Egg freezing is an option that allows you to delay parenthood if you’re not ready to start a family just yet. Through this method, the eggs are extracted from the ovaries and cryopreserved (frozen) to be used in future in vitro fertilization (IVF) treatment. In this article, we’ll review all of the basics you’ll want to know about egg freezing, including who it is for, the process, factors to consider, and what happens when you’re ready to start your family using your frozen eggs.
What is egg freezing?
Female fertility declines with age. Women are born with about one million follicles, but most of these die off naturally with time. According to the American Society for Reproductive Medicine (ASRM), a woman’s best reproductive years are in her 20s. At 30 years old, a healthy, fertile woman has a 20% chance of getting pregnant each month; by age 40, this drops to 5%.
Egg freezing is therefore a way of preserving your fertility, for a greater chance of conceiving with IVF using your own eggs, when you’re ready to start a family. While pregnancy can still happen naturally in your late 30s or early 40s, if you find it hard to conceive, it’s good to know you have a plan B.
Should I consider egg freezing?
Egg freezing is an option if:
- You are not ready to get pregnant or, for example, you prefer to start a family with a partner but haven’t met your partner yet, and want to ensure you have a good chance of starting a family in the future. This is known as ‘elective egg freezing’.
- You have a medical condition that can affect your reproductive health, such as sickle cell anemia, and lupus, or you have received a cancer diagnosis which requires fertility-impacting treatment. It may be hard to predict to what extent cancer treatment will affect your fertility, so it’s important to consider egg freezing prior to starting treatment.
- You’re transitioning to a new gender. Treatment may result in infertility – egg freezing preserves your fertility before you start the transition.
- For personal or ethical reasons, you prefer freezing your eggs rather than having leftover frozen embryos after IVF treatment.
The egg freezing process
As renowned Fertility Specialist and Instagram’s ‘@eggwhisperer’ Dr. Aimee Eyvazzadeh explains, egg freezing is a two-week process. During this time, you can expect to visit your reproductive endocrinologist five times, the first time when your period starts and the last for the egg retrieval procedure. In between these visits, are ultrasounds and a blood draw. Below is a more detailed overview of what to expect during this time, and preceding it:
- Preparation – before starting the egg freezing process, your doctor will likely test your ovarian reserve through a blood test on day 3 of your cycle. This is done to determine the quantity and quality of your eggs. The results will help predict how your ovaries will respond to fertility medication. An ultrasound of the ovaries is also done. At this stage, you’re also screened for infectious diseases, such as HIV and hepatitis B and C.
- Ovarian Stimulation – you’re prescribed injectable synthetic hormones to stimulate your ovaries to produce multiple eggs. During this time, you will be monitored by your doctor through blood tests and ultrasounds. After 10 to 14 days, the follicles are ready for egg retrieval. An injection of human chorionic gonadotropin (hCG) helps the eggs mature.
- Egg Retrieval – A mild sedative is given through an IV and an ultrasound probe is inserted into the vagina to identify the follicles. A needle is inserted through the vaginal wall and into each ovarian follicle. Gentle suction is used to retrieve the eggs one by one. It’s a minor procedure and only takes 30 minutes or less. As the Society for Assisted Reproductive Technology (SART) explains, ‘it’s not uncommon to have some vaginal spotting and lower abdominal discomfort for several days following the procedure’, but this resolves in a couple of days.
- Vitrification – aka freezing. Once retrieved, the eggs are flash frozen in liquid nitrogen and stored until you need them.
Using your frozen eggs
When you’re ready to use your frozen eggs, they’ll be thawed and fertilized with your partner’s (or a donor’s) sperm in a laboratory. Since freezing makes the outer shell of the egg harder for the sperm to penetrate on its own, a technique called intracytoplasmic sperm injection (ICSI) is used. The resulting embryo is then transferred to your uterus, or a gestational carrier, if you’re growing your family via surrogacy.
Pregnancy success rates depend on various factors, but a determining one is your age at the time of the egg retrieval as this impacts the quality and the quantity of the eggs retrieved. The younger you are at the time of the egg freezing, the higher the likelihood of a successful pregnancy.
Factors to consider before freezing your eggs
- There’s no guarantee of a successful pregnancy: Not all frozen eggs will be viable once thawed, and there’s no certainty that they will fertilize and develop into healthy embryos, either. A 2015 study of 1,171 IVF cycles using frozen eggs found that, for women under 30, each egg retrieved had a 8.67% chance of a live birth, while for women over 40, this dropped to less than 3% per egg.
- Age: Before deciding to freeze your eggs, you should speak to a reproductive endocrinologist. You will be offered screening tests to determine if egg freezing is appropriate for you. According to the ASRM, “elective egg freezing is most successful for women younger than 38 years of age”.
- You may need more than one cycle: According to the Center for Fertility Research and Education, for a 50% chance of a live birth, women under 35 must freeze at least 6 eggs. For women between the ages of 38-40, this increases to 11 eggs. The average number of eggs frozen in one cycle for women under 35 years of age was 15, whereas for women aged between 38-40, the number of eggs dropped to 9-10. This means that you may potentially need more than one cycle to retrieve and freeze a good number of eggs.
- There may be an element of grief: As FertiCalm Co-founders Dr. Alice Domar and Dr. Elizabeth Grill shared with us in our GoStork Interview Series, egg freezing may require coming to terms with changed plans – and dealing with the grief that comes along with not being where you planned to be at that point in life (whether in a relationship or otherwise). While egg freezing is empowering, many women are also caught off guard by the grief part of it and the fact that, for a few days, you become an infertility patient. It’s important to prioritize your well-being during this time – do seek support or therapy if you’re finding the process difficult.
- Egg freezing can be expensive: According to FertilityIQ, the average cost of a single egg freezing cycle is $15,991. This includes medication, monitoring, the egg retrieval, and egg storage for 5 years. On average, women do more than two egg freezing cycles. The more eggs you freeze, the higher the likelihood of a live birth.
Educating yourself on your options is an important first step as you map out your reproductive future. There is, admittedly, a lot to take into consideration, but finding a fertility provider you trust can help you determine if egg freezing is a good option for you.
At GoStork, we’re here to support you as you research your options.
If you’re considering freezing your eggs in the future and haven’t chosen a fertility clinic yet, watch out for our first of its kind Fertility Clinic Marketplace launching soon! You’ll be able to find, compare and connect with top US fertility clinics all in one 100% free marketplace. Stay tuned for more announcements to come!