Fertility Experts on How You Can Freeze Frame Your Hopes of Being a Parent for the Future

WORDS LIM TECK CHOON

FEATURED EXPERTS

DR ASHLEY CHUNG SOO BEE
Consultant Obstetrician & Gynaecologist and Fertility Specialist
Sunway Medical Centre Velocity
DR FARAH LEONG RAHMAN
Consultant Obstetrician & Gynaecologist and Fertility Specialist
Sunway Medical Centre Velocity

Not everyone that wants to be a parent can set out to become one at the present.

They may want to establish their career or education first, for example, or perhaps they aren’t certain that they are emotionally and financially ready to be a parent at the moment.

However, one’s fertility decreases over time, especially for women, so in the past, it would be a race against time to achieve one’s dreams of parenthood.

These days, technology has opened up the option of ‘freeze framing’ one’s fertility at their peak, for use when they are ready but their declining fertility at that point may make it more difficult for them to have a child.

This technology is called cryopreservation.

CRYOPRESERVATION OF A WOMAN’S EGGS
  • More popularly known as egg freezing, this procedure involves the extraction of a woman’s eggs for freezing and storage.
  • Dr Farah Leong Rahman shares that these eggs are frozen in liquid nitrogen at a temperature of around -195ºC.
  • The eggs can be stored indefinitely through an extremely quick freezing or vitrification process. However, the Human Fertilization and Embryology Association recommends that eggs should only be frozen for up to 55 years.
  • This is something that can be considered by women that wish to defer motherhood to a later age, or those that would undergo medical procedures that will affect their fertility such as cancer treatments.

“In egg freezing, a woman goes through a series of hormonal medications to stimulate her ovaries to produce more eggs,” Dr Farah tells us.

“Once the eggs are deemed to have reached maturation, egg retrieval is done to retrieve these eggs. From here, we can store these eggs for future use,” she adds.

OVARIAN INSUFFICIENCY & EGG PRESERVATION

“Ovarian insufficiency means the ovaries stop functioning earlier than expected (before 40 years old), leading to the absence of menstruation,” explains Dr Ashley Chung Soo Bee.

“If there is a family history of premature ovarian insufficiency, it is recommended for female family members to consider egg preservation prior to developing this condition if they plan to have a family in the future. Preserved eggs can be used through in-vitro fertilization to create healthy embryos for future pregnancies,” she adds.
CRYOPRESERVATION OF A MAN’S SPERM
  • A man’s sperm can also be frozen in a manner similar to egg freezing described above. This procedure is known as sperm cryopreservation.
  • A semen sample will be obtained through ejaculation and then sent to the laboratory for cryopreservation.
  • If the man is unable to produce semen naturally, Dr Ashley reveals that there are sperm retrieval procedures that may be able to overcome this issue.
  • This is an option that can be considered by men that would be undergoing treatments that can affect their fertility, such as cancer treatments. According to Dr Ashley: “Cancer treatment can cause lower sperm production, damaged sperm, or the inability to produce sperm. These effects on sperm production can be temporary or permanent, depending on the type of treatment one undergoes.”
IS CRYOPRESERVATION SAFE?

Cryopreservation is considered to be a relatively safe procedure.

“The survival rate of frozen eggs and sperm is quite high,” Dr Farah tells us, “although there is always a possibility that some cells may not survive the thawing process.”

When it comes to freezing one’s eggs, the ovarian stimulation process may cause natural elevation of hormone levels in the woman. Dr Ashley shares that this may lead to side effects such as:

  • Nausea.
  • Mood swings.
  • Hot flashes.
  • Headaches.

“A small number may be at risk of ovarian hyperstimulation syndrome or OHSS, and may experience symptoms such as nausea, flatulence, tummy discomfort or pain, and vomiting,” Dr Ashley adds.

To minimize the risk of side effects, the fertility doctor will come up with a customized regime based on one’s needs, age, health status, and other factors.

 

A Quick Primer for Understanding Ovarian Cysts & Uterine Fibroids

WORDS LIM TECK CHOON

FEATURED EXPERTS
DR WONG YEN SHI
Consultant Obstetrician & Gynaecologist
Sunway Medical Centre Velocity
DR FARAH LEONG RAHMAN
Consultant Obstetrician & Gynaecologist and Fertility Specialist
Sunway Medical Centre Velocity
DR WONG YEN SHI ON UTERINE FIBROIDS
Click on image for a larger, clearer version.

