WEBVTT - 144. Should I Freeze My Eggs? 0:00:03.680 --> 0:00:06.760 Welcome to the kick Your Expert led podcast, helping you 0:00:06.840 --> 0:00:11.240 explore and learn everything about getting pregnancy, birth, and becoming 0:00:11.240 --> 0:00:11.639 a parent. 0:00:12.000 --> 0:00:15.800 On the podcast and our online pregnancy program grow My Baby, 0:00:15.920 --> 0:00:18.840 we share my experience of helping more than four thousand 0:00:18.960 --> 0:00:20.080 babies to be born. 0:00:20.079 --> 0:00:22.760 And our experience of running a women's health clinic and 0:00:22.840 --> 0:00:23.919 parenting for boys. 0:00:24.120 --> 0:00:27.120 We're here to help everyone to feel empowered in pregnancy 0:00:27.280 --> 0:00:30.120 and birth with real life, practical information. 0:00:33.320 --> 0:00:35.640 Welcome everyone. I'm Bridget Maloney. 0:00:35.320 --> 0:00:37.479 And I'm obstetrician doctor Patrick. 0:00:37.159 --> 0:00:39.440 Maloney, and today we're in a brand new studio. 0:00:39.479 --> 0:00:40.960 It feels good, doesn't it great? Isn't it? 0:00:41.040 --> 0:00:43.120 Yeah, it's out in the country a little bit more. 0:00:43.640 --> 0:00:51.840 And there's guitars on the walls and a set of drums. 0:00:49.479 --> 0:00:51.000 So we might be branching out. 0:00:51.560 --> 0:00:53.480 I'm just saying you do not want me to sing, 0:00:53.560 --> 0:00:55.320 but I will if someone requests it. 0:00:55.360 --> 0:01:00.160 There's a banjo, yep, and a bunch of handmade guitars. 0:01:00.200 --> 0:01:04.640 It's very exciting, very exciting. So today is an exciting 0:01:04.720 --> 0:01:05.720 episode as well. Pattern. 0:01:05.800 --> 0:01:11.080 Yeah, we're talking about egg freezing. Yeah, when you should 0:01:11.640 --> 0:01:14.920 why you wouldn't Does it work? 0:01:15.319 --> 0:01:18.000 Yep? Because it is a question that is on the 0:01:18.040 --> 0:01:21.080 lips of lots of people, because you know, we're having 0:01:21.080 --> 0:01:24.480 our babies later, we're finding our partner later. Maybe we 0:01:24.520 --> 0:01:26.000 want to go it alone, but we want to do 0:01:26.040 --> 0:01:30.160 that later. So yeah, let's dive into all those things. 0:01:31.400 --> 0:01:35.319 But first I want to ask Pat, why would someone 0:01:35.440 --> 0:01:36.520 consider to do this. 0:01:37.360 --> 0:01:41.520 Well, I think that the main reason is somebody who 0:01:41.640 --> 0:01:45.080 you really wants to have children and feels like they're 0:01:45.080 --> 0:01:48.640 getting to a point, perhaps in their thirties, where there's 0:01:48.960 --> 0:01:53.640 a decline in egg number and equality, or that they 0:01:53.720 --> 0:01:56.880 think that by the time they get to that point 0:01:57.240 --> 0:01:59.920 that there might be a problem with those things. 0:02:00.280 --> 0:02:02.280 And how would they know that there's a problem with 0:02:02.400 --> 0:02:04.240 say egg quality or quantity. 0:02:04.760 --> 0:02:08.200 Well, you can't really know. There are various tests that 0:02:08.240 --> 0:02:10.720 can be done, AMH levels and so forth, but those 0:02:10.800 --> 0:02:13.800 things are not terribly useful. What we really need to 0:02:13.800 --> 0:02:16.919 know is what are the goals of that individual woman. 0:02:18.080 --> 0:02:23.120 How old is she, is she currently in a relationship, 0:02:24.280 --> 0:02:28.760 how many babies does she want to have? And sometimes 0:02:28.919 --> 0:02:30.959 these are things that people know but know about already 0:02:30.960 --> 0:02:34.079 you know pretty clear about. And other times they're you know, 0:02:34.120 --> 0:02:35.600 in terms of that how many do we want? They're 0:02:35.639 --> 0:02:38.240 not so sure, especially if we're starting with someone who's 0:02:38.280 --> 0:02:39.600 outside of our relationship. 0:02:39.800 --> 0:02:42.840 Yeah, and I suppose a lot of people look towards 0:02:42.880 --> 0:02:45.160 things like, oh, well, is it time for me to 0:02:45.200 --> 0:02:48.880 preserve my fertility freeze my eggs because I don't know 0:02:48.880 --> 0:02:51.440 what's happening. I don't know what my future holds. 