Dr. Jamie Grifo.

Finding Mr. Right. Twice.

For Would-Be Mothers, NYU Langone’s Fertility Center Makes Dreams Come True

Just four months after having her first baby, Cara (not her real name) contacted Jamie Grifo, MD, PhD, chief of the Division of Reproductive Endocrinology and professor of obstetrics and gynecology, about her hopes of having another. “I loved having siblings, and I love kids,” she explains. Three years earlier, when she was 38 and still single, Cara had turned to Dr. Grifo, director of NYU Langone Medical Center’s Fertility Center, to discuss how long her fertility would last (another doctor had told her to get pregnant right away if she wanted kids).

Not only did Cara want children, but she wanted lots of them. So when Dr. Grifo showed her a chronological chart detailing how fast her fertility was plummeting, she was shocked. But Dr. Grifo and his team had been having success with egg freezing, medically known as oocyte cryopreservation. Still an experimental procedure, it is commonly recommended to young women with cancer who wish to spare their eggs from toxic treatments. NYU Langone had begun offering the procedure to single women in their mid-30s who hoped to preserve their fertility. “It’s frightening for women to talk about this because it’s not the idealized romantic dream of how you thought you’d live your life,” notes Dr. Grifo. “Having experienced the heartache, disappointment, and rigors of infertility treatment, my wife, Anne, and I are big proponents of egg freezing. It would have greatly simplified our many years of unsuccessful treatment. We wish that all women choosing to have babies later in life know about this option, so that they won’t suffer as we did.”

Cara, for one, did not want to risk such disappointment.She didn’t want to let life happen to her, but she also didn’t want to rush into marriage for the sake of having children. So she decided to freeze her eggs through a procedure similar to that used for in vitro fertilization (IVF). Now, she needed those younger eggs. Though she did eventually marry and have a child without the need for fertility treatment, hers was a case of so-called secondary infertility—the inability to get pregnant a second time. In the first reported instance of its kind, Cara used her own frozen eggs to overcome her secondary infertility. Dr. Grifo and his colleague Nicole Noyes, MD, professor of obstetrics and gynecology and co-director of the Fertility Center’s Egg Freezing Program, described the process in the journal Fertility and Sterility

“There is a whole psychology around freezing eggs, how it impacts you, and how it affects the ticking clock,” explains Dr. Grifo. For many single women in their 30s and 40s, it’s the elephant in the room. Should they wait it out? Should they have children on their own? Should they use an egg donor? Now, there’s another question: How many children do they want? With women marrying and starting families later in life, by the time they’re ready to have a second child, many are in their 40s, facing secondary infertility because of the rapid decline in the number and quality of their eggs after 40.

To date, more than 500 women have chosen to have their eggs frozen at NYU Langone’s Fertility Center, and 24 babies have been born from them. The center has reported among the highest success rates for egg freezing and thawing in the world. This success is the result of more than a decade of pioneering work by Dr. Grifo’s team, which has refined the art and science of making babies. Freezing eggs is more complicated than freezing sperm because the egg cell is large and fragile, and when it’s frozen, ice crystals can form and damage organelles in the egg. Dr. Grifo’s center uses both a fast-freeze and slow-freeze method for nearly all patients because it’s still unclear which one is more effective. His team first tested and perfected these methods in animals; then, they conducted a clinical trial in which they offered the costly procedures for free. When their success rate equaled that of standard IVF, they made the procedure available for clinical use. Of Cara’s nine frozen eggs, five survived the thaw and were fertilized.Three embryos were implanted in her uterus, and one thrived—a baby girl. She considers her second child “a miracle” and is grateful for having found not one Mr. Right, but two.

Web Extra: for a Q&A with Dr. Jamie Grifo, see “Making Babies—a Labor of Love” at http://newsandviews.webdev.nyumc.org/web-extras-7.