Steps to Egg Banking
The first step toward fertility preservation through egg freezing is to meet with one of our fertility specialists to review your medical history and provide a comprehensive overview about your egg freezing options. At this consultation you will also have the opportunity to meet with other members of your team, including your nurse clinician and financial counselor. The financial counselor will help determine your insurance benefits and provide information about other financial options if appropriate. You can expect this visit to last approximately one hour.
Testing Ovarian Reserve
Ovarian reserve testing itself will require about an hour of your time on the 3rd day of your menstrual cycle. The testing is fairly simple: blood work and an ultrasound, but it is extremely important in determining your current level of ovarian function. The results are instrumental in helping the doctor prescribe the best medication protocol to optimize the number of eggs produced during the stimulation phase of the egg freezing cycle. The two tests we use to determine ovarian reserve are:
Antral follicle count (AFC) via ultrasound. The antral follicles are the 2-10mm fluid sacs within the ovary that represent the next wave of ovulation and can be visualized on a day 3 transvaginal ultrasound. In general, the more antral follicles we visualize, the better prognosis for the patient. We like to see at least 10 follicles between both ovaries.
Day 3 blood work. Measures Follicle Stimulating Hormone (FSH), estradiol, Lutenizing Hormone (LH) levels, prolactin and Thyroid Stimulating Hormone (TSH). Higher than normal levels of FSH indicate a potentially reduced fertility potential.
Both the ultrasound and bloodwork are excellent indicators of fertility potential but combined they complement each other in helping us more accurately predict outcomes and protocols for our patients.
On day 3 of the same menstrual cycle as your ovarian reserve testing, or any subsequent cycle, you will begin taking birth control pills and continue for approximately 21 days. While taking birth control pills may seem a little counter-intuitive, the pills suppress the natural ovarian processes that produce one egg each month which then allows the fertility specialist to ‘drive’ the production of multiple eggs through the administration of fertility medication.
Each woman receives medications tailored to her age, history, antral follicle count and hormone levels to stimulate the optimal growth of many eggs in one cycle rather than the usual one egg per cycle.
After appropriate monitoring by ultrasound and blood estrogen levels, an ultrasound-guided harvesting of eggs from both ovaries is scheduled in an AAAHC accredited ambulatory surgery center under light intravenous sedation. The 20-30 minute egg retrieval process is painless.
In the embryology laboratory the eggs are identified under the microscope and withdrawn from their fluid in preparation for freezing.
The embryologist places the eggs in special solutions to remove the water from the eggs and then bathe them in protectant solutions during the freezing process known as vitrification.
Cryopreserved eggs are securely stored in sealed, uniquely identified cyro-vials filled with liquid nitrogen. These vials are placed in our storage tank under strict laboratory conditions until needed.
Using Frozen Eggs to Achieve Pregnancy
Thaw and fertilize
When you are ready to conceive using the frozen eggs cryopreserved months or years earlier, some or all of the eggs are thawed and then injected with a single sperm of your male partner of donor to bring about fertilization in a procedure called ICSI. The fertilized eggs are cultured in our embryology laboratory and begin to divide and develop into embryos.
Transfer and Implantation
Generally one or two of the best dividing embryos are transferred into the uterus using a thin transfer catheter at a designated time in the cycle. Other embryos that have grown well after fertilization but that are not transferred may be cryopreserved as embryos. They may then be used for another try at conception if the first embryo transfer is not successful or for another baby if the first transfer is successful.