0:02:51.120 --> 0:02:54.880 And that's the whole point. And once upon a time, 0:02:54.880 --> 0:02:57.519 at the very start of my career, you could preserve 0:02:57.560 --> 0:03:00.480 your fertility in a certain sense, but really only by 0:03:00.480 --> 0:03:04.320 preserving embryos. And to make an embryo you needed some sperms, 0:03:04.400 --> 0:03:06.280 and the whole problem with that is that that might 0:03:06.280 --> 0:03:09.360 have been watching the very thing you didn't have. So 0:03:10.440 --> 0:03:17.639 in those early days of IVF, you could freeze an 0:03:17.639 --> 0:03:20.720 embryo that had been created, so a fertilized egg, and 0:03:21.080 --> 0:03:24.080 that worked really well, and they could be they could 0:03:24.080 --> 0:03:27.720 be preserved as people. I'm sure, no, practically, and definitely 0:03:29.320 --> 0:03:34.359 the early experiments with freezing eggs were it didn't work. 0:03:35.320 --> 0:03:39.400 So they just didn't have the scientific technique necessary. And 0:03:39.440 --> 0:03:41.440 if you tried to freeze an egg, they would just 0:03:41.520 --> 0:03:44.279 break open and be lost. 0:03:45.440 --> 0:03:47.560 At the time or when people decided to. 0:03:47.960 --> 0:03:52.240 At the time, at the time, and of course, sperms freeze. Fine, yeah, 0:03:52.320 --> 0:03:55.000 they knew that back then as well. So the name 0:03:55.040 --> 0:03:56.840 of the game was always to try and work out 0:03:57.120 --> 0:04:00.800 how to get eggs to freeze, because it was that 0:04:01.120 --> 0:04:06.920 step that meant that a single woman could potentially, you know, 0:04:07.080 --> 0:04:12.400 take out an insurance policy against the expiration of her 0:04:12.520 --> 0:04:17.000 practical fertility before she was ready to use it. 0:04:17.800 --> 0:04:20.040 I'll take it back to me, Like, you know, I'm 0:04:20.080 --> 0:04:22.839 sure I'm not alone in thinking that I had a 0:04:23.000 --> 0:04:26.640 ticking time bomb. You know, I was always working against 0:04:26.640 --> 0:04:30.279 this loss of fertility at a certain age. But can 0:04:30.320 --> 0:04:33.400 you tell me a little bit about the decline of that, 0:04:33.560 --> 0:04:37.320 Like it's a rapid decline towards your later thirties, isn't it. 0:04:37.760 --> 0:04:41.359 Well, yes, the quantity and quality of the eggs do 0:04:41.480 --> 0:04:44.880 decline in your late thirties. The thing is, though, that 0:04:45.760 --> 0:04:49.480 societal changes are such that so many of my patients 0:04:49.480 --> 0:04:54.960 now I haven't even really turned their attention to starting 0:04:55.000 --> 0:04:58.240 a family until they're well into their thirties. One of 0:04:58.320 --> 0:05:01.000 the things that's also happened in the recent years that 0:05:01.040 --> 0:05:03.920 people are getting started much later is they want way 0:05:04.000 --> 0:05:07.520 fewer babies. So, for example, if you are thirty four 0:05:07.600 --> 0:05:10.680 years old, and wanted one or perhaps two babies, then 0:05:10.800 --> 0:05:13.039 it's not the same emergency as if you wanted six. 0:05:14.440 --> 0:05:17.200 I don't know if there's many people still wanting six. 0:05:17.480 --> 0:05:20.200 Well there's a few, but they start in their early twenties. Yes, 0:05:20.680 --> 0:05:24.760 it's so we're going to when we talk about this technology, 0:05:24.760 --> 0:05:28.040 we sort of wonder who it's for. In my experience 0:05:28.120 --> 0:05:31.919 with this, it's not as simple as saying that these 0:05:31.960 --> 0:05:36.640 are you know, women excessively focused on Korea who think 0:05:36.680 --> 0:05:38.360 that they can sort of push their career as hard 0:05:38.400 --> 0:05:40.159 as they can until their late thirties and then suddenly 0:05:40.240 --> 0:05:44.120 turn around and want a baby. That's really