Freeze now, fertilise later: Cryopreservation as a means for managing parenthood
14 July 2023
KUALA LUMPUR - Cryopreservation, the act of safely freezing and storing eggs and sperm, can help couples planning for parenthood to protect and extend their fertility and is especially useful for those intending to delay or anticipate parenthood.
Consultant Obstetrician, Gynaecologist and Fertility Specialist from Sunway Medical Centre Velocity (SMCV) Dr Farah Leong Rahman explained that cryopreservation uses liquid nitrogen to freeze eggs, sperm or even embryos to sub-zero temperatures - around -320 degrees Fahrenheit (-195 degrees Celsius) to be stored for future use.
"The more popularly known process called oocyte preservation is more commonly known as egg freezing, and it is a process in which a woman’s eggs (oocytes) are extracted, frozen and stored so they can be used for fertilisation and pregnancy at a later stage,” she said in a statement.
She said as far as fertility options go, In-vitro fertilisation (IVF) is a relatively popular procedure, and some may not be able to differentiate between IVF and egg freezing. Dr Farah shared that while there are similarities and the intended outcome of pregnancy is the same, the methods and processes differ.
"In egg freezing, a woman goes through a series of hormonal medications to stimulate her ovaries to produce more eggs. Once the eggs are deemed to have reached maturation, egg retrieval is done to retrieve these eggs. From here, we can store these eggs for future use.
"Same preparation is done for those undergoing IVF, but the retrieved eggs are now fertilised with the partner’s sperm in the lab. Embryologists will monitor the growth and development of the embryos. These embryos can also be frozen and can be used to transfer into a woman’s womb at a later date. Frozen eggs can be thawed and used in fertility treatments such as Intrauterine insemination (IUI) or IVF,” she noted.
With current technological advancements, specimens can be stored indefinitely through a vitrification process that causes rapid freezing (15000’C /min), equivalent to near instantaneous freezing. With this, the Human Fertilisation and Embryology Association supports the cryopreservation of eggs, sperm and embryos for up to 55 years.
She said couples or individuals may choose to preserve their eggs or sperm and undergo cryopreservation for a number of reasons - be it a potential decline in fertility, an increase in age or even impending treatments for diseases such as cancer.
According to Dr Farah, cryopreservation also helps preserve a better quality of sperm, eggs or embryos before starting cancer treatment, as it can impact the function of the gonads and lead to infertility.
Like egg freezing, men are able to freeze their sperm to extend and preserve their fertility through similar processes. Also known as sperm cryopreservation, this is a method of preserving sperm cells for future use and involves collecting a semen sample from a male through ejaculation and then subjecting the sample to cryopreservation.
Meanwhile, Consultant Obstetrician, Gynaecologist and Fertility Specialist from SMCV Dr Ashley Chung Soo Bee said cancer itself can also affect the quantity and quality of sperm even before treatment.
"In men, cancer treatment can cause lower sperm production, damaged sperm, or the inability to produce sperm. These effects on sperm production can be temporary or permanent, depending on the type of treatment one undergoes,” she said.
She said when it comes to preparing for sperm freezing, the male patient is required to produce his semen naturally before it can be sent to the IVF laboratory.
"If the man is unable to produce semen naturally, he may need to undergo a simple procedure to retrieve sperm from the testicles,” she added.
Dr Ashley further said that couples who are keen to start a family should consider undergoing fertility screening if they have been having regular sexual intercourse without contraception for a year and the female partner is under 35 years old.
However, if the female partner is 35 years old and above, it is recommended to seek fertility consultation if they have been trying to conceive for six months or longer, where the couple will undergo examinations, scans and tests to assess their fertility status.
Regarding the side effects, Dr Ashley said any medical procedure has its own side effects and possible risks, but cryopreservation is considered to be a relatively safe procedure.
"The survival rate (of frozen eggs and sperm) is quite high, though there is always a possibility that some cells may not survive the thawing process. There are many factors in determining the success rates of pregnancy. Age is one of the most crucial factors. Of course, the lab, equipment and personnel play an important role as well,” stressed Dr Farah.
Dr Ashley echoes this sentiment and highlights the possibility of side effects caused by natural hormonal elevation as a result of ovarian stimulation.
"Side effects such as nausea, mood swings, hot flashes, and headaches are common. A small number of patients may be at risk of OHSS (ovarian hyperstimulation syndrome) and may experience symptoms such as nausea, flatulence, tummy discomfort or pain, and vomiting.
"Hence, every patient will have an individually customised treatment regime by their respective fertility doctor to reduce the risk of this complication,” she said.
Dr Ashley said in order to determine the suitability of cryopreservation for each individual, they should reach out to their trusted healthcare practitioners for further information and confirmation of the next best step of action towards their journey in starting a family.
Sunway Medical Centre Velocity is located at Lingkaran SV, Sunway Velocity. For enquiries, please contact +603 9772 9191 or email [email protected]. For more information on Sunway Medical Centre Velocity, visit www.sunmedvelocity.com.my (Facebook: Sunway Medical Velocity). - BERNAMA
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