Later, baby

By Geraldine Fitzgerald

Equality and liberty have evolved for women. We marry later, we have careers, we’re busy. It’s still a shock to discover than when we’re ready to start a family, our bodies are not.

Frustratingly, fertility declines with age. We’re born with a certain number of eggs, which deplete in quality and quantity from our mid-thirties.

In 1981, almost 60 per cent of all births in Ireland were to women under 30. Now that figure is about 27 per cent.

As awareness of the emotive and difficult facts about fertility and biology increases, so too does the number of women exploring the option to freeze their eggs.

Egg freezing as a process is not new. It was initially introduced in the 1980s as an option for women undergoing cancer treatment in cases where ovary removal or potential damage to fertility was a concern.

However, success levels were low until a new freezing process called vitrification was introduced in 2010, which rapidly freezes eggs in liquid nitrogen.

It cools eggs instantly and transforms them into a glass-like state so they are less prone to damage by ice crystals.

The growing number of fertility clinics in Ireland offer women support and choices and are seeing an increasing number of enquires post-lockdown, as people reflected on their situation and those who ultimately would like a family, but perhaps aren’t ready now, want to be proactive.

The process is similar to the initial stages of IVF.

Women are given medication to hyper-stimulate their ovaries to generate a surplus of healthy eggs, which are then drawn off the ovaries in a procedure under sedation, frozen in liquid nitrogen and stored.

When the woman is ready to attempt pregnancy, the eggs are thawed and the ones that survived the freezing process are fertilized by in vitro fertilisation.

In Britain, where egg freezing has been available since the 1990s, the British Human Fertilisation and Embryology Authority reports that women using their own frozen eggs in IVF treatment currently have a success rate of 18 per cent.

In Ireland we don’t have as much evidence accumulated yet as although an increasing number of eggs have indeed been frozen, few have been thawed.

However, IVF can be a challenging enough process using fresh, fertilised eggs, so frozen unfertilised eggs are certainly not a failsafe insurance policy.

Most specialists say women need at least 20 eggs in the freezer for good odds of pregnancy success, but whereas freezing eggs at age 31 might generate that amount in one treatment cycle, doing so at age 38 might only produce five eggs and need more cycles.

The quality of the eggs is also an issue.

It does bear remembering that the process is highly individualised though, so the first step of the process is to have your ovarian reserve checked to get an idea of how much reproductive potential you may have.

Based on the number of eggs in the ovaries, fertility specialists can make an educated guess at the number likely to be produced in a treatment cycle.

Many women spend too long thinking about it and are past peak fertility by the time they make a decision to have their eggs frozen, which reduces their chances.

Fertility doctors will candidly discuss the physical, financial and often emotional realities of the process for each individual patient so an informed decision can be made.

The cost per cycle (about €3,000) is only the beginnin - further cycles and the IVF itself are a major financial consideration.

The message from all clinics is clear – the sooner, the better.

It’s not surprising therefore that a number of Irish women have decided to forget waiting for Mr Right, and opt for a sperm donor instead.

More about that next week.