Embryo Banking for Improved Fertility
We have seen a sharp increase in the number of women who want to bank embryos. Banking now accounts for one half of our IVF cycles. There are several reasons for this change all related to women’s improved knowledge about factors affecting their current and future fertility. We have come a long way from when the use of contraceptives was the only way to plan child bearing.
A vital factor is the dramatic improvement in delivery rate with “Vitrification” methods of embryo cryopreservation (“freezing”). Pregnancy potential for vitrified embryos is at least equal to the chance with a fresh embryo.
Embryo Banking for Future Fertility
Fertility is much better at younger ages. The potential for having a genetically abnormal baby increases rapidly starting in the mid 30s. By collecting eggs at a younger age, fertility is improved and the potential for a chromosomal abnormality in the baby is reduced. However, other aspects of life frequently interfere with a plan to have children earlier. Women are delaying marriage and childbearing for a variety of reasons. However, nature may not cooperate and fertility may not be adequate when she wants to conceive, especially if this is in her late 30s or 40s. And what if she wants more than one pregnancy?
37-year old woman trying to achieve her first pregnancy. Evaluation has shown that she has a reduced ovarian reserve. Her long term plans are to have at least two children.
This is a very common occurrence. If she is successful in having a baby now, will she be successful if she tries for a second pregnancy in two years? A very helpful way to think about pregnancy potential is to think about the chance of having a baby per egg collected. The chance per egg decreases with age. That chance drops faster at 35 and faster still at 37.
41-year old woman attempting conception. She conceives but loses the pregnancy. It takes 3 months for her to be ready to try again. At this age, a three month delay can result in a significant drop in fertility. If she does 3 or more cycles first and banks the embryos then she will have a better chance of being successful since there is less chance of a fall in the number of eggs she produces for each egg collection.
Embryo Banking to Time Delivery
For patients with infertility it may seem to be asking for too much to plan when delivery occurs but it is a realistic option now. With the busy life many people have it can be very hard to find time for both the IVF cycles and the delivery. A common example would be school teachers. Ideally they could do everything in the summer months but if IVF is done at this time, delivery will occur during the next spring interfering with work. A solution would be to do IVF with retrievals in the summer and bank the embryos with transfer in the fall to give a summer delivery. Many business women have similar problems and solutions with their business having predicable periods of higher and lower work load. Frozen embryo transfers require much less time on the part of the patient. Unlike regular IVF, we can pick an exact day to do the transfer while we look into the future at the most convenient delivery dates.
Embryo Banking With Genetic Testing
We are having a rapid increase in the number of women requesting genetic testing of their embryos. This was originally done only for couples who were at risk of having a baby with a genetic disease. This is now the least common reason that genetic testing is done. Biopsies in our lab are done on day 5 or 6 at the blastocyst stage. Genetic testing at this stage is very accurate. Women choosing to do embryo biopsy tend to be older with fewer embryos. This is frequently also combined with multiple cycles of banking to improve future fertility. This way, if you are banking for future use, you know that the embryos are at least genetically normal.