A Beginner’s Guide to Egg Freezing

Jul 12, 2021 | Uncategorized

Just a generation ago, egg freezing wasn’t an option. Most women had their children early in life, even if this meant giving up a successful career or other life goals. But science now offers today’s women the time to pursue college and advanced degrees, military service, conduct research, follow their passions and careers, and delay motherhood until they’re really ready. 

Egg freezing, also called mature oocyte preservation, makes this possible. 

Egg freezing allows a woman’s eggs to be removed from her ovaries just prior to ovulation, frozen, and stored for use at some future point in time. 

There’s no single reason women pursue egg freezing. For some, it may be necessary because of a medical diagnosis or concern that essential medical treatment might affect egg quality. For others, it’s simply an insurance policy for when (and if) they become ready to pursue parenthood. 

Whether you decide to freeze your eggs or not, it’s good to get the facts, find out exactly what’s involved, what egg freezing costs, and if it might be the right decision for you.  

The Egg Freezing Process

 

Initial Consultation

The first step in choosing to freeze your eggs is to be evaluated by a fertility specialist. A fertility doctor will want to know about your family planning goals. 

He or she will also review your medical history, fertility history, and recent bloodwork and ultrasound results.  All of this information gives your specialist the info he or she needs to create a protocol that will be successful.  Depending on your results, your doctor may suggest additional fertility testing. If you have a male partner and want to freeze embryos (a.k.a. fertilized eggs), your partner will most likely be asked to have some male fertility testing to make sure his sperm is healthy and up to the task.

If you decide to move ahead with egg freezing, you and your doctor will create a treatment plan, and you’ll be prescribed some medications.

Ovarian Stimulation

While it only takes one healthy egg for a successful pregnancy, we know that not every egg is viable, and sometimes it takes more than one round of IVF to achieve a live birth.

Because of this, it is ideal to freeze many eggs.  To produce more than the single egg that is typically released each cycle, your ovaries must be stimulated using hormone injections.  These hormones tell your ovaries to produce multiple eggs.

How many eggs mature is a function of your age and your body’s response to medications. To keep tabs on how your body responds and to prevent overstimulation, you will be required to have several monitoring appointments

During these, you will have a transvaginal ultrasound so your doctor can see how many follicles are responding and what size they are and bloodwork to check various hormone levels. 

Most women need 3-5 monitoring appointments during the stimulation phase.  Based on your results, your doctor can adjust your medication, treatment plan and update your schedule if necessary. 

Retrieving Your Eggs

Once the stimulation phase is complete and your doctor sees multiple follicles developing, it’s time to harvest all of those eggs during the egg retrieval.  Egg retrieval occurs just prior to when ovulation would naturally occur and is a relatively simple surgical procedure that takes only 5-15 minutes.  It is minimally invasive and requires no cutting or stitching, so recovery is quick and easy.

Before the procedure begins, an anesthesiologist administers light anesthesia to ensure you are comfortable. Your fertility doctor accesses and drains fluid from your ovarian follicles using a small needle. This fluid contains mature eggs.  The follicular fluid is then taken to an embryology lab, where your eggs are located and isolated in preparation for freezing. 

Freezing Your Eggs

After your eggs are isolated and prepared for the deep freeze, they are frozen using a flash-freezing technique called vitrification. This technique dehydrates and freezes the eggs instantly.

This quick freeze and very cold storage provide the best survival rate upon thawing. Once frozen, the eggs are moved to long-term storage tanks, where they remain until you are ready for them to be fertilized and transferred.

You May Need Additional Cycles

Depending on several factors, like your age, ovarian reserve, and hormone levels, one cycle may not be sufficient to produce the number of eggs required to reliably preserve your fertility. Although you can freeze whatever number of eggs you like, fertility experts generally advise women to freeze 10-15 eggs per planned pregnancy attempt. This is just a general guideline. Your provider will be able to suggest an appropriate goal number of eggs for freezing based on your individual circumstances. 

