Women who want to use their own eggs to become mothers have the option to have their eggs or embryos frozen until the time they deem fit to have children.
Reasons to preserve fertility
Perhaps the most pressing reason why some women choose this option is the effect that chemotherapy has on their reproductive organs.
“A lot of patients who undergo chemotherapy and post-treatment, they find themselves barren,” explained Dr. Marc Ancheta, an OB-GYN at The Medical City. “Their ovaries were also attacked by the chemotherapeutic drugs.”
“Their options will be narrowed down if they don’t have any eggs. That’s why they’re thinking about egg freezing.”
Preserving eggs and embryos also gives women more options on how and when they can start their families, either on their own or with a partner.
Dr Marc Ancheta, OB GYN @ The Medical City, says they are offering egg freezing services to give women more options re: starting a family. pic.twitter.com/dhX6K9OJUc— Rie Takumi (@rie_takumi) April 1, 2017
“Because of the times, a paradigm shift, there are a lot of permutations which are happening and we’re trying to offer or trying to increase the chances of at least preserving your fertility or having options later on,” Ancheta explained.
“If they’re not yet ready to get pregnant at this point, but they would want to get pregnant at probably 42 or 43, wherein your chances of getting pregnant are not that good anymore because your eggs are already aged, then freezing your eggs and embryos at an earlier age will afford you that fertility potential,” he added.
Eggs and embryos
Women may have either their eggs or embryos (fertilized eggs) frozen. In embryo cryopreservation, a woman’s egg is fertilized with her partner or a donor’s sperm, nurtured into an embryo in tubes, and put into storage until implantation.
Women who want to defer fertility for health, work, etc. reasons may freeze their eggs or embryos to have children later (1/2) pic.twitter.com/EolDSz0b7C— Rie Takumi (@rie_takumi) April 1, 2017
Egg preservation is a more challenging process than embryo freezing and with a lower survival rate.
Both egg and embryo freezing require daily injections of gonadotropins for controlled ovarian hyperstimulation, which will allow doctors to harvest as many eggs as possible.
“What we try to do with egg preservation is we try to harvest as many eggs as we can in one go. Just in case, let’s say, you get pregnant this year. Five years down the line, you want to get pregnant again, you don’t need to harvest them again or undergo the same procedure again kasi meron ka pang naka-freeze na eggs,” Ancheta explained.
“They need to get injections to produce eggs. We need to monitor them to see the response. Once we see that the eggs are big enough, then we get them out,” he added.
While both eggs and embryos can be implanted at any age, Ancheta said live birth rates from frozen-thawed embryos “depend on the age of the woman at the time of egg retrieval.”
If eggs and embryo are harvested from women younger than 35, live births have a 43 percent chance of survival; if they are 41 or 42, the survival rate drops to 15.6 percent.
Eggs also have lower survival rates than embryos post-thawing: 50 to 70 percent to an embryo’s survival rate of 90 percent.
As for the carrier of the eggs or embryos, age is of no matter as there have been documented cases where women as old as 70 could carry pregnancies to term with no abnormalities.
“In Mumbai, in Calcutta, yung mga established na, you see patients who are 60, 70-years-old nagsu-surrogate pa sila. It doesn’t matter kung menopausal ka pa or lola ka na, you can still get pregnant,” Ancheta said.
Legality and waivers
At the moment, the Medical City can only offer to preserve eggs. Current ethical guidelines of the Philippine Society of Reproductive Endocrinology and Infertility does not allow third-party in-vitro fertilization (using a sperm donor or an egg donor, or pregnancy via surrogacy).
“The only thing we can offer legally at this point is to freeze them as eggs and not as embryos,” Ancheta said. “Freezing them as eggs [is] a possibility...We can do [third-party IVF] elsewhere, around the area. You can do it in China, you can do it in India, but in the Philippines kasi it’s not allowed yet.”
However, other than restrictions set by PSREI, there are no legal laws about third-party IVF in the country. The Family Code of the Philippines was put into law before IVF was made available here, so the procedure is not covered by the law itself.
Health Secretary Paulyn Jean Rosell-Ubial confirmed in a text to GMA News Online that there are no written laws regarding surrogacy and IVF in the Philippines.
“We don’t have standards for this,” Ubial said. “We still don’t have laws and guidelines.”
LGBT couples and single women, she added, could also have surrogates in the Philippines.
“I guess we will respect the decision of the couples,” Ubial said.
Couples must also sign a waiver, either of their own agreement or pre-prepared by the hospital, in case they separate.
Couples must sign a waiver before freezing; in case of separation, they no longer have a claim on the eggs; couples may make own waivers. pic.twitter.com/iFbAQwbs7u— Rie Takumi (@rie_takumi) April 1, 2017
“Kunwari ikaw yung wife, nag-hiwalay na kayo nung husband mo. If you want to use it later on, you need to get a written waiver from your ex-husband [that will allow] you to use it,” Ancheta said.
Women aged 35 and younger will spend around P250,000 to P300,000 to preserve their eggs, while women aged more than 35 can expect a bill of P350,000 to P400,000.
“The ballpark figure depends on the age. The younger you are, the lesser medications are needed to produce eggs. If you have a patient who’s 35 or younger, you probably [would] spend P250,000. If you’re a lot older, maximum probably is around P400,000 to P500,000,” Ancheta said.
“That already includes freezing the eggs and the embryos for one year. Board and lodging every year is P15,000,” he continued. — BM, GMA News