Egg freezing gives cancer patients hope

By MARTIN JOHNSTON health reporter

Kyrie Kohlhagen is single, wants to have children one day and last Christmas had to face the prospect of never being able to.

In the middle of breast cancer treatment, she had a choice of sorts: start chemotherapy immediately, or delay it to protect her fertility from the drugs by having her eggs frozen.

But she would have had to go to Australia for the fertility treatment because it was not approved in New Zealand until several months later.

"I would have done it if it was available here and I had the time," the 31-year-old said. "But having chemo through the public system over Christmas ... you have to do that when you can."

Ms Kohlhagen wasn't strong enough to make the trip to Australia so she had to hope the treatment wouldn't make her infertile.

Only certain drugs threaten fertility, but Ms Kohlhagen faced a one in five chance of it happening. Yet she was fortunate: she is "pretty much cured" of breast cancer, following surgery and chemotherapy, and a blood test has shown that she is still producing eggs.

Breast surgeon Dr Belinda Scott said she saw one or two women a year who wanted a way to protect their fertility from the drugs.

Last week, the fertility specialist Ms Kohlhagen consulted, Fertility Associates' Dr Mary Birdsall, revealed that the group has frozen the eggs of four women after receiving approval from the National Ethics Committee on Assisted Human Reproduction.

The Government-appointed committee permitted freezing eggs for both lifestyle and medical reasons, as well as for couples with religious objections to freezing embryos, and when sperm cannot be obtained following egg collection.

The procedure - essentially the first phase of in-vitro fertilisation - involves giving the woman hormone injections to stimulate egg production, collecting the eggs and freezing them to minus 196C. They can be stored indefinitely.

It costs about $7000, plus $150 a year for storage. There is no taxpayer funding and health insurers are considered unlikely to cover it.

To use the eggs - the second stage of IVF - they are thawed and the sperm is injected inside. The fertilised eggs are grown into embryos and put into the woman's uterus. This costs the woman about $1000, unless she qualifies for state funding.

The chances of conceiving this way have not been quantified - only 65 babies have been born through the technique worldwide - but experts think it is far lower than the 50 per cent IVF clinical pregnancy rate at Fertility Associates.

Dr Birdsall said there had been fears of babies being born with chromosomal abnormalities because of the risk of damage within the egg caused by ice crystals, but newer freezing solutions reduced this risk.

"There has been very reassuring data about eggs coming out of the freezer undamaged."

The technical breakthrough was in Melbourne where experts showed that the sperm needed to be injected into the eggs - rather than being left to make their own way in - because the egg shells had hardened.

Despite winning official approval, egg freezing still poses ethical problems.

A Fertility Associates director, Dr Richard Fisher, said many expected that the procedure would appeal primarily to single women wanting to delay child-bearing until they had climbed the career tree, but he thought that unlikely.

Robyn Scott, co-president of support group Fertility New Zealand, said public debate was needed on whether it was acceptable for women to have eggs frozen so they could have babies when aged 60.

Publicly funding egg freezing for all comers would be unwise use of state cash, she said, but it would be justifiable for women facing infertility from cancer treatment.

The Catholic Church believes human life begins at fertilisation and objects to IVF and the discarding of embryos.