over simplifying 0:05:44.160 --> 0:05:47.520 the situation. I guess there's that's a little bit, but 0:05:48.080 --> 0:05:50.440 these we're talking about human beings with complex lives, and 0:05:52.040 --> 0:05:54.440 I would say the main thing that I deal with 0:05:54.480 --> 0:05:59.760 in my practice in regional Australia is just people who 0:05:59.839 --> 0:06:02.520 just have not found the right partner and they're trying 0:06:03.080 --> 0:06:06.720 and they want a family and that process has taken them. 0:06:06.600 --> 0:06:12.240 Awhile absolutely I think it is over used that it's 0:06:12.279 --> 0:06:14.720 a selfish decision for people to wait until that time, 0:06:14.800 --> 0:06:16.960 until they have a baby or whatever. It just simply 0:06:16.960 --> 0:06:17.960 isn't the right time for them. 0:06:18.080 --> 0:06:20.360 No, I don't think there's anything selfish at all about 0:06:20.680 --> 0:06:24.279 about having a baby at forty. Yeah, it's a deeply 0:06:24.320 --> 0:06:25.600 selfless thing to do. 0:06:25.760 --> 0:06:29.080 Yeah, says people who had their third and four at 0:06:29.080 --> 0:06:33.239 thirty nine and forty. All right, so someone has decided 0:06:33.279 --> 0:06:36.400 we'll go into a bit more depth what age somebody 0:06:36.400 --> 0:06:40.800 should maybe even consider freezing the eggs. But before they 0:06:40.800 --> 0:06:44.320 do that, let's talk about how it's done. What do 0:06:44.400 --> 0:06:45.520 people expect. 0:06:45.800 --> 0:06:48.360 Well, it's done in exactly the same way as a 0:06:49.080 --> 0:06:53.600 standard IVF cycle. Basically, you go and see a reproductive 0:06:53.800 --> 0:06:57.880 clinic like an IVF clinic. They give you some hormonal 0:06:57.920 --> 0:07:03.840 injections to take over about two weeks, and that causes 0:07:03.880 --> 0:07:07.039 your ovaries to make a bunch of mature eggs in 0:07:07.080 --> 0:07:09.760 one cycle in one month instead of instead of just 0:07:09.800 --> 0:07:14.840 one Yeah, and when those eggs are nice and ripe, 0:07:15.080 --> 0:07:19.520 you have a little ultrasound guided procedure to collect the 0:07:19.560 --> 0:07:21.840 eggs out of the ovaries before they have a chance 0:07:21.880 --> 0:07:22.440 to pop out. 0:07:22.920 --> 0:07:24.360 And that's called retrieval, isn't it. 0:07:24.440 --> 0:07:24.640 Yep. 0:07:24.760 --> 0:07:28.080 Yeah, that's exactly the same as with standard IVF cycle, 0:07:28.520 --> 0:07:30.960 except when they get the eggs out in a standard cycle, 0:07:31.200 --> 0:07:33.920 they mix them up with a sperm straight away, create 0:07:33.960 --> 0:07:38.160 embryos in the laboratory, immediately get the best embryo and 0:07:38.200 --> 0:07:40.640 put it in fresh and put the rest in the 0:07:40.680 --> 0:07:43.000 freezer to be thought out and news later on. And 0:07:43.320 --> 0:07:47.280 with the egg process, if we're going to preserve eggs alone, 0:07:47.640 --> 0:07:50.080 then they're frozen in a sort of a snap freezing 0:07:50.160 --> 0:07:53.880 process called vitrification. And that was the that was the 0:07:53.920 --> 0:07:56.120 breakthrough that allowed this to be done. 0:07:57.280 --> 0:08:00.520 If someone's listening to this episode, I want to help 0:08:00.600 --> 0:08:05.240 them understand what the retrieval process is. Can you just 0:08:05.320 --> 0:08:06.680 describe that procedure? 0:08:06.880 --> 0:08:10.840 Yees. So the process is quite well tolerated by patients. 0:08:11.400 --> 0:08:14.400 You come in on the right day when the IVF 0:08:14.400 --> 0:08:17.440 people have determined that the eggs are ready to go, 0:08:17.920 --> 0:08:23.320 and under some sedation, an ultrasound probe is put into 0:08:23.320 --> 0:08:27.000 the vagina, just like a transvaginal ultrasound that we might 0:08:27.080 --> 0:08:30.720 use in gynecology. And there's a little set up on 0:08:30.760 --> 0:08:33.920 the end of that ultrasound probe that allows a needle 0:08:33.960 --> 0:08:35.760 to be passed through the edge of the vagina and 0:08:35.880 --> 0:08:38.760 up into the ovaries and then the eggs can just 0:08:38.760 --> 0:08:40.320 be sucked out one by one out of their little 0:08:40.320 --> 0:08:43.319 eggs acts in the ovary and collected in the tube 0:08:43.360 --> 0:08:45.840 and pass through into the laboratory. 