In a world increasingly dominated by new technologies, freezing your eggs might just seem like one more luxury that comes with our science fiction-inspired lives. Freezing your eggs, though, isn’t a luxury. For women who know they want to have children but who – for whatever reason – aren’t yet ready, freezing your eggs is an insurance plan for your fertility. At Overlake Reproductive Health here in Seattle we have provided a variety of information below to help you understand the egg freezing process so that you can make a more educated decision.
Why Freeze your Eggs?
Who Should Consider Freezing Their Eggs?
How Are Eggs Frozen?
How Many Eggs Are Enough?
Ready to Use Your Eggs?
Egg Freezing FAQS
Why Freeze Your Eggs?
Ensuring Maximum Egg Quality
In terms of egg quality, today is always better than tomorrow. As you age – and even before you notice the physical signs of aging – egg quality deteriorates. The process begins around age 30, with a marked drop-off in egg quality after 35. Further complicating matters is the fact that the number of eggs you have available will also decrease as you age. This phenomenon, known as diminished ovarian reserve, means that there will be fewer eggs available to you in the future; these eggs may also be of lower quality.
Society’s demands are an increasing mismatch with women’s biology. Many women need ten or more years of post-secondary education to prepare for careers, and it can take a decade or longer to build a lucrative career, which means women are increasingly having children in their late thirties and forties. Likewise, women who face health challenges or financial obstacles to having children may also delay pregnancy and childbirth. Freezing your eggs gives you the freedom to focus on other pursuits now. Frozen eggs serve as a fertility insurance program, affording you access to healthy eggs when you’re ready to use them, freeing you up to avoid fertility worries while you pursue higher education, a career, or treatment for a medical condition.
Protecting Your Fertility
Women who freeze their eggs are often concerned about how effective the process is. This is a valid concern for all fertility treatments, however egg freezing is a proven technology. In 2012 it was moved from being classified as an experimental procedure to being a fully approved technique in reproductive medicine. Since then the technology has only improved. Today, freezing your eggs is highly effective, safe and relatively non-invasive. When you’re ready to use your eggs, you can fertilize them with your partner’s sperm or with donor sperm.
While women who opt not to freeze their eggs may have to try for months – or even years – to create a child, freezing your eggs means you can be pregnant in as little as one cycle of trying. For women who aren’t yet sure whether they want to have kids, as well as for those who know they want to have kids but who aren’t ready to commit just yet, this option is an invaluable one.
Who Should Consider Freezing Their Eggs?
Life is unpredictable. A long-term partnership and motherhood could be just around the corner with the right life circumstances, but it’s just as likely that lifestyle factors will conspire to further delay becoming a mother. We advise any woman seriously considering freezing her eggs to evaluate the relative merits of doing so. After all, once your eggs are frozen, you have a strong fertility insurance program. Though any woman can freeze her eggs, it’s particularly important for women in the following circumstances to focus on preserving their fertility. If you would like to see just how much egg freezing would benefit you at your current life stage please check out this egg freezing calculator. It incorporates recent data and is the most accurate tool that we have seen so far.
Health and Fertility Preservation
Some health conditions, particularly cancer, can undermine or even destroy your fertility. If you’re facing a serious medical diagnosis, consider freezing your eggs. Doing so allows you to pursue the most aggressive treatment options without harming your eggs. When you’re well again, you can then use those same eggs to conceive a child of your own.
Health-related egg freezing isn’t just for women facing life-threatening illnesses, though. If early menopause runs in your family, you should consider freezing your eggs. And if you suffer from a condition that can undermine fertility, such as endometriosis or polycystic ovarian syndrome, freezing your eggs ensures you have quality eggs available even if your condition takes a turn for the worse.
Women are increasingly waiting until their late twenties to get married, and some women delay marriage even longer than this. Fertility concerns shouldn’t pressure you into marrying someone who’s not right for you. Freezing your eggs allows you to take the time you need to pick a partner who will be a good friend and good father, rather than settling for the next guy who comes along.
Women now outnumber men in colleges and universities, and women are increasingly prioritizing their careers. It makes good sense to develop a career and save some money before you have a child, but the time it takes to establish yourself may also be the only time you have optimal fertility. Freezing your eggs enables you to focus on your career now so you can enjoy motherhood later.
Diminished Ovarian Reserve and Aging
As you age, your ovarian reserve drops off dramatically. Ovarian reserve is a measure of both the number of eggs you have remaining and the quality of those eggs. If you’re already in your thirties and have not yet had children, freezing your eggs now ensures they’ll be around for you when you want to use them. Likewise, some women may experience a condition known as diminished ovarian reserve where their ovarian reserve is much lower than their age would suggest due to a medical condition or simply unlucky genetics. If your doctor discovers you have a low ovarian reserve, freezing your eggs now is the best way to protect your prospects for long-term fertility.
As menopause approaches, your odds of using your own eggs become increasingly slim. The good news, though, is that your uterus can still sustain a pregnancy, so you may be able to use donor eggs to get pregnant.
How Are Eggs Frozen?
