Women who are not yet ready to start a family may choose to freeze their eggs to keep the option on the table for longer.

There has been significant promise, but also significant disappointment, with egg freezing to date. The disappointment stems from the relative lack of success rate data. Many more women are freezing eggs than thawing them. And until they are thawed, how do we know how successful the treatment really was?

At first, the data was generally only coming from egg donors, women pre-selected to have eggs that would be expected to succeed. Significantly less data was available for “social” egg freezing, that is, women who are choosing to delay their reproduction and hope to be able to freeze their eggs in time. The majority of our patients were waiting for the latter data sets to come through, as we tried to keep expectations firmly in check.

We are now finally seeing the numbers, and it appears that for most patients egg freezing works as well as embryo freezing, with success rates often in the range of 60% (see this article for more). This published data fit our internal data suggesting clinical pregnancy rates 55-60% per set of eggs for women under 38.

Egg freezing is promising when we have enough good eggs to freeze. If you are under 38 years old (age being a marker for egg quality) and have been told you should be able to freeze 12-20 mature eggs (ie. you have a good ovarian reserve), and are working with a good lab able to offer vitrification, you may anticipate having three or more fertilized egg develop to blastocysts and a reasonable expectation for pregnancy in the future. No, it isn’t perfect – all things being equal frozen eggs do not work as well as fresh eggs – but with good counselling egg freezing may provide some measure of reassurance that had been missing until now.

For a good video that walks you through the process check out this video, or a more detailed scientific review, see this article.

The post New data on non-donor egg freezing success rates! appeared first on Fertility.ca.

Sometimes, these are valid concerns. But there are things you can do about it.

1. Get a sperm test with DNA fragmentation. Women may not be able to confirm their egg quality until they complete an IVF cycle, but for men it’s much more straightforward.

2. If you have sperm quality worries, it may be appropriate to introduce lifestyle changes and vitamin therapy.

3. Get further testing done. Your testosterone levels can be checked with a simple blood test. Low testosterone levels can often be treated successfully with Clomid or Arimidex. You can also check for varicoceles, dilated veins that heat the testes. They can be found with a physical exam or scrotal ultrasound, and treated through minimally invasive surgery with faster recovery times than in the past.

4. Talk to your doctor to find out if Viagra or Cialis is right for you. You may not need these in other sexual encounters, but procreational intercourse can be quite stressful. If you worry that you can’t have an erection with timed intercourse, it’s okay.

Another option is intrauterine insemination. You might find it easier to just let your sex life be your sex life, and procreation can take the form of providing sperm samples in the morning for the clinic to inseminate later that day. In the event you’re unable to provide a sample one day, frozen sperm is available as a backup. This lessens some of the pressure to have procreational sex.

5. Take your overall health seriously. Some men worry that their ejaculate has less volume than it did when they were younger. In many cases, this can be addressed through better hydration. A volume drop may be related to other health concerns, such as retrograde ejaculation (ejaculate travels backward into the bladder rather than out the tip of the penis). Take care of your overall health by having frank discussions with your doctor.

Now and again, men are concerned they don’t “shoot” as far. Well, it does happen with age. Let me reassure you, there’s absolutely no proof that it makes any difference to anything whatsoever.

I don’t think the distance the ejaculate moves is as important as volume, which is necessary to protect the sperm with seminal fluids while they find their way out of the acidic vagina, into the cervical mucus, and ultimately up into the uterine cavity.

6. Do IVF with ICSI. Intracytoplasmic sperm injection (ICSI) will ensure eggs will be fertilized. Newer techniques in the lab have been shown to be associated with lower DNA fragmentation rates, rather than higher. That’s right! It’s possible the modern techniques are better able to sort out the “best sperm” than nature alone.

The only real problem with IVF is the expense. I don’t mean to minimize it – expense is a very real stress for most couples – but so can be the month-in/month-out lack of success for pregnancy and the strain of a sexual act that can make you feel further away from your partner, rather than bringing you closer.

In our clinic, we strongly recommend that couples consider IVF after all other reasonable options have been exhausted over a five month period. Fertility treatment can take an emotional toll on a couple, and we want to see you move past the hopeful phase and into the pregnant phase as quickly as possible.

The science behind paternal aging and how it may affect the health of children is interesting and changing all the time. (At least, it’s interesting to us.) If you want to know more, please let us know in the comments. I will be very happy to expand this section further.

The post What impact does aging have on male fertility? appeared first on Fertility.ca.