Beyond egg freezing, embryo preservation offers fertility lifeline for couples

medium nocaption120119032When 32-year-old Poonam (name changed) was diagnosed with breast cancer in 2017, she had already started planning for a baby. Aggressive chemotherapy meant that her eggs could be damaged substantially, harming her chances of conceiving. That’s when doctors suggested that the couple freeze their embryos before Poonam began chemotherapy.“We did an ICSI (intracytoplasmic sperm injection procedure in which a single sperm is injected directly into the egg) in 2017 and froze the embryo. Post chemotherapy, once her oncologist gave a go-ahead, we did the frozen embryo transfer in 2022 through a natural cycle,” says Dr Sneha Sathe, fertility specialist at Nova IVF Fertility, Mumbai who treated Poonam. In 2023, the couple welcomed a healthy baby boy.With late marriages and external factors like stress and pollution leading to a rise in fertility issues in both men and women, several couples are opting for techniques like embryo freezing. The Indian Society of Assisted Reproduction estimates that as of 2024, around 27.5 million couples in India are infertile. While 35 was assumed to be the cut-off age for a smooth pregnancy earlier, doctors say this age is progressively getting pushed back. However, by freezing their embryos, couples can bypass the biological clock to a good extent though no procedure offers guarantees.But what exactly is it and how is it different from freezing one’s eggs? Specialists say embryo freezing is a process that requires fertilised eggs and sperm. Dr Sathe explains the process. “For embryo freezing, one needs to wait till the blastocyst stage (5-6 days after fertilisation, for a high success rate in pregnancy),” she says. The selected embryos are frozen.medium nocaption120119152There are couples who use it for family planning as well. “Couples who conceive successfully during their first IVF cycle and wish to have another child without undergoing another IVF cycle also go for embryo freezing. We also see women with severe endometriosis, recurrent miscarriages, or uterine abnormalities come to us along with their partner to freeze their embryos,” says Dr Beena Muktesh, clinical director-IVF, Motherhood Fertility and IVF Centre, Gurgaon. Dr Muktesh even gets international patients as the cost of embryo storage is lower in India compared to western countries, and the quality of service is also much better.She recalls a recent case where a couple diagnosed with an unexplained fertility issue in their thirties got worried about their chances of conception after trying to get pregnant for three years. “During the woman’s IVF cycle, the fertility team successfully retrieved and froze six embryos. After the highest quality embryo was transferred and a successful pregnancy achieved, the couple were overjoyed. After four years, they decided to expand their family and returned to our centre. The medical team thawed one of her previously frozen embryos and implanted it. The process was smooth, and the woman conceived successfully again,” says Dr Muktesh, adding that even if a woman comes to them a year after her menopause, they can implant the frozen embryo by preparing an endometrium and successfully impregnate her.However, according to the Assisted Reproductive Technology (Regulation) Act of 2021, embryos can be stored for a maximum of 10 years, after which they must either be allowed to perish or be donated to a registered research organisation with the consent of the commissioning couple or individual. “In case a couple chooses to go for surrogacy, the embryo would be implanted into the surrogate in keeping with the Surrogacy (Regulation) Act, 2021,” adds Dr Muktesh.ShowQuotesFrozen embryos, combined with advanced genetic screening techniques, can also prevent inherited diseases, says Dr Hema Divakar, director, division of well women health care at FIGO (International Federation of Gynaecology and Obstetrics). Previously, these tests would be done after conception, where doctors would have to advise abortions in case of life-threatening genetic anomalies, which would be quite traumatic for couples and their families. “But now, by enabling preimplantation genetic testing (PGT), we can identify embryos free from genetic disorders before implantation, ensuring healthier future generations while giving parents the opportunity for informed reproductive choices,” she says.Such genetic screening is also useful in cases where families having a child with thalassemia want to conceive a second time with the hope that the second child could be a match for stem cell transplantation. Dr Divakar says she saw success in one such case where a disease-free embryo was selected and the newborn’s cord blood was used for stem cell transplantation, successfully treating the older sibling’s thalassemia.But simply freezing embryos does not guarantee a pregnancy in future. “Along with the quality of the embryo itself, success also depends on the woman’s age and her uterine health,” says Dr Divakar. And it’s pretty expensive, too. A one-time fee for IVF and freezing of embryos ranges between Rs 1.5 lakh and Rs 2 lakh in a tier-one city. Additionally, annual payments for embryo storage may amount to Rs 15,000-Rs 30,000.