As we age, so do our eggs. This is a major factor in why it can be so hard for women to fall pregnant as they age — but it's also where egg freezing can help.
Exactly how it sounds, the egg-freezing process involves retrieving them from your ovaries, freezing them and storing them for future use. It helps your eggs stop time and maintain their youth. This means you can keep them healthy and of high quality until you want to make a call on whether you will use them or not later in life.
It'll give you the choice to use the same eggs that might have otherwise declined in quality as you aged. But how exactly does it work? Let's find out.
Why should you consider freezing your eggs?
Well, there are both medical and social reasons for putting eggs on ice.
Medical reasons
Medically speaking, it's about fertility preservation.
There are situations where women can lose their fertility earlier in life due to medical conditions such as endometriosis or signs of early menopause. In fact, egg freezing was developed initially to help women preserve their fertility who were undergoing chemotherapy or radiation treatment.
Social reasons
Other women also choose to freeze their eggs so they can keep their options open. The cultural mindset around having kids is changing, and women are choosing to start their families later; for a variety of reasons.
Their careers could be taking off, they are taking the time to tick a few more things off their bucket list or they want to build a bigger financial safety net.
If this is you, you might not be ready for babies right now, even though you know it’s something you want to consider later in life. Or you could still be considering whether you actually want kids or not or you haven't met the right person yet.
Either way, because the biological realities of our fertility declining with age aren’t changing, freezing eggs might give you choices in the future.
What to expect during the egg-freezing process
Egg freezing involves 5 steps:
1. Ovarian stimulation
Over a period of approximately 2 weeks before the egg collection procedure, you have to give yourself hormone injections that help you ‘grow’ multiple follicles in your ovaries.
During this time, your doctor will be monitoring the amazing work your body is doing through transvaginal ultrasounds. This is to help them count and measure your follicles, to hopefully find a good amount of healthy-looking eggs.
They might also do some blood hormone tests on you as well, which helps them adjust the dosage of the medication if it's needed.
As soon as the follicles on your ovaries are looking primed, you will have to take a "trigger shot" of a hormone called Human Chorionic Gonadotropin (HCG for short). Simply put, this tells your body to get ready to release the eggs.
The timing of the HCG shot is really important.
The doctor needs to plan the shot with your surgery because your egg retrieval has to occur at just the right time so you do not ovulate before your doctor collects your eggs. But don't worry, your doctor will help you work out when that is. It won't be all on you.
2. Egg retrieval
After lots of monitoring, a fertility specialist inserts a long and very thin ultrasound-guided needle via your vagina to retrieve your eggs.
In most cases, you’re under anaesthesia for this so you shouldn't feel a thing. The whole process is known as a ‘cycle' and recovery time for this surgery is often 1-5 days.
3. Egg freeze
After your eggs are retrieved, they will go through a process called vitrification. Basically, this is where the freezing part happens.
They use high levels of antifreeze that protect each egg from damaging ice crystals. Then, they’re placed in a freezer and stored there until you’re ready.
4. Thawing and fertilisation
When you’re ready to use your eggs, they will be thawed and fertilised. Fertilisation can be done through a standard procedure of combining a concentrated amount of quality sperm with the egg on a petri dish, in hopes that the magic of fertilisation will happen.
Alternatively, if male fertility is an issue, a process known as ICSI (Intracytoplasmic Sperm Injection) can be used, where a single sperm is injected into the egg. Once the egg is fertilised, it’s officially an embryo.
5. Embryo transfer
About 3-5 days after fertilisation, an embryologist will identify the healthiest-looking embryo, sometimes done through genetic testing.
Then, they'll transfer the embryo into the uterus via a thin, flexible catheter through the vagina and cervix.
Does it always work?
Unfortunately, the math doesn’t quite check out here, because one egg does not equal one kid. The reality is that egg freezing is not an insurance policy. You should be prepared for the fact that when you collect a batch of eggs, there’s no guarantee that any of them will be ready to become an embryo.
They won’t all make it through the next steps of thawing, fertilising, growing a good quality embryo, implanting and then making it through the pregnancy.
In each part of the process, we lose some eggs and on average, each egg frozen has a 2-10% chance of turning into a live birth.
So really, it’s a bit of a numbers game. The more eggs retrieved from the egg-freezing cycle, the more chances there are for a baby.
How many eggs should I collect?
So, how many eggs should you freeze to give yourself the best chance? Your fertility specialist will be the best person to help you set a good target number of eggs for you.
This will primarily depend on the age you choose to freeze eggs and how many children you want to have with those frozen eggs. Success with egg freezing still depends on collecting and freezing a batch of healthy eggs but remember, as we age, so do our eggs and egg quality declines.
And the older you are, the more eggs you'll have to collect to ensure a fair chance of achieving at least one live birth from those eggs. So if you want multiple children, freeze more eggs.
A 2017 study suggests the following as an estimate for success rates from egg freezing:
- Women under 35: Freezing 15 mature eggs offers an 85% chance of at least one live birth
- Women 35 to 37: Freezing 20 mature eggs offers an 80% chance of at least one live birth
- Women 38 to 40: Freezing 30 mature eggs offers a 75% chance of at least one live birth
- Women 40 to 42: Freezing 30 mature eggs offers a 50% chance of at least one live birth
If you want to have multiple children with the eggs you’ve frozen, check out this tool that was created from the results of this study.