0:08:46.040 --> 0:08:49.320 Wow, And does somebody have sort of pain after that 0:08:49.360 --> 0:08:52.240 procedure or yeah, there. 0:08:52.080 --> 0:08:54.520 Is pain afterwards. It's like ovulating a whole bunch of 0:08:54.559 --> 0:08:59.360 times in one day, so that requires some pain relief 0:08:59.400 --> 0:08:59.840 for sure. 0:09:00.440 --> 0:09:03.920 And let's say it's somebody in their thirties, mid thirties 0:09:04.040 --> 0:09:07.800 or early thirties. I know, because the amount of eggs 0:09:07.800 --> 0:09:10.960 that you retrieve would be different if they're in towards 0:09:11.000 --> 0:09:14.280 their forties. But what would you expect. What's a good 0:09:14.320 --> 0:09:15.240 retrieval rate? 0:09:18.480 --> 0:09:22.720 Look, it varies enormously compared to the woman's age and 0:09:22.840 --> 0:09:25.120 the hormones that jin's been given. You can sort of 0:09:25.120 --> 0:09:28.520 tell in advance how many you expect to get off ultrasound, 0:09:28.600 --> 0:09:32.200 but to get ten to fifteen would be terrific. Bearing 0:09:32.200 --> 0:09:36.440 in mind that they won't all be suitable for freezing, 0:09:36.480 --> 0:09:40.720 they won't all freeze efficiently, they won't all be genetically normal, 0:09:40.880 --> 0:09:43.840 they won't all unfreeze at the end of the day. 0:09:44.400 --> 0:09:48.520 So Patty, before you mentioned once upon a time that 0:09:48.559 --> 0:09:52.040 they would freeze embryos and mbryos could freeze, is there 0:09:52.080 --> 0:09:56.320 a difference, or is embryo versus egg freezing because I'm 0:09:56.320 --> 0:10:01.280 assuming some couples decide early to do this process if 0:10:01.320 --> 0:10:02.400 they're not ready to have a baby. 0:10:02.480 --> 0:10:06.200 Oh, there's no question that you would freeze embryos over 0:10:06.280 --> 0:10:09.480 freezing eggs if you were a committed couple and you 0:10:09.559 --> 0:10:13.080 had access to the wherewithal to make the embryos. Yeah, 0:10:13.520 --> 0:10:17.920 so that's that's not a question. This is this is 0:10:17.960 --> 0:10:21.360 basically for people, you know, for a single person or 0:10:21.440 --> 0:10:25.920 for some other reason, doesn't have the access to the sperm. 0:10:26.240 --> 0:10:29.360 So, Patty, if somebody has, you know, got their ten 0:10:29.400 --> 0:10:32.680 to fifteen eggs, what happens next? What's the success rate? 0:10:32.800 --> 0:10:35.480 How many people expect to get a pregnancy from that? 0:10:35.920 --> 0:10:37.560 Well, the first thing we have to remember is that 0:10:37.600 --> 0:10:41.160 most people don't use them, So most women with frozen 0:10:41.200 --> 0:10:45.600 eggs will go on to have their pregnancy the old 0:10:45.760 --> 0:10:49.680 fashioned way and not require that eggs that are frozen. 0:10:50.320 --> 0:10:54.080 And then for those that do actually turn up to 0:10:54.200 --> 0:10:57.679 use them, around eighty to ninety percent of the eggs 0:10:57.720 --> 0:11:04.600 would survive thor and about fifty to eighty percent of 0:11:04.640 --> 0:11:09.320 those would be successfully fertilized, and then about twenty to 0:11:09.400 --> 0:11:13.640 forty percent of the fertilized eggs would actually go ahead 0:11:13.679 --> 0:11:18.000 and develop into an embryo, which is sort of the 0:11:18.080 --> 0:11:21.440 standard success rates in IVF. So you've got to start 0:11:21.440 --> 0:11:25.440 off with big numbers to wind up with small, usable 0:11:25.520 --> 0:11:26.520 numbers at the end of the day. 0:11:26.679 --> 0:11:30.240 So Patty, for those that have decided to go ahead 0:11:30.320 --> 0:11:32.839 with the pregnancy and they've got an egg and it's 0:11:32.880 --> 0:11:36.760 ready to go, it's now met up with the sperm 0:11:36.840 --> 0:11:40.880 and it's formed an embryo. How what happens next. 0:11:40.640 --> 0:11:44.080 Well, you can just thaw out those eggs one by 0:11:44.120 --> 0:11:50.600 one and fertilize them with semen from your new partner 0:11:50.640 --> 0:11:54.520 who you've found in the meantime. Then and that forms 0:11:54.520 --> 0:11:58.760 an embryo, and that embryo is transferred fresh into the 0:11:58.880 --> 0:12:01.520 urus in a procedure cord an embryo transfer. 