{"id":17979,"date":"2018-12-14T15:14:32","date_gmt":"2018-12-14T20:14:32","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=17979"},"modified":"2023-03-22T13:53:43","modified_gmt":"2023-03-22T18:53:43","slug":"your-guide-to-freezing-your-eggs","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/your-guide-to-freezing-your-eggs\/","title":{"rendered":"A Guide to Freezing Your Eggs"},"content":{"rendered":"

Valerie Landis was familiar with the process of oocyte cryopreservation, known informally as egg freezing and euphemistically as \u201cfertility preservation.\u201d After all, she’d been working in the women\u2019s health and fertility space for most of her career. She first considered freezing her eggs at 28, but held off to work through a difficult relationship. When that ended, she set out to meet someone else. After three years of \u201cendless blind dates,\u201d she decided it was time to put her eggs on ice. <\/span><\/p>\n

A growing number of people with ovaries have made the same decision in recent years. Between 2009 and 2016, the annual number of egg freezing cycles in the U.S. climbed from 564 to 8,892, according to the Society for Assisted Reproductive Technology. Even since Landis launched her educational site <\/span>Eggsperience<\/span><\/a> in 2015 (she also has a podcast, <\/span>Eggology Club<\/span><\/a>), egg-freezing has become a more widely accepted practice, with celebrities openly giving it a go and tech industry leaders adding it to their employee benefits packages. Instagram ads targeting women in their 20s now portray freezing your eggs as a no-brainer for the modern millennial. <\/span><\/p>\n

For women who want more control over their reproductive future, or know that they won\u2019t have viable eggs for much longer, freezing can be an empowering choice, advocates say. But it can also be a much more <\/span>expensive, speculative and emotionally taxing experience than women bargain for, and one that might make more sense to do when there\u2019s a clear reason why \u2014 beyond just \u201cwhy not?\u201d<\/span><\/p>\n

If you\u2019re considering freezing your eggs, here\u2019s what you should know. <\/span><\/p>\n

What are the main reasons women freeze their eggs?<\/h3>\n

The general purpose of freezing your eggs is to preserve your ability to have children in the future. The procedure was developed in the 1980s for women who had a medical condition, or had to undergo medical treatment, that might leave them prematurely infertile.\u00a0<\/span><\/p>\n

In 2008, with the introduction of a more effective freezing technique called vitrification, elective or \u201csocial\u201d egg freezing<\/a> started to gain traction among healthy women who hadn\u2019t yet found partners to have kids with or wanted to postpone parenthood for other personal reasons. And within the past few years, social egg freezing has seen even more pronounced growth, most notably among younger women opting to freeze their eggs years before fertility might become a concern. There\u2019s also been an uptick in the number of transgender men freezing their eggs before they\u00a0undergo gender confirmation surgery. <\/span><\/p>\n

What does egg freezing actually entail?<\/h3>\n

From stimulation to egg retrieval, one round of egg freezing (known as a \u201ccycle\u201d) typically takes about two weeks. Here\u2019s a breakdown of the process: <\/span><\/p>\n

Prep period<\/b>
\n<\/span>First, your doctor will perform a vaginal ultrasound to determine how easily they can retrieve your eggs. Then they\u2019ll run blood tests to help them prescribe the proper dose of ovarian stimulating medication, as well as figure out how many eggs can realistically be frozen from one cycle. <\/span><\/p>\n

Injections and monitoring (about 10 days)<\/b>
\n<\/b>At the same times each day, you\u2019ll inject fertility drugs (two at first, usually, and then a third one added after a week or so) into your stomach or thigh. The shots go right under the skin, like insulin injections. Instructions for the shots can be confusing, especially for first-timers. At one point, for example, you need to start using smaller needles, which some people forget to do.<\/span><\/p>\n

The drugs, which may cause bloating, stimulate the ovaries to produce multiple eggs and then facilitate their maturation. Without this help, your body would only produce one egg (or more rarely, two) at a time. \u00a0<\/span><\/p>\n

During this period, you\u2019ll also need to head to the clinic every two to four days. Each time, your doctor will check your blood hormone levels and do a pelvic ultrasound to measure follicle growth, meaning the rate at which the eggs are developing, and evaluate your body\u2019s response to the drugs.<\/span><\/p>\n

Egg retrieval<\/b>
\n<\/b>Thirty-six hours before retrieval, you\u2019ll give yourself a final \u201ctrigger shot,\u201d <\/span>which accelerates maturation of the eggs so they’ll be released at exactly the right time.\u00a0The procedure itself, which is typically performed under twilight anesthesia, only takes about 20 minutes. Afterward, common side effects include spotting, cramping and nausea, but most women don\u2019t need more than a day of recovery.<\/p>\n

After the eggs are retrieved, an embryologist (a reproductive medicine expert) at the clinic freezes and stores them for however long you decide. <\/span><\/p>\n

