Dr. John Jain is a board-certified reproductive endocrinologist and a pioneer in the field of reproductive medicine. His specialty is fertility preservation through cryopreservation and embryo development.
Q:
What is egg freezing?
A:
Egg freezing is a process that allows women the opportunity to freeze and store their eggs to preserve the potential for having children into their later years. When and if the decision is made to pursue pregnancy, the eggs are thawed, fertilized and transferred into a woman's uterus as embryos.
Q:
Why do it?
A:
One of the things we do know about fertility is that there are four categories to evaluate when a couple is having difficulty conceiving.
We need sperm, we need the tubes open so the egg and sperm can meet, and we need a quality egg.
We know that after age 40, the quality of a woman’s eggs declines.
With egg freezing, a 32-year-old woman can freeze her eggs, and plan to use them later in life. She can wait until she finds a partner and use his sperm. You can be 40 years old, and have a baby with a 32-year-old egg.
It’s also a matter of sheer numbers. The average woman has 500,000 eggs at age 14; by 40, she has 28,000.
You drop off the scale at that point. You have 3 percent to 4 percent of what you started with, and women don’t like those odds. It is that sense of finality that women may recognize. They know they may have a hard time in three to four years, and there’s urgency.
Q:
Who is your typical client?
A:
There are the women I’ve mentioned: women who are single, in their 30s, and perhaps pursuing their career. They know they may want children at a later time, and they want to preserve those healthy eggs now.
I also have more than a handful of women who are currently married, and not ready to close that door. Some of them didn’t tell husbands. I know that’s a tricky thing. There’s deception. But she is freezing eggs because she knows and sees and feels the changes that happen with age, and I don’t know if all men see that. I don’t know if they see how passionately a woman feels about that approaching age.
Why is the husband not being told? It’s almost a safety valve for these women. It’s an emotional roller coaster and they want that security.
Then, there’s a third group of patients: women who are in a relationship where the partner doesn’t know about having kids, but the woman wants to prepare for the future.
Good things can come of that. I’ve seen boyfriends come in, and think it’s a great idea. Let’s hang out for a while; it’s not a guarantee, but it could work. And it changes the whole courtship – once you take the "baby thing" off the table, the relationship is more fun and less focused.
Q:
We saw on Deliver Me that one of your recent patients was your ex-wife, Dr. Allison Hill.
A:
Yes, Allison came to me and said she wanted to freeze her eggs. In the episode, you see that she does. There are a lot of women like Allison who might not know where life is going to go, what the future holds, and they want to have that option of having another child. I don’t know if you saw it, but our two kids came in and they are hanging all over me. I remember saying to her, “Aren’t these two challenging enough?” But they are great!
Q:
What’s in the future?
A:
We’re doing a great deal of work with cancer patients. Women who are diagnosed with cancer, and we know that chemotherapy destroys eggs in the vast majority of patients. The good news is that 70 percent of people with cancer will survive, but can’t have a child again. Their eggs are gone.
If we freeze their eggs before chemo, they have a chance to have a biologically related child in the future. This holds true for young women or even a younger child who is not married. They are having chemo so early, freezing embryos becomes difficult in the case of, say, a 21-year-old in college. They might not be mature to the point of having a family.
Freezing embryos is not the right thing for her; freezing eggs is the right thing.
We have parents bring their daughters in. She doesn’t quite have that maturity, but they know this will be an issue for her later down the line.
Of course, there are ethical issues should something happen. Who owns the frozen eggs? Can they create another child?
Overall, being able to freeze eggs, not embryos, is a tremendous application of this technology.
We can also look toward freezing the entire ovary, with thousands of eggs in it. We bring the patient in, and through laparoscopic surgery, freeze the ovary shell. When the time comes, we can implant embryos back into her uterus. That’s ovarian cryomaturation … We can take strips of the ovaries, and re-transplant those strips back into the body when the cancer is clear. In vitro maturation is going to be the wave of the future.
Q.
Is all of this expensive?
A:
It’s about $11,000, without insurance, and there’s a storage cost of $600 annually. When and if the patient returns, and wants the eggs thawed and fertilized into embryos, it’s $5,000.
Dr. John Jain leads a state-of-the art fertility center in Santa Monica, Calif., specializing in fertility preservation. In order to improve the care of his patients and make available more options for fertility and fertility preservation, Dr. Jain created a nonprofit research institute and research lab named the Lyan Institute of Fertility Research (liferesearch.org), equipped to conduct advanced experiments in the areas of stem cells, embryo development and cryopreservation. Dr. Jain’s ongoing collaboration with colleagues at the USC Institute of Regenerative Medicine, where he served on the Stem Cell Steering Committee, will enhance ongoing projects in the promising area of embryonic stem cell research.
For more information, visit www.santamonicafertility.com or www.eggfreezingcenter.com.
