There’s a lot of hype surrounding egg freezing nowadays, and many young women are questioning if it really presents them with a practical option. Let’s clarify what the process of egg freezing entails, deconstruct the more alarming media pressure to freeze by emphasizing the medical basis for the procedure, and answer your most commonly asked questions.
What Is Egg Freezing?
Egg freezing, or oocyte cryopreservation, is an elective process that involves stimulating the ovaries with hormones to produce multiple eggs, retrieving the eggs from the ovaries, and “freezing” the eggs by cooling them to minus 320 degrees so no degradation occurs and they can be thawed at a later date.
As women age, they become less fertile because the number of eggs in their ovaries decreases. They also face a higher risk of pregnancy complications, such as diseases that can affect fertility like endometriosis, and miscarriages. Egg freezing presents women with an opportunity to, in effect, stop their biological clock.
Who Should Freeze Their Eggs?
Women who are not ready to become pregnant now but who want to optimize their pregnancy outcomes later should consider freezing their eggs. At IRMS, we believe the most ideal age range for egg freezing for fertility preservation is from 30–39, but it may also be a reasonable option for women who fall outside of that age range.
In particular, you might consider egg freezing if:
• You have a circumstance or condition that can affect your fertility.
Examples include being transgender or having a known health condition that can impact your fertility.
• You need treatment for cancer or another illness that can affect your fertility.
Radiation and chemotherapy can both harm your fertility. Egg freezing before treatment might enable you to have biological children later.
• You want to preserve younger eggs now to use in the future.
Indeed, there are a variety of reasons why someone might elect to freeze their eggs. However when surveyed, the primary reason given by women who choose to freeze their eggs is they are presently not in a relationship conducive to childbearing.
How Does Egg Freezing Work?
The egg freezing process begins with a consultation. This appointment with a physician does not commit you to move forward—it simply gives you the detailed information you need about an egg freezing cycle to make an informed decision about whether or not you wish to pursue it.
To embark on an egg freezing cycle, testing and evaluation of your reproductive system is required. This includes an internal exam (to check the ovaries) and bloodwork, specifically FSH, AMH as well as genetic testing . As a result, the egg freezing process provides you with a wealth of medical information that can help you in more aspects of your life than just reproduction.
The actual egg retrieval process is identical to the first phase of in vitro fertilization (IVF). You start by initiating a series of hormone injections which stimulate the ovaries to produce multiple eggs. During this stage, you will frequently visit the fertility clinic, where your ovaries will be monitored by vaginal ultrasound. After approximately 1–2 weeks of hormone treatments, a doctor will retrieve your eggs.
The egg retrieval procedure is done under mild anesthesia and only takes about ten minutes. Your doctor guides a needle through the vagina to the ovarian follicle, and a suction device attached to the needle gently removes your eggs from the follicles. Given current success rates, physicians recommend approximately 18–21 eggs be frozen per desired child.
Following the retrieval, your eggs are frozen through a process called vitrification , an instantaneous freezing process. Because your eggs are frozen at such a low temperature, all cellular activity halts, and there is no deterioration of your eggs. This means they can be frozen indefinitely.
When you’re ready to use your eggs, your doctor will prepare your body (or that of a gestational carrier) to receive embryos. This usually includes taking estrogen so that you build up a uterine lining conducive to a pregnancy. In coordination with the Lab, some of your eggs will be thawed and then fertilized through a process called ICSI (intracytoplasmic sperm injection), which must be done when using eggs that have been frozen. You may choose to use the sperm of your partner, spouse or sperm donor. Then a recommendation will be made whether a single- or double-embryo transfer is advised based on your specific case and embryo quality.
How Much Does Egg Freezing Cost?
The cost of egg freezing has dropped considerably since the science was first introduced, but at most centers the egg retrieval process costs around $10,000, not including the necessary medications and cold storage costs.