How are they frozen?<\/h3>\n

As of 2008, the preferred egg-freezing method is vitrification, which uses liquid nitrogen to \u201cflash freeze\u201d eggs in about 20 minutes. Before vitrification took over, doctors relied on slow freezing, which took two hours and allowed crystals to form while the eggs cooled. This was a problem, as those crystals could break during the thawing process, damaging the eggs\u2019 internal structure and rendering them useless<\/span>.<\/span> With vitrification, there\u2019s not enough time for crystals to form, giving the eggs a better chance of surviving the thaw and becoming successfully implanted embryos.<\/span><\/p>\n

While vitrification has helped make eggs hardier, they\u2019re still fragile compared to embryos, according to fertility specialists. That’s why doctors usually advise women who have partners they plan to conceive with to freeze their embryos, not their eggs.<\/span><\/p>\n

What\u2019s the success rate for frozen eggs?<\/h3>\n

Even if an egg thaws without a problem, there\u2019s no guarantee it will get fertilized and grow into an embryo, let alone become a baby \u2014 known as a \u201clive birth\u201d in fertility-speak. And compared to fresh donor eggs, it\u2019s not clear how likely frozen eggs are to produce live births. Some <\/span>recent research<\/span><\/a> found similar live-birth rates for fresh and frozen eggs, but <\/span>study results<\/span><\/a> overall are mixed. <\/span><\/p>\n

At this point, we just don\u2019t know that much about pregnancy outcomes for frozen eggs. That\u2019s due in part to egg-freezing being an expensive, relatively new procedure \u2014 it was considered experimental until 2012. While egg freezing has surged in popularity, the vast majority of women who\u2019ve frozen their eggs haven\u2019t tried to take them off ice and get pregnant. That means clinics don\u2019t have much experience thawing and implanting frozen eggs. It also means experts only have very limited data to inform predictions about the likelihood of frozen eggs yielding healthy, full-term pregnancies. <\/span><\/p>\n

In 2016, for example, doctors performed only 229 thaw cycles total for women ages 35 to 37 using their own frozen eggs. Of those women, 54.5 percent carried their babies to term,<\/span> according to <\/span>SART<\/span><\/a>. As of 2015, fewer than 2,000 live births (total) had been <\/span>reported<\/span><\/a> from egg freezing.<\/span><\/p>\n

That data, and most data on pregnancy outcomes from egg-freezing, is limited in its applicability. It largely comes from older women, who made up the bulk of the egg-freezing population until recently. And it mostly concerns eggs frozen the old, pre-2008 way \u2014 or at a minimum, it lumps together old and new freezing methods. That\u2019s not very helpful; to<\/span> get an accurate sense<\/span><\/a> of how likely pregnancies are to result from cryopreservation, you\u2019d have to isolate only instances where vitrification was used. Recent research indicates that eggs frozen today have a <\/span>90 to 95 percent<\/span> chance of surviving the thaw and then functioning as if they’re fresh.<\/span><\/p>\n

Last year, a research team lead by doctors at Brigham and Women\u2019s Hospital introduced a counseling tool to help doctors loosely predict patients\u2019 live-birth outcomes from frozen eggs. Dr. <\/span>Mark Trolice<\/span><\/a>, a reproductive endocrinologist and infertility specialist\u00a0in Winter Park, Florida,<\/span> says these models are <\/span>\u201cthe best guide we have to provide patients with a reasonable expectation based on the number of mature eggs [they\u2019ve] frozen.\u201d <\/span><\/p>\n

Still, in the end, your ability to have a full-term pregnancy using your own frozen eggs doesn\u2019t solely depend on the eggs themselves. Regardless of how old your eggs are, the age at which you try to get pregnant matters too. \u201cThere are so many other medical issues, such as high blood pressure, diabetes and uterine fibroids, that are more common as women age and can affect chances of bringing a pregnancy to term,\u201d says Dr. <\/span>Shefali\u00a0<\/span>Shastri<\/span><\/a>, a <\/span>reproductive endocrinologist, ob-gyn and clinical assistant professor at Rutgers-Robert Wood Johnson Medical School in New Jersey<\/span>.<\/span><\/p>\n

Other factors that affect full-term pregnancy likelihood (using any eggs, frozen or fresh) include the age of the father (meaning the sperm-supplier), as well as the health of the uterine cavity and fallopian tubes.<\/span><\/p>\n

How long do I have to freeze my eggs?<\/h3>\n

There\u2019s no official medical age limit for egg freezing, but here\u2019s the reality: <\/span>Women who freeze their eggs by age 34 appear to have better chances of live births than older women, according to a 2015<\/span>\u00a0<\/span>study<\/span><\/a>. For the average woman, fertility declines slightly after 30 and then drops off dramatically between 35 and 37. While the most important fertility determinant is egg quality, quantity factors in too. At birth, women have <\/span>1 to 2 million egg<\/span><\/a>s. By age 37, that number falls to 25,000. <\/span>The more eggs you freeze, the more chances you have to get pregnant using one. <\/span><\/p>\n

