For this article, I would like to review the impact of preimplantation genetic screening (PGS) and egg freezing, two advances shifting the reproductive landscape. Egg freezing allows women flexibility to create families. Flexibility is an important attribute since couples are waiting longer to start families and single women are getting married later. This trend would be devastating for women without egg freezing or embryo freezing. Thankfully, advances in fertility are providing exactly what women need to extend their reproductive window.
PGS results allow fine tuning of our approach to egg freezing. Criteria to recommend egg freezing were borrowed from our data for women of different age groups. The impact of PGS has been astounding. 35% of our patients are unable to produce genetically normal embryos and PGS is able to identify the deficiency. In addition, single embryo transfer can be realized due to high implantation rates and lower miscarriage rates. Twinning has been reduced to 4%. Most importantly, our understanding the probability of success by age and egg reserve suggests only freezing eggs for patients up to age 38 with a normal egg reserve. The percentage of patients without normal embryos increases dramatically after the age of 38. In our center, the probability to fail goes from 20 to 90% for ages 38 to 43, respectively. Results support freezing eggs as early as possible to maximize the number of normal eggs available for future reproduction.
Moreover, improvements in efficiency due to PGS with in-vitro fertilization (IVF) are challenging the traditional recommendations for fertility treatment. Recommendations for a couple seeking treatment included insemination. Although still recommended, many experts are challenging the belief that all patients eligible should start with insemination. Success rates for insemination have not improved significantly for 50 years while IVF success rates continue to increase. For unexplained infertility, success rates are approximately 17% for insemination compared to an average of 60 to70% per normal embryo transferred with IVF and PGS. Younger patients often create multiple normal embryos allowing more than one transfer and often more than one pregnancy. In addition, couples know the gender and are reassured the baby is genetically screened for Down’s syndrome and other genetic abnormalities. For these reasons, more women are considering IVF or egg freezing as first line treatment for fertility, future fertility, or gender selection.
The take home for this article is clear. Fertility treatment has changed dramatically and especially women have more flexibility to create their families. The main point is to make the commitment early to preserve your eggs or embryos. Cryotechniques are sophisticated and reliable so fertility can be extended for many years if not indefinitely.
For more information on the numerous fertility treatments and family building options offered at Wilcox Fertility, please continue to review other areas of our site or to inquire about financial information, please don’t hesitate to contact us via our online form or Call us at 626.657.9327.
