Other approaches to optimizing IVF success include the detection of certain factors within the egg that are important for normal embryo development. These factors could reside in certain manufacturing structures within the egg itself or in the genetic material. Future developments may be able to replace specific missing factors that could overcome problems related to infertility.
Fertility on Ice
As more and more women delay childbearing, they are seeking ways to keep their fertility options open. Traditionally, these fertility preservation methods were made available to women who were facing radiation or chemotherapy and were likely to lose their reproductive function. Nowadays many women wish to preserve their future fertility for social reasons. Embryo freezing is the most efficient and effective method of preserving fertility. This requires the woman to undergo ovarian stimulation, use her partner's or a donor's sperm to fertilize the eggs, and freeze the resulting embryos. However, many young women and girls do not have a partner and can only have eggs or ovarian tissue frozen.
Egg freezing is a potential way to save eggs for future use. Young women may eventually deposit high-quality eggs into a reproductive bank for use when they are older, just as men can freeze their sperm and place them in sperm banks. Later, when a woman is ready to have a baby, she can simply go to the bank and withdraw what she needs.
Mature eggs are notoriously tricky to freeze safely. Newer freezing media rely on higher concentrations of coolants and faster cooling times. This results in glasslike solutions rather than ice like frozen ones that can damage the egg. Even so, only a proportion of eggs survive thawing. Some babies have been born from thawed frozen eggs in women who cannot undergo ovarian stimulation, but this is still considered a largely experimental treatment. Technological advances such as these, along with ever-improving IVF techniques, make it possible for more women than ever before to have babies.
You'll learn more about these fertility treatments as you read A Baby at Last! The first step to get you started on the right path is to figure out whether you or your partner is at risk for infertility, and you'll find help with this in Chapters 2 and 3.
If you are a woman over age thirty and have not conceived within six months of having sexual intercourse two to three times per week, you should have a fertility workup.
Advancing age impacts a woman's fertility and pregnancy outcome but should not prevent you from trying to have a baby.
Two of the most important tests to assess the number of eggs remaining in a woman's ovary are measurements of FSH and AMH in the blood on day 3 of the menstrual cycle.
If you are a woman in your late thirties or forties, talk with your doctor about donor egg IVF, embryo development in the laboratory, and preimplantation genetic diagnosis.