\u201cIf you take 10 eggs from a 25-year-old and 10 from a 45-year-old, quantitatively you have the same number,\u201d says Dr. Alan Penzias, an ob-gyn and reproductive endocrinology and infertility specialist, who\u2019s also the surgical director of Boston IVF and an associate professor at Harvard Medical School. \u201cBut I would guess you\u2019d get seven or eight quality eggs from the 25-year-old and one or two quality eggs from the 45-year-old.\u201d<\/span><\/p>\n

Some experts say that news of famous women getting pregnant at advanced ages \u2014 like Janet Jackson, who became a mom at 50 \u2014 contributes to misconceptions about the average reproductive lifespan, which <\/span>many women overestimate<\/span><\/a>. <\/span><\/p>\n

Does that mean I should freeze my eggs as early as possible?<\/h3>\n

It depends on whom you ask. Because both egg quality and quantity decrease with age, doctors do sometimes recommend that women freeze their eggs before age 30. That\u2019s the crux of the argument for social egg freezing. But while some doctors are on board with this growing trend, others are hesitant to endorse it. <\/span><\/p>\n

For one thing, while eggs should theoretically last indefinitely once they\u2019re frozen, we don\u2019t actually know if that\u2019s the case. Other doctors just don\u2019t feel comfortable encouraging 20-something women to freeze their eggs without a reason. \u201cIt would be unethical to say every 25-year-old woman must freeze her eggs or she\u2019s crazy,\u201d Penzias says. \u201cThere\u2019s no empirically great reason to freeze your eggs just because.\u201d<\/span><\/p>\n

Encouraging healthy women to freeze their eggs before age 30 is an unnecessary medicalization of women\u2019s bodies, believes Kylie Baldwin, a <\/span>senior lecturer and postdoctoral fellow in sociology at the Centre for Reproduction Research in the U.K., and lead author of a <\/span>recent study<\/span><\/a> about women\u2019s reactions to the egg-freezing process. \u00a0<\/span><\/p>\n

\u201cIt\u2019s often painful, even if someone\u2019s doing it proactively, and certainly not enjoyable,\u201d Baldwin says. \u201cWhy go through something like that when you can do it naturally?\u201d<\/span><\/p>\n

Of course, not all women can do it naturally. If you want to freeze your eggs and have a condition that affects your ovarian reserve, such as endometriosis or ovarian cysts, or need to undergo chemotherapy (which destroys eggs and is the reason that cancer patients have been offered the option to freeze their eggs for decades), then you\u2019d be better off doing it sooner rather than later, Shastri says.<\/span><\/p>\n

But if there\u2019s no medical reason to suspect you\u2019ll have trouble conceiving when you\u2019re ready to be pregnant, Shastri says it\u2019s not practical to freeze your eggs at 25: \u201cIf I had daughters, I would tell them that if you hit 30 and are not in a relationship and don\u2019t see a prospect, it would probably be a good time to freeze your eggs.\u201d<\/span><\/p>\n

Penzias agrees that 30 is a reasonable age to start seriously considering freezing your eggs if you know you want children. \u201cI think it\u2019d be good to take social pressure off and make you feel you have some control over your life,\u201d he says. \u201cAs long as you\u2019re not scared into it, but are doing it with intention.\u201d<\/span><\/p>\n

How much does it cost?<\/h3>\n

Unless you work at Google, Apple or Amazon, don’t assume your health insurance covers egg freezing, <\/span>which costs around $5,000 or more per cycle<\/span><\/a> \u2014 and it\u2019s relatively common for women to do multiple cycles. There are also storage fees, which vary but typically run at least several hundred dollars a year. <\/span><\/p>\n

Be wary of companies that offer monthly payment plans, because one cycle could end up costing you $15,000, which is way above market price. \u00a0\u00a0<\/span><\/p>\n

Some clinics might offer to retrieve a set number of eggs for a flat fee or advertise a bundled cost that includes retrieval, thawing and embryo conversion, whether or not you use those services. <\/span><\/p>\n

The cost of hormone medications will also dip into the thousands, putting the total cost of one round of egg freezing in the ballpark of $10,000, Trolice says, and if you ever decide to try to use the eggs, that process costs around $10,000 more. Fertility doctors can\u2019t just put your thawed eggs back in; they need to be fertilized with an intracytoplasmic sperm injection, or ICSI, which is a type of IVF, or in vitro fertilization<\/span>.<\/span><\/p>\n

Many but not all clinics also charge a few hundred dollars for a consultation. \u201cYou shouldn\u2019t have to pay $400 just to talk about whether [their clinic] is the right place for you,\u201d Landis says.<\/span><\/p>\n

Does it matter which clinic I use?<\/h3>\n

Yes. Do your homework before you choose where to freeze your eggs, as success rates vary from clinic to clinic. A clinic lab director might show you national statistics or research claiming frozen eggs are as good as fresh eggs, but don\u2019t confuse national success rates or study findings with outcomes for an individual clinic. <\/span><\/p>\n

Here are a few questions to ask the clinic director:<\/span><\/p>\n