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The Science Of Well being: Welcome again to “The Science Of Well being”, ABP Reside’s weekly well being column. Final week, we mentioned what stem cells are, how stem cell transplants for blood cancers and issues work, and what the challenges are. This week, we focus on what egg freezing is, how human oocytes are retrieved, and what the advantages of egg freezing are.
Egg freezing, often known as oocyte cryopreservation, is an assisted reproductive expertise (ART) technique that includes the hormonal stimulation of a girl’s ovaries to extract viable eggs or oocytes through transvaginal retrieval, and subsequent freezing and storage with a purpose to protect reproductive potential in girls of reproductive age.
Why is egg freezing accomplished?
The method helps a girl protect her fertility in order that she will be able to attempt to have a household sooner or later. When a girl desires to have a child, she will be able to get her frozen eggs thawed with a purpose to use them in fertility remedy resembling in-vitro fertilisation.
As a girl grows older, her probabilities of conceiving naturally lower. Subsequently, egg freezing is an effective possibility for a lady to protect her fertility at a time when her eggs are wholesome and of top quality.
Over the previous few years, egg freezing has superior drastically, and the general success of eggs surviving the freezing course of has improved.
ABP Reside spoke to gynaecologists Dr Nisha Bhatnagar and Dr Vandana Ramanathan, and requested them about egg freezing, and the scientific process behind it.
Dr Bhatnagar is an MD in Obstetrics and Gynaecology, and the medical director at Infinite Fertility Wellness Centre, a specialised egg freezing facility in Vasant, Vihar, New Delhi. Dr Ramanathan is a DNB in Obstetrics and Gynaecology, has a fellowship in reproductive medication, and is a advisor in reproductive medication at Milann, an infertility centre in New Delhi.
In line with specialists, the age of marriage is getting delayed, and due to this fact, egg freezing permits a girl to take motion whereas she continues to be younger, and has eggs of excellent high quality.
“Assisted reproductive applied sciences for females embody steps resembling ovulation induction, intrauterine insemination, and in-vitro fertilisation. Ovulation will be induced in a feminine who is just not ovulating by medicines. That is adopted by intrauterine insemination, the place the girl is artificially inseminated. The third step is in-vitro fertilisation. For all these steps, a male accomplice and a feminine accomplice are required. Of late, girls have change into extra unbiased and career-oriented. Their age of marriage is getting delayed. They do not need to have a baby on the proper age, which is from late twenties to early thirties. Egg freezing is completely different from different methods of assisted reproductive expertise as a result of the feminine doesn’t want the opposite accomplice. She realises that her organic clock is ticking, and therefore, takes motion when her eggs are nonetheless younger and of excellent high quality. The lady freezes her eggs after which makes use of them about 10 to fifteen years later. One other distinction between egg freezing and different assisted reproductive applied sciences is that the latter strategies are used when one of many two companions, or each are infertile. Nevertheless, within the case of egg freezing, the girl is fertile, however she preserves her fertility for the long run,” Dr Bhatnagar instructed ABP Reside through name.
Subsequently, there are two variations between egg freezing and different assisted reproductive applied sciences. The primary distinction being {that a} accomplice is just not required for egg freezing, and the second distinction is that egg freezing permits a fertile lady to protect her fertility, whereas assisted reproductive applied sciences are used when both or each the companions are infertile.
Dr Ramanathan defined that the method of stimulating the ovaries throughout egg freezing is just like the strategy used to stimulate the ovaries within the case of in-vitro fertilisation. After the eggs are retrieved, they’re preserved within the in-vitro fertilisation laboratory. With ageing, a girl’s eggs additionally age, due to which their high quality declines.
“Girls who are usually not ready to have a being pregnant for any cause, at a youthful age, have an possibility of getting their eggs retrieved and frozen, for future use. These eggs can be utilized at a later date, perhaps just a few months later or perhaps a few years later, to carry out ICSI and make embryos,” Dr Ramanathan mentioned.
Intracytoplasmic sperm injection (ICSI) is a method during which an embryologist selects a single sperm from a semen pattern and injects it straight into the egg for fertilisation. In the meantime, within the case of standard in-vitro fertilisation, a girl’s egg is surrounded by sperm in a Petri dish, and finally, one sperm fertilises the egg.
Dr Ramanathan mentioned that ladies who intend to postpone being pregnant, or are present process remedy for different medical circumstances resembling most cancers can go for egg freezing. “It’s best to freeze your eggs at a youthful age, ideally earlier than 35 years, so that you’ve got enough amount and higher high quality eggs frozen, although, there isn’t any explicit age restrict for a similar.”
Thawing of frozen eggs and stage at which embryo is inserted into the womb
The frozen eggs should be thawed earlier than they’re used for in-vitro fertilisation. After the embryo is shaped, it will likely be transferred into the uterus of the girl.
Dr Bhatnagar defined that the embryo will be transferred into the physique of a girl two to 3 days after fertilisation, when the embryo has six to 10 cells, or 5 to 6 days after fertilisation, when the fertilised egg known as a blastocyst.
A blastocyst is a quickly dividing ball of cells, and consists of two differentiated cell sorts, the internal cell mass and the enveloping layer.
“The fertilisation course of occurs contained in the fallopian tube. The pure habitat of the egg and sperm earlier than fertilisation is the fallopian tube. After fertilisation, the embryo stays within the fallopian tube for about 4 to 5 days. Subsequent, the embryo enters the uterus with a purpose to implant itself into the uterine wall. So, the pure habitat of a day 5 embryo is the uterus, and that of a day 3 embryo is the tube,” Dr Bhatnagar mentioned.
A day 3 embryo might not survive whether it is inserted into the uterus after in-vitro fertilisation. Subsequently, many egg freezing speciality centres choose blastocyst switch.
Dr Bhatnagar mentioned that mature oocytes are frozen as a part of the egg cryopreservation. In mammals, the first oocyte extrudes the primary polar physique earlier than ovulation, and turns into the secondary oocyte. The mature oocytes are haploid, which suggests they comprise 23 chromosomes every.
Dr Ramanathan defined that when girls who have gotten their eggs frozen want to conceive, they need to bear intracytoplasmic sperm injection, whereby the egg is injected with a sperm underneath the microscope. After this, the fertilised egg is cultured for 3 to 5 days within the laboratory underneath applicable circumstances. About three to 5 days after fertilisation, the embryo is transferred into the girl’s uterus.
She mentioned that embryo switch is usually carried out for a day 5 embryo, retaining in thoughts that the day of egg retrieval is taken into account day zero. “On day zero, the sperm is injected into the egg. On day 3, the embryo will include six to eight cells. If left within the tradition for an additional two days, they progress to kind a blastocyst, which consists of an internal cell mass and an outer trophectoderm layer. The embryo will be transferred as a day three embryo or a day 5 embryo . The choice to switch the embryo on day three or day 5 is made by the physician after consulting with the couple and considering earlier therapies undergone by them.”
Trophectoderm is the primary layer of cells or epithelium that develops in mammalian embryos.
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