Preserving empowerment

Fertility preservation is not common dinner table conversation. In fact, it’s fairly taboo to talk about it anywhere, but a new series of workshops from Keren Gefen, the renowned organization providing support for women undergoing fertility treatment, is aiming to change that and shed some light on the subject with the Fertility Preservation Workshops.

“I started hearing more and more about freezing the egg as a form of fertility preservation and that it can yield children later on,” Keren Gefen founder Dr. Karen Friedman states.

“I thought about how I could offer support groups on this subject and that it could save women a lot of pain. Since I started doing these groups, I have been flooded with phone calls. The idea is just to do it and get it over with. Then you can go on with your life. Maybe you’ll get married next year and you won’t even have to touch those eggs, but if you freeze them when you’re in your 30s and you get married years from then, you’ll have them and you won’t need to be stressed about your chance of having children.”

Fertility Preservation Workshops are geared toward women aged 30 to 36 who either haven’t found their partner yet, or for whatever reason are not ready to have children in the foreseeable future. It is not necessarily for women who have known fertility problems; Friedman sees egg freezing as a kind of insurance and wants women to become educated about the option and thus empowered to make their own decision.

There are no other workshops like this in Israel.

“We want to start by addressing the decision-making process and the fears,” Friedman says.

“Most women harbor this fairytale fantasy of growing up, meeting a prince, and living happily ever after.

When they come to this group, they are facing the fact that that hasn’t happened. So part of this is support; not everything in life is what we planned. Now how do we face that? “Coming to this group means that they are not ignoring or denying it. They are taking control of their lives. My role is to take the taboo out of fertility preservation. It’s not a bad thing and it’s not shameful.

They are taking their fertility into their own hands. This also affects dating; women might be making the wrong decisions because they feel rushed about who their partner is going to be and stressed about their fertility. They don’t have to marry the next person they meet.”

One session will focus solely on the medical procedure itself. Answering questions like what are the hormones used? Is it painful? Workshop attendees will hear about the success rates and learn how long frozen eggs remain viable. Friedman will bring in a doctor from Hadassah University Medical Center for each session to answer questions on the nature of the egg freezing procedure.

Dr. Yuval Bdolah, senior physician at the Sperm Bank and IVF unit of Hadassah on Mount Scopus, is one of the doctors facilitating the Fertility Preservation Workshops.

“As fertility physicians, we see more and more women who seek help trying to conceive at a later age,” Bdolah explains. “When they’re 40 and over, they ask why no one told them about preservation. It is very important for a woman to think about her fertility before she gets to that age. Sometimes a woman is in the middle of her career, but at the end of her fertility. There is a discrepancy there. We think it’s a very good idea for a woman of about 30 to try and preserve her fertility. The main problem when trying to conceive at an older age is the eggs. It’s not the uterus.”

Bdolah emphasizes that when a woman’s fertility begins to decline somewhere in her 30s, there is a twofold process taking place: quantity and quality. He goes on to explain that when a woman is in her mother’s womb, she has about six million eggs. When she is born, it immediately drops to a million. When a girl starts to ovulate around the age of 12, she has about half a million eggs. When she reaches 45, she will have approximately one thousand left, but the quality of those eggs is typically no longer good.

“Egg quantity and quality work synergistically,” he adds.

“Based on that, it’s a good idea for a woman in her 30s to think about these issues and to have insurance in the form of egg preservation. We give the woman a hormone treatment for a week beforehand, which is very mild with few side effects. The procedure of drawing out the eggs is also not very difficult. It’s done under general anesthesia in half an hour. It is not a major operation. This is a good idea, but it is far from 100%. It’s not something to do and then forget about your fertility.”

Hadassah has been freezing fertilized eggs since the 1980s, but freezing unfertilized eggs, which is technically more difficult, is relatively new. Some patients who come to Dr. Bdolah and his staff for help with preservation choose to freeze half of their eggs fertilized with donor sperm and half unfertilized, in case they meet their partners later on. That is an option that is only possible at Hadassah, as it has the only sperm bank in Jerusalem.

One drawback to the egg freezing method of fertility preservation is financial; the procedure is costly. Due to this and lack of awareness, only 100 to 200 women come to Hadassah for egg freezing each year, and very few return to thaw them. Thus the data on success rates is low. Health Ministry regulations dictate that a woman 30 or older can undergo the procedure three times and can freeze up to 20 eggs. On average, Bdolah says they freeze seven eggs per procedure. Hadassah is the only hospital in Jerusalem that allows a woman to use her frozen eggs later as a single parent.

“Egg freezing is expensive, but I could make the point that raising children is also expensive,” Friedman says. “It’s important to see this in perspective. This really is like insurance that you would pay for your car or your home and hopefully you won’t have to use it, but if you do, it’s there. I don’t want to come to the group with a spreadsheet. I would like to say, guys, this is an issue, let’s discuss it. There is a lot to learn.”

Regarding the financial concerns, Friedman hypothesizes that women might want to start a lobby and find out which sources will give them funding. She points out that Hadassah is connected to a free loan society, which could prove helpful for those who want to preserve their eggs but can’t afford it.

The Fertility Preservation Workshops will focus on the emotional concerns, as much as the medical and economic ones, harking back to the mind/body platform that is the bedrock of Keren Gefen. Participants may be troubled by what egg preservation says about them; whether it means that they’re old.

“These are questions that need to be dealt with in the presence of an experienced therapist,” Friedman says.

“Our mission is to expose the important issues and make information and support readily available to these women. I hope that women will view the fertility preservation process as a way to take responsibility for their future.

“Creating a baby is usually done with a partner. Our organization wants to be that partner. We offer emotional support during the process of fertility treatment or preservation, and in some ways we imbue it with spiritual meaning. It’s not just the 10-week sessions; women have a professional to guide them afterwards.

“We all pride ourselves in keeping our lines open. That’s just how it is when you’re in this line of work.”

The Fertility Preservation Workshop in Hebrew is already under way, and the English group begins February 13. More workshops will be added in the future to meet demand.

www.kerengefen.org/

Keren Gefen’s newest initiative focuses on fertility preservation.