If your peak reproductive years — your 20s and early 30s, that is — aren’t exactly your preferred reproductive years, you aren't alone. More and more women are waiting longer to get pregnant, whether it's because they haven’t yet found a partner to have a baby with, because of career considerations, or because they’re just not ready to start a family.
For some, egg freezing may be an attractive option, offering a sort of reproductive insurance policy against age-related fertility decline.
Here’s what to know about egg freezing, including how egg freezing works, what we know (so far) about its success rates, and how much it typically costs for a woman to freeze her eggs.
What is egg freezing?
Egg freezing, known formally as oocyte cryopreservation, is a process in which medication is used to stimulate a woman’s ovaries to produce multiple mature eggs. Those eggs are then retrieved, frozen and stored.
Once you're ready to get pregnant, the eggs are thawed, fertilized with your partner's (or a donor's) sperm and implanted in your uterus using a procedure called in vitro fertilization (IVF).
The hope is that the egg will implant in the uterine lining and result in a pregnancy.
Who's a candidate for egg freezing?
If you aren't ready to get pregnant, but want to in the future — say, for example, in your late 30s or 40s — you could be a good candidate for egg freezing.
Egg freezing lets you tap into your fertility before it starts to decline, and can be an option for women who aren’t ready to get pregnant when their chances of conceiving are at their highest.
A woman in her 20s or early 30s who isn’t using birth control has about a 20 to 25 percent chance of conceiving each month. By age 40, those monthly chances have dropped to about 5 to 10 percent, and for women over 40, those odds go down even further.
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Testing your levels of anti-mullerian hormone (AMH) may help you decide whether to go ahead with egg freezing. This simple blood test can indicate how many eggs you have left in your ovaries. Patients with low levels for their age may want to seriously consider egg freezing in the near future.
Egg freezing may also be considered for women who have endometriosis or ovarian cysts, as well as women who have a family history of primary ovarian insufficiency or early menopause — leaving them with a shorter-than-usual baby-making window.
Women who are about to undergo cancer treatments that might affect their eggs may choose to preserve their fertility through egg freezing. Finally, women undergoing IVF might choose to freeze eggs in addition to freezing embryos as part of IVF treatment.
What is the best age to freeze your eggs?
The best time to freeze your eggs is likely in your 20s and early 30s — and ideally, when you're younger than 35 years old. In general, the younger the woman is, the better quality her eggs will be.
Some research has shown that freezing your eggs between the ages of 25 and 30 is most likely to result in a successful birth.
Most experts say that women over 38 years old aren’t ideal candidates for egg freezing, since they’ll have less success with healthy egg retrieval and eventual fertilization than a younger woman.
Wondering whether it's worth it to freeze your eggs? This egg banking calculator, from UNC Fertility, can help you determine the likelihood of getting pregnant in the future if you choose to freeze your eggs or try to get pregnant naturally.
What is the process to freeze your eggs?
You’ll undergo the same egg-retrieval process as a woman undergoing IVF. Here's what to expect from the process:
- To prepare your eggs for the freezing process, you'll get hormone injections over the course of nine to 14 days. Those hormone injections will stimulate your ovaries to produce multiple eggs (as opposed to the one mature egg that your body normally produces each month).
- You’ll have ultrasounds to check how many follicles (the sacs containing the eggs) are growing and how well they are developing, plus blood tests to monitor your hormone levels.
- Once the follicles are mature enough, you’ll get a trigger shot (the hormone hCG or Lupron) to finish egg maturation and begin the ovulation process.
- Instead of letting the eggs release on their own, your doctor will remove them transvaginally from your ovarian follicles through an ultrasound-guided needle that reaches your ovaries and aspirates the fluid and egg from each follicle. The goal? The retrieval of up to 15 eggs (some clinics may try for 20).
- The brief procedure takes around 20 to 30 minutes. You’ll be given IV medications to lightly sedate you, so you won't feel any pain.
- Immediately after egg retrieval, your eggs will be frozen using a flash-freezing, ultra-rapid cooling process known as vitrification.
- Eggs can be frozen for a number of years (you’ll pay a fee for storage), but because the technology is still relatively new, it’s not yet clear to experts how long eggs can effectively and safely be stored.
