 2-3 days.
• Cracking Needle:When the follicles reach the desired size, a trigger injection is given for the eggs to mature.
• Egg Collection (OPU):36 hours after the injection, eggs are collected under light anesthesia and guided by vaginal ultrasound. The procedure is painless and takes about 15-20 minutes.
• Vitrification (Freezing):Mature eggs sorted in the laboratory are frozen to be stored in liquid nitrogen tanks at -196 degrees.

Legal Framework and Storage Period

According to the current regulations in Türkiye, egg freezing requires a committee report stating "decreased egg reserve" or a medical necessity such as a cancer diagnosis. Frozen eggs are initially stored for 5 years. At the end of this period, if the person wishes to continue keeping it, he or she can extend the period by submitting a petition every year. In order to use stored eggs, it is a legal obligation for the person to be married in the future.

Embryo transfer, genetic evaluation or additional laboratory applications may not be necessary for every patient; The decision should be made based on the individual clinical picture [2][3].

Factors Affecting Success

The two most critical factors in egg freezing are; womanageAndis the number of eggs frozen. 10-15 eggs frozen before the age of 35 can increase the chance of a healthy birth in the future to over 80%. As the probability of eggs being genetically healthy decreases with age, more eggs may need to be frozen.

Frequently Asked Questions (FAQ)

1. Does egg collection damage virginity?Standard practice is done vaginally. However, in patients with virginity sensitivity, the procedure can be performed successfully without damaging the hymen by performing abdominal ultrasound guidance.

2. Does egg freezing accelerate menopause?No. Every month, your body selects a group of eggs and only one of them grows while the others disappear. Drug treatment aims to save and grow the eggs that will disappear that month anyway; Therefore, it does not deplete the reserves or bring forward menopause.

3. How long do frozen eggs remain healthy?Theoretically, cells stored in liquid nitrogen tanks can remain for very many years (10-20 years or more) without losing their structural properties. There is no technological time limit.

4. How many eggs should I freeze?The ideal number varies with age. While 8-10 eggs generally offer a sufficient chance of pregnancy for women under the age of 35, it is recommended to increase this number to 15-20 for those over the age of 38.

5. When can I return to daily life after the procedure?A light rest is recommended on the day of egg collection. You can fully return to your social and business life the next day.

6. Is there an age limit for egg freezing?Although there is no legal upper limit, the chance of success of the procedure decreases significantly after the age of 43-44, when egg quality drops significantly. Therefore, performing the procedure between the ages of 30-38 is the most medically ideal approach.

The egg freezing process is one of the greatest opportunities offered by modern medicine to women. Protecting your future "becoming a mother" option today reduces the time pressure on you, allowing you to make freer decisions in both your career and private life.

To stop your biological clock and take the right step for your future, Assoc. Prof. in our clinic in Ankara. Dr. You can make a personalized reserve assessment and plan your treatment protocols with the help of Nazlı Korkmaz.

References

• [1] NICE NG257 - Fertility problems: assessment and treatment- Current clinical guidance for infertility evaluation, treatment options and IVF approach.
• [2] ESHRE - Ovarian Stimulation for IVF/ICSI- Ovarian stimulation, monitoring and personalization recommendations during the IVF/ICSI process.
• [3] ASRM - Definition of infertility: a committee opinion- Expert committee opinion on the definition of infertility and the timing of application for treatment.