How many eggs will I be able to collect?
Knowing how many eggs you need to collect versus being able to physically collect those eggs is the consideration here. It largely depends on your ovarian reserve (your egg count). In an average cycle, around 9-15 eggs are collected. This number decreases as you age.
If your ovarian reserve is on the lower end, it could be harder to collect the optimal amount of eggs. This means you may require multiple cycles (and therefore, it’ll cost you more money too).
Remember that every woman is different, and you can test your ovarian reserve by testing your AMH.
Your AMH results will also help your fertility specialist determine what dose of medication to start you on to stimulate your ovaries for egg retrieval. If you have a lower ovarian reserve level, they are likely to start you on a higher dose to try to stimulate more eggs.
When should I freeze my eggs?
The earlier the better, right? It's not that simple, unfortunately.
When you're in your early to mid-20s
For the women out there who are ready to jump on the egg-freezing train in their early to mid-20s, there is a chance they might not use them. Truth is, you've still got many years ahead of you and you can't predict the future.
You could meet someone, start a family the old-fashioned way and then you're going to be out of pocket for not only the initial procedure but for every year you're storing them which can cost you up to $500 per year. That's a lot of money for no return.
But, before you go jumping to any conclusions, let us explain the other side of the age debate with egg freezing.
When you're in your late 30s or early 40s
Egg freezing does rely on being able to harvest a good amount of quality eggs. And as we've said before, it gets harder to retrieve a good amount of eggs as we age. Plus, even if we do have a good amount of eggs, the quality of the eggs isn't guaranteed.
So, waiting to freeze our eggs around our late 30s or early 40s may mean that the eggs we collect are not good enough to produce embryos capable of creating babies. Or, it may mean we need a few more egg retrieval cycles to retrieve more eggs to give us better chances for a baby. Which, of course, costs money.
So, what's the ideal age?
For women in their late 20s or early 30s, specialists agree these are the optimal years to freeze your eggs. This is when most women have a sturdy ovarian reserve and healthier eggs.
But, keep in mind that everyone is different. If you suspect you may have conditions that may impact your future fertility, it’s a good idea to speak to a fertility specialist to understand what your options would be.
When should you book an appointment?
Once you've decided and planned to start an egg-freezing cycle, the first thing you need to do is make sure you have a flexible enough schedule for a few weeks (at least).
There can be limited flexibility in monitoring schedules and appointment times (which are often in the mornings). During this process, injections would need to be taken at the same time, every day.
Plus, you don’t have much say on timing when you need to take a trigger shot and schedule the egg retrieving procedure because your body decides when it's ready.
Are there any risks?
The first step of egg freezing is to inject yourself with hormones. So, be prepared to get hormonal. It's normal, but you might have some days with ups and downs. To future-proof those shitty days, make sure you surround yourself with friends, families and medical professionals who can support you during this time.
But the main risk with the egg freezing hormones is over-stimulating your ovaries. This is a condition known as Ovarian Hyperstimulation Syndrome and it can cause severe bloating, stomach pains and nausea.
You are at greater risk of over-stimulating your ovaries if you have high AMH levels. So, if your AMH levels are high, it’s a good idea to talk to your provider about adjusting your dosage of medication.
How much does egg freezing cost?
We hate to sound like a broken record, but the answer is — it depends.
The cost of egg freezing can vary greatly and depends on the clinic, whether you’re eligible for Medicare and the level of private health insurance you have. However, the average cost of an egg-freezing cycle is around $5,000-$8,000.
This cost typically includes:
- Preparation and management of your egg-freezing cycle
- Routine monitoring with blood tests and ultrasounds
- The actual procedure with your doctor
- Storing your eggs for up to 6-12 months
If your fertility specialist determines there are medical reasons for freezing your eggs, some of these costs can be covered by Medicare, leaving an out-of-pocket expense of around $2,000-$4,000.
In addition to the egg-freezing fee, you may need to pay separately for hormone medication ($500-$1,500 on average), day surgery and anaesthesia ($1,000-$2,000 on average). Plus, there is typically an annual storage fee of around $500 for each year you leave them on ice.
It’s a good idea to check with your private health insurer (if you have one) as they may cover some of the day surgery and anesthesia costs. When it comes time for you to thaw, fertilise and transfer those eggs, that’s an average cost of $3,000-$5,000 per cycle.
Lots of numbers (and money), we know! So let’s pull it all together:
How to choose the right clinic
When you choose a clinic, you choose the medical team and the lab that comes with it.
Make sure you feel comfortable with the medical team you surround yourself with and you trust the lab that will be handling your eggs. After all, they play a huge role in the success of your egg-freezing treatment.
Making the decision
Egg freezing can make you feel empowered. It gives you options and the freedom to choose your own flight path. You're not ready for kids now but want to have that option in the future.
Just remember, it shouldn't be treated as an insurance policy. It's not going to cover you if things go south with your fertility.
So, making the decision with all the facts about your chances, the number of eggs you might need to collect, the number of cycles you might need and the costs of those cycles is critical to determining whether egg freezing is for you or not.
Photo credit: Getty Images
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