When you picture frozen eggs, it’s easy to channel thoughts of Frankenstein or a dystopian future. But egg freezing is no longer an experimental science, and protecting your fertility by freezing your eggs is certainly not a gimmick. When you understand the process, you’ll be better equipped to determine whether freezing your eggs is the right choice for you.
Before your eggs can be frozen, your doctor will prescribe hormone treatments designed to increase your egg output. You normally produce only one mature egg per month, but if you’re going to spend the time and money necessary to freeze your eggs, you might as well get more bang for your buck. Birth control is often used to synchronize your egg production before starting. Hormone treatments – which take around two weeks – increase the number of eggs matured during your cycle.
On the day of your egg retrieval, you’ll be sedated. An anesthesiology doctor keeps you asleep during the procedure, while another doctor retrieves your eggs using a long needle inserted into your ovaries through your vaginal walls. You won’t feel anything, and the procedure is extremely safe.
The Science of Vitrification
Eggs are fragile and highly complex cells. A few years ago, freezing methods caused ice crystals to form that could harm the eggs. Doctors were able to remove some of the water, minimizing the formation of crystals, but our clinic relies on a newer technology called vitrification.
With vitrification, we will apply an anti-freezing substance (cryo protectants) to your eggs. Of course, the anti-freeze solutions used have the potential to harm the egg, so the procedure requires incredible precision. A highly skilled embryologist places the egg in a bath with a low anti-freeze concentration, along with sugar to help remove water. Thereafter, your doctor will place the egg in a highly concentrated bath of anti-freeze and then instantly freeze it. Each step is carefully timed and executed with exacting precision. The result of such care is the high thaw survival rates that we routinely see today.
When you’re ready to use your eggs, your doctor must quickly warm them. Freezing creates a hard outer surface to the egg. Consequently, the egg must be fertilized using a needle through the process called ICSI (or intracytoplasmic sperm injection) as sperm alone can’t penetrate it. This means that, if you want to eventually use your frozen eggs, you’ll need to undergo in vitro fertilization (IVF) to get pregnant.
Does It Work?
The slow freezing process of generations past was never particularly reliable, so if you’re under the impression that freezing your eggs doesn’t work, it’s probably because you’ve only heard about the older methods. Vitrification, though, has revolutionized the field of fertility medicine, offering very high egg survival rates – over 90%. However, to increase your chances for a successful pregnancy attempt you should make sure you have enough eggs banked.
How Many Eggs Are Enough?
If you’re planning to freeze your eggs, your goal should be to freeze a sufficient quantity of eggs to maximize your chances of having a baby when you are ready. There’s no single right number of eggs for every woman; that figure, instead, depends on factors such as your individual health, fertility goals, and how many eggs you are able to produce. We generally recommend freezing about 15 eggs to ensure a good chance of getting pregnant in the future, but some patients need more and some need fewer.
The Gamble of Fertility
No matter how you try to get pregnant, fertility is a gamble. Women between the ages of 20 and 30 who are trying to get pregnant the old-fashioned way only have about a 20% chance of getting pregnant each cycle, and that figure steadily declines with age. Chromosomal abnormalities, problems with sperm or egg quality, and dozens of other factors can affect whether an egg is successfully fertilized, whether it implants in the uterine lining, and whether you carry the pregnancy to term.
It’s much the same with frozen eggs, but the process allows doctors to exert much more control. You don’t have to guess whether you’re ovulating or worry about the sperm reaching the egg, but chromosomal, genetic, and personal health factors can still play a role. While new technologies attempt to ensure every woman’s fertility, we’re still quite a distance away from the lofty goal of a 100% success rate.
Your individual biology affects how many eggs your doctor can retrieve and how likely each egg is to yield a healthy pregnancy. Some factors that are particularly relevant include:
- Age – both your ovarian reserve and average egg quality decrease with age, and this often means doctors are able to retrieve fewer eggs.
- Ovarian and oocyte health – even if your doctor is able to retrieve a large quantity of eggs, some health issues can undermine egg quality and health, reducing the odds your eggs will develop normally into healthy embryos (blastocysts) that are suitable for transferring back into your uterus.
- Structural factors – if you have problems with the structure or lining of your uterus, it may be more difficult for an egg to implant; your doctor should evaluate these issues before you begin the process of freezing your eggs.
- Response to hormones – women typically ovulate one mature egg per month, but fertility hormones can temporarily increase that number, boosting the number of eggs you can get per cycle. Women respond differently to the hormones and some will produce fewer eggs. This can be due to a variety of factors – including, but not limited to, age, health, and hormone levels.
The Right Number of Eggs
Although individual biology plays a large role, we generally recommend banking around 15 frozen eggs per patient to ensure a high chance of getting pregnant later in life. Banking 15 eggs increases the chance that even if several eggs are flawed and fail to develop normally or fertilize, you should be left with enough healthy blastocysts for a healthy pregnancy. If you don’t produce many eggs with the assistance of hormones, we might recommend that you do several retrievals. Likewise, women who wish to have large families, who have a history of miscarriages, or who have structural defects that make implantation more difficult may wish to bank more eggs. Whatever your situation, we will help guide you to ensure your fertility is preserved.
