Q&A: How to freeze your eggs to preserve fertility options

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There is no one model of person who seeks fertility treatment. As technology, attitudes and accessibility evolve, so has the range of people seeking care.

Everyone has a deeply personal reason for considering egg collection and preservation, says Marjorie Dixon, a fertility expert and medical director of Anova Fertility & Reproductive Health in Toronto.

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Patients seeking care can include lesbian couples, couples concerned about hereditary diseases, single women who want options for the future, people who are transitioning or those who are about to undergo medical treatments that will affect their fertility. Oncology departments will expedite patients by communicating directly with a fertility clinic.

“Canada is a kaleidoscope of families,” says Dixon, who grew up in Dorval. “There is not a typical heterosexist approach to fertility and fertility care.”

No matter the reason, preserving one’s eggs without stigma is a comfort. She says she has first-hand experience with “othering,” as a Black woman, and is carrying the torch of inclusivity.

“I came into this out of necessity, because knowledge is power.”

How does one choose a fertility specialist?

Geography plays a part, Dixon says. In Canada, people must have a referral to see a specialist, “and sometimes doctors get into the habit of referring to who’s nearby.”

“I have been a patient myself and was at the mercy of the system,” Dixon says. She says she has a history of challenging systems that don’t make sense to her, “and it doesn’t make sense that a patient should have to use a referring physician as a gatekeeper. Our field is complicated and referring physicians can present a barrier. Patients have agency over that.”

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“You get what you get and you don’t get upset” can be a very Canadian attitude, she says. But patients should advocate for themselves.

“Do your research. Look at the professional bodies, because you can see which fertility specialists are associated with them. Patients will say to me, ‘I wish I had met you years ago. I didn’t think I could get in,’ or ‘My physician sent me somewhere else.’ Patients can say, ‘You know what? I’d like to be seen at another facility.’ Especially if it’s something you’ve been saving for for a long time.”

How much does it cost?

The process can run between $10,000 and $13,000. In Quebec, RAMQ covers up to six IVF cycles, but there are other costs associated with medication to stimulate egg production and ongoing storage costs.

“There’s the anesthesia, cycle monitoring, ultrasounds, blood tests and then the actual procedure under conscious sedation, where the eggs are retrieved or recuperated transvaginally and then frozen in the lab,” Dixon says.

For the extra costs and for people who aren’t covered by a provincial plan, there are financing options. More employers are including fertility benefits in their workplace health programs. Storage costs, which are renewed every year or two, are nominal in the grand scheme of things, she says.

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“Sometimes there’s intergenerational support, because parents want to ensure that they have grandkids down the line,” Dixon says. “They will fund the process as their children are becoming socioeconomically stable or being educated (such as at university).”

“Whenever you have a big investment in life, there is a means of getting there,” she says.

How many eggs can you harvest?

It depends on the person. Fertility experts will use blood tests and ultrasounds to create a baseline for an individual patient.

“We can manage those expectations based on the person’s age, because the younger you do this, the more likely we are to get better quality eggs frozen and more of them in one cycle,” she says. “The scientific literature tells us that to have a good insurance plan for the future, you would want to have somewhere between 15 and 30 eggs to have a good chance of success.”

“Success” is a term Dixon uses carefully, because although the word is used medically, it can be emotionally charged. A successful journey results in a live birth.

“That’s why it’s so important to see a fertility specialist who has the ability to explain it to you, because (baselines) are not created equally.”

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How long can eggs be frozen?

In the early days, cryopreservation techniques were more primitive and affected the quality of the eggs once they were rewarmed and fertilization attempted.

“With the advent of something called vitrification in 2013, we are able to flash-freeze eggs. They will fertilize without any compromise to the integrity of the egg. Thanks to this, we understand that they can be frozen indefinitely.”

Most patients access their eggs within 10 years.

What if I don’t use the eggs I’ve frozen?

Human reproduction material is the property of the person. A consent form signed at the beginning of the process allows people to choose such things as donating the eggs to science, destroying them or donating them to another couple. The decision can be revisited at any time.

Independent legal counsel must be involved in the case of egg donation. In Canada, one cannot buy or sell eggs.

“It is my job as the physician to ensure that people are kept safe and that we follow the rules and regulations that are in the Assisted Reproduction Act and governed by Health Canada,” she says.

AT A GLANCE

Anova Fertility & Reproductive Health, anovafertility.com, has more information about fertility treatments and options.

The MUHC Fertility Centre has information about Quebec programs, treatments and tax credits. muhc.ca/reproductivecentre.

Information about Quebec’s medically assisted reproduction program can be found at tinyurl.com/2hwkfnfx.

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hjuhl@postmedia.com

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