Fertility.

The fact of the matter is that humans are not that great at reproduction. Even in the best circumstances, a young healthy woman only has about a 15-20% chance of becoming pregnant within one ovulation cycle. All types of fertility require a certain amount of patience and effort - and the good news is that modern medicine has evolved to provide women with a variety of safe and successful options for preserving fertility! To learn more about top tips on getting pregnant check out our blog post.

On today’s podcast, we discuss the three main options for safeguarding fertility as well as their benefits and drawbacks:

1. Egg freezing
2. IUI with donor sperm 
3. IVF with donor sperm to create embryos that can be transferred at anytime in the future

Joining us is Dr. Meivys Garcia, FRCSC Obstetrics, Gynecology, Infertility Specialist and medical director and co-owner of the Markham Fertility Center in London, Ontario, Canada. She’s had a passion for fertility from a young age as well as her own experience with infertility treatments, and loves the deeply personal and emotional journey of helping women achieve their dreams and goals of pregnancy!

Note: In this podcast we use the word women and in doing so, we're referring to individuals who identify as CIS female. We appreciate that gender identity and gender literacy is complex and that each person determines themselves their own identity.

Egg Freezing

Egg freezing is the best option for women who don’t want to begin a family immediately and are aiming to meet a sperm carrying partner sometime in the future. Once that time comes, you can start trying to get pregnant without any intervention, and ideally your frozen eggs won’t need to be used! However, if you do need to use them your pregnancy success rate will be equivalent to the age of when you froze your eggs.

How Does it Work?

1. Freezing eggs looks very similar to IVF in the beginning. We begin with looking at AMH (the hormone associated with a woman's ability to produce eggs that can be fertilized for pregnancy) levels to assess how many eggs can be retrieved from a single IVF cycle.
2. Next we do an ultrasound to make sure that the ovaries are healthy.
3. Then we do an infectious disease screen as part of the quality control in the lab. If somebody has an infectious disease like hepatitis B or HIV, we have to take special precautions, and this ensures everyone’s safety.
4. Next come about ten days of injections to stimulate the ovaries to produce eggs. 
5. During this time, there is frequent blood monitoring and ultrasounds to track how the ovaries are responding to the medication.
6. Not all frozen eggs thaw well and not all eggs that thaw will fertilize and develop into viable embryos, so depending on the age of the patient, ideally 10-15 mature eggs are extracted to increase the likelihood of a live birth. 
7. The retrieval is a minor procedure done at a clinic, usually under anesthesia. 
8. After the procedure, typically within a day, you can go to work and return to your regular activities! 

Tune into the podcast to learn more about cost, the insemination part of the procedure, and the recommended ages for when egg freezing is a more or less viable option for you!

Intrauterine Insemination (IUI) with Donor Sperm

IUI with donor sperm is the least expensive and least invasive option, and ideally suited for people looking to have a baby now but do not have access to sperm. It is a good option for same sex couples looking to conceive, or people looking to become single parents.

How Does it Work?

1. The first thing we investigate is whether you are a good candidate. That involves doing blood work, looking at your AMH levels, and to make sure there are no other inhibiting pre-existing medical conditions. 
2. Then you may meet with a genetic counselor to vet the donor sperm and find a good genetic match, lowering the risk of genetic disease. 
3. One the sperm is chosen and purchased, it is inserted into the uterus at the natural time of ovulation with a syringe through the cervix. 
4. The success rate is the same as it would naturally be at your age. Keeping in mind that healthy young women only have about a 15-20% chance of becoming pregnant within one ovulation cycle, several cycles of IUI may be needed for a successful pregnancy.

In Vitro Fertilization (IVF) with Donor Sperm to create Embryos

Between freezing your eggs and getting pregnant right away, there is the third option of doing IVF with donor sperm. What that means is that your eggs will be extracted and inseminated with donor sperm right away, and frozen as embryos which can later be implanted into your uterus. The great benefit to this option is that embryos are closer to a baby than eggs are. If, for example, four embryos are genetically tested to be healthy and frozen, there is a really good chance of having a live birth from one of them once it is transferred and implanted into the uterus.

How Does it Work?

1. Similarly to IUI with donor sperm, once it is determined you are a good candidate the eggs are retrieved from the uterus.
2. You pick the donor sperm from the sperm bank.
3. We then fertilize those eggs and create embryos, which are then frozen. 
4. You can choose to be inseminated with those embryos at any point in the future - 5, 10 even 20 years down the road!
5. The main consideration is that if you do meet a partner you’d like to conceive with at a later date, you might want to consider if you are comfortable starting a family with a new partner with embryos created through donor sperm.

The good news is that with improved medical science you have several options that can be viable for you. Egg freezing has become a much less invasive procedure, and eggs do much better in the thawing process.

If you are considering pregnancy - whether now or in the future - speak to your doctor about which options may be best for you before you may be in a disadvantageous biological position due to age. We are here to help you achieve your family goals and support you every step of the journey!

Blog Post: Single Woman Fertility Preservation

IG: dr.meivys.garcia

www.drmeivysgarcia.com