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Freezing your most precious asset

WOMAN'S INSTINCT
By | March 24th 2012

Your career is on an upward trend and you don’t want an interruption like a pregnancy, but at the same time your biological clock is ticking, what to do. How about freezing your embryo? MAUREEN AKINYI explores embryo preservation

Are you a career woman who is worried about her ticking biological clock? Your career is on an upward trend and you don’t want an interruption like a pregnancy but at the same time you are worried that your fertility rate is declining? How about embryo preservation?

Fertility experts say women who may want to postpone childbirth until they are past 35 may opt to freeze their embryos until they are ready to have a family.

Leading fertility expert Dr Joshua Noreh says embryo freezing though popular in the West with career women who want to postpone childbirth is yet to be embraced by Kenyan women.

"In Kenya the practice happens in principle but in the developed countries it has taken root. In our clinic, though we offer the service we have not seen women who are bold enough to try it," says the Noreh who was the first doctor to perform a successful IVF in Kenya.

So how does this technology work?

According to Dr Alfred Murage, fertility consultant at the Aga Khan University Hospital Nairobi the technique involves harvesting eggs before reaching the age of 35, and then either freezing them or fertilising them with the partner’s sperms and freezing the resulting embryos.

This means that the woman (or couple) have to undergo a cycle of In vitro fertilisation (IVF), costing on average about Sh400,000 in most facilities that offer the service.

They also have to pay an annual charge, approximately Sh100,000 to keep their eggs or embryos frozen.

Dr Murage says a good number of career women may opt for this technology.

This essentially preserves their fertility in an animated state, until they feel ready for a family.

"Women should be in the know that as they shelve childbirth to pursue careers, their fertility is declining. They should be acutely aware that when a woman reaches 35, her chances of conceiving start reducing significantly," he explains.

Steady career growth

The doctor says it is more advantageous to freeze embryos rather than eggs because embryos appear to survive the freezing and thawing process more resiliently compared to eggs.

Women without a partner however cannot freeze embryos (unless they use a donor), as sperms are needed for fertilisation.

"However, the technology of egg freezing is now more advanced, with more pregnancies reported each year from frozen eggs," Dr Murage adds.

Private hospitals and most IVF centres in Kenya offer this service.

So what is the scientific logic behind this move?

Women are born with a fixed number of eggs in their ovaries. There is a steady loss of eggs with each menstrual cycle, and declining egg quality with age.

This decline in egg quantity and quality is more pronounced after the age of 35, meaning that women above this age have less chance of spontaneous conception, coupled with an increasing risk of spontaneous miscarriages. Thus the current fertility advise is to plan a family well in advance, and to be aware of declining chances of pregnancy after the age of 35.

But a good number of high-flying career women do not want to make this sacrifice because it will mean interrupting their steady career growth, which is on an upward trend.

That is why the idea of freezing their embryos may be an attractive option.

We got the privilege to speak to a few daring women who are warming up to this idea.

Jackie who is 35, says she opted to freeze her embryos because she could not afford to interfere with her career — just when she was about to break even — but at the same time she wanted to have a child in future.

So the only solution to make the equation right was to freeze her embryos.

"The world we are living in is like a competitive football match. You cannot afford to exit the game just when the match is getting exciting and you are almost scoring a goal. You do not need any interruptions until the game is over," she says.

Kate a high flier who is approaching her 40s also discovered this path and has no regrets.

"Pregnancy is an interruption that can cost you a lot yet at the same time it is a necessary interruption because the fertility clock is ticking. So the only way to have your cake and eat it is to freeze your eggs or embryos. I know it sounds selfish but that is life," she says unapologetically.

So what is the genesis of embryo freezing?

Scientists have known for a long time that frozen eggs, embryos or sperms can survive in an animated state for many years.

They maintain the potential to develop once they have been thawed from the frozen state to normal body temperatures.

However, not all frozen samples will survive the process, and there is a slight reduction in pregnancy rates when frozen samples are used compared to fresh samples.

The main advantage of using frozen eggs/embryos to preserve fertility is that it allows a couple to have their own genetic children at a time of their choosing.

If a woman is not ready to take this step, Dr Murages says the other alternative is to take chances and postpone childbirth and hope for the best, knowing that chances of pregnancy decline with age.

The risks associated with egg/embryo freezing include side effects of fertility drugs and potential complications with egg harvesting.

Second, the chance of a resulting pregnancy is not 100 per cent and couples must be made aware of this.

Other than career demands, other reasons couples opt to freeze embryos are cancer at a young age, single marital status, or a depleted ovarian function, which endanger a woman’s fertility potential.

LEGAL BOTTLENECKS

In the West there has arisen legal bottlenecks along the way.

Couples have faced challenges after they agreed to freeze embryos, only to part ways later.

If there is no consensus on what to do with the frozen embryos, it becomes a legal nightmare as they jointly have legal claim to the embryos.

There have been famous cases in Europe where partners have disagreed on the use of frozen embryos, and courts have had to concede to destruction of such embryos to accede to one party’s wish.

Locally, the process has not had such hurdles because it is not yet a common practice and there are no specific fertility laws governing the practice in Kenya.

Most fertility centres that offer this service adhere to international guidelines in their practice.

But how long can embryos be stored?

No one knows what the maximum storage period might be. Procedures for human embryo freezing were developed in 1984 and only went into widespread use in the late 1980s.

This means that the longest time a human embryo has been stored is 12 to 15 years.

Some patients have come back after 10 to 12 years and the embryos have been thawed successfully.

Beyond this time frame, experts don’t know how long an embryo will remain viable.

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