8 Common Questions about Egg Freezing Answered
The most common reason women think about fertility preservation is because they anticipate having children at an age later than what the female body intended. Some women may delay childbearing due to life circumstances – they haven’t met the right partner or they don’t feel financially ready to start a family. Egg freezing offers women the opportunity to preserve their fertility while pursuing personal and professional goals. Here, Dr. Cary Dicken, reproductive endocrinologist and infertility specialist answers 8 common questions about egg freezing.
1. Why should I freeze my eggs?
Egg freezing gives women more reproductive options in the future should they have trouble conceiving on their own. While freezing eggs will not guarantee a future baby, it does take away some of the stress of a woman’s biological clock and allows her to focus on other things. A woman may want to focus on her career, financially prepare, and find a partner before starting a family. According to ASRM – the principal organization dedicated to the advancement of science and reproductive medicine – egg freezing is not done to address an immediate fertility problem; it is undertaken with the goal of preventing untreatable infertility in the future.
2. Who should freeze their eggs?
While many women pursue egg freezing to delay childbearing, egg freezing is a useful treatment in other situations. Egg freezing is a critical treatment for young women diagnosed with cancer who need to have their ovaries surgically removed or who require a treatment that is toxic to the eggs. Egg freezing is occasionally done with planned IVF in the rare cases where there are no viable sperm to fertilize the eggs or in situation where a couple is uncomfortable with the idea of having extra embryos and choose to only fertilize a percentage of the retrieved eggs and freeze the remainder.
3. When should I freeze my eggs?
There is insufficient data to advise women on the optimal age to do an egg freezing cycle, but younger is better. As little girls, we are born with all the eggs we’ll ever have, and eggs are constantly lost, even for women who do not ovulate. So over time there are fewer eggs. In addition, the quality of the eggs women have declines with age. So with age there is a decrease in both egg quality and quantity. The younger a woman is when she freezes her eggs, the less likely she is to need them, but younger eggs are more likely to create healthy embryos. Women need to decide for themselves when the time is right to freeze their eggs, but the factors I suggest they take into consideration are age, egg quantity, stage of life (how soon are you going to want to have a baby), and family goals (how many children do you want to have).
4. How does egg freezing work?
An egg is a specialized cell that contains genetic material but is mostly made of water. Over the years we have learned that an egg must be dehydrated and the water needs to be replaced with cryoprotectants prior to freezing to prevent ice crystal formation. Currently, eggs are frozen with an ultra-rapid freezing technique called vitrification. This extremely fast rate of cooling along with the cryoprotectants change the egg into a solid state with little risk of damage.
5. What happens in an egg freezing treatment cycle?
The first step is testing to get a sense of a woman’s ovarian reserve. This is simple to do and requires blood work to check hormone levels – most commonly a hormone called AMH – and a pelvic sonogram to look at the ovaries and determine a woman’s antral follicle count. Both pieces of information help to better understand how many eggs a woman may yield from a single egg freezing cycle. In total it takes approximately 2 weeks to complete an egg freezing cycle. Most women need 10-11 days of medication injections. These medications stimulate eggs to grow and prevent ovulation. Once the majority of eggs have sufficiently matured, a procedure called an egg retrieval is done to extract the eggs from the ovaries. This procedure is done in the office and is not painful. Using IV anesthesia, the procedure is done vaginally, so there are no cuts or scars on the body. Once the eggs are retrieved, they will be assessed by an embryologist in the lab and those eggs that are mature, or very close to being mature, will be frozen and stored.
6. How long can eggs remain frozen and how many eggs should I freeze?
The simple answer is indefinitely. Long term storage of frozen eggs does not decrease egg quality. Currently there is data of eggs fertilizing normally after being frozen for over 10 years! There is no magic number, but ~10-15 eggs for each desired pregnancy in a woman < 35 is a good approximation.
7. How well does egg freezing work?
This boils down to age. A woman’s age when she freezes her eggs and the number of eggs frozen makes a significant difference in whether she will have a baby from one of those eggs. For women < 35, egg freezing works well. Fresh and frozen eggs from women < 35yr have similar rates of fertilization, and the embryos created result in similar rates of implantation and pregnancy. Therefore, pregnancy rates and neonatal outcomes are similar with fresh and frozen eggs for women < 35yr. However, when women freeze their eggs at an older age, many more eggs are needed to achieve the same success. For example, a woman who froze 10 eggs at age 40 only has a 30% chance of pregnancy compared to a woman under 35 who has twice the success with the same number of eggs.
8. How much will it cost to freeze my eggs?
There are several costs to consider when undergoing egg freezing; (1) the cost of medications necessary for an egg freezing cycle, (2) the cost to freeze the eggs, (3) the annual cost to keep the eggs frozen and stored, (4) the future cost if/when you want to use the eggs, and (5) the cost to transfer an embryo into a woman’s uterus. RMANY – Long Island is in network with several insurance carriers and our finance coordinators work with patients to determine the financial option that best meets their fertility preservation and family-building goals.
If you are considering egg freezing or want more information, please reach out to RMANY – Long Island to set up a fertility preservation consultation.