KUALA LUMPUR, July 13 – To some, parenthood is an important milestone or goal to be achieved, and for others, it may be a dream that has to be put on hold for health or other reasons.
This is where technology such as cryopreservation enters the conversation on conservation for future use, and couples or individuals who intend to delay or anticipate parenthood now have the option to do so.
The more popularly known process called oocyte preservation is more commonly known as egg freezing, and it is a process where a woman’s eggs (oocytes) are extracted, frozen and stored so they can be used for fertilization and pregnancy at a later stage.
Dr Farah Leong Rahman, consultant obstetrician, gynaecologist and fertility specialist at Sunway Medical Centre Velocity (SMCV) explains that cryopreservation uses liquid nitrogen to freeze eggs, sperm or even embryos to sub-zero temperatures — around -320 degrees Fahrenheit (-195 degrees Celsius) to be stored for future use.
Egg Freezing Vs IVF
As far as fertility options go, In-vitro fertilization (IVF) is a relatively popular procedure, and some may not be able to differentiate between IVF and egg freezing.
Dr Leong shares that while there are similarities and the intended outcome of pregnancy is the same, the methods and processes differ.
“In egg freezing, a woman goes through a series of hormonal medications to stimulate her ovaries to produce more eggs.
“Once the eggs are deemed to have reached maturation, egg retrieval is done to retrieve these eggs. From here, we can store these eggs for future use.
“Same preparation is done for those who are undergoing IVF but eggs that are retrieved are now fertilized with the partner’s sperm in the lab. Embryologists will monitor the growth and development of the embryos.
“These embryos can also be frozen and can be used to transfer into a woman’s womb at a later date. Frozen eggs can be thawed and used in fertility treatments such as Intrauterine insemination (IUI) or IVF,” she said.
With current technological advancements, specimens can be stored indefinitely through a vitrification process that causes extremely quick freezing (15,000 Celsius /min), equivalent to near instantaneous freezing.
With this, the Human Fertilization and Embryology Association supports the cryopreservation of eggs, sperm and embryos for up to 55 years.
Sperm Fertility Preservation
Like egg freezing, men are able to freeze their sperm to extend and preserve their fertility through similar processes.
Also known as sperm cryopreservation, this is a method of preserving sperm cells for future use and involves collecting a semen sample from a male through ejaculation, and then subjecting the sample to cryopreservation.
This is a process that may be of use to men who are undergoing treatments for serious health conditions such as cancer.
According to Dr Ashley Chung, consultant obstetrician, gynaecologist and fertility specialist at SMCV, cancer itself can also affect the quantity and quality of sperm even before treatment.
“In men, cancer treatment can cause lower sperm production, damaged sperm, or the inability to produce sperm. These effects on sperm production can be temporary or permanent, depending on the type of treatment one undergoes,” she said.
When it comes to preparing for the sperm freezing, the male patient is required to produce his semen naturally before it can be sent to the IVF laboratory before freezing.
“If the man is unable to produce semen naturally, he may need to undergo a simple procedure to retrieve sperm from the testicles,” added Dr Chung.
Factors To Consider
Couples or individuals may choose to preserve their eggs or sperm and undergo cryopreservation for a number of reasons, be it potential decline in fertility, increase in age, or even impending treatments for diseases such as cancer.
According to Dr Leong, cryopreservation helps preserve a better quality of sperm, eggs or embryos before starting cancer treatment as it can impact the function of the gonads and lead to infertility.
She also highlights another health condition that can affect female fertility, which is ovarian insufficiency.
“This means the ovaries stop functioning earlier than expected (before 40 years old), leading to the absence of menstruation.
“If there is a family history of premature ovarian insufficiency, it is recommended for female family members to consider egg preservation prior to developing this condition if they plan to have a family in the future.
“Preserved eggs can be used through IVF to create healthy embryos for future pregnancies,” said Dr Chung.
She adds that couples who are keen to start a family should consider undergoing fertility screening if they have been having regular sexual intercourse without contraception for a year and the female partner is under 35 years old.
However, if the female partner is 35 years old and above, it is recommended to seek fertility consultation if they have been trying to conceive for six months or longer, where the couple will undergo examinations, scans and tests to assess their fertility status.
Potential Risks And Complications
Any medical procedure has its own side effects and possible risks, but cryopreservation is considered to be a relatively safe procedure.
“The survival rate (of frozen eggs and sperm) is quite high, though there is always a possibility that some cells may not survive the thawing process. There are many factors in determining the success rates of pregnancy.
“Age is one of the most crucial factors. Of course, the lab, equipment and personnel play an important role as well,” stressed Dr Leong.
Dr Chung echoes this sentiment, and highlights the possibility of side effects caused by natural hormonal elevation as a result of ovarian stimulation.
“Side effects such as nausea, mood swings, hot flashes, and headaches are common. A small number of patients may be at risk of OHSS (ovarian hyperstimulation syndrome) and may experience symptoms such as nausea, flatulence, tummy discomfort or pain, and vomiting.
“Hence, every patient will have an individually customized treatment regime by their respective fertility doctor to reduce the risk of this complication,” she added.
In order to determine the suitability of cryopreservation for each individual, they should reach out to their trusted health care practitioners for further information and confirmation of the next best step of action towards their journey in starting a family.