0:12:01.720 --> 0:12:04.520 Yeah right, okay, And would you also need to have 0:12:04.640 --> 0:12:07.400 like hormone stimulation or anything for that transfer. 0:12:08.200 --> 0:12:11.360 You just make sure that the lining is perfect, is 0:12:11.360 --> 0:12:14.720 the perfect thickness to receive the transferred embryos. And then 0:12:14.800 --> 0:12:16.760 these days, there's a lot of stuff that goes on 0:12:16.800 --> 0:12:20.280 in IVF clinics, which I call them one percent is 0:12:20.360 --> 0:12:23.280 little things that they've developed along the way to help 0:12:23.600 --> 0:12:27.760 the transferred embryo actually take Yeah. Yeah, And there's been 0:12:27.760 --> 0:12:29.760 a number of those that have come in and out 0:12:29.760 --> 0:12:32.640 of popular use in IVF over the last dec so 0:12:33.000 --> 0:12:35.120 as they're trying to get over some of their rate 0:12:35.160 --> 0:12:38.080 limiting steps, you know, just do things just a little 0:12:38.120 --> 0:12:40.720 bit better at each little step of the way. 0:12:41.559 --> 0:12:44.480 So, pat, do you remember back in August twenty three 0:12:44.720 --> 0:12:47.760 that seems like yesterday, but it was nearly a year 0:12:47.760 --> 0:12:51.160 and a half ago, we had doctor Ralia lu who's 0:12:51.160 --> 0:12:54.679 a specialist in IVF, and we asked her the question, 0:12:55.200 --> 0:12:58.000 when does she see people in her clinic or when 0:12:58.000 --> 0:13:00.600 does she advise people to go and to have egg 0:13:00.640 --> 0:13:03.120 freezing if that's what they have decided to do to 0:13:03.120 --> 0:13:05.400 do in their life. Let's take a listen to what 0:13:05.440 --> 0:13:09.240 she said. The women that are coming to have egg freezing, 0:13:09.600 --> 0:13:12.800 what is the ideal age for that to happen, and 0:13:12.880 --> 0:13:15.080 are they coming as singles or are they coming as 0:13:15.080 --> 0:13:17.040 a couple and the couple aren't quite ready to have 0:13:17.080 --> 0:13:20.120 the baby or what's the most common scenario for you? 0:13:21.360 --> 0:13:25.760 The most common scenario is women coming as either singles 0:13:25.840 --> 0:13:29.960 or in a relationship not yet committed to parenthood, but 0:13:30.080 --> 0:13:33.960 couples do sometimes come together and consider both egg and 0:13:34.040 --> 0:13:39.160 embryo banking. The ideal age to freeze eggs, in my opinion, 0:13:39.520 --> 0:13:45.520 is in the late twenties or early thirties. Why not earlier, Well, 0:13:45.600 --> 0:13:49.040 you're definitely more fertile when you're younger, but you're also 0:13:49.160 --> 0:13:51.960 more likely to have fertile time ahead of you to 0:13:52.080 --> 0:13:57.600 naturally conceive, and you are more likely to have those 0:13:57.679 --> 0:14:01.920 opportunities they still available to you a little bit later 0:14:02.000 --> 0:14:04.800 on in life. And we don't want to be freezing 0:14:05.480 --> 0:14:10.120 eggs for everybody because it puts patients that risk of 0:14:10.440 --> 0:14:15.319 undertaking procedures they may never need and keeping eggs in storage, 0:14:15.640 --> 0:14:19.360 which can incur costs. What I would say is that 0:14:19.400 --> 0:14:22.400 when somebody is in their late twenties or early thirties, 0:14:23.080 --> 0:14:26.200 they're the most fertile they'll ever be from that time 0:14:26.240 --> 0:14:29.720 point