Our aging eggs
Your biological clock is ticking.
Yeah, we've all heard that one before.
Actress Zooey Deschanel put a funnier spin on the tired phrase during a 2012 episode of "New Girl."
"What if all that's left are the weird eggs and the evil eggs?," her 30-something character posed. "I can feel them, they're turning. They watched their brothers and sisters die and now they want to be birthed. I need to be fertilized!"
Turns out there's some truth to it.
"We know that women are born with a finite number of eggs and use those eggs up over time in their lives," said Dr. John Schnorr, with Coastal Fertility Specialists.
"Unfortunately, time is not friendly to eggs ... which is why as women get older, pregnancy rates per month go down with regular intercourse, miscarriage rates go up with regular intercourse and, of course, birth defects go up. We think that has to do with egg number and egg quality."
Medicine is trying to figure out how to fix that, he said.
"One of the things we've talked about is maybe we can take an egg out of a 40-year-old woman and fix the egg. Well, we don't know how to do that. Medicine has no idea how to fix a bad egg. So the second step is, well, maybe we can preserve the egg before it gets bad and, by preserving the egg, we can help a woman's reproductive future."
'How far would you go to have a baby?"
Glamour magazine posed this question to readers in its June issue, but instead of advocating adoption or surrogacy or sperm donation, the fashion magazine focused on an unconventional, expensive, entirely different approach: surgically removing and freezing one of a woman's two ovaries.
"Years later, when you're ready to conceive, your doctor transplants the tissue back onto your remaining ovary - and voila. Within four months you start producing eggs at the rate and of the quality you did at the time of the first procedure," the report explains. "Oh, and you'll have the same hormone levels, too, which may delay menopause."
But freezing an ovary - even freezing just part of an ovary - is much more invasive than freezing a few individual eggs. Some doctors believe the procedure isn't as easy breezy as the Glamour article suggests and that "ovarian tissue cryopreservation" is surgery that should only be considered by very few women looking for ways to extend their fertility.
"It's not a great option," said Dr. Stephanie Singleton, a reproductive endocrinologist at The Fertility Center of Charleston. "I would say it has more historical value. Before we were good at freezing eggs, it was the only option that a woman had."
Today, though, physicians really only recommend it for cancer patients who want to protect their eggs but have a very small window of opportunity to act before starting chemotherapy and radiation treatments. Prepping a woman's body to freeze individual eggs requires at least three weeks of hormone injections and medication. Sometimes, cancer patients can't wait that long, making ovarian tissue cryopreservation, which requires virtually no advance notice, a better option.
"If you're really in a time crunch, taking out your ovary is the right thing to do," said Dr. John Schnorr, a fertility specialist at Coastal Fertility Specialists in Mount Pleasant. "But if you come in at 35 years of age, not having yet met the man of your dreams and you want to freeze some eggs for the future, we have all the time in the world we need to slow down and do this right. But that's not what the Glamour article proposed."
Schnorr called the report "pretty poorly researched." For one, removing an ovary is expensive - about $15,000 for the surgery versus about $9,000 to remove individual eggs, he said. Health insurance policies rarely cover either procedure.
Removing an ovary is also less effective. Freezing eggs is considered far more successful based on the number of babies born after the procedure.
"There are 32 babies - 32 born in the world - from taking out the ovary, freezing the ovary, then putting it back in. 32," Schnorr said. "Now let's compare that to individual egg freezing. There are probably, so far, 300,000 babies in the world from individual egg freezing."
Even some cancer patients prefer freezing individual eggs over freezing an entire ovary.
"I was diagnosed on June 1 and I had my first chemo treatment on Aug. 14," said Sarah Busalachi, 35, of Wilmington, N.C., who was diagnosed with breast cancer in 2010. "They actually delayed (chemotherapy) so I could go through the process of having my eggs harvested. It's usually a much shorter window, but it's something that I wanted to have done."
Busalachi, one of Schnorr's patients, said they never even discussed removing one of her ovaries. She recently conceived naturally, something that doctors told her was a very slim possibility. She and her husband expect their first child in February.
"This was just a fluke," she said. "I was incredibly lucky."
Still, Busalachi intends to keep her eggs frozen in Charleston, just in case one baby isn't enough.
"I might not get that lucky again," she said. "If we decide to have a second one, I might need to use them further down the road."
Reach Lauren Sausser at 937-5598.
Embryologist Jennifer Martin uses a microscope to look at eggs that are projected on a screen at Coastal Fertility Specialists in Mount Pleasant.×
Dr. Stephanie Singleton at The Fertility Center of Charleston said freezing individual eggs is a better option for most women.×
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