Fertility Options for Single Women
Single women may face some challenges regarding fertility options: understanding them then picking one or more options, suitable for your reproductive plans. Clearly, a woman cannot delay pregnancy indefinitely, as the number of good quality eggs decline quickly in her 30s and older.
Modern reproductive medicine enables single women to be mothers now and in the future. As with anything in reproduction, the younger you are, the more successful your efforts will ultimately be, irrespective of your choices. In addition, think of what would you accept: donor sperm? are you ready to get pregnant now or do you want do that in the future?
Are you ready to Start a Family without a Partner?
This could be a difficult question considering the time, financial and emotional commitment of raising children without a male partner. A psychologist with expertise in reproductive issues can help women tackle issues as readiness and commitment, disclosure to children when mature, capitalizing on family resources, legal issues and many more. Some anonymous donors accept open identity in the future.
Starting a family without a male partner requires a selection of sperm donor. The sperm donor could be anonymous (from a sperm bank) or known (friend). In either cases, the donor is screened for infectious diseases (hepatitis B, hepatitis C, HIV, Syphilis, Gonorrhea and Chlamydia) and common genetic abnormalities. The sperm is quarantined then the donor is retested for infectious diseases. Tests are done in a specialized high accuracy labs.
How to use donor sperm to achieve a pregnancy?
This is a question related to female ovarian reserve and other fertility factors. If the fallopian tubes are open, as indicated by HSG (hysterosalpingogram, X-ray of the tubes) then IUI (intrauterine insemination) is possible. Age is also an important factor. Women 38 or older have much higher chance of conceiving with IVF than IUI using frozen sperm. This issue require thorough evaluation by a reproductive endocrinologist.
On Starting a Family with a Partner in the Future
If the use of donor sperm is not acceptable, egg freezing is a viable option for women with reasonable ovarian reserve and younger than 40. Evaluation of antral follicle count using vaginal ultrasound and antimullerian hormone levels (AMH) can predict response to fertility medications and ultimate egg yield from the cycle. Age reflects well how many of these eggs are chromosomally normal. The ovaries are stimulated using injection medications. Eggs are retrieved under vaginal ultrasound guidance which is a minor procedure. Mature eggs are frozen 4 hours later using vitrification. Immature eggs are cultured for <24 hours and frozen if mature. The eggs can be stored for years to come.
If the number of eggs retrieved is low another egg freezing cycle can be attempted to freeze more eggs.
When pregnancy is desired the eggs are thawed and fertilized via ICSI (direct injection of the sperm into the egg) and the resulting embryos are transferred into the uterus after preparation of its lining. The pregnancy rate after egg freezing is close to fresh eggs and is age dependent.
These options allow single women achieve their reproductive goals while respecting their values and preferences.Fertility Options for Single Women by Dr. Amr Azim