By Azoma Chikwe
A major milestone was recently recorded in the field of in-vitro fertilization (IVF) when an egg harvested from a woman with fertility problem was stored over a period of time through freezing, got fertilized to form an embryo, put back in the woman’s body where it developed into a bouncing baby boy whom she has put to bed and named Tiwatope.
Tiwatope’s mother had her eggs frozen using the vitrification, also known as flash-freezing process. This is the cutting edge technology in cryobiology, where the eggs or oocytes of a woman is dehydrated and the water content is replaced with “anti-freeze” solution (cryoprotectants) before freezing. This will prevent the formation of ice crystals which could destroy the cell.
On her readiness for pregnancy, the eggs were fertilized using a standard technique known as intra cytoplasmic sperm injection(ICSI) in order to overcome the egg shell which normally gets hardened with freezing. The fertilized egg was subsequently transferred into her womb, resulting in the pregnancy with Tiwa. She had her antenatal care in her family hospital and delivered the baby boy through caesarian section.
The baby and his mother are in good health to the delight of the family and friends.
Egg freezing is particularly recommended for women diagnosed with cancer who may lose their fertility during chemotherapy; women with a family history of early menopause; women with objections to storing frozen embryos for religious and/or moral reasons; and women who want to delay childbearing in order to pursue some personal goals.
This offering is being delivered to many women in the developed world and is now being offered in Nigeria.
The feat is a major scientific breakthrough not only for the Bridge Clinic where it was recorded but also for Nigeria as a nation. This is the first time the procedure of making a baby from a frozen egg will yield fruit in Nigeria despite efforts by IVF experts to make it happen over the years. However, the procedure has been perfected in some advanced countries and the success rate over there impressive.
Speaking, Dr Emmanuel Owie, Fertility Physician, Bridge Clinic, said, “ we are celebrating the birth of Tiwatope, our first baby (boy) conceived through the oocyte (egg) freezing protocol.
“Tiwa’s birth is significant in many respects. He puts Nigeria on the global map as regards the practice of oocyte cryopreservation, a new offering in the in-vitro fertilization (IVF) space. Before his birth on 16 February, 2016, this new practice seemed to be an exclusive preserve of the developed world of Europe and North America. It is even more significant considering the fact that since the report of the first pregnancy through this protocol in 1986, the practice has resulted in the birth of only about 5,000 babies worldwide.
“We celebrate Tiwa’s birth as it is a further demonstration of our coming of age in the practice of assisted reproductive technology. It is a show of the sum of our strengths – our people, our process andour infrastructure. It demonstrates our commitment to global best practices whichensures that our offerings are in tandem with what is obtainable in the developed world, both in variety and in quality.”
Egg freezing – Facts you need to know
Oocyte cryopreservation(egg freezing) – Cryopreservation refers to the cooling of cells and tissues to sub-zero temperatures in order to stop all biological activity and preserve them from future use. Human oocyte cryopreservation (egg freezing) is a process in which a woman’s eggs (oocytes) are extracted, frozen and stored. Later, when she is ready to become pregnant, the eggs can be thawed, fertilized, and transferred to the uterus as embryos.
When the practice of egg freezing started – Cryopreservation itself has always played a central role in assisted reproductive technology. The first cryopreservation of sperm was in 1953 and of embryos in 1983. Dr Christopher Chen of Singapore reported the world’s first pregnancy in 1986 using previously frozen oocytes.These eggs were frozen using a slow-freeze method.This report stood alone for several years indicating a much lower success rate than that of traditional in vitro fertilization (IVF) techniques using fresh oocytes. Then came a new direction in cryobiologyin 1999, called vitrification, a flash-freezing process used by Dr Lilia Kuleshova, to achieve a live birthfrom frozen human oocytes.
How egg freezing works – Although sperm and embryos have proved easy to freeze, the egg is the largest cell in the human body and contains a large amount of water. When frozen, ice crystals form that can destroy the cell. We must dehydrate the egg and replace the water with an “anti-freeze” (cryoprotectants) prior to freezing in order to prevent ice crystal formation. We also learned that because the shell of the egg hardens when frozen, sperm must be injected with a needle to fertilize the egg using a standard technique known as ICSI (Intracytoplasmic Sperm Injection).
What is involved in egg freezing – In order to retrieve eggs for freezing, a patient undergoes the same hormone-injection process as in-vitro fertilization. The only difference is that following egg retrieval, they are frozen for a period of time before they are thawed, fertilized and transferred to the uterus as embryos.
Who should consider egg freezing – Generally, egg freezing is viewed as a way to thwart a “ticking biological clock” of women who when they grow older, are more likely to produce eggs that will have chromosomal abnormalitiesthat can make it harder or impossible for them to conceive and carry pregnancies to term. On the other hand, egg freezing is particularly recommended for the following:
Women diagnosed with cancerthat may lose their fertility during chemotherapy. Women with a family history of early menopause. Women with objections to storing frozen embryos for religious and/or moral reasons. Women who want or need to delay childbearing in order to pursue some personal goals.
When a woman can freeze her eggs – The chances for success (pregnancy) are greater if a woman uses “younger” eggs — meaning either eggs she froze in her 20s or early 30s, rather than later on.
How long the eggs can remain frozen – Eggs are frozen in the same manner as embryos, utilizing a freezing temperature of -196 degrees Celsius. Eggs could be preserved for more than ten years. Long-term storage of frozen eggs does not result in any decrease in quality.
How many eggs a woman can store to achieve a pregnancy – Based on studies, egg thaw rates of 75% and fertilization rates of 75% are anticipated in women up to 38 years of age. Thus, if 10 eggs are frozen, 7 are expected to survive the thaw, and 5 to 6 are expected to fertilize and become embryos. Usually 3-4 embryos are transferred in women up to 38 years of age. It is recommended that ten eggs be stored for each pregnancy attempt.
Is egg freezing safe? – To date, approximately 5,000 babies have been born from frozen eggs and so far, studies have shown no increased rate of birth defects when compared to the general population. Also there has been no sign of either increased rates of chromosomal defects orpregnancy complications between embryos derived from frozen eggs and those embryos derived from fresh eggs.
The costs – The costs for egg freezing are identical to those of routine IVF