- Once you’re ready to get pregnant, one or more of the eggs will be warmed and assessed. The eggs that survive the freezing process will be fertilized with intra-cytoplasmic sperm injection (ICSI) — when a single sperm is inserted directly into the egg — with the hope that they become fertilized. The resultant embryo(s) will then be transferred to your uterus.
- You may need to undergo more than one cycle of ovulation induction to harvest enough eggs to reach the target number of eggs to freeze — 12 to 30 depending on your age.
How much does freezing your eggs cost?
While prices vary from clinic to clinic and will also depend on how many treatment cycles are required, the cost to harvest your eggs may range from $9,000 to $20,000, including the egg retrieval and the hormonal drugs that help stimulate ovulation.
There are also costs associated with storing harvested eggs, which could run over $1,000 per year. Finally, you’ll want to factor in the costs of fertilizing and implanting the embryos once you’re ready to get pregnant, which could add another several thousand dollars to the total cost.
Some clinics offer payment plans or loans to help defer the upfront costs of egg freezing.
Does insurance cover egg freezing?
Only about 4 percent of employers cover egg freezing for non-medical reasons, though women at high risk of early menopause or primary ovarian insufficiency, or those who are freezing their eggs because of cancer treatments, may be more likely to have some of their costs covered.
More and more companies are also offering fertility benefits to their employees. Some companies — like Apple, Google, Facebook, AT&T and Pinterest, to name a few — reportedly have insurance plans that cover some of the costs associated with egg freezing.
What are the possible risks or downsides of the procedure?
The hormone shots that are used to stimulate egg production can cause side effects like headaches, nausea, bloating, breast tenderness and bruising around the injection site.
In around 5 percent of women, the hormonal medications used to stimulate the ovaries will work too well, resulting in ovarian hyperstimulation syndrome (OHSS).
The symptoms, which usually begin within a week of starting the injections, include ovarian and abdominal swelling, mild pain, nausea, vomiting, diarrhea, shortness of breath and rapid weight gain (two or more pounds a day).
If you notice any symptoms of OHSS, call your doctor or the fertility clinic. Mild OHSS usually resolves on its own within a week or two, while severe OHSS usually requires hospitalization.
Women with polycystic ovary syndrome (PCOS) and younger women under age 35 are at higher risk of OHSS. But even if you fall into a high-risk category, your doctor can reduce the chances of OHSS by using the lowest possible dose of hormones needed to stimulate the ovaries.
After the egg retrieval procedure, you might feel some cramping. More rarely, the needle used to retrieve the eggs can cause bleeding, an infection or damage to the surrounding areas, like the bladder or bowels.
What is the success rate of freezing your eggs?
There is no guarantee that freezing your eggs will successfully result in a baby when you're ready. And as it turns out, most women who freeze their eggs don’t end up warming them and using them to attempt a pregnancy — some estimates are as low as 10 percent.
Because so few women have warmed and used their frozen eggs, there isn’t yet robust data on the success rate. The data available so far shows that the odds of one frozen egg resulting in a baby are about 2 to 12 percent in women under the age of 38. The data also suggests that the older you are when you freeze your eggs, the lower the chances of successful fertilization later.
There is some good news, though. Preliminary stats show that frozen eggs may be as likely as fresh eggs to be fertilized and result in a healthy pregnancy and a healthy baby. And so far, frozen eggs don’t seem to be linked with an increased risk of pregnancy complications or birth defects.
Can you still get pregnant after freezing your eggs?
Yes — and in fact, many women do. For example, some women choose to freeze their eggs when they're younger, and then when they're ready to have a baby, try to get pregnant naturally before deciding to tap into their frozen eggs.
Plus, freezing your eggs doesn't make you less fertile later on. The egg freezing process simply retrieves about a dozen eggs that otherwise would have been lost over time. (Women are born with all of their eggs, and will naturally lose hundreds of them each month.)
Egg freezing could be a good option for a lot of young women who aren’t ready to start a family yet. But the technique doesn’t come with guarantees — and it does come at a high cost as well as with some risk, which means it’s a decision to make after careful consideration and discussion with your doctor.
Luckily, as the technology advances, more companies offer family planning benefits and more clinics gain experience in warming and fertilizing those eggs, more women may be able to have the baby of their dreams, at the right time.
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