Frozen eggs are no guarantee, really!

Women can't stop the biological clock from ticking, so some are choosing the next best thing: freezing fertility.

Freezing eggs technically known as oocyte cryopreservation eases age-related barriers to childbearing by extending fertility and raising the chances of conception in women over 37, a time when fertility begins to plummet.

These frozen eggs are stored and used for in-vitro fertilisation (IVF) treatments whenever a woman is ready to have a baby, at an added cost of Rs 1.5 lakh to Rs 2 lakh per attempt in India.

Egg freezing seized the public imagination this week after US-based corporations Apple and Facebook offered to cover up to $20,000 of the costs of the procedure for their women employees, sparking debate over whether this was a perk or a nudge to young working women to put off having a baby and focus instead on their careers.

Women in India, however, aren't waiting for employment perks to fund preserving their fertility. For one, compared with the $15,000 to $20,000 it costs in the US (about Rs 9 lakh to Rs 12 lakh), hospitals and clinics in India offer the procedure for Rs 1.5 lakh to Rs 2 lakh (about $3,200), with the annual freezing costs hovering around Rs 30,000 ($500).

Until five years ago, egg freezing was used mostly for women with certain cancers or those undergoing treatments known to cause infertility, such as some chemotherapy and radiation treatments. Now, many more women are opting for it for social reasons.

Namrata Pant*, 32, had 15 eggs frozen three months ago. The software professional, who is married and has a three year-old daughter, says she wanted the option of having a second child after three or four years.

"I am on the fast-track professionally and I don't want to take time out to have a second child. I may want one in the future, though, so my husband and I thought it would be a good idea to have back-up, just in case," says the New Delhi resident. 

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"It makes me feel like I am in control of my life. Most women who opt to freeze eggs for social reasons are either professionals who don't want to take a career break or women who haven't found the right man yet," says Dr Shivani Sachdev Gour, founding director of SCI Healthcare, which has been offering egg-freezing services in Delhi for nearly four years.

One of her patients has already used up her frozen eggs to deliver twins. Her other clients include a lawyer, a marketing head at an MNC, and a politician. The average age of women who opt for cryogenic freezing is 38, though it should ideally be under 35 because that's when women produce a larger number of healthy eggs.

To ensure a successful pregnancy in the future, at least 12 to 15 eggs are frozen per client. Though egg freezing is not foolproof-chances of success are the same as any in-vitro fertilisation (IVF) cycle, which is roughly one in three - new cryopreservation techniques have improved the viability of eggs.

Until recently, the only method for freezing unfertilised eggs was slow, which destroyed the cell's structure and lowered pregnancy rates. The newer, flash freezing process, known as vitrification, chills the eggs to -196 degree celsius in less than a second, preserving quality. It also raises chances of conception from 10% five years ago to about 40%.

In routine UIVF, women opting for egg freezing inject hormones subcutaneously into the fatty tissue in the stomach, hips, or thighs, which is painless, for 11 days to stimulate the ovaries to release multiple eggs. All women produce some poor-quality eggs, with the percentage of unviable eggs climbing as they age.

For a woman in her late 30s, it can take up to 10 to 12 frozen eggs to be reasonably sure of a single pregnancy, which means at least two cycles of injecting hormones for viable embryos. Even then, there is no guarantee that every woman who opts for egg freezing will end up with a baby. While eggs that are obviously flawed are discarded right after retrieval, it is not until the eggs are fertilised with sperm that their viability can really be known.

And the risk doesn't end there. Not every healthy embryo implanted in a womb results in a baby. The last word? If you delay conception thinking of egg-freezing as fool-proof insurance, you may be disappointed. As long as you think of it as an option when there is none other, you will do fine. 

(* Name changed on request)