Gynecology and Obstetrics Specialist Assoc. Prof. stated that the interest in Ovarian freezing, which is performed to preserve fertility and increase the chance of healthy pregnancy at older ages, has increased. Dr. Çiğdem Yayla Abide stated that Ovarians collected before the age of 35 increase success. Referring to the importance of women planning to give birth for later ages to have their ovarian reserve checked regularly, Abide stated that women who have not given birth yet, have low ovarian reserve, have a family history of early menopause, and women who undergo chemotherapy, radiotherapy, and surgeries that will damage the ovarian reserve can freeze their Ovarians.
Ovarian freezing, which became widespread all over the world after the first live birth in 1986 and became one of the fertility preservation methods, has also been applied in Turkey since 2010. The scope of Ovarian freezing, which could only be applied by cancer patients in the first years, was expanded with the regulation published in 2014 and offered the right to Ovarian freezing to every woman, whether married or single, with low ovarian reserve. Underlining that there has been a great increase in Ovarian freezing demands, especially in the last 5 years, Gynecology and Obstetrics Specialist Assoc. Dr. Çiğdem Yayla Abide said, “Today, women postpone their fertility due to reasons such as career planning, education, working life, searching for a suitable partner, not being ready for a second child, or health problems. During this process, ovarian quality decreases and chromosomal problems may occur in the ovarians. ovarian freezing is a practice we carry out at this point in order to preserve a woman's fertility and increase the chance of healthy pregnancy at older ages. There has been great interest in this subject, especially in the last 5 years. ovarian freezing can be performed for those who have not given birth yet, have low ovarian reserve, have a family history of early menopause, before chemotherapy, radiotherapy treatments and surgeries that will damage the ovarian reserve. "ovarian freezing is not applied to people who have no disease or a history of early menopause and have normal ovarian reserves," he said.
Stating that the chance of pregnancy in women is highest in the 25s, it decreases after the age of 30, and there is a significant decline after the age of 35. Abide recommends that ovarian freezing be performed before the age of 35; “Two important factors determine pregnancy rates after ovarian freezing; the woman's age at the time she froze her ovarians and the number of ovarians frozen. Freezing 8-10 ovarians under the age of 35 gives a 55-60 percent chance of pregnancy. If the ovarian reserve is low, it is necessary to perform this procedure more than once. "For women over the age of 35, even if 8-10 ovarians are frozen, the chance of pregnancy does not exceed 30 percent."
It is Possible to Store Frozen Ovarian for More than 5 Years
Abide stated that the ovarian freezing process is similar to in vitro fertilization; “First of all, we start hormone therapy to enlarge the ovarians, and we monitor the follicles in the ovarians with ultrasound and hormones. When the ovarians reach 18-20 mm (usually takes 10-11 days), we mature the ovarians by giving a cracking injection, and after 34-36 hours, we collect the ovarians with the OPU process and deliver them to embryologists. "The collected mature ovarians are frozen by the rapid freezing method called vitrification and are stored in storage tanks containing liquid nitrogen at -196 degrees," he said. Underlining that storage conditions are very important, Abide added that it is necessary to ensure that reliable embryology laboratories are preferred. Stating that frozen ovarians can be stored for 5 years and can be stored for longer with the permission of the Ministry of Health, Abide said, “The storage period, which can be extended up to 5 years every year with the approval of the patient, can be extended further with a petition to be submitted to the Ministry of Health after 5 years. In this way, ovarians can be thawed and used even after 10 years. "When the approval and petition period is delayed, the ovarians can be destroyed by the decision of the committee," he said. Stating that the time between freezing the ovarians and thawing them does not affect the success, Abide stated that it is seen in the literature that live birth can occur even after 15-30 years of thawing.
Ovarian Freezing Process is Stopped in Covid Diagnosis
Stating that if the patient is diagnosed with Covid during the ovarian freezing process, the treatment is interrupted, Abide stated that health problems such as flu infection that may arise during this process may also postpone the treatment. Abide stated that ovarian freezing is performed quickly and without waiting for patients whose treatment has not yet started after their cancer diagnosis, and expressed their concerns about the ovarian freezing process, especially for hormone-sensitive breast cancer patients. Stating that cancer patients can undergo ovarian freezing procedures in a short time, Abide stated that anti-estrogen drugs are added to the treatment of breast cancer patients, thus reducing the risk of increased estrogen hormone.
Should Murta or Embryo be Frozen?
One of the questions frequently asked by married patients before the freezing process is "should the ovarian or the embryo be frozen?" Abide made a statement on the subject; “If embryo freezing was done and the couples divorced, the embryos must be destroyed, these embryos can no longer be used. For this reason, our married patients who do not want to take risks prefer the ovarian freezing option,” he said.
Referring to the success rate of in vitro fertilization treatments with collected fresh ovarians or frozen ovarians, Abide said, “This issue is among the questions that many of our patients have. ovarian freezing means temporarily stopping the metabolism of the ovarian cell. With the vitrification method, the formation of ice crystals is prevented and ovarian cells are stored for years without dying. "According to many studies, it is possible to say that the success rate is the same."
Gynecology and Obstetrics Specialist Assoc. Dr. About Çiğdem Yayla Abide:
After studying medicine in English at Marmara University Faculty of Medicine, Assoc. Prof. obtained a high degree in the medical specialization exam (TUS) in 2007 and started to specialize in Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, which was her first choice. Dr. Çiğdem Yayla Abide completed her public service obligation at Nallıhan Hospital between 2011 and 2014. Then, he returned to Zeynep Kâmil Training and Research Hospital, where he received his specialization, as a specialist physician and took part in countless births and the treatment of thousands of diseases. The infertility treatments he applied (insemination, in vitro fertilization, ovarian freezing), risky pregnancies he followed, births he performed, gynecology surgeries (open and closed), urogynecological surgeries and cancer research were the subject of many articles published both in the country and abroad. His studies on infertility, in vitro fertilization and risky pregnancy attracted attention from international authorities, and his article on pregnancy cholestasis published in Lancet, one of the most prestigious journals in the world, shed light on many international research. Assoc. Prof., who was awarded the title of associate professor with the academic knowledge and experience he gained in 2018. Dr. Çiğdem Yayla Abide left her position at Zeynep Kâmil Hospital in 2021 and opened the doors of her clinic in Istanbul Ataşehir in 2022. He continues to share his knowledge and experience with his patients in his areas of expertise: infertility treatments (insemination, in vitro fertilization), genital aesthetics, vaginismus, closed uterine and ovarian cyst surgeries, urinary incontinence surgeries, pregnancy follow-up and birth.
