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Beat the Clock
Women in their thirties and forties sometimes struggle with infertility—which is why more young, single women are freezing their eggs. By Karina Giglio
Comments () | Published August 13, 2013

On the Monday after Mother’s Day this spring, Anne C., an accomplished Bethesda entrepreneur who had always dreamed of becoming a mother, was 15 weeks pregnant and scheduled for an amniocentesis, a test that determines genetic disorders in fetuses. Because she was 43, the risk of Down syndrome and other chromosomal abnormalities should have been about 1 in 50. Yet for her pregnancy it was 1 in 90 because the egg that resulted in Anne’s pregnancy was chronologically only 40 years old, having been frozen in 2010 after an acrimonious divorce left her wondering if she’d ever be able to have biological kids.

Thanks to advances in oocyte cryopreservation, or egg freezing—and at a cost of $60,000—Anne had essentially become her own egg donor. In the process, she managed to outsmart her biological clock.

The new buzzword in feminist and fertility circles is “social egg freezing,” referring to the fact that the procedure is a lifestyle choice. Until recently, freezing was done almost exclusively to try to preserve fertility when a young woman was facing a medical condition such as cancer, which can cause sterility.

Celebrities including Sofia Vergara and a pre-pregnant Kim Kardashian have openly discussed their decisions to freeze their eggs. Former State Department director of policy planning Anne-Marie Slaughter (the first female to hold the post) wrote in a 2012 Atlantic essay, “Why Women Still Can’t Have It All,” that upwardly mobile women busy chipping away at the glass ceiling should have children by age 35—or put their eggs on ice. The article became widely circulated on the internet, with 218,000 shares on Facebook alone.

• • •

In an unassisted race against a ticking reproductive clock, women are almost always certain to lose: By age 30, nearly 90 percent of their eggs are gone forever; by age 40, only about 3 percent remain. Scientists have tried for years to save those eggs before they dwindle, but while sperm has been successfully frozen for more than 60 years, the “experimental” label was lifted from oocyte cryopreservation by the American Society for Reproductive Medicine (ASRM) only last October, thanks to a new flash-freezing process called vitrification.

“It’s a no-brainer to freeze sperm—you could actually freeze them in water and they’d survive because they’re the smallest cell in the body,” explains Fady Sharara, an infertility specialist at the Virginia Center for Reproductive Medicine in Reston. However, he adds, “the egg is the largest, with a large water content, which historically led to crystal formation. Vitrification significantly minimized that damage so that thaw rates are almost identical to using fresh eggs.”

According to several studies, those thaw survival rates—indicating the eggs that are viable—are an astounding 90 to 97 percent. About 40 to 60 percent of women in the studies who underwent in vitro fertilization using previously frozen eggs were able to achieve pregnancy on their first IVF attempt, a rate similar to that of using freshly harvested eggs. According to ASRM, the 1,000-plus reported births from eggs frozen via vitrification show no increased risk of birth defects compared to those conceived naturally.

To hear local fertility specialists tell it, all of these numbers amount to a boom in interest. Type “oocyte cryopreservation washington dc” into Google and you’ll get about 692,000 results.

“You have a lot of women in this area who may be marrying later, who focused on their education and career during their twenties, when fertility is at its peak,” says Dominion Fertility medical director Michael DiMattina, whose youngest social-egg-freezing patient to date was 32. “It’s not unlike disability insurance. You hope you’ll never need it, but if you’re delaying childbirth until after 35, you can fall back on it. I have five patients signed up right now to do it.”

Shady Grove Fertility, whose network of clinics span DC, Maryland, and Virginia, performed 131 cryopreservation cycles for women banking their own eggs in 2012—up from 44 in 2010.

At the Virginia Center for Reproductive Medicine, Dr. Sharara is also fielding inquiries—which doubled between 2011 and 2012 and are still going strong this year—but one factor often puts the brakes on moving forward: “You have women in their mid- to late forties saying, ‘I want to freeze my eggs right now,’ and I think, ‘What eggs are you talking about?’ These are often women for whom 40 is the new 30 when it comes to how they look and feel, but ovaries are on their own timeline—they’re either your chronological age or even older, but never younger.”

The survival rate for eggs in the over-40 set is so dismal that Sharara and most other fertility specialists generally draw the line at age 40, making Anne (and Sofia Vergara) notable exceptions. But at $10,000 to $15,000 per freezing cycle—more than one cycle is often required to harvest enough eggs—many younger women find the cost prohibitive.

“That’s the quandary,” Sharara says. “Women under 35 often don’t have the financial resources, and those over 40 don’t have the reproductive resources.”

• • •

With her 34th birthday approaching, Jennifer R., a Reston marketing consultant, was well aware of her biological clock. “I had a great life and a wonderful boyfriend, but a part of me was very sad that I wasn’t in a place where I was ready to have children,” she says.

Though she was in a relationship that seemed to be heading toward the altar, her boyfriend was almost ten years older with children from a previous marriage, and he wasn’t sure if he wanted more. Complicating matters was the vasectomy he’d had before meeting her, meaning they’d likely need to undergo IVF treatments if they did decide to conceive together.

“I knew that I wanted to have kids with him, but if we broke up I didn’t want to feel like two years of my life were wasted and that I’d have to start all over again at 38 or 40 and not be able to have children,” she says.

After a coworker suggested Jennifer look into egg freezing, she researched it and told her boyfriend that night that she wanted to do it. He offered to pay. “It definitely took the pressure off of him to hurry up and decide if he wanted to be a dad again,” she says, “and it let us enjoy our time together without the worry of it being too late to try in a few years.”

A few months later, Jennifer had 12 eggs extracted from her ovaries. Eight were viable, enough for two IVF cycles. “What he gave me was so much bigger than a diamond,” she says. “He gave me life.”

Melanie B. froze 18 eggs immediately after a divorce at age 35. Her decision was helped by two divorced friends who’d had to rely on donor eggs to get pregnant during their second marriages.

For Melanie, the subject serves as a deterrent for potential Mr. Wrongs. “Some guys say it’s unnatural and weird, or they seem scared—probably because they’re not sold on the idea of having kids,” she says. “But that just weeds out the ones who aren’t a good fit for me.”

The majority of men, Melanie says, commend her for thinking ahead and being purposeful about following her dream. As a senior practice liaison for Shady Grove Fertility, she’s occasionally asked on a first date if she has frozen her eggs: “It’s surprising how many single guys know about it, and that my decision is actually a relief for them because they’re used to dating women my age who try to hurry the relationship and talk nonstop about having babies.”

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Posted at 01:31 PM/ET, 08/13/2013 RSS | Print | Permalink | Comments () | Washingtonian.com Articles