Fertility Preservation

Fertility preservation means collecting and freezing reproductive cells or tissue now so they can be used to attempt a pregnancy later. Eggs, embryos, sperm and in selected cases ovarian tissue can all be stored. Freezing is done by vitrification, a very rapid cooling that turns the cell glassy and avoids the ice crystals that would otherwise damage it, and the material is then held in liquid nitrogen.

The age of the cell at freezing is what is preserved. An egg frozen at thirty-two behaves like an egg from a thirty-two-year-old whenever it is thawed, and this is the whole reason the timing of the decision matters.

Two situations bring people to it. One is a planned medical treatment that may damage fertility, where the collection is fitted around the treatment schedule in consultation with the treating doctor; ovarian stimulation can now be started at most points in the cycle, so the delay is usually short. The other is a personal decision to keep options open.

In India, storage and later use are governed by the Assisted Reproductive Technology (Regulation) Act, 2021. Material is stored at a registered bank under written consent that sets out what may be done with it and for how long, and storage fees recur. Freezing improves the chances of a later pregnancy and does not guarantee one, and your specialist will discuss realistic expectations for your age before you start.

Egg and embryo freezing is a day procedure, with the collection done under sedation, and you go home the same day.

The part that takes time comes first. For ten to fourteen days you give yourself daily hormone injections at home, with a scan and sometimes a blood test every two to three days to watch the follicles grow and adjust the dose. A final trigger injection is given at a precise time, and the collection is scheduled for about 34 to 36 hours after it.

On the day of collection you come in fasting. Sedation is given through a drip so you are asleep and comfortable, and the procedure takes 20 to 30 minutes. A fine needle is passed through the wall of the vagina under ultrasound guidance into each ovary in turn, and the fluid from each follicle is drawn off. The embryologist examines that fluid immediately, identifies the eggs, and freezes them within hours, or fertilises them first where embryos are being stored. You are observed for two to four hours and need someone to take you home.

Sperm freezing needs no anaesthetic at all: a sample is produced at the clinic, assessed and frozen the same day, usually across two or three samples. Ovarian tissue freezing is a different operation, done by keyhole surgery under general anaesthetic.

During the injection phase most people work normally. Bloating, tenderness in the lower abdomen, mood changes, headaches and small bruises at the injection sites are common in the last few days as the ovaries enlarge.

After egg collection, expect cramping like a heavy period, bloating and light spotting for two to three days. The sedation wears off over a few hours and you should not drive, sign anything important or be alone that day. Most people go back to work the next day or the day after.

The ovaries stay enlarged for one to two weeks, so avoid strenuous exercise, heavy lifting and intercourse for about a week, and longer if your clinic advises it. Your period usually comes within two weeks and the next cycle is generally normal.

Contact the clinic promptly instead of waiting if abdominal swelling increases quickly, you gain weight rapidly, you are short of breath, you are passing much less urine, or you have severe pain, vomiting or fever.