AT A GLANCE
  • They are non-cancerous growths that form in the muscular layers of the uterus.
  • One can have a single fibroid or multiple fibroids.
  • Often found in women in their reproductive years—that is, the period of time when they are capable of conceiving.
  • We still don’t know what causes fibroids to develop in a woman. Dr Wong states that hormones and growth factors could be possible causes.
YOU MAY HAVE UTERINE FIBROID(S) IF YOU HAVE…
  • Irregular or painful period
  • Heavy bleeding during your period
  • Frequent urination or constipation
  • Abdominal distension or bloating
  • Back pain
  • Unexplained weight gain
  • Painful sexual intercourse

TREATMENT

  • Fibroids can be removed via surgery. Depending on the location and size of the fibroid(s) present in the uterus, this can be open surgery or laparoscopic surgery, the latter involving the use of a laparoscope to make fewer and smaller cuts in the body. Women that no longer want to have children can also opt to have their womb surgically removed.
  • Newer treatments such as uterine artery embolization (blocking the blood vessels that nourish the fibroid, thus causing it to shrink) and high intensity focused ultrasound (HIFU) surgery can be considered, but note that not every medical facility in Malaysia offer these treatments.
  • Medicines to relieve symptoms such as heavy menstrual bleeding and painful period
DR WONG YEN SHI & DR FARAH LEONG RAHMAN ON OVARIAN CYSTS
Click on the image above for a larger, clearer version.

AT A GLANCE
  • These are sacs that contain mostly fluid, sometimes with tissues or blood, which form within the ovaries or on its surface.
  • They are mostly benign, but can be cancerous on rare occasions–especially among women between 60 and 65.
  • Ultrasound and CA125 tumour marker test are used to tell whether an ovarian cyst is benign or cancerous.
  • Conditions such as pregnancy, pelvic infections, and endometriosis can increase the likelihood of developing ovarian cysts. A woman with a history of ovarian cysts is more likely to develop ovarian cysts in the future.
  • Yes, it’s possible to have both fibroids and ovarian cysts at the same time.
YOU MAY HAVE OVARIAN CYST(S) IF YOU HAVE…
  • Irregular or painful period
  • Frequent urination or constipation
  • Abdominal distension or bloating
  • Back pain
  • Unexplained weight change
  • Unexplained loss of appetite
  • Quick sense of fullness while eating
  • Painful sexual intercourse

TREATMENT

  • Smaller cysts usually don’t require treatment. Instead, the doctor will monitor the cyst for signs of growth and other changes. 
  • Larger cysts can be removed via open or laparoscopic surgery.
CAN UTERINE FIBROIDS & OVARIAN CYSTS AFFECT ONE’S CHANCES OF HAVING A BABY? DR FARAH EXPLAINS 
  • Most women with fibroids and cysts have no problems getting pregnant.
  • However, depending on the size and location, uterine fibroids may affect one’s fertility. For example, fibroids that form in the womb lining may block the fallopian tubes, keeping the egg from being fertilized by a sperm cell, or make the womb environment less conducive for a fertilized egg to attach to the womb for further development.
  • Fibroid developing during pregnancy may increase the risk of early delivery. “In some cases, it can cause severe pain when fibroids outgrow their blood supply. If the fibroid is large, it can cause the baby to be positioned wrongly, such as the baby’s head not turning down even at term,” explains Dr Farah.
  • Ovarian cysts forming during pregnancy is usually not a cause of concern, except when the cyst grows so big that it ruptures open.

DR FARAH’S ADVICE

  • Go for regular gynaecology check-up to detect the growths of uterine fibroids and ovarian cysts as well as to ensure that the rest of the reproductive system is in good condition and working order.
  • When you’re about to embark on your pregnancy journey, seek advice from your doctor if you have a history of uterine fibroids and/or ovarian cysts.
  • We still don’t have any evidence-based method to prevent the formation of uterine cysts or ovarian fibroids. However, practicing good health and maintaining a well-balanced diet will be good for your overall well-being and improve your chances of a safe and successful pregnancy.