At IRMS, our rates are likely better than any practice in New Jersey or the tri-state area. The first egg freezing cycle costs $6,475 (plus the Anesthesia and Facility fees of $1,200 per cycle), and we offer significant discount packages for multiple egg freezing cycles.
Additionally, some insurance carriers have started to cover all or part of elective freezing cycles, and a select group of progressive companies like Apple, Facebook, and Google cover up to $20,000 in egg freezing fees for their female employees.
What Are The Risks Of Freezing Your Eggs?
Despite the egg retrieval procedure being considered low-risk, Dr. Samantha Pfeifer, Associate Professor of Clinical Reproductive Medicine at Weill Cornell Medical College, says, “the hormone shots do carry a risk of ovarian hyperstimulation syndrome (OHSS), which occurs when a woman responds too aggressively to the hormones and the ovaries become swollen and painful.” Most often, OHSS affects younger women in their 20s and 30s but overall, occurs in less than 5% of patients. Here at IRMS we monitor our patients so closely that our OHSS rate is less than 1% of all patients.
Though egg freezing is a very reasonable insurance policy for your future fertility pregnancy is not a guarantee. Success depends on a number of factors, from the woman’s age at the time of egg freezing, the quality of those eggs as well as the quality of your partner’s or donor’s sperm. Better outcomes usually occur the younger a patient is when they freeze particularly under the age of 35.
How can I gauge my fertility?
Your ability to get pregnant hinges on multiple factors, so any testing done to monitor your hormone levels or eggs must be comprehensive to give you an accurate idea of your fertility.
Anti-Müllerian hormone (AMH) testing has become increasingly popular due to AMH’s association with healthy egg reserves, but a single free AMH test in the back of a boutique van can’t provide you with a holistic picture of your fertility.
In fact, a 2017 study by Dr. Anne Steiner, Medical Director of Duke University’s Fertility Center, found that AMH was not useful in assessing the “natural fertility” of 30–44 year-old women “without a history of infertility, who had been trying to conceive for three months of less.” It’s important to remember that the most critical factor in determining your fertility is your age, and abnormal AMH results can cause you unnecessary stress if you’re not ready to seriously consider reproduction. Accordingly, Dr. Pasquale Patrizio, Director of Yale’s Fertility Center, warns, “having inaccurate or incomplete information can be more damaging than having no information at all.”
Our very own Dr. Natalie A. Cekleniak says, “unlike much else in the medical field, fertility is not an exact science. There’s no one test that can tell us your exact chances of getting pregnant. To get an idea, you need an extensive evaluation of your reproductive factors—FSH and AMH levels and antral follicle count, in particular. This is an especially challenging concept for us, because people can present all of the right indicators and not get pregnant, and conversely, present none and surprise us by getting pregnant. The bottom line is that there’s no one indicator to gauge the status of your ovarian reserves. To get the most accurate assessment, you need to have a comprehensive consultation with a doctor.”
Am I ever going to use my frozen eggs?
Maybe.It’s difficult to predict whether or not you will ever use the eggs you freeze. In a hypothetical scenario, after seven years of freezing your eggs, you may conceive naturally and then choose to use your frozen eggs for baby #2. In another, after seven years, you may find yourself in a relationship you deem conducive to childbearing or at a point in your career or education where you feel you can also incorporate motherhood into your life, and you can thaw your eggs and try to achieve a pregnancy with them. (Again, these are hypotheticals. You can freeze your eggs for as long you want.)
Like everything else in life, egg freezing is an investment that should be made after weighing its potential risks and rewards. If you know, for example, that you are thirty and working towards an advanced medical degree that a pregnancy would interrupt, then considering egg freezing would be practical. But no one should feel like they have to freeze their eggs with no real reason to just because of some unrealistic media-hyped pressure. We want patients who are accurately informed and who can be partners in their care.
If you are interested in pursuing elective egg freezing, book at an appointment at one of our seven New Jersey locations. For further information on elective egg freezing or any other fertility questions you may have, feel free to comment below, reach out to us online or on social, explore our website, or give us a call at 973.548.9900.