Thoughts change, goals change, and strategies adapt accordingly... that's why today I want to talk to you about «social freezing». Perhaps not everyone is familiar with this fertility preservation technique, but more and more young Italian women are requesting it.
Precautionary egg freezing (also called «social freezing») can be defined as a form of prevention or treatment for future infertility. It involves applying the traditional techniques of cryopreservation of female gametes (oocytes), by now standardized worldwide, so that, should natural conception not occur, a woman can access assisted reproduction techniques.
Of course, recommending a healthy lifestyle from a young age should be common sense, but unfortunately that doesn't mean a woman can, or wants to, pursue a pregnancy before the age of 40. As well illustrated by Dr. Marcone in her article on «pre-primary infertility», who can say whether a given woman will have the economic stability that allows her to «afford a pregnancy», or whether she will have found the right partner with whom to conceive and raise a child?
In recent years, and even more so during this period of severe global economic crisis, in industrialized countries and particularly in Italy, women, due to economic and social factors such as job insecurity, the desire to build a career, or unstable relationships, tend to postpone the decision to have a child to an age at least ten years later than previous generations. Moreover, over the past 30 years fertility in the Western world has fallen by a third compared to the past.
It should also be said that in Italy today attention is focused on pensions rather than on social policies that would allow young women and/or couples to think about building their own family and having children.
And so the need to inform women, mothers, and aunts that social freezing exists is growing ever stronger in Italian society.
Until now, this technique was used in Italy mainly for women who had to undergo chemotherapy for a cancer diagnosis, pelvic radiotherapy, or destructive surgery on the reproductive organs (for example for endometriosis), which can irreversibly affect future reproductive capacity.
Women who wish to cryopreserve their fertility must undergo treatment with gonadotropins, injectable medications that induce the development of several ovarian follicles. These follicles are then aspirated in the operating room under sterile conditions, and the oocytes retrieved from them are sorted according to their stage of maturation; those in metaphase II are cryopreserved.
Ideally, at least 10 to 15 oocytes should be preserved. These are stored in liquid nitrogen at -196°C in a dedicated container. The survival rate of oocytes after thawing is around 70 to 80%.
The pregnancy rates achieved using cryopreserved oocytes are around 15%.
From a biological standpoint, it would certainly be preferable to preserve one's fertility and oocytes at 20 to 25 years of age; indeed, at this age the method would deliver truly excellent pregnancy rates. But of course, at this age, hardly anyone in our part of the world is thinking about having children or preserving their fertility; if anything, the focus is on reliable contraception.
Unfortunately, the older a woman gets, the less effective this technique becomes, to the point that it is considered strongly inadvisable after age 36 to 38, depending on the study.
Let's take a moment to reflect on something that, sadly, I see every day: how many women today have to turn to donor conception techniques, using the gametes of a stranger, to achieve a pregnancy before the age of 30? If we banked our own oocytes while our biological age still allowed it, wouldn't it be far more reassuring to use them if we were unable to conceive spontaneously?
It's a simple thought, but one that should lead us to genuine reflection, without hypocrisy.