Some patients respond exceptionally well to ovarian stimulation and, in one cycle, produce enough eggs to cover all of their family-building goals.  Other women require multiple cycles, particularly if they would like to have multiple children or if their ovaries don’t produce many eggs each cycle. 

Women who’ve been diagnosed with endometriosis or another condition known to impact egg count and quality may need additional cycles.  Patients with diminished ovarian reserve and older women may also require multiple cycles – though supplements like DHEA have been shown to help increase the number of eggs retrieved in some instances. 

Unfortunately, multiple egg freezing cycles are not an option for every woman.  If a patient requires immediate cancer treatment, she may only have time for one cycle.  For these women, any number of eggs they get from one cycle, even if it doesn’t match their ideal number, can still provide the opportunity to have a child in the future.  In such a case, these women may not have the opportunity of having a biologically related child in the future if they do not freeze their eggs before treatment.

 

Best Age to Freeze Eggs?

When to freeze your eggs is an important consideration since egg quality begins to decline as you age. While the general rule of thumb is younger is better, you can choose to freeze your eggs at any age.  Freezing your eggs stops the clock. Once frozen, eggs don’t continue to age like the rest of your body, and they don’t decline in quality like your ovarian reserve.  Your chances of having a child using frozen eggs are based on the eggs’ age when you froze them, not on your biological age at the time you use them.

Women have the highest probability of achieving live birth when they freeze their eggs before age 34.  However, most women don’t start to think about egg freezing until they’re several years older.  Fortunately, research shows that egg freezing can also be beneficial to older women who wait. 

Researchers have discovered that compared to taking no action whatsoever, egg freezing provides the most significant improvement in the probability of live birth when performed at age 37.  When a woman freezes her eggs at age 37, the likelihood of a live birth more than doubles to 51.6% as compared to 21.9% if they were to do nothing to preserve their fertility.

Women approaching age 40 still have a high likelihood of producing viable eggs. Women who freeze their eggs before they turn 40 still have a reasonably high percentage of healthy eggs and a good ovarian reserve of around 13,000.   But after 40, these numbers decline. That’s why it’s important to schedule a fertility evaluation as soon as possible if egg freezing is an option you’re considering.

 

Using Your Frozen Eggs

When it comes to using previously frozen eggs to get pregnant, research is very positive and shows that women in their 40s can successfully achieve pregnancy with eggs they froze earlier in life. 

Studies show women can get pregnant with frozen eggs well into their 40s.  And fertility specialists agree that a woman older than 40 is more likely to achieve a healthy pregnancy using frozen eggs that were retrieved while she was in her mid-30s versus attempting IVF or ICSI with fresh over-40-year-old oocytes. 

    Who Should Freeze Eggs?

    Egg freezing is an effective method for single women to preserve their fertility for the future.  Many couples elect to freeze both their eggs and sperm.  Aside from these for elective reasons, oocyte cryopreservation is also recommended for women with cancers requiring treatments that may put their reproductive futures at risk or those who are at risk for premature ovarian failure.  Studies show that future fertility is a concern for many women diagnosed with cancer.  Life-saving cancer treatments, like chemotherapy, radiation, and surgery, can also affect survivors by harming their reproductive and endocrine health. 

    Women may also decide to freeze their eggs if they learn they have endometriosis or other medical condition that impairs fertility and only gets worse with time. Research shows that egg freezing presents a viable fertility preservation method for endometriosis patients.  Egg freezing is frequently recommended for endometriosis patients because it is minimally invasive and has little to no effect on future ovarian reserve

    Reasons to freeze eggs include:

        • You received a diagnosis or discover a health condition/circumstance that may affect your fertility, like premature ovarian failure caused by a chromosomal abnormality (e.g., Fragile X syndrome, Turner Syndrome), or a history of early menopause in women in your family.
        • You require cancer treatment or treatment for another illness that may impair your future ability to get pregnant.
        • You are undergoing surgery that might impact your ovaries, or you have a genetic disorder that requires you to have your ovaries removed.
        • You’re undergoing IVF and wish to freeze eggs and not embryos.
        • You are transitioning to a different gender, and you want to maintain your ability to have a biological connection to a future child or children.
        • You’re looking to preserve younger eggs for use in the future.

