Introduction

Reproductive autonomy is becoming a highly contested topic in society today - and with good reason. As women are increasingly becoming financially independent, they have greater control over their reproductive choices. More and more women are already storing their eggs for future use, with even greater numbers considering the option. 

Our guest, Dr. Karunakara Marikinti is one of the best reproductive endocrinology medical industry experts in Dubai who acts as a consultant obstetrician and gynecologist at Prime Hospital and Prime Medical Centre located in Motor City and Deira.

He explains the details of what social egg preservation involves, what it consists of, average success rates and which parameters are most important for a successful preservation. He also addresses the financial considerations involved in choosing to preserve your eggs. 

What is Social Egg Preservation?

In reproductive medicine, egg freezing is emerging as a new trend in female fertility preservation. This process allows healthy, fertile women to freeze their eggs and store them until they are ready to conceive. A process that increases the probability of future pregnancy. 

The number of women wishing to freeze their eggs for this purpose has increased significantly over the last years. One reason for this might be that the modern age women have become career-oriented, and have a desire to be independent and self-sufficient. If a woman does not have a suitable partner or does not want to be in a relationship, or is afraid of losing their fertility she may also choose egg freezing as an option for preserving her reproductive freedom 

Another reason might be that the popularity of this procedure depends on the awareness of citizens in the country they are in and on the health informatics of the country that are available. In most countries, this procedure is legal, but in rare cases there are ethical and religious reasons as well as regulatory disapproval of new technology without safety codes. However, this legal practice in the field of medical and healthcare in Dubai and the Middle East. 

Procedures to Egg Preservation

Knowing a large number of eggs are available bear an effect on whether the woman will conceive or not. This technology allows them to store unused eggs for future fertility. This is because despite eggs being surplus in nature, of the 3 million eggs women lose several thousand by the time they are 20, and later lose 50 to 100 eggs every month. 

Social Egg Preservation includes a cycle which includes 12 to 14 days with 4 to 3 visits. During this time the patient receives 10 injections to take at home. A doctor will also perform a small procedure in which eggs are collected from the ovaries. Recovery time is less than 1 day and the entire process is supervised and monitored by specialists. 

Some people worry about the long-term cumulative effects of these medications, but so far there is no cumulative effect or damage seen using these medications over successive cycles. However, the procedure is highly regulated by a special Law in UAE, therefore a general verified gynaecologist should not do this. 

The success rate

The success rate of frozen eggs to become a baby is dependent on both the egg and the uterus available. Egg contributes to 30-40% chances, while good sperm and uterus availability contribute to 80-90% chances. Even though the egg is only contributing 30-40%, without it, a child cannot be born. 

Women need at least a 10-15% chance for the egg to be a child. This means that she should store between 15 to 20 eggs before the age 30, so that they can produce at least one healthy child with them. 

Most embryologists use a physical appearance test called the 60% healthy egg test, a common assessment method for determining the health of an egg for the purpose of IVF. The method is based on the evaluation of physical features, such as the shape and colour of the egg. Based on these criteria, an embryologist will determine whether an egg is viable for preservation and the expats health and wellness in Dubai. 

Does age and lifestyle matter?

Gender, age, and lifestyle all play a role in determining a person's fertility. When it comes to women, age is an important factor in reproductive health and pregnancy. As women grow older their fertility declines due to the depletion of their egg supply and the increased likelihood of genetic abnormalities. On average, women under 35 have a higher chance of getting pregnant than those between 35 and 40 (when they enter menopause). 

Men have a higher fertility rate even at a late age, they can produce children even at an old age, limitations may be lifestyle such as obesity and smoking, hence they can also store eggs to have competent sperms. They are advised to avoid sports that increase temperature around the testicles/scrotal area such as cycling. 

For women who are under the age of 30, the process of egg preservation generally requires only one cycle and one batch of 15 to 20 eggs to be collected. However, for women between the ages of 30 to 35, two cycles and five batches are necessary to collect enough eggs for long term storage. This is because the amount of eggs that a woman under 30 has stored in her ovaries decreases with each passing year. 

Once a woman reaches the age of 35 and older, she will most likely need to undergo additional cycles and more batches to collect enough eggs for freezing. 

A safe process

Advances in reproductive autonomy technology have given us more options than ever before. As a woman, you can now freeze your eggs and preserve your ability to have children later in life. The new technology is safe and efficient with a 90% probability of the eggs resulting in a healthy baby. For over 20 years, a technique called the Slow Freezing has been used to store eggs for future fertility. 

According to the Human Fertilisation and Embryology Authority in the UK, in any form of fertility treatment there are only 13% of the stored eggs that stand a chance of success with this technique. And since the innovation enticed women to think there was a higher chance of getting kids, they faced disappointments over the years due to failed social egg preservation processes. 

What to be aware of

Once you've passed your childbearing years, there are few options left aside such as surrogacy. If you don't want to be pregnant right now, or if you don't want to risk having a child with genetic defects, egg preservation can be an option. Also your future financial stability plays an important role in this process for it is expensive not only in storing eggs, but also in finding a carrier and a suitable partner. 

All these play a part in ensuring you get healthy good quality eggs. Clients need to remember that storing eggs is not the same as storing the baby or embryo, the chances rely on probability. Social embryo preservation is even more controversial - it involves saving an embryo from someone who has decided not to continue with a pregnancy. 

The cost of Social Egg Preservation

Some women are facing a difficult choice: Should they freeze their eggs now, or should they wait until it’s closer to the time that they think they’ll want them? The decision may be different for every woman. If you wait, you might end up with a lower biological clock, but if you freeze now, you might find yourself with fewer resources to pay for the procedure. 

In most countries around the world, where IVF is not yet covered by insurance or government healthcare plans, egg freezing can cost between 40-50%  of the total cost of IVF. Dr. Marikinti estimates the price of an egg preservation cycle in the UAE being between AED 15,000 and AED 18,000. Which is quite expensive for most of the expats and expat families in the country. 

Ethics and Regulations

While egg preservation is proven to be medically safe and effective in preserving the potential fertility of women, leading to future pregnancies, it is still met with resistance from some countries. These nations look at it as artificial and unnatural while other religious-guided laws imply that it is illegal. With these factors taken into consideration, social egg preservation may not be as socially accepted as it could be in the near future. 

In 2013, 20% of surveyed people were aware of egg freezing and found it to be a very safe and helpful thing to do. This number has increased to 70-80% by now. Similarly, the number of women seeking to engage in the process have risen with the only constraints being the law and the high cost of the process. 

Take a personal choice to dictate your future fertility

Egg freezing has emerged in the 21st century as an efficient and cost-effective technique that can help women of all ages, including career women to exercise control over their biological clock. The technology is a proven science that helps women to achieve reproductive autonomy. This is a procedure that expat women in the UAE should definitely consider.

Follow the link to listen to the full podcast with Dr. Marikinti.