What are the advantages of social freezing?
The chances of pregnancy depend on the age of the egg. Social freezing stops the aging process of the cryopreserved egg. This prevents a further reduction in the chances of pregnancy. In addition, the increasing risk of chromosomal malformations (e.g. trisomy 21) of the egg is stopped.
What is the treatment procedure for social freezing?
Prior to the actual Social Freezing procedure, an initial consultation and a basic examination (blood sample and gynaecological examination) take place at the Kinderwunschzentrum Niederrhein. The results of the basic examination are then explained in a consultation and the treatment cycle is planned. The start of the treatment cycle can be decided individually after consultation.
A treatment cycle includes ovarian stimulation and egg collection. The treatment cycle usually starts on the 2nd or 3rd day of menstruation. The ovarian stimulation is carried out by taking medication for about 10-12 days. During these days, approx. 1-2 control appointments are necessary. Oocyte retrieval is performed around the 14th day of the cycle by transvaginal follicle puncture under short anaesthesia as an outpatient procedure.
Usually two to three treatment cycles are necessary to obtain a sufficient number of eggs.
What are the costs of social freezing?
The cost of social freezing is not covered by health insurance and depends on the number of treatment cycles and the medication required. Pertreatment cycle, the cost is around €1,700 for the medical treatment and around €1,000-1,800 for the medication. The storage costs for the eggs are 395€ per year. If the egg is fertilised at a later stage, there are further costs for fertilisation of the egg and embryo transfer.
Age plays a central role in the later realisation of the desire to have children (>35 years of age). In addition to the decreasing oocyte reserve in the ovary, the rate of genetically abnormal (aneuploid) oocytes increases at the same time. The individual oocyte reserve can be determined by measuring the AMH (anti-Müllerian hormone) and the AFC (antral follicle count).
On the other hand, the number of genetically abnormal oocytes cannot be determined individually. The aneuploidy rate (number of oocytes with an incorrect number of chromosomes) is about 10% in women aged <35 years, 36% in women aged 35-41 years and up to 80% in women aged >41 years.
Since the egg reserve and the egg quality decrease with increasing age, the chances of success are higher the earlier social freezing is carried out. The optimum time for carrying out social freezing is before the age of 35. Social freezing can be carried out between the ages of 36 and 39 after determining the individual egg reserve and after detailed and critical information about the chances of success.
It is recommended to freeze at least 20 mature eggs to increase the chance of having a child. A 2016 study looked at the live birth rate after fertilization of previously frozen eggs. The live birth rate depends on the age of the woman at the time of egg retrieval. If 20 mature eggs were frozen, the chance of a live birth was 94% for a 20-year-old woman, 90% for a 34-year-old woman, 75% for a 37-year-old woman, and 37% for a 42-year-old woman. The chance of two live births after cryopreservation of 20 mature oocytes was 66% in a 34-year-old woman, 39% in a 37-year-old woman, and 7% in a 42-year-old woman.
The number of eggs that survive freezing and thawing depends on the freezing process (=cryopreservation). At the Kinderwunschzentrum Niederrhein, vitrification is used for the cryopreservation of unfertilised eggs (as well as for the cryopreservation of fertilised eggs and embryos). This "new" freezing procedure allows >95% of mature eggs to survive the process. With the "old" freezing procedure, "slow freezing", the survival rate of the frozen oocytes is around 60%.
The eggs frozen by vitrification have the same pregnancy rates in artificial insemination as eggs that were directly fertilized and transferred after retrieval.
Not all retrieved oocytes can be frozen. Only the "mature oocytes" that are in metaphase II are cryopreserved. Experience shows that approx. 70-90% of the retrieved oocytes are in this stage.
The number of eggs retrieved per treatment cycle depends on the woman's individual egg reserve.
The D-I-R (German IVF Register) presents the average number of eggs retrieved during an ICSI (intracytoplasmic sperm injection) treatment cycle from 2014 to 2018. The average number of eggs retrieved is 10.4 eggs for a 30-34 year old woman, 8.4 for a 35-39 year old woman, and 7.1 for a 40 year old woman. Experience shows that the number of eggs retrieved is slightly higher in social freezing. Since social freezing does not induce pregnancy after the treatment cycle, the stimulation dose in a treatment cycle can be chosen more generously. This results in an increased number of eggs retrieved.
Ovarian stimulation is a controlled overstimulation. However, due to the chosen stimulation protocol (antagonist protocol with GnRH agonists for triggering) the occurrence of an overstimulation syndrome is very rare.
Transvaginal follicular puncture is a surgical procedure lasting approximately 15 minutes. As with any medical intervention, certain risks cannot be completely eliminated, but bleeding or injury to surrounding tissue is extremely rare.
Many studies worldwide have investigated the effect of ovarian stimulation on a possible cancer risk. So far, no significant correlation has been found between hormonal stimulation treatment and the development of cancer (breast, ovarian, endometrial and cervical cancer).
There is no premature onset of menopause after social freezing treatment. In a natural cycle, several eggs start the maturation process at the same time. Of these, only one egg (the dominant follicle) leads to ovulation. All the other eggs atrophy (follicular atresia) and are broken down by the body. In a natural cycle and with ovarian stimulation, about the same number of eggs start the maturation process. However, ovarian stimulation in the context of social freezing results in more eggs completely completing the maturation process
Cryopreservation in liquid nitrogen means that the cells can be stored almost indefinitely. Studies have shown that storage times of up to 30 years have no effect on the quality of the eggs.
Pregnancy over the age of 40 carries more risks, even with previous social freezing. There is an increased risk of premature birth, gestational diabetes, increased blood pressure or pre-eclampsia (=pregnancy poisoning). Transfer is not recommended after the age of 50.
If the time has come to realise the desire to have a child, the first step is to try to conceive naturally. If there are no known causes of infertility on either side, we recommend that you try to conceive naturally for at least 6 months.
If the desire to have a child remains unfulfilled in this way, the thawed eggs are fertilised by means of ICSI (intracytoplasmic sperm injection). The embryo transfer is then carried out in the natural cycle.