Dr. Human Fatemi
Dr. Barbara Lawrenz
Due to changes in life-style, women or couples nowadays tend to postpone their wish to start a family for some years. Unfortunately, the chance to conceive, to have a successful pregnancy and a healthy baby declines with the increasing age of the couple. This fact is much more related to the age of the female than of the male.
In order to improve the chance of pregnancy when the wife is in her late thirties (30s) or early forties (40s), some women wish to create a stock of eggs, which they can rely on in case it might be difficult to achieve a pregnancy at that age.
Due to advantages of the reproductive medicine various different options are available for both men and women to preserve their fertility for the time.
In Women: Fertility starts to decline from the end of 20ties and this process continues rapidly after the age of 35 due to the fact that the number and also the quality of the eggs drops with the age. No medical treatment and not even the healthiest life style can avert this process.
Therefore to achieve a good chance for a later pregnancy, the eggs have to be frozen, before this natural process starts. The best results for later pregnancy will be achieved when the eggs are frozen before the wife reaches the age of 35.
In men, the influence of age on fertility is not as obvious as in female. Anyway it is known, that the risk of fathering a child with genetic abnormalities is higher in older men compared to young men. In case freezing of sperm should be done out of social reasons it is recommended to do this before the age of 50.
To create a stock of good eggs, the woman has to undergo hormonal stimulation treatment so that the ovaries produce more eggs compared to a normal cycle. These eggs have to be retrieved out of the body of the women by a vaginal procedure, called egg retrieval or ovum pick up. The retrieved eggs will be frozen by a process called vitrification.
The vitrification of oocytes allows the mature eggs to be cryopreserved in a stable condition so that they can be used at a later date, when the patient decides she is ready. The chance for pregnancy will be the same as at the point when they were vitrified.
In this process, the unfertilised eggs will be frozen and fertilization process has to be done whenever the patient wishes to achieve a pregnancy. To give a good chance for a later pregnancy approximately 10 to 15 unfertilized eggs should be frozen, so some women have to undergo more than one stimulation procedure.
Egg (oocyte) freezing success has significantly improved and is now more readily available than it was just a few years ago. According to the American Society for Reproductive Medicine, it is no longer considered experimental.
Another technique used for preserving fertility is the cryopreservation of the ovarian cortex.fertility through which various births have already been achieved around the world. This technique is till now not used for social freezing, it is an option for fertility preservation in cancer patients. For this option ovarian tissue will be removed from the ovary by a laparoscopic procedure and then frozen.
In case of a reduced function of the ovary at the time a pregnancy, the ovarian tissue can be thawed and re-implanted. This technique enables spontaneous pregnancy as ovarian function and hormone levels are restored to normal levels.
Worldwide, there have been many reported cases of multiple births from re-implantation done using cryopreserved ovarian tissue, which is why it still may be considered as an experimental procedure.
Sperm banking is a simple way to preserve fertility, with a generally high success rate. Specimens are collected through masturbation. Multiple collections (2-3) with 48 hour abstinence between collections is the ideal. It is best to collect before treatment begins.
It has to be noted that according to the UAE law the freezing of oocytes and of sperms is only allowed for a maximum of 5 years.
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