Adina Reff

So­cial free­zing and En­do­me­triosis

Lower ab­do­minal pain as soon as mens­trua­tion starts, back pain, di­ar­rhoea — Julia went through hell for a de­cade be­fore she found out what she had been suf­fe­ring from: en­do­me­triosis.

“What I thought for years was ir­ri­table bowel syn­drome, bladder in­fec­tions, a poor im­mune system and ge­neral hy­per­sen­si­ti­vity was fi­nally going to make sense with the dia­gnosis. But until I was fi­nally taken se­riously, I had to con­ti­nuously live in pain and igno­rance for eleven years.” This is how the now 23-year-old de­scribes it.

De­pen­ding on esti­ma­tions, bet­ween eight and 15 per­cent of women with cysts and in­flamma­tion of the ova­ries or in­tes­tines caused by en­do­me­triosis not only suffer for years. Their sym­ptoms are often not taken se­riously. After all, there are pain­kil­lers and “women have to go through it” — this is often the un­ani­mous opi­nion of re­la­tives, but also of doc­tors. But per­se­ve­ring and ta­king pain­kil­lers is not en­ough, be­cause the foci spread with every cycle and can cause long-term da­mage. Scar­ring and ad­he­sions are the re­sult.

The pro­blem is often a lack of know­ledge, be­cause the causes of en­do­me­triosis have not yet been fully re­se­ar­ched. Ne­vertheless, en­do­me­triosis is now re­garded as a sys­temic di­sease whose tre­at­ment is multi-pronged — for ex­ample, through sur­gery, hor­monal the­rapy, changes in diet and re­la­xa­tion tech­ni­ques.

Espe­cially for women who want to have children, the dia­gnosis of en­do­me­triosis is often ca­ta­stro­phic. This is be­cause the re­cur­rent in­flamma­tions and ad­he­sions on the ova­ries, as well as scar­ring caused by pre­vious en­do­me­triosis ope­ra­tions, can se­verely af­fect fe­male fer­ti­lity in ad­vanced stages. For every se­cond woman suf­fe­ring from en­do­me­triosis, the di­sease is the re­ason why pregnancy does not work out so ea­sily.

Medizinische Behandlung

So what can be done to pre­serve fer­ti­lity in en­do­me­triosis?

One pos­si­bi­lity is the so-called “so­cial free­zing”. This pro­ce­dure, also known as cryo­pre­ser­va­tion, in­volves the har­ve­s­ting of eggs and their sub­se­quent pre­ser­va­tion at very low tem­pe­ra­tures. The ac­tual free­zing pro­cess in­cludes a de­tailed gynae­co­lo­gical ex­ami­na­tion to ex­amine the egg re­serve, hor­mone sti­mu­la­tion to ob­tain as many (at least twenty) eggs as pos­sible and a sub­se­quent short ope­ra­tion in which the eggs are re­moved via punc­ture. These are stored at minus 196 de­grees in li­quid ni­trogen and can be kept safe in­de­fi­ni­tely.

In the case of en­do­me­triosis, the de­sire to have a child can be post­poned until a later date. The eggs are then thawed and fer­ti­lised with sperm via IVF or ICSI and then im­planted in the uterus. Like the free­zing me­thod, thawing is also con­si­dered a safe stan­dard pro­ce­dure.

To be dsi­t­in­guish, in the case of en­do­me­triosis it is more of a me­dical free­zing, be­cause the re­a­sons for cryo­pre­ser­va­tion are not of a so­cial na­ture (for ex­ample, be­cause there is not yet a stable part­nership or you are still stu­dying), but of a me­dical na­ture.

The chances of suc­cess with so­cial free­zing

In the course of time, not only the vi­ta­lity of the eggs de­cre­ases, but also their quan­tity. It is the­re­fore ad­vi­s­able to carry out a pos­sible cryo­pre­ser­va­tion as early as pos­sible. The pro­ba­bi­lity of a he­althy child from an egg of a woman in her mid-twen­ties is about three times higher than that of a woman in her for­ties

The chances of suc­cess the­re­fore in­crease the less the en­do­me­triosis has spread in the ab­domen and the younger the woman is. If a pa­tient is under 35 when she freezes her eggs, the rate of pregnancy is esti­mated to be 40 per cent per cycle. Two in three women under 35 years of age at the time of their first IVF tre­at­ment, the de­sired baby is con­ceived after three tre­at­ment cy­cles.

The costs of so­cial free­zing

There is no ques­tion that the costs of so­cial egg free­zing are high. Several thousand euros come tog­e­ther for the tre­at­ment. This is due to drugs for the hor­monal sti­mu­la­tion, but also to the com­plex me­thod of ob­tai­ning the eggs. In com­pa­rison, sperm free­zing is che­aper, be­cause sperm ex­trac­tion is so much simpler. The costs of sto­rage must also be con­si­dered.

After a long tug-of-war, sta­tu­tory he­alth insurances will now pay for fer­ti­lity pre­ser­va­tion mea­sures for cancer pa­ti­ents on a pro-rata basis from 1 July 2021. This also in­cludes so­cial free­zing. The costs for the later, ne­cessary ar­ti­fi­cial in­se­mi­na­tion will also be co­vered on a pro-rata basis.

It is to be hoped that in the near fu­ture en­do­me­triosis pa­ti­ents will also be fi­nan­cially sup­ported in their de­sire to have children. Julia, an en­do­me­triosis pa­tient since the fourth grade, was lucky: after her dia­gnosis and an ope­ra­tion, she and her partner de­cided to have a child ear­lier than planned be­cause of the di­sease. And it worked out wi­thout ar­ti­fi­cial in­se­mi­na­tion! Now Julia is in the last tri­mester of pregnancy and is loo­king for­ward to being a little fa­mily.

About Fer­tilly

At Fer­tilly, we have made it our mis­sion to ac­com­pany cou­ples (ho­mo­se­xual and he­te­ro­se­xual) and sin­gles on the way to ful­fil­ling their child wish. In doing so, it is im­portant to us to create trans­pa­rency in the area of fer­ti­lity ser­vices, to pro­vide in­for­ma­tion and know­ledge on the to­pics of pregnancy and fer­ti­lity and to help you to find the most sui­table Fer­ti­lity Center. Through coope­ra­tion with first-class Fer­ti­lity Cen­tres and cli­nics in Eu­rope, en­qui­ries about Fer­tilly are given pre­fe­ren­tial tre­at­ment. This means that our pa­ti­ents avoid the usually long wai­ting times and get ap­point­ments more quickly.

If you would like more in­for­ma­tion about Fer­ti­lity Cen­ters, suc­cess rates and prices, please con­tact us using this ques­ti­onn­aire. We will ad­vise you free of charge and wi­thout any ob­li­ga­tion.

  • An­swer the first ques­tions in the on­line form in order to book an ap­point­ment. This way we can better ad­dress your needs du­ring the con­ver­sa­tion.

  • We will find the best con­tact person for your in­di­vi­dual needs. Sche­dule 20 mi­nutes for the con­sul­ta­tion.

  • We will in­tro­duce you to the right fer­ti­lity clinic from our net­work, make an ap­point­ment and ac­com­pany you until your wish for a child is ful­filled.

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