Oocyte freezing, also known as egg freezing, is a medical technology that can preserve a woman's fertility and is a medical knowledge that the new generation of women need to know. It was not until 2012 that the American Society for Reproductive Medicine considered oocyte freezing to be a mature technology and began promoting its use. It has recently become a hot topic in Taiwan.

Medical and Elective Oocyte Freezing

Medical oocyte freezing: for young women with cancer or at risk for premature ovarian failure

    Young women with cancer often face a dilemma between cancer treatment and fertility planning. Depending on the doctor's assessment, they may be able to complete oocyte cryopreservation as early as two weeks before cancer treatment, and then thaw the eggs for IVF once the disease has stabilized.

    Young women may also encounter risk factors for premature ovarian failure, such as ovarian cysts, previous surgery for ovarian cysts, familial premature ovarian failure, abnormal menstruation, obesity, stress, and exposure to environmental hormones. An ultrasound examination and a blood test for anti-Mullerian hormone (AMH) can be used to assess the ovarian reserve. Not only can you find out if the ovaries are healthy, but also ask your fertility doctor to help you assess whether to freeze your oocytes at this stage.

 Elective oocyte freezing " for non-medical purposes

    Companies such as Google in the United States have begun to subsidize reproductive health benefits for their employees so that women of childbearing age who are not yet mentally ready can freeze their eggs at a healthy age. They try to balance the career achievements with their fertility plans. Many YouTubers and female celebrities in Taiwan have also started to share their experiences with oocyte freezing. Most of the motivations are related to women's autonomy, career planning, late marriage in general, uncertainty about whether or not to have children, not meeting their ideal partner, peers getting married and having children, and pressure from family elders. In addition, if lesbian couples or single women choose to freeze their oocytes in Taiwan, they need to go abroad to match with donor sperm to fulfill their dreams of having children. These requirements are worthy of attention.

Couples who have a consensus to have more than two children can consider "fertility planning embryo freezing" to store young embryos with a low rate of chromosomal abnormalities. Only thawed embryo transfer will be required in the future. If couples have difficulty conceiving or have infertility, they should seek early medical consultation. However, it is important to note that complications of pregnancy may increase depending on the age of embryo transfer. It is recommended to complete the fertility plan as soon as possible.   

 Elective oocyte freezing, not too young or too old, the number of frozen eggs should be sufficient.

    The most suitable age is between 30-34 years old. The younger you are, the more "good eggs" you can get in a single cycle. The number and quality of eggs decreases with age, resulting in higher rates of chromosomal abnormalities and miscarriage in future fertilized embryos. The decline rate is faster after the age of 35. Older women may require multiple oocyte freezing cycles and more medical expenses to obtain the optimal pregnancy rate. Women younger than 30 years old who are healthy may not need to consider oocyte freezing because they have a high chance to conceive naturally.

Considering the survival rate and the age at which the oocytes are thawed, the Taiwan Society of Reproductive Medicine recommends that if 20 mature oocytes can be frozen, women younger than 35-year-old could have an 80-90% chance of a live birth, women aged 36-37 have a 70% chance, women aged 40-41 have a 40% chance, and those aged 44 have a 10% chance.

    When considering egg freezing, women should be fully aware of the rights and regulations governing the use of their eggs. Under the current artificial reproduction law in Taiwan, a legal couple must be in a relationship in order to thaw oocytes for IVF. We hope the government will open up more options in the future so that more women can benefit from Taiwan's excellent reproductive technology. 

The oocyte freezing procedure takes only 2-3 weeks to complete

Initial evaluation: medical history, blood sampling and gynecologic ultrasonography

Controlled ovarian hyperstimulation: Ovulation stimulating drug are started since day 2-4 of menstruation, followed by 2-3 times ovarian follicles and hormone examination

Oocyte retrieval: When the follicles are mature enough, the ovulation drug is administered. After 34-36 hours, the oocytes are retrieved under anesthesia. The oocytes will be aspirated through the vagina by ultrasound guidance and sent to the laboratory for evaluation of the oocyte grading. The procedure is short and usually does not require hospitalization. It is recommended to take a day off and rest at home on the day of the procedure. A small number of women experience ovarian bleeding, infection or ovarian hyperstimulation syndrome after oocyte retrieval.

Oocyte freezing fee and annual cryopreservation fee

The cost includes ovulation medication, oocyte retrieval surgery, anesthesia, oocyte freezing. The total cost varies depending on the type and dosage of ovulation medication used and the number of eggs frozen per person. In our center, the cost of oocyte freezing is around NT$100,000-$150,000 and the annual preservation fee is NT$8,000. There is no limit to how long the oocytes can be preserved, while embryos can be preserved for 10 years.

 Conclusions

Ultrasound-guided transvaginal oocyte retrieval

Reference: Far Eastern Reproductive Center