What did we learn to date from the experiences of women who opted for cryopreservation of their oocytes?
Fertility psychologist and researcher Julie Nekkebroeck talks more about the experiences of women who opted for oocyte vitrification.
Preserving your oocytes for later use?
Freezing oocytes for later use is a way of increasing your chances of having biological children in the future. You anticipate on the fact that your ovarian reserve may be insufficient at a later stage in your life, either for personal or medical reasons, and therefore impair your ability to have children.
Female fertility declines significantly around the age of 35. A woman’s ovarian reserve diminishes over the years, both in terms of quantity and quality. Lower oocyte quality means an increased risk of chromosomal abnormalities in oocytes, of a pregnancy that does not progress as it should (miscarriage), or a disabled child.
Thanks to oocyte vitrification, you can freeze oocytes for later use if necessary. Although you have grown older, the age and quality of your oocytes have remained the same.
For whom?
This treatment is for women (< 40 yrs) who want to maximise their chances of having a child later in life, for personal or medical reasons.
This includes women who have gone through early menopause, women with Turner syndrome, people considering gender-affirming surgery…
We have developed a specific ‘Oncofertility’ care pathway for people who are diagnosed with cancer.
Non-medical reasons such as a latent desire to have children, the lack of the right context for having children, or the lack of the right partner may also be good reasons for considering oocyte cryopreservation.
Please note that oocyte cryopreservation does not offer any guarantees, but it does increase a woman’s chances of having a child if they decide to have children later in life.
From application to treatment: a roadmap
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Contact - appointment with a fertility doctor
You call our Contact Center (+32 (0)2 477 66 99) to make an appointment. You briefly explain your situation so we can schedule the necessary appointments.
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Consultations with your fertility doctor
You attend your first consultation with the fertility doctor. During this intake, the gynaecologist will ask targeted questions to get a better idea of your situation and your specific question.
The doctor will review your gynaecological history with you and schedule the necessary fertility tests. This is always done with a blood test. If necessary, a vaginal ultrasound is also scheduled. The blood test screens for any health problems and analyses your ovarian reserve. The gynaecologist will also explain general medical aspects of the hormonal treatment and oocyte cryopreservation.
The follow-up consultation may be in person or by phone. Your doctor discusses your test results and the chances of success of the treatment with you. If you decide to go ahead with oocyte cryopreservation, the doctor will draw up a treatment plan with you.
The doctor will review your gynaecological history with you and schedule the necessary fertility tests. This is always done with a blood test. If necessary, a vaginal ultrasound is also scheduled. The blood test screens for any health problems and analyses your ovarian reserve. The gynaecologist will also explain general medical aspects of the hormonal treatment and oocyte cryopreservation.
The follow-up consultation may be in person or by phone. Your doctor discusses your test results and the chances of success of the treatment with you. If you decide to go ahead with oocyte cryopreservation, the doctor will draw up a treatment plan with you.
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Optional: consultation with a psychologist
Making the decision to freeze your oocytes can be a bit more complicated for some women.
You may have questions about your current stage of life and your future and may find it difficult to cope with the unknown. One of our fertility psychologists can provide support during this decision-making process. During a psychological consultation, our psychologist discusses your specific situation and questions with you, and assists you with the psychological, financial, and practical elements. That way, you can make an informed decision about your future.
The psychologist also discusses your motivation, concerns, fears, expectations, and wishes with you. During these consultations, you also take a closer look at where you stand today and we reflect on the advantages or disadvantages of oocyte cryopreservation for you.
You can also always request more time to think about your decision, or can schedule a second consultation with the fertility psychologist if necessary.
You may have questions about your current stage of life and your future and may find it difficult to cope with the unknown. One of our fertility psychologists can provide support during this decision-making process. During a psychological consultation, our psychologist discusses your specific situation and questions with you, and assists you with the psychological, financial, and practical elements. That way, you can make an informed decision about your future.
The psychologist also discusses your motivation, concerns, fears, expectations, and wishes with you. During these consultations, you also take a closer look at where you stand today and we reflect on the advantages or disadvantages of oocyte cryopreservation for you.
You can also always request more time to think about your decision, or can schedule a second consultation with the fertility psychologist if necessary.
GOOD TO KNOW
If you don't need this, you can skip this step. You can schedule an appointment at any time if you think this may be beneficial.
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Appointment with the counsellor
Before you start your treatment, we will schedule an appointment with a counsellor for you to discuss:
- The practical aspects of your treatment: the start date and contact details of the planning manager, the opening hours, the place where your appointment takes place (route number), how to make appointments at our centre for the various procedures, and so on.
- The medical aspects: what your treatment involves, which medication you will need to take, how to administer it correctly, and how to prepare for a procedure, and so on.
- The legal aspects: which consent forms you must sign; and
- The financial aspect of your treatment. The cost of hormonal stimulation is borne in full by the patient. The cost for hormonal stimulation and oocyte preservation (for up to ten years or until the day before your 48th birthday) is approximately €2,700. You will have to pay for this, even if you are affiliated with a Belgian mutual health insurance fund.
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Start of your treatment
The following process applies for oocyte preservation:
- Your hormonal treatment will induce maturation of several oocytes at once.
- We monitor the evolution of ovarian stimulation with blood tests and ultrasounds.
- The Daily Monitoring (DM) team will give you instructions about the dosage and administration of medication, based on your test results.
- After hormonal stimulation, a single hormonal injection will be administered that triggers ovulation.
- Oocyte retrieval is scheduled just before ovulation:
- The mature follicles are punctured with a fine needle.
- This procedure is performed under local anaesthesia as an outpatient procedure. (You are unfit for work on the day of the procedure itself and the two days after.)
- We examine your oocytes in the lab under the microscope to distinguish between mature and immature oocytes. Only mature oocytes can be preserved or cryopreserved through vitrification. We cannot assess the quality of the oocytes.
- We will send you a written confirmation of the number of oocytes that were eligible for cryopreservation.
Repeating the treatment:
To increase the number of frozen oocytes and your chances of having a child in the future, you can repeat the treatment (several times). Contact our Contact Centre to schedule a new treatment cycle. We will schedule a consultation with your doctor to discuss the previous treatment and check whether this needs to be optimised. During this consultation, your doctor also sets a new start date with you.
What medically assisted fertility treatments are there?
Stimulation
Assisted reproductive technologies usually involve some form of ovarian stimulation
PCOS-clinic
A multidisciplinary care pathway at UZ Brussel for women with polycystic ovary syndrome. Counselling on a variety of health matters