forward, and they have some idea of when they 0:14:29.840 --> 0:14:32.720 might plan a first child, they wish to be parents, 0:14:33.560 --> 0:14:36.840 and they have a better notion of how useful having 0:14:36.840 --> 0:14:39.320 a supply of frozen eggs as an asset will be 0:14:39.520 --> 0:14:43.040 for them. And so I think it's that sweet spot 0:14:43.120 --> 0:14:47.160 between not yet having reached an age where fertility decline 0:14:47.840 --> 0:14:51.360 is really serious where you still have a reasonable overin 0:14:51.440 --> 0:14:54.840 reserve in most instances to get a good outcome from 0:14:54.920 --> 0:14:59.280 an egg freezing treatment, but also being able to look 0:14:59.320 --> 0:15:03.160 into your feuture think about how useful that asset will 0:15:03.200 --> 0:15:04.320 be to your future though. 0:15:06.120 --> 0:15:10.480 So I think that's really interesting and it's great to 0:15:10.520 --> 0:15:13.840 hear that. Again. One of the things, one of the 0:15:13.880 --> 0:15:16.400 comments I would make about that is that I guess, 0:15:16.400 --> 0:15:18.920 at the absolute peak of your fertility powers, when you 0:15:19.000 --> 0:15:21.240 might be the very very best egg collector you can 0:15:21.280 --> 0:15:25.240 possibly be, you don't know you've got a problem. And 0:15:25.480 --> 0:15:31.280 I think that that's relevant. Also, someone like Raley is 0:15:31.480 --> 0:15:34.720 a doctor in a reproductive service who sees people who've 0:15:34.760 --> 0:15:39.240 perhaps sought her out for that particular service. As a 0:15:39.280 --> 0:15:43.760 general gynecologist, I'm actually in the lucky old position of 0:15:43.920 --> 0:15:48.680 raising fertility preservation with people who have not considered that 0:15:48.800 --> 0:15:51.640 at all, and sometimes who don't think that it's a 0:15:52.080 --> 0:15:54.320 problem that they needed added to their problem with thank 0:15:54.320 --> 0:15:58.240 you very much. So it can be challenging to say 0:15:58.280 --> 0:15:59.720 to someone have you considered this? 0:16:00.120 --> 0:16:00.280 Yep? 0:16:00.920 --> 0:16:02.560 Some people go, oh my god, thank god you mention it. 0:16:02.600 --> 0:16:04.720 That's terrific. I'm so glad you brought that up, let's 0:16:04.720 --> 0:16:09.600 do that. And other times people say no, should I excuse. 0:16:09.240 --> 0:16:12.880 Me, I'm not that old exactly, And that is it? 0:16:12.960 --> 0:16:15.280 Because I don't know. I think we get a bit 0:16:15.280 --> 0:16:20.360 of a skewed representation of successful pregnancies in people's forties. 0:16:21.360 --> 0:16:24.160 What we don't see are people that perhaps are keeping 0:16:24.200 --> 0:16:28.200 their fertility struggles quiet, you know, because so therefore, I 0:16:28.200 --> 0:16:31.760 think it gives us a false sense of security that 0:16:31.800 --> 0:16:36.120 we will be fertile well into our late thirties early forties. 0:16:36.320 --> 0:16:41.080 Absolutely, that's a problem, and there are there is publication 0:16:41.200 --> 0:16:45.320 of data reasonably easily available that says how many babies 0:16:45.320 --> 0:16:47.720 born in Victoria Edge yet are born as a result 0:16:47.720 --> 0:16:51.480 of assisted reproduction. I would love to know and have 0:16:51.560 --> 0:16:54.160 it my finger tips. How many babies are born from 0:16:54.200 --> 0:16:57.120 a frozen eck, not a frozen embryo as part of 0:16:57.120 --> 0:16:59.960 an IVF cycle, to a couple experiencing a fertility properm 0:17:00.520 --> 0:17:03.480 But how many are born from a woman who's thirty three, 0:17:03.880 --> 0:17:06.360 wants three babies, think she's running out of time, freezes 0:17:06.400 --> 0:17:09.720 her eggs because she's single, meets a partner, uses those 0:17:09.800 --> 0:17:13.440 frozen eggs, yeah, and has her babies that way. Yeah, 0:17:13.920 --> 0:17:15.200 I haven't seen that data. 0:17:15.240 --> 0:17:18.199 All right, so you know, if we follow Riley's