Plus Five Important Questions Answered About Frozen Eggs, Frozen Embryos, the Role of Your Partner’s Sperm and Whether You Can Do IVF over the Age of 45.
My May 16th Egg Whisperer show was devoted to my new passion, The TUSHY method. No, it’s not what you think. To learn more, I recommend reading this story I published last month, but the gist of it is what I believe needs to be the standard of fertility care?—?personalized fertility medicine that is easier and more affordable. It’s a new first step for every fertility patient that will ensure you are taking the right path and will experience the highest likelihood for a healthy pregnancy and baby.
Many of us know it’s not always so easy to make sperm and egg meet
We all like to watch telenovelas where making a baby takes a few glasses of wine and a romantic evening, but so many of us know it’s not always so easy to make sperm and egg meet. The basic idea of the TUSHY method is diagnosis before treatment, which will decrease the time it takes to get pregnant and therefore help you to achieve the family size that you want.
- “T” in TUSHY stands for tubes (the fallopian tubes)
- “U” in TUSHY stands for ultrasound of uterus.
- “S” in TUSHY stands for semen analysis.
- “H” in TUSHY stands for hormone testing.
- “Y” in TUSHY stands for your genetic profile.
A lot of people also called in with their most pressing fertility questions, which I always love to answer:
1. You recommend that patients don’t transfer their eggs or embryos to another center. Why and what are the risks of transferring eggs and embryos?
Think of it this way, if you had this really intricate cake made and it was frozen just for you, you’re not going to move it across the country. What if the person who received the cake didn’t know all the steps of thawing it or setting it up right? It’s the same for egg freezing.
Let’s say you moved your eggs and they didn’t survive. The first reason could be that you moved your eggs.
We freeze eggs using a process called vitrification, and there’s also a recipe we follow to thaw the eggs. But no two fertility labs are alike just like no two eggs are alike and no two people are alike. It’s very tricky to thaw eggs in exactly the same way that someone else thawed them?—?there are so many different kits and types of media, which is the fluid that embryologists use to thaw your eggs.
Let’s say you moved your eggs and they didn’t survive. The first reason could be that you moved the eggs. It has nothing to do with the strength of the lab that you moved them to.
As for embryos, it really depends on the embryos and if the clinic receiving the embryos knows the protocol. For example, I have a system in place at my clinic. I look at the protocol used at the other clinic. I look at the quality of the embryos. And then I say, I think these embryos are strong enough to move. Then I talk to the lab director and ask what he or she thinks. If the lab director tells me that the lab does have experience with this type of freezing technique or this kind of media, then we use a company called Cryoport to move the embryos. If one lab doesn’t have the ability to thaw, I have privileges at many different labs. So then I’ll talk to other people in the Bay Area and ask if they have experience with the protocol until I find someone who does.
2. After thawing my eggs and converting them to embryos, how long can I keep them frozen before implanting them?
There’s no such thing as embryo freezer burn. Your embryos can sit in the freezer as long as human beings exist to thaw them. At the end of 2017, we heard this incredible story about a woman who used an embryo that was 26-years-old. We know that embryos can be frozen for at least that amount of time. So that should give you comfort in knowing that as long as an embryo has been safely frozen and stored, there’s shouldn’t be any issues thawing and transferring in five years or ten years. I know we’ve heard some heart breaking stories recently about clinic malfunctions, but this is a rare case. This means you can try for baby number 2 or 3, or even 4 if that’s what you want.
3. To proceed with my frozen eggs, do you recommend any supplements for my husband to increase his sperm quality?
Before you thaw your precious eggs, you want to make sure everything about your partner’s sperm (or donor sperm) has been tested. We only get one chance with your frozen eggs. So encourage your husband or partner to see a male fertility specialist to make sure everything is excellent about his sperm health. This includes: sperm DNA fragmentation testing (I recommend Reprosource) and testosterone level testing.
If your husband or partner had any abnormal tests, encourage him to make health adjustments, wait another cycle and then retest to make sure his sperm is normal before you thaw your eggs.
Supplements
I also recommend supplements. Just like women take prenatal vitamins, I strongly believe that men should be taking prenatal vitamins as well. This includes: Vitamin D, Fish Oil, CoQ10, a high dose L Carnitine (Proxseed) and an antioxidant supplement blend. The blend can be expensive, so I would say in lieu of that take 1000 mg of Vitamin C and 75 mg of Zinc.
Normal BMI
It’s also important that your partner has a normal BMI and any medical problems like diabetes or high blood pressure are managed.
I also recommend that you wait a sperm life cycle, which is 2–3 months, in order to make sure that your partner’s sperm is in tip-top shape. If he had any abnormal tests, encourage him to make health adjustments, wait another cycle and then retest to make sure his sperm is normal before you thaw your eggs.
4. My AMH test results were very low (0.3). Is IVF recommended with such a low egg reserve or should I use my frozen eggs?
Everyone is different, and it depends on your age, but I would recommend frozen eggs first and then you can consider doing IVF. We know that frozen eggs are only a chance for pregnancy. Your chances will be over 35% of having at least one live birth in a batch of twelve eggs versus 2% from an IVF cycle at age 44 with a low AMH. Certainly, I don’t think of any of my patients as a number. I think of everyone as a fertile person, but these statistics are diagnostic tools to guide us about what your fertility chances are.
My oldest live birth for a patient who used her own eggs is 46. I can tell, based on your numbers, whether I think it’s worth it to try or not.
5. Based on your experience is age 45 the latest age to conduct IVF? I know some fertility doctors don’t accept women over 45.
My oldest live birth for a patient who used her own eggs is 46. I’ve had patients who are 47, 48 and 49 who I’ve helped to go through IVF, but I wasn’t able to help them become parents with their own eggs. When I look at someone’s fertility story, I look at everything. I look at their age. I look at their hormone levels, and then I give them an idea based on my experience. I have a lot of experience with patients over the age of 43. I can tell, based on your numbers, whether I think it’s worth it to try or not.
At the end of the day, however, if someone wants to try even if they have a 1 or 2 percent chance, who am I to say no? But it’s really important to know your chances, your levels and your diagnosis before doing any treatment.
Catch more of me, and topics like this through The Egg Whisperer Show. Episodes are live-streamed on YouTube, Facebook, Twitter and on iTuneson Wednesdays at 7PM PST.
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