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4B Wednesday September S, 2052 // The Statemet
Wednesday,eptember 5, 2012 // The Statement 5B
eTelive in an age of mechanical production. OnStar,
rather than the North Star, guides us home. Texts
determinedly buzz at our legs wherever we walk.
Technological gadgets have insinuated themselves into our
personal, professional and internal lives.
So it should come as no surprise that we also live in an age
of mechanical reproduction. That's right, the most intimate
biological process is now online and open for business.
gandwiched between Craigslist calls for "$$$ Exotic
Dancers $$$' and "Happy Finnish Massages" are multiple
inquiries-for college-aged egg donors. In the 1970s, one of
these eggs would be joined with a sperm in a petri dish and
clumsily fumble into its embrace. Sometimes, this process
- called IVF, in vitro fertilization - created a baby. Other
times, it didn't.
But now, these eggs can be frozen, hermetically sealed in
liquid nitrogen until revived from their cryogenic freeze to be
injected into a hopeful mother's uterus. You could do whatever
you wanted with these eggs - save them, implant them, study
them, throw them out. Yet, as new technologies in assisted
reproduction glide inevitably onward, the question remains:
what implications will this have on donors and the recipient
couples?
Fresh vs. frozen
There's no better adjective to describe Michael Mersol-
Barg's fertility clinic in Birmingham, Mich. than clean. A
pitcher of ice water and a tin of biscotti cookies welcome
prospective patients to the brightly-lit space. Tidily stacked
atop the waiting room chairs are magazines emblazoned with
proud parents clutching babies, their skin as smooth as egg-
shells.
A floor below, nearly 20 different eggs are suspended in
deep-freeze, tightly packed in liquid nitrogen tanks at temper-
atures nearly 200 degrees below zero. Some of these eggs are
more than three years old, waiting for the day their cell walls
will be cracked open by a sperm cap and implanted into a pro-
spective mother's womb.
Pregnancy with a frozen egg is a relatively new development
in the field of assisted reproductive technology. Rather than
going through the interminable trials (and failures) of obtain-
ing eggs from a fresh donor, infertile couples can select a pre-
frozen egg from Mersol-Barg's egg bank - the only one of its
kind in the state of Michigan - and begin IVF immediately.
Bill and Julie VanDerworp, a couple struggling with infertil-
ity from Commerce Township, Mich., recounted their struggle
to obtain fresh oocytes.
"It's a numbers game, completely," Bill said.
For every donor they selected, the VanDerworps had to wait
until the college-aged women were available for a summer
break, then gradually sync their ovulatory cycles to the recipi-
ent mother and wait with bated breath to see if the embryos
would take.
The first donor produced 13 eggs at the outset. Out of
those, 11 were viable for fertilization. But by the time the
embryos were ready for implantation - about five days after
the eggs we're mixed with sperm - only two of the original
13 remained
The two embryos implanted into Julie's uterus didn't take
and she suffered a miscarriage two weeks into the pregnan-
cy.
Another donor only produced four or five eggs at retrieval,
so it wasn't worth going through the rest of the process. But
the VanDerworps still had to incur all the cost of her medi-
cal bills and infertility drugs - about $25,000 per cycle.
"Every time you picka girl for fresh, you're.out of pocket,"
Bill said. "But it might work, it might not."
Ice without the freezer burn
The newest technology in the field - oocyte vitrification -
can preventsuch inconsistencies from happening. Now, as soon
as the eggs are retrieved from'a willing donor, they're imme-
diately frozen, stored in an egg bank and thawed at the recipi-
ent couple's convenience. Egg freezing offers a guarantee that
those oocytes selected for IVF are viable, increasing the chance
of pregnancy.
Donor sperm have been frozen and thawed for decades.
For lack of a better term, they don't get freezer burn. After
the sperm are collected, they can be quickly dehydrated and
popped into a freezer, ready to be thawed at any time.
But the difficulty with freezing the sperm's female counter-
part - the oocyte - is that it is inundated with water droplets.
Water in its liquid form is innocuous. But when it is frozen, ice
crystals form,and these crystals can be deadly to the developing
baby.
"Crystals, like snowflakes, can become jagged," said Marsha
Parker, an embryologist at Mersol-Barg's fertility clinic.