advice 0:17:18.240 --> 0:17:20.640 and maybe you know, late twenties or early thirties, we're 0:17:20.640 --> 0:17:24.359 thinking about having our eggs frozen, like, it's a pretty 0:17:24.359 --> 0:17:27.880 costly thing to do. It is cost I thought what 0:17:27.920 --> 0:17:30.080 we could do now is I did a bit of 0:17:30.200 --> 0:17:35.400 research different IVF clinics. I've got a rough estimate of 0:17:35.400 --> 0:17:38.520 what it costs. And what people have to be really 0:17:38.560 --> 0:17:40.680 aware of is often what they're quoted on, say a 0:17:40.760 --> 0:17:46.359 website is just about the process of freezing eggs. They're 0:17:46.359 --> 0:17:51.679 not adding things like the daybed, hospital, the anethetist, the 0:17:51.800 --> 0:17:54.240 storage costs, the medication costs. 0:17:54.480 --> 0:17:57.399 Yeah so, or even just going to see the doctor 0:17:57.440 --> 0:18:00.840 at the clinic in the first place visit. They tend 0:18:00.920 --> 0:18:04.680 to quote in terms of how much a cycle costs, 0:18:05.240 --> 0:18:09.600 and that involves mostly the laboratory costs. There are other costs. 0:18:09.920 --> 0:18:14.200 Yeah, So for all up, I think it's about seven 0:18:14.240 --> 0:18:17.800 and a half thousand dollars, with an ongoing storage fee 0:18:17.960 --> 0:18:21.240 of about five hundred and fifty six hundred dollars per year. Okay, yeah, 0:18:21.800 --> 0:18:26.040 so we watched one of those doctor shows. People might 0:18:26.040 --> 0:18:29.080 find this surprising, but we watch a lot of medical 0:18:29.119 --> 0:18:34.760 shows like House and one of the doctors remember her 0:18:34.800 --> 0:18:37.520 parents had said we will pay for you to have 0:18:37.600 --> 0:18:40.879 your eggs frozen, and she was shocked. She was like, 0:18:41.000 --> 0:18:43.159 you know, firstly, I'm not of the age that I 0:18:43.160 --> 0:18:46.439 should be even worrying about my fertility. Why are you 0:18:46.480 --> 0:18:48.400 wanting me to go and pop out babies. I've got 0:18:48.400 --> 0:18:51.360 this big career, don't you know. And then she came 0:18:51.400 --> 0:18:53.040 back to it and said, n actually it was a 0:18:53.040 --> 0:18:56.520 really good idea. What are your thoughts, doctor pat. If 0:18:56.520 --> 0:18:59.359 a parent said I will pay for you to have 0:18:59.400 --> 0:19:01.520 your eggs froz, do you think it's worth it. 0:19:01.880 --> 0:19:05.160 I think it's a brave parent who would bring it up. Yeah, 0:19:06.160 --> 0:19:09.760 but if you knew that was an issue within your family, 0:19:10.520 --> 0:19:15.400 then yeah, I guess why not. There's certainly I mean, 0:19:15.440 --> 0:19:20.320 you know, they're biggish figures. It's common in Australia for 0:19:20.760 --> 0:19:24.760 grandparents to pay for things that the current generation might 0:19:24.760 --> 0:19:25.600 be priced out of. 0:19:25.960 --> 0:19:26.120 Yeah. 0:19:26.200 --> 0:19:27.920 Oh, we're seeing that in the clinic, aren't we. We're 0:19:27.960 --> 0:19:30.959 seeing a lot of anti natal care being paid for 0:19:31.119 --> 0:19:32.440 by the grandparent. 0:19:32.480 --> 0:19:34.719 We do, so I guess this is no exception. 0:19:34.960 --> 0:19:38.159 Yeah, all right, So people might also ask, hang on 0:19:38.200 --> 0:19:40.479 a minute, can Medicare pay for any of this? 0:19:41.400 --> 0:19:46.520 I think Medicare gets involved and some of the providers 0:19:46.560 --> 0:19:49.400 get involved in a sort of a charitable sense. If 0:19:49.440 --> 0:19:54.639 you're having reproductive preservation done because you've got cancer, yeah, 0:19:54.680 --> 0:19:57.040 and you might be about to start a course of 0:19:57.119 --> 0:20:01.600 chemotherapy for your breast cancer, what have you. So the 0:20:01.640 --> 0:20:04.960 big providers of IVF have got a sort of a 0:20:04.960 --> 0:20:07.359 hotline that you can ring and say, my patient's about 0:20:07.359 --> 0:20:10.000 the start chemo. Can you give them a really quick 0:20:10.640 --> 0:20:17.399 and discounted or free cycle to put their eggs or embryos, 0:20:17.440 --> 0:20:21.200 depending on their circumstances in the freezer before we start 0:20:21.200 --> 0:20:23.240 that potentially destructive treatment. 