For many women, having a baby is a race against the clock. School and career can put a relationship and a baby on hold. But it's becoming easier than ever for a woman to stop the clock by freezing their eggs.
For many women, postponing pregnancy is an option chosen for many reasons, both social and economic.
Rachel Risco was no different. At age 32, she was focusing on her career in finance, and a relationship, when she discovered a lump in her breast.
At first, her previous doctor dismissed it. Months later, she noticed it had grown. Tests showed it was triple negative breast cancer, a type of cancer that is particularly difficult to treat. What's worse is that the cancer had spread to her lymph nodes.
"I don't think there is anything that can prepare you for that," Rachel said of the shock she felt.
Her treatment would include extensive surgery, radiation and strong chemotherapy -- treatment that could jeopardize her ability to conceive a child.
"Sometimes as you go through chemo, and it will affect you and you can't have kids at a later time," she said.
Rachel said it was her oncologist who pointed out the potential problem. He encouraged her to consider freezing her eggs.
"You must have been overwhelmed though. You're getting information about your cancer, treatment, and about donating eggs. What was going through your head at that moment?" I asked.
"I honestly didn't have a chance to look up. I was completely inundated with information," Rachel remembers.
Chemotherapy would begin in three weeks. Harvesting eggs usually takes more than a month. From Moffitt, Rachel was referred to the University of South Florida. USF Reproductive specialist, Dr. Shayne Plosker, fast tracked the egg retrieval process, starting Rachel on injections to stimulate her ovaries.
Typically, only one egg is released per month during ovulation, but several other follicles also have the potential to develop. Hormonal therapy nourishes their growth, increasing the number of mature eggs available for retrieval.
Dr. Anthony Imudia is a reproductive endocrinologist at USF Health. He is not Rachel's doctor, but works on the same team. He says, "The procedure itself does not have significant risk."
The retrieval process takes place while the patient is asleep. Doctors pass a needle through the vagina into the ovary and aspirate the egg. It's all visualized using an ultrasound.
The eggs are frozen and stored using cryopreservation, or liquid nitrogen. Although the process of freezing embryos or fertilized eggs has been around for decades, freezing eggs by themselves was considered experimental by the American Society of Reproductive Medicine until last year.
In Rachel's case, her procedure was covered by insurance. Because it may not be clearly stated in the policy, Rachel recommends calling your insurance company or human resource department, and asking questions.
The cost is about $6,000 plus medication. Depending on a woman's age, that could mean an extra $1000 or more.
"For you to maximize the efficacy of egg freezing, we have to have enough eggs. We know not all the eggs that are frozen will survive. The higher number you have, the better chance the patient would have," Dr. Imudia says.
That chance, of having a baby, depends on many factors, includinig a woman's age. Dr. Plosker believes the odds may be about 40 to 45 percent for women as young as Rachel.
Because of Rachel's accelerated process, she says doctors could only retrieve four eggs. It will take time to heal, so she can't begin trying to conceive for at least another year. When that time comes, no matter her chronological age, her eggs will still be those of a 32 year old.
Recently engaged this Christmas, Rachel says the prospects of having a baby gives her something to look forward to as she completes her radiation therapy.
She says she has no regrets, from either not having a child sooner, or from freezing her eggs.
"I'm more than happy that I did it. And I feel very thankful and feel very blessed that I got an opportunity to do something like this," she smiles.
She wants to spread the word to other women who might not get the same advice from their oncologist, and let them know that freezing eggs can help them freeze their biological clock.
Freezing eggs has only been recognized by the ASRM as non-experimental beginning in 2012. Dr. Plosker says many believe the rate of a successful pregnancy using thawed eggs will be in the 40 percent range. He says it's too soon to know since success is measured by the number of babies born, not by the number of pregnancies.
For more information:
Tampa General Hospital
American Society Reproductive Medicine
Animation Egg Retreival