Ready to Use Your Eggs?
You don’t know what tomorrow might bring, and a choice as important as the decision to become a mother need not be left up to chance. Freezing your eggs is like an insurance program for your long-term fertility, ensuring your eggs are ready when you need them. If you’re ready to become a mother using your frozen eggs, the process requires the use of in vitro fertilization (IVF).
Consultation and Testing
The first step is scheduling an appointment with your doctor. Based on your health and reproductive history, your doctor will recommend certain tests or medications. In most cases, your doctor will examine your uterus to ensure you can sustain a healthy pregnancy and test you for communicable diseases that could harm a pregnancy. Based on the results of testing and evaluation, you may have to take medications or undergo medical treatment before beginning the in vitro fertilization process. Once you’re medically cleared, though, you can begin immediately.
Since you’ll be using frozen eggs rather than those you produce during your next ovulatory cycle, your doctor will give you birth control to suppress ovulation. Midway through your cycle, you’ll also begin taking hormone injections – usually estradiol and progesterone – to begin preparing your body for pregnancy. In a normal menstrual cycle, your uterine lining thickens to prepare for implantation, but when ovulation is suppressed with birth control, your body needs some extra help to prepare a healthy uterine lining. Toward the end of your cycle, you will also need daily injections of progesterone to ensure the healthiest uterine lining possible.
Egg Warming and Fertilization
With modern vitrification techniques, your eggs are rapidly thawed. Your doctor will thaw your eggs, and your partner must provide a fresh semen sample to fertilize them. If you’re using donor sperm, it will be thawed on the same day as your eggs are warmed. Your doctor may inject the sperm directly into each egg. Multiple eggs will be fertilized to maximize your chance of achieving multiple healthy embryos.
Preimplantation Genetic Testing (PGT-A)
There are two types of genetic testing that can be done on the embryos before they are used in a pregnancy attempt. Preimplantation Genetic Testing for Aneuploidies (PGT-A) tests for chromosomal abnormalities such as Down’s syndrome while Preimplantation Genetic Testing (PGT-M) tests for specific genetic disorders such as cystic fibrosis. As of 2016, PGT-A is recommended for all patients at ORH as it has been shown to drastically increased success rates when combined with freeze-all cycles, and single embryo transfer. All appropriate embryos are biopsied on day 5 – day 7 and then frozen (vitrified). The results from the genetic screening generally take a week or two to come back.
At ORH, we only transfer one genetically normal embryo per cycle. Lesser clinics may insert multiple embryos hoping one will implant and mature into a healthy baby. But carrying multiples is high risk to the fetuses and the mother. Depending on timing and several other factors, the transfer could occur during the same cycle or it could occur in a subsequent cycle. Your doctor will advise you of your options. A mock transfer procedure is sometimes performed to better understand the shape of your uterus.
Transferring the embryo is a relatively easy process. Your doctor will use a catheter inserted through your vagina and into your cervix. This procedure usually occurs under light sedation, and is not painful. With the guidance of ultrasound, your doctor will deposit the embryo directly into your uterus. You may be asked to rest for a few hours after the procedure.
Two weeks after the procedure, you’ll go back to your doctor for a blood test to determine if the procedure successfully yielded a pregnancy. If the procedure is a success, your embryo successfully implanted, resulting in a pregnancy. Progesterone helps sustain your pregnancy, so if you’re pregnant, you’ll take progesterone for the next several weeks.
Egg Freezing FAQS
How long can the eggs remain frozen?
- Theoretically, up to several hundred years.
How many eggs should I store to achieve a pregnancy?
- Thaw survival rates at our clinic are over 90%. For women under 36, fertilization rates of 60-80% have been reported. For a reasonable chance at pregnancy, the goal is 15 eggs/pregnancy attempt. We expect to retrieve 9-15 eggs per IVF stimulation, in most cases.
How well does egg freezing work?
- Pregnancy rates of 50-65% have been reported so far. Most of this data has been obtained from screened egg donor cycles.
What if I am over 38 years of age?
- While the viability of a women’s eggs goes down with age, our success rates with freezing eggs and IVF keeps going up. So yes, even at age 38, freezing your eggs is an option. At ORH, we no longer use fresh eggs. We’ve adopted a new standard in IVF including a Freeze-all vitrification protocol which allows us to do a routine day 5 Preimplantation Genetic Screening (PGT-A) to test for chromosomal abnormalities. Weeding out the fertilized eggs/embryos with chromosomal abnormalities gives the best chance of a healthy pregnancy – no matter what age.
As every patient has a unique set of circumstances, we recommend you come in for a consult with one of our fertility specialists.
Is egg freezing safe?
- There has been no reported increase in birth defects to date.
What are the costs?
- The costs of egg freezing are similar to those of routine IVF through the retrieval process. Embryo storage costs are $90/month and are billed through our partner, Embryo Options. Please call for current pricing.