The risks associated with egg freezing relate to the administration of medications to stimulate the ovaries and the procedure of egg collection. The main risk associated with the administration of medications to stimulate the ovaries is ovarian hyper stimulation syndrome (OHSS). This is a transient syndrome in which there is increased permeability of the blood vessels, resulting in fluid loss from the vessels into the surrounding tissues. In most cases the syndrome is mild, with symptoms such as abdominal bloating, mild discomfort and nausea. In moderate OHSS there is increased abdominal bloating resulting in pain and vomiting. Reduced urine output may occur. Severe OHSS is serious with even further bloating so that the abdomen appears very distended, thirst and dehydration occur with minimal urine output. There may be shortness of breath and there is an increased risk of DVT and/or pulmonary embolism. Kidney and liver function can be compromised. Hospitalisation under specialist care is indicated. There is no treatment for OHSS, supportive care until the symptoms naturally resolve is required. If an hCG trigger has been used with no embryo transfer, OHSS usually resolves in 7–10 days. If an embryo transfer has occurred and pregnancy results, the symptoms may persist for several weeks. Doctors reduce the likelihood of OHSS occurring by decreasing the doses of gonadotropins (FSH) administered, using a GnRH agonist trigger (instead of an hCG trigger) and freezing all embryos for transfer rather than conducted a fresh embryo transfer. Risks associated with the egg collection procedure relate to bleeding and infection. The collection procedure involves passing a needle through the wall of the vagina into vascular stimulated ovaries. A small amount of bleeding is inevitable. In rare cases, there is excessive bleeding into the abdomen requiring surgery. It is important that women undergoing the procedure advise their specialist of all medications, including herbal supplements, they are using so the specialist can assess whether any of these medications will affect the ability of the blood to clot. In relation to infection, provided the woman does not have additional risk factors for infection (suppressed immune system, use of immuno-suppressive medications or large ovarian endometriomas) the risk of infection is very low. One additional risk of the ovaries being temporarily increased in size is ovarian torsion. Ovarian torsion occurs when an enlarged ovary twists around on itself, cutting off its blood supply. The condition is excruciatingly painful and requires urgent surgery to prevent the ischaemic loss of the ovary.
Oocyte cryopreservation
Embryo cryopreservation
Egg donation
Fetal surgery
Assisted zona hatching
Gonadotropin preparations
Fertility preservation
Embryo transfer