0:20:23.520 --> 0:20:27.040 Yeah. Otherwise, if it's elective, there's no Medicare rebate on 0:20:27.080 --> 0:20:27.480 any of this. 0:20:28.000 --> 0:20:30.280 There is for IVF, there's not for egg freezing. 0:20:30.520 --> 0:20:33.359 Yeah, all right, good, Now you did mention chemo, and 0:20:33.400 --> 0:20:35.920 I did want to say, like we've talked about your age, 0:20:36.480 --> 0:20:40.480 but what about those people that have got perhaps endometriosis 0:20:40.600 --> 0:20:44.760 or PCOS or a known problem that could cause fertility. 0:20:44.800 --> 0:20:47.320 Would you recommend that that's I think that they should 0:20:47.320 --> 0:20:47.760 consider to. 0:20:47.880 --> 0:20:51.080 Yeah, definitely, so that that's one of the things that 0:20:51.119 --> 0:20:54.080 comes into the decision. And it's definitely one of the 0:20:54.320 --> 0:20:56.760 things that drives my decision about whether to bring it 0:20:56.840 --> 0:20:59.000 up and whether to discuss it, and whether to encourage it. 0:20:59.480 --> 0:21:04.600 For example, there's a thing called an ovarian edometrioma, which 0:21:04.680 --> 0:21:07.800 is a form of endometriosis where a whole lot of 0:21:07.880 --> 0:21:11.720 endometriosis forms in a big blob inside the ovary and 0:21:11.760 --> 0:21:15.240 the woman develops essentially an ovarian cyst that's made out 0:21:15.240 --> 0:21:19.639 of endometriosis, and it's very destructive to ovarian tissue, and 0:21:19.720 --> 0:21:22.480 sometimes you might have one on both sides. So a 0:21:22.520 --> 0:21:29.440 woman with bilateral ovarian endometriomas might run out of fertility 0:21:29.520 --> 0:21:34.520 of usable eggs much sooner than a woman who had 0:21:34.520 --> 0:21:38.800 no endometriosis or the ordinary type of peritoneal endometriosis on 0:21:38.840 --> 0:21:43.199 the pelvic lining, and that woman I would definitely be 0:21:43.280 --> 0:21:49.560 talking earlier about egg preservation, and then the woman with 0:21:49.720 --> 0:21:53.520 ordinary endometriosis perhaps a bit later, and the woman with 0:21:53.680 --> 0:21:58.919 no reproductive problems other than her social issue probably the 0:21:59.000 --> 0:22:00.480 latest all. 0:22:00.440 --> 0:22:03.320 Right, and any other conditions like pcos or perhaps if 0:22:03.320 --> 0:22:07.680 they've had an earlier ectopic pregnancy, lost an overtube yea. 0:22:08.200 --> 0:22:12.159 Each one of those circumstances has some potential issues that 0:22:12.240 --> 0:22:15.080 would come into the discussion. Yeah, for sure. You know, 0:22:15.440 --> 0:22:17.199 if they'd lost one tube to an ex topic but 0:22:17.240 --> 0:22:19.760 the other side was fine, then their fertility is not 0:22:19.960 --> 0:22:22.800 greatly reduced. If they're still young, they've already got their partner. 0:22:22.840 --> 0:22:24.840 I don't think I'd be saying much other than try 0:22:24.840 --> 0:22:28.240 again when you're ready. Someone who'd lost both tubes is 0:22:28.240 --> 0:22:30.919 clearly going to need some reproductive assistance, and some of 0:22:30.960 --> 0:22:34.240 those other conditions severe phos and so forth. I think 0:22:34.960 --> 0:22:38.479 they all would come into what amounts to quite a 0:22:38.480 --> 0:22:39.920 complex and rich discussion. 0:22:40.160 --> 0:22:44.639 Good well, I think people will know by this episode 0:22:45.280 --> 0:22:49.480 what questions to ask their GP to begin with. Hopefully 0:22:49.520 --> 0:22:52.440 get onto a gynecologist so they can sort of deep 0:22:52.480 --> 0:22:54.600 dive on some of these issues, yes, and then make 0:22:54.640 --> 0:22:57.359 a really informed decision about whether they want to freeze 0:22:57.359 --> 0:22:58.080