I briefly mentioned how Olive was using new technology to assess egg quality. So, I sat down with Dr Jason Hitkari, from Olive Fertility Centre, in May 2022 to discuss the latest technology they are using to evaluate egg quality for women going through egg freezing.
In our discussion below, Dr. Hitkari shares how Artificial Intelligence (AI) allows them to personalize for an individual based on their eggs’ appearances and what could be their potential of future success. This can help with planning too. Based on the Violet results, you may want to freeze more eggs or you may feel confident with what you have frozen. Dr. Hitkati and I also discuss how the months leading up to an IVF egg freezing cycle is when you can be proactive in optimizing your egg quality.
I included the original blog post from December 30th, 2021 below the video as well.
Video: New IVF Technology to Assess Your Egg Quality
Improved freezing technology, vitrification, has been used in British Columbia since 2009. This technique freezes your eggs and can be a choice for women wanting or needing to delay childbearing.
Aging can be a difficult topic, and I am sorry to have to bring this up, but age still plays a key factor in the quality of the eggs. Many women I see in my practice are already over the age of 35 (closer to 40) and they would have needed hindsight to have known to freeze their eggs in their early thirties. The biggest challenge is when eggs are frozen, the quality is not known until it is later thawed and inseminated. The hope is the inseminated egg is fertilized (becomes the embryo) and is of good enough quality to grow to a day-5 blastocyst and is able to implant in the uterus and develop into a healthy pregnancy. And eventually, you deliver your baby.
Unfortunately, you need to have some faith because the actual quality is not easy to determine when you freeze your eggs. And just because you froze some eggs does not guarantee a future pregnancy. As Dr. Sarah Martins Da Silva, an NHS gynecologist, and lecturer in reproductive medicine at the University of Dundee say, “Not every egg makes an embryo, not every embryo makes a pregnancy, and not every pregnancy makes a baby.”
Let’s do some number crunching and discuss how to increase your odds of success. I will also share some good news with you about some new technology to help you assess egg quality.
There are two important factors when it comes to freezing your eggs with the hope that you can have a baby (babies) with your own eggs in the future. One is the quality of the eggs and the other is the quantity (number of eggs frozen).
Quality
Quality is often based on age. And it is a good predictor for outcomes. Still, not all 38-year-olds are equal. Chronologically you are 38, but your cells may be behaving biologically older than your chronological age which makes you biologically older than your chronological age. There are fertility tests and markers that can determine if you are biologically older or younger than your peers of the same age by testing hormones such as FSH, AMH, Estradiol, and LH. You can also have an ovarian ultrasound to count follicles (AFC) in each ovary. There are steps you can take to help optimize your egg quality before you start an egg freezing cycle. If you go to a naturopathic or Chinese medicine clinic, we will look at other biological markers to help assess if you are functioning at your biological peak potential for your age. We offer suggestions to help you optimize your egg quality so you can go into your egg freezing cycle with more confidence and hope that you have done all that you can to be at your peak fertility potential.
Quantity
Quantity is also important as not all eggs collected in an egg freezing cycle will be of normal genetic quality, will survive the thaw, or will become fertilized when inseminated with sperm. Egg freezing is a numbers game. There is data published that you can use to help predict how many eggs you need to freeze at your age to have a chance of having a baby. Remember, vitrification (freezing) started to become a more common practice in 2009 and many women who have frozen their eggs may not have returned to using them yet. The data set may be small, but it is the best we have and it will continue to become more robust with time as more women choose to thaw their frozen eggs and are followed to their live birth.
In simple terms, more eggs lead to more opportunities. The younger a woman is when she freezes her eggs, the higher the likelihood that using those eggs will result in a pregnancy and live birth. Unfortunately, it’s not just egg quality that declines with age, egg count declines too. This may require you to do multiple egg freezing cycles to freeze enough eggs to provide the likelihood of having at least one good egg.
To give you an idea of how many eggs you may want to freeze, I have posted data on predicting live births from egg freezing cycles by age.
A study published in the medical journal, Sterility, and Fertility in September of 2017 suggests the following rough numbers:
- Women under 35: freezing 15 mature eggs offers a cumulative 85% chance of at least one live birth.
- Women 35 to 37: freezing 20 mature eggs offers a cumulative 80% chance of at least one live birth
- Women 38 to 40: freezing 30 mature eggs offers a cumulative 75% chance of at least one live birth.
- Women 40 to 42: freezing 30 mature eggs offers a cumulative 50% chance of at least one live birth.
Dr Areiyu Zhang from Olive Fertility Centre in Vancouver, provided this chart below in her Fall 2018 newsletter from the data found in Human Reproduction 2017 study – Goldman RH et al. Predicting the Likelihood of Live Birth for Elective Oocyte Cryopreservation: A Counselling Tool for Patients and Physicians:
| Age | 5 eggs | 10 eggs | 15 eggs | 20 eggs |
| 25 | 35% | 60% | 73% | 83% |
| 30 | 30% | 57% | 70% | 81% |
| 35 | 29% | 53% | 69% | 78% |
| 40 | 22% | 37% | 50% | 60% |
These numbers are general guidelines and since you are unique please consult with your reproductive endocrinologist about your individual past and current medical history to determine the correct target number for your unique situation.
There is also a tool developed by the Brigham & Women’s research team you can use to help calculate your chances of having one, two, or three babies, based on your age and how many eggs you’ve frozen. The calculator is not externally validated, and as such, should be used with caution and your doctor’s recommendations and opinion would trump this tool.
We share the same goal as you at Acubalance, for you to have a healthy baby. The formula for a healthy baby is Healthy Egg + Healthy Sperm + Healthy Uterine environment. At Acubalance, we play a role in helping you maximize your egg quality. I have been excited about the laser for fertility method we have been pioneering at Acubalance. I invite you to check out some of the resources listed on our website.
I wanted to share some recent positive and hopeful news. The goal of egg freezing is to lead to the birth of a healthy child, which discussed above has been estimated by age and the number of frozen eggs. The promising news is there is new technology being tested at Olive Fertility Centre in Vancouver that can actually help them to make personalized predictions, not just based on age and the number of eggs, but also on the characteristics of your individual eggs. It is non-invasive as it only needs a picture of your egg to analyze it. Olive IVF is the clinic we at Acubalance go onsite to provide IVF acupuncture on transfer day. We make a good integrative team as we are both innovating and pioneering new fertility treatment approaches.
The name of this AI tool is called Violet. Each egg is analyzed independently, and a probability distribution is generated to predict the chances of developing into a healthy embryo and resulting in a live birth. Violet provides a more granular, evidence-based probability of success for each patient.
According to Dr Nakhuda, a co-founder and co-director at Olive Fertility Centre, “Violet offers a more personalized knowledge base than we have ever had before. “Instead of playing the odds just based on age and egg number, every patient, every cycle, and every egg can be considered independently.”
I know for many it is unlikely or even possible to freeze as many eggs as suggested by the current data to increase your chances of success to a satisfactory level. I wish there was a way to guarantee you success. But by using these tools like laser acupuncture for fertility and AI technology like Violet, you may be able to increase your chances with freezing fewer eggs than the charts we shared above. That is my hopes anyway. I look forward to supporting you on your fertility journey including your next egg freezing cycle.