Mput the possibility of becoming a mother in the safe, for when you are ready to be one. Why society has changed, but biology has not: the best years to have a child remain between 20 and 35, but today it is increasingly difficult for a woman to have the economic, working and perhaps even emotional stability for such a choice before having blown out 35 candles. As cryopreservation of oocytes, which basically “freezes” fertilityit can become the right way to avoid having to give up motherhood, by trying it when you feel really ready: it is “social egg freezing” is slowly growing in Italyalso in the wake of the testimonies of famous women such as supermodels Emily Ratajkowski and Bianca Balti, who decided to do it and told it on social media.
Oocyte cryopreservation, there are many reasons
The reason, for both, is the desire to have more children even if they don’t have the right partner to share the pregnancy with; in their case no economic or career difficulties can be called into question, but there is no doubt that there are many others today they postpone motherhood because they are busy training and studyingin looking for a job that guarantees them economic stability, in finding a home.
Added to this is the desire to discover the world, have experiences, give priority to self-building which brings so many things find yourself listening to the ticking of the biological clock on the threshold of the doors. When it may be too late. Explains Daniela Galliano, gynecologist and director of the IVI clinic in Rome: «After the age of 35, the number and quality of oocytes decrease and to date science has not found solutions to avoid this. Gamete freezing is an opportunity for those who are not available to have children before the age of 35 or 40 for personal, work or social reasons and is growing in Italy in the last year by around 40 percent. It’s not about advising women not to have children when they’re young, but about being realistic: the World Health Organization has declared infertility a pathology, cryopreservation is a means of preventing it, taking social changes into account.”
Which was noticed first, perhaps not by chance, by hi-tech companies such as Facebook or Apple, which for about ten years they offer workers the possibility of freezing their gametes as a benefit: In the United States, more than one in four of the largest companies has plans to guarantee a “fertility policy” to its employees.
There are those who have criticized the decision, considering it a not-so-hidden way to encourage one’s career at the expense of the family. But, as Galliano specifies: «I wouldn’t consider it an incitement not to have children a weapon to prevent infertility if you don’t want to become a mother now. It is help, even financially, to have them when you feel ready.”
How does cryopreservation work?
Egg storage for in vitro fertilization (IVF). Tube of eggs in cryogenic (frozen) storage.
Literally put your maternity plan in the freezer in fact it is not at zero cost. The clinical procedure is simple: if the ovarian reserve is good and there are no contraindications, it involves undergoing hormonal stimulation for about ten days and then an oocyte retrieval which takes place under sedation, without general anesthesia, and which lasts a few minutes. Then i gametes are “vitrified”, i.e. frozen in liquid nitrogen at -196°C, where they are stored until use: 95 percent of oocytes survive and then, even after years, can be fertilized in vitro to obtain an embryo to implant to start a pregnancy. The entire procedure costs around three thousand euros, to which must be added one hundred euros per year for maintaining the eggs in the freezers. «Social freezing can be done in private or public centers, but even in this second case it is paid» explains Luca Mencaglia, coordinator of the Technical Table for research and training in the prevention and treatment of infertility of the Ministry of Health.
«However, you do not pay if there is a clinical reason to preserve the gametes, as happens in the case of women who have been diagnosed with cancer, in which the eggs can be collected before undergoing surgical or medical oncological therapies. In some regions, however, the indications are being extended and in Tuscany, for example, it is also offered to patients at risk of losing the ability to produce oocytes early due to chronic diseases or gynecological problems such as endometriosis: in these situations, withdrawals up to age 38. If you have no pathologies and the choice of cryopreservation is “only” a policy on future fertility, it would be best to intervene between the ages of 28 and 32″.
If the eggs remain in the bank
In addition to the possibility of freezing oocytes, however, there is also the opportunity to put flaps of ovarian tissue “in the bank”.. Adds Mencaglia: «The advantage is not having to do hormonal stimulation, the tissue is removed laparoscopically. The method is chosen based on the woman’s situation: if you have to undergo an operation to remove cysts or for endometriosis, the ovarian tissue is taken in the same operation, if an operation is not planned, the oocyte collection is opted for.” They are relatively simple procedures which, in the case of cancer patientsas Galliano underlines, «they help to deal with therapies better, because they project towards a possible and positive future of motherhood: today oncologists talk about it more and more often, but it is important that everyone knows that this opportunity exists.” Because many, if they don’t have a medical problem, don’t know about this “insurance for future children” and only discover it when they can’t get pregnant.
Cryopreserving eggs, among other things, certainly does not imply having to resort to in vitro fertilization: data presented at the last conference ofEuropean Society of Human Reproduction and Embryology (ESHRE) demonstrate that among those who opt for social freezing, few return to recover their eggs, often because they became pregnant naturally. «Unused oocytes could be donated» points out Mencaglia. «In Italy, unlike the rest of Europe, there are no reimbursements for expenses for donors, so donations of female gametes are very few and are a major obstacle to the use of ‘heterologous, which in the last two years has grown by 87 percent but which is often not done because there is a lack of eggs. Those not employed by women who have chosen social freezing could help others realize the dream of having a child.”
Finding the right way to inform and learn about cryopreservation
Talk about fertility by finding the right words, because the search for a child is a complicated path and empathy is needed to be close to those who undertake it. This is the objective of various projects including the poster The language of fertility (downloadable from ivitalia.it ), promoted by IVI to change the way doctors, the media and society in general talk about infertility: Saying the implant failed is a hard blow for a woman, who often perceives it as an abortion, it is much better to talk about a missed implantation; calling an embryo of poor quality is very different than explaining that it did not grow as expected.
In short, words are important, and the BabyHeART project also underlines this (babyheart.it) in which alongside practical information on PMA there are also the stories of couples, who share their journey so that no one feels alone in facing this journey.
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