Egg Freezing

Egg freezing at a glance

• Women can freeze and store their mature, unfertilized eggs for use in a future attempt at pregnancy through in vitro fertilization (IVF).
• The process involves stimulating ovulation to produce multiple eggs, retrieving them in our clinic, and freezing and storing them (cryopreservation) indefinitely.
• There are several medical reasons a woman may wish to freeze eggs including facing fertility damaging cancer treatment.
• When a woman is younger and her eggs are more viable, she may wish to freeze her eggs to delay having a family in order to pursue a career or due to other reasons for wanting to start a family at an older age.
• When pregnancy is desired, the eggs are thawed and fertilized through IVF, with the resulting embryo implanted in the mother’s uterus.

Freezing eggs to preserve fertility

Egg freezing has been around for some time but it wasn’t until 2012 when the American Society for Reproductive Medicine proclaimed that it was no longer considered an “experimental” process. This was due to improvements in the cryopreservation technology and processes, particularly in vitrification.

Vitrification is like flash freezing. The human egg is a cell that consists of a good deal of water, and previous freezing methods tended to result in ice crystals that damaged the egg. Vitrification greatly reduces that risk, in part by removing water and replacing it with an anti-freeze like fluid. The process of re-warming the eggs out of their frozen state has also improved.

The success of attaining pregnancy later using frozen eggs depends on several factors related to the quality of the eggs and the woman’s reproductive health. One study published in the journal Human Reproduction found an average pregnancy success rate of 73%. That rate generally decreases with the age of the woman.

Who should consider egg freezing?

It’s important to know that a woman’s reserve of eggs declines with age, in quantity and egg quality, which affects their ability to result in pregnancy. The time to consider egg freezing is generally in a woman’s younger reproductive years, ideally in her 20s. But egg freezing can also be done when a woman is in her 30s, even later 30s if she still wishes to delay having children.

Women who may wish to consider freezing their eggs include the following

• Those who want to delay having children until a later age for any number of nonmedical reasons that can include being free to focus on career or school, desiring to be a mother later in life, and having not yet found a mate they want to have children with.
• Those facing cancer treatment like chemotherapy that can cause infertility. Preserving eggs for this reason is known as oncofertility.
• Women about to have gynecologic surgery that may render them infertile.
• Those with conditions that can harm fertility such as sickle cell anemia and auto immune disease.
• Women with a family history of premature menopause or who have diminished ovarian reserve, which means few eggs and eggs of poor quality.
• A transgender man (born female but identifies as male) who does not wish to become pregnant but does wish to have genetically related children using their own eggs.
• Women or couples who are undergoing IVF but do not wish to freeze embryos for religious or personal reasons.

Good candidates for egg freezing

While egg freezing can be a good option for the people describe above, it is not a good option for all of them. Typically, if a woman is a good candidate for IVF using her own eggs, she is also in a good position to freeze her eggs for future use.

A primary objective of egg cryopreservation is to preserve as many eggs as possible. Studies show that retrieving more eggs has better rates of pregnancy success. The first step is to evaluate the woman to see if this will be possible. We consider good candidates for egg freezing to be:

• Women in a lower age bracket, ideally 20 to roughly 37, with prospects still good for some older women.
• Those with good evaluation of ovarian reserve as indicated by an antral follicle count (counts the fluid-filled follicles on the ovaries that contain an immature egg), as well as proper levels of follicle stimulating hormone and the anti-Müllerian hormone.

The process of oocyte cryopreservation

As with IVF, the egg freezing process begins by using medications to induce ovulation of multiple eggs. Normally a woman ovulates one egg per menstrual cycle. But with egg freezing we want to retrieve multiple eggs at once, which involves controlled ovarian hyperstimulation. The woman will take injectable hormones for about 12 days before her ovulation.

With the woman under conscious sedation, our fertility specialist inserts a long needle through the vagina directed through ultrasound imaging. The physician uses this instrument to pierce the follicle and suction out a mature egg. Our embryologist evaluates the eggs, retaining those eggs that meet our quality criteria.

These eggs are frozen by vitrification. The embryologist records the specifics of the process, including particulars on the solution used, as this information is needed to properly thaw the frozen eggs later.

The retrieval procedure doesn’t take long. The woman spends a short time recovering in our clinic and will generally go home in about an hour.

The eggs are stored in our cryopreservation system, which utilizes liquid nitrogen storage in a tank system that is rigorously monitored.

Eggs can be stored indefinitely, as the freezing suspends their biologic activity.

Egg freezing cost

Because the egg freezing process includes many of the steps used in IVF, it involves considerable cost. These include cost of medication, office visits, monitoring and the egg retrieval process.

Then the eggs need to be stored until it is time for the woman or couple to attempt pregnancy. This involves a monthly or annual fee that covers use of advanced equipment and professional monitoring of the cryopreservation system. We have financing programs that may help patients more easily afford egg freezing.

An indirect later cost is thawing the eggs and completing the IVF process to fertilize one or more and implant the embryo(s) in the woman for a pregnancy.

Considerations and risks of freezing eggs

Women should be aware that egg freezing does not guarantee a pregnancy later. This is a procedure growing in popularity and has generated a considerable amount of marketing. Often egg freezing is positioned as an insurance policy against age related infertility, but this is not the case medically speaking.

We counsel each patient on the prospects for individual success with egg freezing and discuss all factors of it. This includes addressing risks of the procedure, which follow.

In rare cases, a few days after retrieval the woman may have ovarian hyperstimulation syndrome, which is swelling of the ovaries and associated pain due to the stimulation medications used. This usually resolves on its own after a few days, though medical treatment is sometimes in order.

As with any invasive medical procedure, the retrieval process may result in infection, pain and damage to nearby tissue or organs.

The eggs themselves are rarely damaged during the process. And studies show that using frozen eggs does not result in any effects on the future child.