IVF - frozen egg questions

[mummyoneday]

Hi,

I am 31 and undertaking treatment for breast cancer. Last week I had 24 eggs frozen (I am not in a relationship), all of apparently good quality, before I start chemo next week.

I have 2 questions:

1. I have been referred to a genetics expert to see if I have a breast cancer gene (my Mum also had it at a young age). Assuming I do, does anyone know if it is possible to check this in the frozen eggs? I've done some research and it is possible (and legal) to check a fresh embryo, but I know frozen eggs are more difficult. Can someone explain this all to me?
   

1. With 24 good eggs what would my chances of having 3 kids be? I found out the day before I had them removed each one only has a 7-8% chance of success (I thought it was much higher). The clinic were only focussed on the fact that I had a good chance of having a baby, but I don't want a baby, I want lots of babies!
   

Any help appreciated! Thanks

[freelancescientist]

First of all so sorry that you are having to go through this.

OK - checking the eggs is tricky - it is certainly not possible to test them frozen, they would have to be thawed out. Also the tests to check the eggs are just not as reliable as the embryo testing. Genetic testing destroys the cell that is tested, so you take 1 or 2 cells from an early embryo (which it can replace), but when they test the egg they take the polar body which is a bit of waste product from the egg so may have some junk chromosomes etc in there. Generally what is in the polar body is what there is in the egg but not always, and you only get one result per egg. With an embryo usually a couple of cells are taken so you get more chance of a reliable result.

Your second question....I think 3 children may be a bit of a big ask. The eggs have to survive the thaw, fertilise and then make a baby. 7-8% compares well with the results for a fresh egg so it is not the freezing that is the problem, just the chance that each egg has of making a baby. 24 is a great number of eggs though and we would be hopeful at my clinic of getting you at least 1 baby from that. We do some egg freezing and although our pre-chemotherapy ladies haven't come back to use their eggs in large numbers yet, our pregnancy rate in ladies having eggs frozen for other reasons is really good and we have managed to make enougn embryos to freeze them as well for a later try/second baby.

It may be that your chemotherapy doesn't make you infertile - it isn't always the case. It is hard when the future you have planned gets thrown a curve ball - have you been offered any counselling to talk through these issues?

Good luck with everything.

[FatimaLovesBread]

I can't answer your question about the genetic testing but thought if give my experience of success rate.

I had a cycle of IVF so my eggs were fresh rather than frozen so I don't know exactly how it will compare.
But I had 22 eggs collected, I donated half of them so out of my 11, 8 fertilised, 4 got to day five blastocyst although two weren't as good. I had one frozen and one put back in which resulted in my 7 month old.

I don't know the details of my recipients cycle but I do know she was successful and now has a child. So that's 2 pregnancies from 22 eggs. I'm hoping to use my remaining frozen embryo at some point but if that doesn't work I'll have to make do with one (I always thought I'd have at least two).

I'm not sure about three but I'd say your chances of having one, if not two were good although im no expert. I'm sorry you're having to go through this and I hope you get the children you want in the future

[mummyoneday]

Thanks both

@freelancescientist
I'm new to all this, and have some questions - sorry if these are naive but I don't know too much about fertility treatment, and I've had a lot to deal with!

Let's say in 6 years time I'm ready to start a family. Is the process this: the eggs get thawed, sperm added, embryo created, is it then genetically tested, and if okay, can be "given" to me? Is this possible, or do you have to test the egg by itself, before creating the embryo? Which would work best?

Also, are you able to advise roughly on my chances of being fertile? I am 31, but have better than average fertility for my age (started stimulated drugs a week late and still managed 24 good ones), but I won't be able to consider pregnancy for five years. What are my chances? And, assuming I've eggs still in me and want to do the genetic test, am I better off using my (very old) fresh eggs, or my much younger frozen ones?

Thanks again!

[freelancescientist]

Hi

Things change a lot in 6 years! We couldn't reliably freeze eggs 6 years ago and now pregnancies from thawed eggs are old news.

Anyway, at the moment the best way would be as you say, thaw the eggs,fertilise them then genetically test the embryo (this has the advantage of checking the male contribution as well). Testing the eggs and only fertilising the normal ones would be the least effective way as the science is now, as egg testing is not as reliable so you may get 'no result' from some eggs then have to decide whether to use them or not. We just have more experience with testing embryos, things may improve in the next few years or it may turn out that egg testing is a waste of time.

Your fertility in 6 years is really hard to predict. It may very well turn out to be better to use your younger frozen eggs than your older ones which have also been exposed to chemotherapy. This is really a bridge to cross when you come to it to be honest. It is encouraging that you have done well with your egg harvest this time and it means you are in a good position for the future if you do need to use your frozen supply. There are tests that can be done to check your fertility potential when you are ready to try to get pregnant, so if things look bad you can start the ball rolling with fertility treatment.

[Hoophopes]

Hi sorry to hear your news.
I have no science knowledge but have gone through Ivf myself. Firstly 24 eggs is a great number. And also you may still be able to conceive naturally which is a hope.
Also techniques in fertility treatments are changing all the time so in 5 yrs time there may be even greater success rates. For n stance there is a new technique which is basically a camera used to check embryos developing which predicts which embryos are more likely to succeed. That did not exist when we had treatment. We only got 5 eggs, 4 fertilised and only one could be put back (NHS only funds one put back at a time) and others not good enough to freeze. Have one child!!

With fresh cycles we were told it is a numbers game and usually one n three cycles are successful. Te advantage you have is that there is was no infertility issue when you froze your eggs so hopefully your young eggs will give you your required family.

Whether you will get lots of children from 24 eggs no one can sadly predict. I wanted lots of children too, however years of fertility treatment mean one is all I realistically will have. Also the NHS only funds treatment due to infertility until have one child. After that have to pay for own treatment for any remaining eggs, not sure about funding for multiple attempts for wanting more children due to cancer issues, so might be worth saving if you need to use your frozen eggs as it can be pricey sadly!

[mummyoneday]

Thanks again.

@ freelance scientist
I don't know how much you know about the genetic aspect of this? I take it that if I do have a cancer gene there is a 50% chance of this being passed on? (ie in practical terms I should discount half my eggs?).

Also, once an egg has thawed can it be re-frozen? Would there be any problems freezing an egg, and then later freezing the embryo? Is freezing again likely to cause problems/reducing chances of a happy result?

Cheers

[Hoophopes]

I am pretty certain they can re freeze yes.

[mummyoneday]

Thanks. I really don't know anything about fertility treatment!

[freelancescientist]

Hoophopes is right, there iseems to be no problem with thawing an egg then re-freezing it as an embryo.

The genetics bit is out of my experience I'm afraid - it may be 50/50 but sometimes it is more complicated than that. You would need to get expert advice on that from the clinic where you wanted your genetic testing of the embryos done - they also need to be able to look specifically for your gene so there might be a bit of work around that if you don't have one of the common mutations. I don't know much of the nitty gritty of that I'm afraid, and you may need to travel to find a clinic that can do your PGD for you.

[Boygirl5]

Hi, I haven't been in your situation.

I have got two children from frozen embryos (not eggs). I've never done any testing on them though.

Good luck with everything. I wish you well and pray you get your babies too x