Delayed motherhood: Why more women are opting to freeze their eggs

A middle-aged woman admires her pregnancy. [Getty Images] "I froze my eggs three years ago after I realised time is running out of time and I am still not in a stable relationship and not financially stable to have a baby," says 35-year-old, Liz, who chose anonymity. Meeting her at her house in Nairobi, the bubbly, petite, 5'4 ft woman says that she did not know there existed a procedure, egg freezing and its benefits until she accidentally saw it in a movie. "The movie was an eye-opener. I discussed it with my mother, who was against it. That is why I have chosen not to reveal my name to you at this interview because I do not want anyone to know," she says laughing. Sitting with me at her dining table, for this interview, Liz is subconsciously playing with a coaster as she explains how she faced her fears and decided to go for egg freezing. "I was really scared about the idea of removing my eggs. I was imagining the worst, but after research and consulting experts, I knew I will be okay," she says. She explains that before freezing her eggs when she was 31, the planning started when she was 30 years since the procedure was quite costly. "It cost me almost half a million, hormonal injections, retrieval and the freezing of the eggs that costs Sh10,000 per month, so I paid for the whole year, that was Sh120,000 just for storage," she says. For about two weeks, she took hormonal injections every day to stimulate the eggs. "I went to the hospital every single day for the injection, but there was an option of me doing it at home but I was too scared. After 10 days, they retrieved the eggs and froze them," she says. She chose the procedure because she is yet to find the right partner. "I am single, the person I thought I would start a family with dumped me," she says, adding, "I want to raise a complete family because I did not have that. My mother was a single mother. Right now, I am 35, maybe I will get married in 2-3 years which is almost 40. I don't want to risk conceiving, I would rather relax knowing my eggs are somewhere safe." And Liz is not alone. More women, who plan to postpone having children in future are freezing their eggs. Medical experts explain that egg freezing is a procedure where a woman's eggs are harvested from her ovaries and then stored away from her body but can be accessed anytime she is ready to carry a pregnancy. When a woman is ready, according to medics, she can access her frozen eggs to be conceived by being fertilized in a lab using a partner's sperm or donor sperm. After the eggs are fertilized in a procedure that does not involve traditional sexual intercourse, the embryo is now implanted in her uterus or a surrogate's uterus. In Vitro Fertilisation expert, Dr Sarita Sukhija, founder of Myra IVF Centre, says that every woman is born with a certain set of eggs. "When a girl child is in the womb, she has around a million eggs and when she is born, she has about 30,0000-40,000 eggs in her ovaries. It is said that when a woman starts her period to the time she gets into menopause, she ovulates about 400 times, every month one egg ovulates and the rest do not grow," Dr Sukhija says. She explains that the maximum fertility time is between 25-35 years since in this age group the eggs can be fertilised easily. After 35, the eggs become older and the embryos could be abnormal. The modern woman is engaging in the new science for many reasons. Apart from the social one, where she, for instance, wants to focus on her career, some women in the country go for the procedure due to medical reasons. Maryanne, not her real name, a 42-year-old mother of one, chose to freeze her eggs before starting her cancer treatment. "I had my firstborn when I was 20. I want more children, so when I was diagnosed with breast cancer at the age of 31, I knew I had to freeze my eggs due to the effects of the treatment," Maryanne hasn't used her eggs yet. Cancer went into remission, she got married last year and is now planning to start a family soon. "When a girl has her period, we call them on the second or third day of the cycle and start them on the hormonal injection. Because every month a certain set of eggs will come up on the ovaries like five eggs on one side, and six or seven eggs on the other side, so we want all those eggs stimulated, we give them the hormonal injections after checking their hormonal profiles and other blood tests," she says. The hormonal injections are given continuously for 10 days and the patient is called periodically for an ultrasound scan to see how the eggs are growing. Once the eggs are mature, the patient is called for egg retrieval. "We go through the vagina ultrasound-guided. Because it is a slightly painful procedure, it is done under anaesthesia, it is short anaesthesia. So we extract the eggs and take them to the embryology lab. The embryologist will look at the eggs, there could be 3 kinds. Metaphase 2 (M2) are the mature ones ready for fertilisation. Metaphase 1 (M1) in between the immature ones known as Germinal vesicle (GV)," Dr Sukhija. There are different kinds of straws in which the eggs are loaded, with permanent markers. "Every patient has a straw which is labelled. Once it goes into the liquid nitrogen, the name remains. In one tank there could be hundreds of samples every patient is marked with a name and ID, because there could be two patients with the same name. We have manual and computer records also," says Dr. Sukhija If one woman has frozen around 10 eggs, they are frozen in groups of 3. The survival of the eggs is 80-90 per cent. The hormone injections are given because more eggs are required. The injections are meant to stimulate the eggs which are in the ovary and can come out in one cycle. "Naturally, a woman will have only one egg. We want to freeze 10-15 eggs; some women might not have that in one cycle so we ask them to come back in the next cycle. We want more eggs to be frozen so that when we take them out we have enough that can be fertilised," she said. Due to age and medical complications, not every woman can freeze her eggs. That is where donors come in. Donating is not harmful, the donors are paid between Sh 60,000-70,000. It's mostly college girls. "We encourage not more than two donations from one girl. After a gap of 6 months or 1 year, she can donate again," Dr Sukhija says. Faith Kemunto, a Fertility Advocate, whose job is to do the matching, says that she carefully looks through the donor pool, reviewing donor characteristics, facial structure, skin tone and personality traits against the recipient's characteristics profile. "Not an easy task to say the least. Recipients want to feel like the options I present to them will allow their future child to fit in with their family, and that they will look at this child and know they made the right decision. They come to me to help create their dreams. I have not had a complaint so far," she says. Kemunto would send the client profile of the donors and if they feel some compatibility then they would start the counselling sessions and medical tests. The new procedure has side effects that are caused by the fertility drugs that clients of the exercise use. The most common effects are abdominal pain, bloating of the stomach area, nausea, diarrhoea, and vomiting. IVF specialists also say there are risks of miscarriage depending on the age at which one sought the service of freezing their eggs. Older women have a higher chance of having a miscarriage because they have older eggs. Other team members in the process of egg freezing are the IVF Specialist, embryologist, anaesthetist, nurse, and a gynaecologist. Embryologists play a critical role in an IVF clinic. "We are the scientific staff who help make babies happen, literally creating life in our hands. We are sometimes referred to as the 'caretakers' like a mother of a patient's sperm, eggs, or embryos because we are the nurturers of this new start of life," says a senior Embryologist at Myra IVF and Medical centre, Dr Satyawan. Dr Satyawan says frozen embryos are stored and monitored at hospital facilities, usually a lab, or commercial reproductive medical centres. The eggs can be safely preserved for more than 10 years. "There is a separate process for embryos from mothers that are HIV positive", says Dr Satyawan, adding, "Yes, we have a separate storage facility at our center. We even separate such cases from ordinary cases. After that, we clean all our equipment (incubator and work area) properly, 2-3 times as per protocol." Anne Kawira, a senior IVF nurse at Myra IVF and Medical Centre, says that her major role is educating patients and their partners about medication, administration, test preparation and specimen collection. "I also teach patients how to administer IVF treatments assisting with Scans-Transvaginal scans/ultrasounds," Kawira says. Moses Maina, an anaesthetist at the clinic, says that anaesthesia can be general where a drug is injected into patients' bloodstream leading to loss of consciousness or regional anaesthetist where a drug can be injected through the patients' lower back to cause numbness.

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