    Does Insurance Cover Egg Freezing?

    Maybe, but maybe not. Every insurance plan is a little different. Some provide coverage for fertility treatment and preservation, others do not.  This can vary based on your employer and where you live. It is important to check with your insurance provider to determine what is and isn’t covered. Many insurance companies consider egg freezing an elective procedure unless it is necessary based on a diagnosis or treatment that will likely impair your fertility (such as cancer). The good news is that the list of states that require fertility preservation coverage is growing. Most fertility centers can give you a rundown of what your out-of-pocket costs are anticipated to be.

     

     

     

    What Does Egg Freezing Cost?

    Out-out-pocket costs for egg-freezing on average can run between $15,000 and $20,000 per cycle. 

    And this doesn’t include some additional costs and fees, like yearly storage and medications.  Medication costs can run between $2-6,000 per cycle. These are typically paid directly to the pharmacy and not to the fertility center. Monitoring, egg retrieval, and anesthesia combined cost about $11,000. Annual storage fees can be as little as $500/year up to $1,200/year.

    Should I Consider Freezing Embryos Instead of Eggs?

    For couples or women who have a male partner or have already identified a sperm donor, embryo freezing is another good fertility preservation option to consider.  Embryo freezing follows the same steps as egg-freezing right up and through the retrieval process. Instead of freezing unfertilized eggs, the mature oocytes are fertilized in an IVF/ embryology lab with partner/donor sperm.  The resulting embryos are then frozen until needed.

    Just like egg freezing, embryo freezing can be done electively or as a medical necessity.  Studies show that freezing embryos significantly improves pregnancy rates for patients over age 35.  Embryo freezing has also been shown to provide good chances for future fertility in endometriosis and cancer patients.  Because embryo freezing requires sperm from either a partner or donor at egg retrieval, many single women opt for egg freezing.

      Egg Freezing May Benefit You If …

      • You’re younger and not sure what the future holds. As you get older, your egg quality diminishes, your number of eggs declines, and you are more likely to have chromosomally abnormal eggs. When you freeze your eggs, they don’t continue to age.  Freezing several eggs when you’re younger increases your odds of having a greater number of healthy eggs available for fertilization and transfer.
      • You want peace of mind that having a family will be an option. Freezing eggs is really an insurance policy that gives women the flexibility and time to accomplish whatever career or life goals they’ve established before taking on family responsibilities. With frozen eggs to fall back on, you can choose when the time is right, even if that doesn’t coincide with your biological clock. And if you don’t currently have a partner you want to start a family with, egg freezing gives you the time to find one or a suitable sperm donor. Either way, your eggs are available when and if you’re ready.
      • You’re undergoing medical treatment that might affect your fertility. By freezing eggs before treatment, you can focus all of your efforts on beating this disease and recovering without the added stress of “will I or won’t I be able to have kids after this?”
      • You’re a transgender person about to begin the transitioning process. Transitioning involves both hormone therapy and surgery, impacting your ability to have a biologically related in the future. Many people don’t think about how their treatment might affect their future fertility, but this is a critical consideration before starting any treatment.

      Final Words of Wisdom

      If you think you’re even a little interested in learning more about egg freezing, schedule a consultation with a fertility specialist now rather than later. Time is of the essence, particularly for older moms. Egg freezing can be affordable, but do some research and ask around before choosing a clinic.

      And don’t be afraid to travel. Many people find that by traveling to an affordable fertility center, they still save thousands of dollars on egg freezing even with travel costs.  Egg freezing is an exciting opportunity for today’s future parents!

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