Sunday, August 02, 2015

Egg Freezing for Patients with Severe Endometriosis


Our technology for freezing eggs has progressively improved over time, thanks to the availability of vitrification.  When this was first introduced , it was primarily done for fertility preservation for young women with cancer who needed medical treatment ( chemotherapy and radiation) which would destroy their ovarian reserve.  This was a medical emergency, and was often done as a last ditch effort to help them store their eggs.

However, over time, we have gained lots of experience with egg freezing. We now routinely use frozen eggs for our egg donation program , and our pregnancy rates with frozen eggs is as good as it is with fresh eggs because of the experience and expertise we’ve accumulated. Consequently, we are much more confident about offering this technology for everyone, which is why social fertility preservation by egg freezing for young women has become so increasingly popular.

Interestingly, another indication these days is young women with severe endometriosis, who require surgery because they have disabling pain. Now their situation is actually surprisingly similar to that of young women with cancer, who require both fertility preservation and surgery.  The major difference is that this is being done on an elective basis rather than an emergency basis, so the egg freezing can be planned properly. 

The trouble with the surgery is that just like the endometriosis itself damages ovarian reserve, the surgery itself also reduces ovarian reserve . One of the side effects of the surgery is that a lot of these women will be left infertile , because of the harm to their ovarian reserve, both because of the disease and because of the surgery. This usually means that they will not be able to get pregnant on their own, and that even if they do try to get pregnant with IVF, their pregnancy rates are poor because their egg quality has been markedly impaired . A lot of these women will end up having to use donor eggs. This means that the price they pay to manage their endometriosis is huge .

One option for these patients is to freeze their eggs before they go in for their surgery.  This is something which can be planned and we can do an IVF cycle and freeze their eggs ( or embryos, if they are married) before the surgery. This is a relatively new indication for these patients and we still don’t have much experience with it. However, this offers them a viable alternative so that instead of completely wiping out their fertility as a result of the surgery, they at least have an option which offers them hope for the future.

Even though we still have a lot to learn, it’s also possible that as technology advances, we’ll be able to do cleverer things with these frozen eggs. This is why it's important for these patients ( and their doctors) to explore these options, as part of a reproductive insurance policy.


Want to learn more about this option ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better !




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