• In Spain the average age of first time mother is 30.7 years, second-highest age in Europe. In Assisted Reproduction it’s already close to 38.
• Fertility preservation offers women, men and kids the possibility of freezing their gametes to have a family in the future, both for medical and social reasons.
Valencia, 9th March 2017.- CREA, assisted reproduction medical centre, observed in the last 5 years an increase of 30% of patients attending the Clinic to preserve their fertility, not only for social reasons but also for medical ones.
This increase could be explained by last data provided by INE (Spanish National Statistics Institute), which reveals that in 2015 deaths exceeded births, reflecting not only the unpreventable Spanish population ageing but also the increasingly later access to motherhood which has risen by more than one year in the last 10 years and that was of 30.7 years in 2015. It’s an increasingly growing figure that becomes even higher in assisted reproduction treatments, where it almost reaches the age of 38.
Similar data were also reflected in the last Eurostat report (8th March 2017) which is informing that in 2015 although Spain had the fifth highest birth rate in Europe (418.400), Spanish women (30,7 years), together with Italians (30,8 years) kept being the ones more delaying motherhood of the whole continent, where the average age is around 28,9 years. It’s also important to highlight that compared to the European average, Spain has the fourth lowest fertility rate (1.33), exceeding only the ones of Portugal, Poland and Cyprus. The highest fertility rate belongs to France, with 1.96 points, still far from recovery rate, that would be around 2.1 points.
Likewise, last figures from INE (2015), point out that birth rate in Spain was only 9 births per 1000 persons, 15% less than in 2010. Fertility rate also dropped considerably in the past few years; it concretely dropped more than a 6%, actually being of 38.9 born babies per 1000 women.
“Nowadays we are facing a very complicated panorama (we found ourselves in very complicated circumstances) which is not at all favouring motherhood. Financial crisis we have been suffering over the last years, in addition to other issues, such as the desire of having a successful career, the need to save before thinking about starting a family or the lack of a stable partner. Together with purely medical issues, these are the factors for which motherhood is increasingly been delayed in our Country”, Dr. Carmen Calatayud, CREA’s co-director explains.
Fertility preservation, an investment for the future
Each woman is born with a limited number of eggs, which she’s losing over the years. From the age of 35, only a 10% of the initial reserve is left. This is accompanied by a decline of egg quality, thus pregnancy chances in women are dropping due to age and over the years this decline is progressive. In this sense, Dr. Calatayud points out “This is the reason for we have to highlight the importance of becoming aware that if a woman wishes to become mother but she believes that it’s not her time yet, it’s advisable to preserve her fertility in order to have more chances of having children with her own eggs in the future”.
Fertility preservation consists of submitting the best quality eggs to ultrarapid freezing with liquid nitrogen to -196ºC, through a procedure called vitrification. They can subsequently be thawed years later, maintaining the same characteristics and properties they had at the time of freezing. “It is therefore advisable to carry out gametes vitrification when there is still an adequate ovarian reserve, that is, before the age of 35. As age increases, eggs might have worst survival, as well as more chromosomal abnormalities and thus pregnancy chances will be lower”, Doctor explains.
When fertility is jeopardized by disease
These procedures are also playing a leading role in cases of medical nature as some treatments, such as oncology ones, might seriously or irreversibly affect patient’s fertility. In these cases it is fundamental the cooperation with a multidisciplinary team of health professional among which there must be a fertility specialist since the disease’s diagnosis, in order to offer patient the possibility of preserving his gametes without compromising treatment for his disease. Likewise, each patient is different and, therefore, his fertility preservation treatment must be individualized as much as possible to obtain the best results.
Once disease has been treated, patients who had preserved their fertility will have the chance of achieving their wish of becoming parents. Dr. Calatayud explains: “Thanks to advances in reproductive medicine, the occurrence of cancer does no longer involve a renounce to have descendants. Thanks to fertility preservation we can offer, to both adults and kids, the possibility of freezing their gametes so they can decide whether to start or not a family with their own genetic material after having overcome the disease. A part from cancer, this treatment is recommended in cases of endometriosis, family history of early menopause, autoimmune diseases or prior to ovarian surgery or gonadotoxic treatment”.
To obtain optimum results in this kind of treatments it’s always important to count on state-of-the-art technique, not only in cell freezing but also in posterior storage of samples, aspects that allow offering more safety and effectiveness. “Also” – explains Dr. Calatayud – “advances as vitrification or use of laser technology meant a real revolution in assisted reproduction. They allow cryopreserved gametes and embryos to have the same potential of implanting and of giving rise to a healthy baby than fresh embryos and fresh gametes. Also, new banks, with continuous liquid nitrogen supply and telematic control with alarms for any critical factor, guarantee a stable maintenance of samples, without changes of temperature”.
In addition to these indications, there are others, not so medical, such as freezing semen sample before vasectomy or during assisted reproduction treatment when the male patient won’t be present or even if he has difficulties in obtaining the sample. “In short, thanks to fertility preservation, nowadays science allows bypassing medical issues and it is moving the hands of the biological clock at our favour, so that we can keep fulfilling the dream of becoming parents of all our patients”, concludes Dr. Calatayud.