Couples look to fertility preservation methods to plan their family

Couples grappling with building up careers, securing financial stability, and preparing for parenthood may take charge of their fertility with fertility preservation methods. The process of freezing eggs, sperm, or other reproductive tissue has somewhat reduced the stress related to time factor for these couples, especially women.

“Every woman is capable of producing a finite number of eggs in her lifetime, and the quality and quantity of these declines with age,” explained Dr Aldrin Lie, a consultant obstetrician and gynaecologist. “The sharpest decline occurs after the age of 35—while it’s not impossible to conceive at a later age, it can be a harder process for many.” Hence, egg freezing in particular has become a more acceptable idea.

The process and function of egg freezing
Egg freezing, or oocyte cryopreservation, involves retrieving and storing a woman’s eggs to be used in the future to conceive babies. The method, first introduced in the 1980s, offers women with serious medical conditions a chance at having children after completing treatment for their illness. The process starts with a consultation with the doctor including physical examination and a series of tests to assess the woman’s ovarian reserve and to see if she is a good fit for the procedure. After the woman is deemed fit, she will undergo ovarian stimulation whereby hormone injections are administered for about 2 weeks to help her ovaries produce more eggs.

“On average, a woman will release one egg per month during her ovulation cycle. By encouraging a greater number of eggs, we have a better chance of retrieving ones that are suitable for future use and have a greater reserve of usable eggs when they’re ready to be thawed,” said Lie.

During the ovarian stimulation procedure, some women may have a complication called ovarian hyperstimulation syndrome (OHSS) where the hormones used to stimulate the development of eggs cause the ovaries to swell. Symptoms can range in severity, and include abdominal pain, nausea, and vomiting. In this case, the doctor needs to assess the patient’s risk profile and monitor them continuously for adverse reactions.

Matured eggs are collected from the ovaries via a relatively pain-free transvaginal procedure using a fine needle attached to an ultrasound-guided probe. In the hands of a well-trained medical professional and, since some form of light sedation is applied, most women only feel some mild discomfort. In the final step of vitrification, the eggs are rapidly frozen in liquid nitrogen using substances that prevent ice crystals from forming. The eggs can then be stored for up to 10 years, waiting to be thawed when the couple is ready to become parents.

The idea that egg retrieval affects the number of eggs a woman produces in her lifetime is a myth. This is because only the eggs that are available will be collected during the procedure. Another misconception is concern over the health of infants born from frozen eggs. However, research has shown that there is no significant difference between babies born from fresh or frozen eggs, said Lie.

Sperm freezing can be done too
While men’s fertility declines more gradually, studies show that ageing can affect semen volume, and sperm quality in terms of motility and genetic abnormalities. Men too may preserve their fertility through sperm banking, where their semen is frozen and stored for future use. Similar to the egg freezing process, men first undergo a health screening to make sure they are free from any infectious diseases, before their semen sample is collected.

The semen collection part may make some men uncomfortable. However, medical staff are trained to be discrete, and in most cases, they will lead the man to a private room and leave him to complete the task. The semen sample is analyzed to assess the health and quantity of sperm available for freezing, before being added into a special freezing solution. Finally, the prepared samples are stored in freezers that contain liquid nitrogen to preserve the sperm. It is said that sperm can be stored indefinitely without any ill-effects.

Aside from simply freezing reproductive material, some fertility centres have even introduced genetics-based tests to assess the health of couples at a deeper level. These tests offer insights into their risk of passing on hereditary diseases to their future child. “Tests like these can also give people a better picture of why they may be experiencing fertility issues, allowing them to seek the treatment they need,” said Lie.

While the decision to freeze eggs or sperm is a highly personal one, it’s worth thinking about future-proofing fertility regardless of whether the person is single or partnered. Although fertility preservation methods cannot offer a guarantee, they can definitely increase the odds at conceiving. Thus, it can help with easing the stress of ‘when’ to have children and give people some breathing room in making the right choice depending on their circumstances, he said.