Fertility Preservation or Fertility Banking



Everything that has been written in this blog is my personal view, that has been backed up by years of experience as an Embryologist and more so because I am a self made woman. I have spent years of my early twenties and thirties in learning and working. This blog is not an intentional post on feminism, it is just a practical thought process mixed with lot of scientific evidence.

We invest money in Pension Plans to secure our finances post retirement, we invest in health insurance to cater to the unforeseen. So why does it not make sense to invest in our Fertility and secure our future chances of Parenthood? Why shouldn’t young woman or even men for that matter, invest and bank their gametes (oocyte or eggs and sperms) while they are still young?

We all are aware that Fertility declines with age, and unfortunately the impact is irreversible. Ironically the age at which our gametes are healthiest also coincides with the age at which we have just about completed our education and ready to take on the world. The decline of fertility with age is more for a woman as compared to a man.

After the age of 35 there is sharp decline in the ovarian reserve for a woman. Recent studies also suggest that Men over 40’s do show a decline in their semen quality that can eventually affect the fertility potential of the couple in question.

Fertility Banking or Fertility Preservation for a Man

Fertility Investment or Fertility Banking for a Man is very simple, they just need to go ahead and cryopreserve their semen for a couple of years. Very inexpensive, very easy and very non invasive. The technique for cryopreservation of sperm sample is quite effective and technically the sample can be preserved for more than few decades. However every country has a different guideline on the maximum tenure upto which one can keep the sample cryopreserved.

Fertility Banking or Fertility Preservation for a Woman

However, when it comes to women, nothing is that easy and simple!

A professionally oriented hardworking girl reaches the age of 23 or 24 by the time she finishes her Master’s Degree. She spends the next 3 to 4 years working which finally gives her an edge over others professionally. This is the time where she can think of getting due promotions and think of earning good money. This makes her reach 27 or 28 years of age.

Culturally everyone around her wants her to “settle down” while she is thinking all the while of “settling professionally”. Even if she gets marries by 28 or 29, the couple is not obviously going to jump into parenthood right away. So a logical 2 to 3 years of getting to know each other period makes the girl, now a woman, cross the 30 year mark.

Professional commitment and work induced stress plus other environmental factors including aging oocytes makes the job of getting pregnant for her not as easy as a 25 year old for sure. We haven’t even discussed the stress and age related factor on the Man yet.

So yes, 1 in 6 couples will face issue in conceiving naturally and will need help from an Assisted Reproduction procedure which could be as simple as follicular monitoring, Intra Uterine Insemination(IUI) to IVF / ICSI. Sounds scary obviously.

So what should we advocate our highly educated and ambitious young girls? Should we ask them to sacrifice their professional dream and ask them to first get married right after college for the sake of human race? Tell them that they should first fulfil their reproductive goals before they can fulfil their career goals? All of this just because their biological clock is ticking?? Is this even FAIR?

As an Embryologist, I strongly believe in the concept of fertility preservation or Social Freezing because I have seen assisted reproductive techniques like vitrification evolve over past few years. Vitrification or Freezing of eggs can be performed without damaging the eggs and the frozen eggs can be stored for   long duration. Well trained Embryologist’s can cryopreserve oocytes and embryos with 100% cryo survivability for sure.

Ideally women should freeze their eggs or oocytes before they reach 30 if they are not married by then. However, in case you are in your early thirties and married but you would want to delay motherhood for a few years, it makes complete sense to undergo an IVF cycle and freeze your Embryo’s. This way you can plan to transfer the embryo’s when you are READY. Freezing your Embryos or oocytes will ensure that you will not run out of your ovarian reserve later down the line and will not have to opt for donated eggs or oocyte donor when you decide to have children.

It is disheartening to see working well read women in their late thirties or early 40’s visiting infertility clinic’s for treatment to only find out about their diminished ovarian reserve. Often patient’s with poor ovarian reserve or low AMH do conceive after a cycle or two of IVF, however their chances of pregnancy is lower than women who have a normal ovarian reserve. It takes a very personalized stimulation protocol, meticulous timing and dosage of stimulation drugs and personalized embryo culture strategies to retrieve precious good quality oocytes out of such poor responders and make good quality blastocysts out of them. And above all it takes a lot of patience from both ends.

However sometimes, even after multiple trials, IVF cycles fail to achieve pregnancy with own oocytes, for such females the next step would be to start thinking of donated eggs to achieve pregnancy. This again is a very difficult decision.

As an Embryologist, I have spoken to many such well educated and independent women who struggle with multiple IVF failures due to advancing maternal. When asked, would they have chosen to voluntarily freeze their embryos or eggs in their early thirties if they had an option and awareness, would they do so? The answer without any second thought is Yes.

This lack of awareness amongst young women needs to be addressed. Master’s program should have sessions in Universities to cover this subject. So should corporates employing young females. Every individual, whether man or woman should be aware of what they are getting into and more importantly, they should know, their choices before it is too late.

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This article has not been written to commercialize IVF practice. It is merely a thought process that has been derived by logic, experience and availability of new advances in assisted reproduction that I have complete faith in.

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