It seems that almost instantly after tying the knot, you begin to be bombarded with questions about babies. While most of the time these questions come from a place of excitement and genuine caring, they can feel intrusive and maybe even offensive—especially if you’re just not ready or are struggling.
Women who are in their mid- to late-30s may often feel that they’re quite literally up against the clock (the biological one, that is) when it comes to their fertility. Yet, thanks to modern medicine, you can, in a sense, slow down time with the help of fertility preservation and medical technologies.
We spoke with Rony T. Elias, a doctor and assistant professor of obstetrics and gynecology reproductive medicine at New York Presbyterian Weill Cornell, for expert insight into the world of fertility preservation.
We all know that deciding to start a family is a huge decision, one that should not be taken lightly. Unfortunately, fertility begins to decline somewhere in your mid-30s, so women often feel pressured and worried that they’re running out of time. Luckily, there are many options that exist for women looking to preserve their fertility now to start a family in the future.
“Some options are either freezing eggs, embryos (for single women, embryos created using donor sperm), or ovarian tissue,” explains Elias. While ovarian-tissue freezing is still considered experimental, and the chances for success are much lower than for eggs or embryos, it is recommended for patients who can’t undergo the stimulation that will result in egg collection.
According to Elias, there are many women who would benefit from fertility preservation. Those include "any patient who is in her mid- to late-30s who is single and desires future fertility, and couples whose female partner is in her mid- or late-30s and are not ready to get pregnant for the next few years and desire larger families in the future,” he says. Occasionally, some much younger patients with special medical conditions, such as signs of early menopause or cancer with a good chance of cure, also benefit from the process.
Being psychologically and emotionally ready to consider this option is incredibly important, and, from a medical standpoint, the proper age to consider treatment would be “between the ages of 33–38, assuming there is no medical indication and it is being done purely electively,” says Elias.
It depends on the center and facility, but Elias estimates that typical fertility treatments that are preservation focused range from about $8,000 to $10,000. In certain situations, there is also outside financial assistance and grants available, depending on the unique circumstances of the patient.
Regardless of the process that is best for you, there are medications and medical procedures involved in the treatments, and with them come some risks. “With eggs or embryo freezing, the risks are typically due to the retrieval of the egg (infection, bleeding, injury to surrounding organs, sedation/anesthesia), but these risks are very low,” Elias clarifies. He further explains: “Another possible risk is due to ovarian hyperstimulation (1–2 percent). At our center, we see three to four cases a year (we do around 4,000 cycles, highest in the nation) due to our frequent monitoring and tailoring the medication dosage based on the response. We strive to treat each patient’s individual needs, because each case is really unique.”
As for other problems down the road, “so far there has not been evidence that shows an increased risk of cancer to the mother due to stimulation, nor increased risk of congenital problems in the babies born via this technology,” he says. For women who opt for tissue freezing, risks appear to be limited to the usual possible side effects that accompany surgeries, including “infection, bleeding, injury to surrounding organs, and [complications of] general anesthesia,” says Elias. “These are also very low risk, especially in young patients less than 40 years old.”