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From the moment a baby girl is born, her fertility clock begins the countdown. Though she has millions of eggs in her immature ovaries, by the time she's a woman, the viability of those eggs has already started to diminish.
By age 40, her chances of conceiving have declined, while her chances of having a child with chromosomal abnormalities have increased. And if she's like thousands of women in their 30s who have yet to meet Mr. Right and whose careers and personal choices don't include, for now, child rearing, she may find herself wishing that should could freeze time.
Actually, she may be able to. Although the procedure is still considered by many to be experimental, about 200 fertility centers around the country are using new technology to collect and freeze unfertilized eggs of women in their 30s for use in their 40s.
Until now, egg banking has been employed mostly by women about to undergo chemotherapy for cancer. What is new is who it is being marketed to: thirtysomethings who are postponing having families. They see it as a way to improve their odds of having healthy children.
For older women, fertility issues generally lie not with the uterus, but with the eggs.
"We can make the uterus do what we want it to do," said Dr. Mary Ramie Hinckley, a reproductive endocrinologist at Reproductive Science Center of the San Francisco Bay Area. "Egg quality is the problem."
Even though a woman in her 40s is capable of conceiving, she stands a greater chance of complications and of having a child with health issues. As she ages, the risk of bearing a child with certain chromosomal disorders increases. A 25-year-old woman has a 1 in 1,250 chance of having a baby with Down syndrome; at age 45, the risk is 1 in 30.
But if a woman preserves and banks her eggs when she is 35, then those are available to her if she decides to have a child at 45.
Hinckley said her group has recently begun offering the procedure to women who want to safeguard their fertility.
"Sperm freezing has been around for decades," Hinckley said, "followed by high success rates with embryo preservation. Now we're having a much better success rate for freezing and thawing unfertilized eggs."
While egg banking has so far drawn none of the controversy and ethical dilemmas that preserving embryos has, the success rate with the eggs has been low, Hinckley said. Eggs, she said, can be fragile, and when frozen, they can shatter like a glass bottle left too long in the freezer.
The chance of taking a frozen egg, thawing it, fertilizing it and having a successful implantation has been only about 5 percent. But new techniques have improved that number, increasing the probability of conception to 20 percent.
The odds are still low, Hinckley said, but improving.
The numbers are too low for some. The official position of the Society for Assisted Reproductive Technology is that the procedure should be limited to women whose fertility is threatened by illness and disease.
"It's something that isn't really ready to be offered commercially," said society spokeswoman Eleanor Nicoll, "because the success rates for it still aren't very good. It's still under development, and a lot of work is still needed."
She said the society is concerned that women might place the future of their fertility on a procedure that may not work for them. They could be banking on a pregnancy that will never happen while overlooking the obvious: getting pregnant in the traditional way.
While Hinckley and others readily acknowledge that egg banking is not for everyone and that it still has relatively low rates of success, it can offer a measure of security and insurance for some.
Reproductive Science Center, which has offices in San Ramon, Orinda, Fremont and San Jose, Calif., sets an age limit on using banked eggs. Women must undergo the implantation procedure before their 51st birthday.
The cost of collecting eggs is an expensive one, Hinckley said. Women undergoing the procedure receive a daily injection for eight to 10 days to stimulate egg production. Then 10 to 15 eggs are extracted in an outpatient process. The price is $6,000.
The eggs are then frozen and shipped to a storage facility in Minnesota, said Kristin Ivani, a reproductive biologist who oversees the lab for the Reproductive Science Center. Cost of long-term storage is about $1 a day.
Should a woman later decide to use the eggs, there is another fee for thawing, fertilizing and implanting.
Egg banking is a natural progression of reproductive science, Hinckley and Ivani said.
"It's next new thing," Ivani said.
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(c) 2006, Contra Costa Times (Walnut Creek, Calif.). Distributed by Knight Ridder/Tribune News Service.