The knife-like tips of the ice crystals can destroy the egg's
interior structure, slashing through the floating chromosomes.
And pregnancy via a damaged egg can result in catastrophic
after-effects - mostcommonly, miscarriages.
Enter the process of vitrification.
Loosely translated as "freezing to glass," oocyte vitrification
involves the use of a cryoprotectant - colloquially known as
antifreeze. Unlike water, cryoprotectants don't expand when
they solidify. So if the water droplets inside of the egg could
somehow be exchanged for cryoprotectant, the harmful con-
sequences of ice crystal formation, when subjecting an egg to
temperatures changes, would be eliminated.
The first part of the process seeks to slowly exchange
the water in the egg for the cryoprotectant. Then, once the
exchange is complete, the egg is immediately plunged into a vat
of liquid nitrogen, remaining in the frozen state until it's ready
to be inseminated and implanted.
Of course, there is no guarantee with anything.
Egg freezing, especially IVF via frozen egg, is still consid-
ered an experimental procedure by the American Society for
Reproductive Medicine.
"There could be a fracture that happens at the time of
retrieval," Parker said. "There could be something innately
wrong with these eggs."
But Mersol-Barg is optimistic. -
"We always need to be cautious, and there's always uncer-
tainty," he said. "But to move forward, there has to be some
risk."
So far, Mersol-Barg has found the likelihood of pregnancy
via in vitro fertilization with a frozen egg - with about a 45 to
50 percent success rate - is equal to that of a fresh egg. Today,
his clinic has helped give birth to 29 babies from frozen eggs,
with five more on the way.
The VanDerworps count themselves among the lucky 29.
Their son, Kent, turns one in October.
Eggs for sale
To Mersol-Barg, the technology for vitrification has become
so powerful that it could eliminate the need for egg donation
agencies.
"The age of egg agencies ... eventually they're going to go
bye-bye," he said. "It's justthe future."
In other words, the central goal of the egg bank is to make
egg donation something more akin to sperm donation.
Over the years, sperm donation has morphed into a sim-
ple outpatient procedure. After filling out some preliminary
paperwork, a prospective sperm donor is handed a stack of
pornographic magazines, a plastic cup with a lid and a bio-
hazard bag. After he "produces," he will ring a buzzer. A nurse
takes the bag, holds it up to the light (there is a request that no
jokes are made duringthis moment), and
that'sit. The sperm is crystallized, stored,
and - when selected a week, a year or five
years down the line - thawed, grasped by
a fine needlepoint pipette, and injected
into a waiting oocyte ina petri dish.
But how similar is the process of egg t
donation to its male counterpart?
Well, not very much. Far from a quick
lunch-break trip to a fertility clinic, egg
donation is at minimum a three-month
process. Before their eggs are even looked
at, donors have to fill out a 30-page appli-
cation detailing their deepest, darkest
secrets, and subjected to lengthy screen-
ings of their psyches, genes and bodies.
And once they are selected by a couple
(a process that can take anywhere from
six months to a year), the donation proce-
dure is no walk in the park. Donors have to
get up early every week to get their blood
drawn and ultrasounds performed. They
must store and mix vials and vials of medi-
cation in their refrigerators - suppression
hormones to prevent premature ovula-
tion, birth control pills to synchronize the
cycles of the donor and recipient, follicle
stimulating hormones to stimulate the
growth of multiple mature follicles, anti-
biotics to reduce the chance of infection
- injecting tiny syringes of hormones into
their bellies and thighs.
The ovaries, normally the size of olives,
produce so many eggs that they swell to
the size of navel oranges. Donors can't 2 o e
drink, smoke, have sex, exercise or even
walk very fast, for fear that their swollen ovaries will knock
into their abdomen. They can't stay up too late or go to bed too
early, as this would disrupt their injection cycles.
On behalf of the egg
Mitzi Heineman, who runs Egg Donor Program of Michi-
gan, an egg donation agency based in Saginaw, Mich., regards
her role as a donation coordinator as absolutely essential.
"I am the middle person, the communicator for what's
going on with the donor, the doctor and the recipient couple,"
Heineman said. "Things can go wrong, tests can come back as
abnormal. Everything has to be perfect in order for things to
proceed."
Deemed something of a cross between a real estate broker-
See EGG FREEZING, Page 6B