Florida Institute for Reproductive Medicine

Egg Cryopreservation - Save My Eggs, Inc.

Introduction
Over the last several decades, much effort has been extended towards the successful cryopreservation (freezing) of human cells and tissues. Cryopreservation of human sperm has been available for decades enabling men to bank sperm who otherwise may become sterile, i.e. due to radiation, chemotherapy, or surgical castration. Scientists have been trying to cryopreserve human eggs for all of the same reasons. In addition, because there is no ongoing production of eggs throughout a woman's life, the quality of eggs released each month changes with age, making childbearing after age 35 more difficult and risky due to an increased incidence of genetically abnormal eggs. Technically, cryopreservation of sperm is quite simple due primarily to the small size and relatively low water content of spermatozoa. The egg is a large cell with high water content, and is therefore prone to ice crystal damage. It is the prevention of this ice crystal formation that is critical to successfully freezing an egg.

Since 1984 advanced reproductive medicine programs worldwide have been cryopreserving fertilized eggs. Thousands of babies have been born using this technology with a large body of reassuring health data. As opposed to the cryopreservation of an unfertilized egg, most of the critical functions of the cell have already been performed when freezing fertilized eggs. Therefore, if a female desirous of cryopreservation of her gametes has a male partner, it is recommended in most cases to consider cryopreservation of fertilized eggs. Given the number of eggs we have had to freeze and thaw to produce these pregnancies, we believe this is by far the most efficient experience with this technology anywhere in the world.

At the Florida Institute for Reproductive Medicine we have had 49 babies born and one ongoing pregnancy to date. Given the number of eggs we have had to freeze and thaw to produce these pregnancies, we believe this is by far the most efficient experience with this technology anywhere in the world.

If you are considering cryopreservation of your eggs, it is of primary importance to ask some key questions:

	•	How many live births has the program had?
	•	What is the average number of eggs cryopreserved to produce a live birth?
	•	What is the cost of the procedure including medications and annual ongoing cryopreservation storage fees?
	•	Are there any means to recoup some of the costs of the procedure should I choose not to use my eggs?

Who may benefit from Egg Cryopreservation?

Individuals faced with the prospect of losing ovarian function either surgically, through chemotherapy or radiation exposure may benefit from the cryopreservation of eggs. There may be medical contraindications for some individuals to participate in the cryopreservation program. Medical consultation with your oncologist or surgeon may be required.

B.	Couples undergoing in vitro fertilization who are morally or ethically opposed to the cryopreservation of either pre-embryos or embryos.
C.	Individuals who anticipate delaying childbearing into their late thirties. Certainly we know that many individuals after age 37 will have severely diminished fertility due to remaining egg number and quality.

Assessing Who is a Good Candidate for Egg Cryopreservation -
Tests of Ovarian Reserve

With the current efficiency of our egg cryopreservation protocol, we wish to identify individuals who are likely to be able to obtain at least sixteen mature eggs. We believe with this number of eggs the majority of individuals should have a 50% or better chance of obtaining a live birth. Because egg quality will vary from individual to individual, it is not possible to assert for any one particular individual their chances of obtaining a pregnancy from a given number of eggs. Some individuals may not get this number of eggs from a single stimulation/ retrieval cycle, but may be able to go through stimulation/retrieval more than once. Some cancer or surgery patients may not be able to go through a stimulation/retrieval because of time constraints, i.e. the need to proceed with immediate care for their underlying health problem, or because of their current health status. Age is an indicator of ovarian reserve and remaining egg quality to some degree. Clearly the majority of 38 year-olds will obtain significantly fewer eggs following gonadotropin stimulation than the majority of 20 year-olds, but amongst all 38 year-olds there will be some who will get as many eggs as the 20 year-old. Better assessment of ovarian reserve can be obtained through dynamic testing. The test that we currently recommend is the clomiphene citrate challenge test which involves drawing blood on menstrual day three and assessing two hormones, follicle stimulating hormone and estradiol. Individuals will take a medication called clomiphene citrate, two tablets (100 mg) days five through nine, and will have a repeat FSH and estradiol level checked on day ten. Egg quality for any particular age group is more difficult to assess, but in general, declines with age and significantly so after age 37. Due to the concern over egg quality, we do not offer egg cryopreservation to patients older than 38.

Florida Institute for Reproductive Medicine

836 Prudential Drive, Suite 902
Jacksonville, FL 32207-8336

Phone: (904) 399-5620

Fax: (904) 399-5645