Egg Freezing 101 Kristen Mancinelli, MSPH Director of Education, Extend Fertility

Who is Extend Fertility? Helping women freeze eggs for over a decade by referring to fertility clinics around the country. BUT the physical and emotional needs of women seeking fertility preservation options are vastly different from those who hope to get pregnant immediately through techniques like IVF. SO, we opened the very first practice in the US focused exclusively on women who want to preserve their fertility for the future. It’s a dedicated environment, offering specialized, superb clinical care, at a dramatically reduced price.

Why are we here? “A big goal of Cycles+Sex is to present people with all the options, so they can ask all the questions firsthand and figure out what works best for them as unique individuals...I want to raise up and empower women to have not shame, but [instead] to have autonomy, support, and courage to make decisions for themselves.” - Lauren Billes

How does fertility decline with age? Source: American Society for Reproductive Medicine. Age and Fertility: A Guide for Patients

AMH Reflects Egg Quantity Shebl et al. Fertil Steril 2011

Egg “Quality” Aneuploidy = an abnormal number of chromosomes in the cell

We need more direct messages like this one

31% expected to get pregnant without difficulty at the age of 40 ‘What information did you have about fertility and age before you started trying to get pregnant?’ and ‘What did you learn once you proceeded with fertility treatment?’ 30% expected fertility to decline gradually until menopause at around age 50 31% expected to get pregnant without difficulty at the age of 40 Most participants had not anticipated the possibility that they would need IVF to conceive. 44% were ‘shocked’ and ‘alarmed’ to discover that their understanding of the rapidity of age-related reproductive decline was inaccurate. Mac Dougall, K., Beyene, Y., & Nachtigall, R. D. (2013). Age shock: misperceptions of the impact of age on fertility before and after IVF in women who conceived after age 40. Human Reproduction (Oxford, England), 28(2), 350–356.

What would they do about this? Why? Incorrect information from friends, physicians or misleading media reports of pregnancies in older celebrity women. Followed by: healthy lifestyle and family history of fertility recollections of persistent and ongoing messaging about pregnancy prevention starting in adolescence What would they do about this? 28% advocated better fertility education earlier in life 23% indicated that with more information about declining fertility, they might have attempted conception at an earlier age. 46% of women acknowledged that even if they had possessed better information, their life circumstances would not have permitted them to begin childbearing earlier.

Can IVF Save the Day?

ASRM Statement Frozen eggs vs. fresh eggs No difference in pregnancy rates No increase in chromosomal abnormalities or birth defects Survival rates for frozen eggs when thawed are 90-97% No longer an experimental procedure

Freezing Eggs Stops Them From Aging Cryopreservation stops all metabolic activity and prevents further deterioration (aging) of eggs over time. Quantity: freeze a group of eggs, not just one. Quality: freeze eggs at an age when many are still genetically normal.

What can you do?

Get a fertility assessment. Get an AMH test and an ultrasound. Meet with a fertility specialist. It is never too early to do this. Talk to other women about their fertility experiences. Ask about age of menopause for mom and other maternal relatives. Inquire who’s had trouble (or not) getting pregnant. What advice might they have? Think about your family planning future. Do you want to have your own biological children? When? What needs to be in place for that to happen? Who / what are trusted information sources for you?