What we'll cover

⚡In a nutshell

  • Egg freezing can help women preserve their fertility; so they can have options in life... but it's not the best option for everyone.
  • If you are considering egg freezing, specialists agree that your late 20s to early 30s are the optimal years to freeze your eggs.  
  • 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.
  • You need to consider 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.
  • Egg freezing isn't cheap (average $5,000-$8,000 per collection cycle) and can vary greatly depending on the clinic you choose, whether you're eligible for Medicare and the level of private health insurance you have.

🥶 Egg Freezing

Exactly how it sounds, the process of freezing your eggs involves retrieving them from your ovaries, freezing them and storing them for future use.

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.  

This is where egg freezing can help. It helps your eggs stop time and maintain their youth.

This means you can keep your eggs 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.

👀 Why freeze?

Well, there are both medical and social reasons for putting eggs on ice.

Medical: It's about fertility preservation. There are situations where women can lose their fertility earlier in life due to medical conditions such as cancer treatment, 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: Then we have women who are choosing 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 really 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.

So, you might not be ready for babies right now, but you know it’s definitely something you want to consider later in life.  

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

There are 5 main steps involved in egg freezing (and then using those eggs):

1. Ovarian stimulation

This is your time to prime. Over a period of approximately 2 weeks before the retrieval 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 this amazing work your body is doing through transvaginal ultrasounds. This is to help the doctor count and measure your follicles. They're looking for a good amount of healthy-looking eggs.

They might also do some blood hormone tests on you as well. This 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. This is 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 this timing. 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 anesthesia for this so you shouldn't feel a thing! The whole process is known as a ‘cycle.’ Recovery time for this surgery is often a 1-5 days.

3. Egg freeze

If you’re freezing your eggs, after they 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 protects each egg from damaging ice crystals. Then, they’re placed in a freezer and stored there until you’re ready.

And when I’m ready to use my eggs?

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 three to five days after the fertilisation, an embryologist (cool title) 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.

🥚 One egg does not equal one baby

Unfortunately the math doesn’t quite check out here, because one egg does not equal one kid.

The reality is, 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.

So, 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 your 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 their 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. Which means you may require multiple cycles (and therefore, it’ll cost you more money too).

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 your early to mid 20s, there is a chance you might not use them. 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 it can cost you up to $500 per year.  That's a lot of moolah for no return.

But, before you go jumping to any conclusions. Let me 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 aren't guaranteed.  

So, waiting to freeze our eggs around our late 30s or early 40s may mean that the eggs we collect may not be 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.

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.

Time to clear the calendar!

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.

😬 There will be hormones...and risks

The first step of egg freezing is to inject yourself with hormones. So, be prepared to get hormonal. It's totally 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. 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.

AMH is the main hormone we test in our Kin Fertility Test.

💸 How much will it set me back?

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.

🔎 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 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 anesthesia ($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), I know! So let’s pull it all together:

🏥 The clinic you choose matters

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.

Hang tight, we’re putting together an Egg Freezing Discussion Guide of the questions you should be asking your clinic and fertility specialist if you’re considering freezing your eggs.

🛬 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 determine whether egg freezing is for you or not.

📕 References

  1. Aboulghar, M., et al. Impact of anti-mullerian hormone assays on the outcomes of in vitro fertilization: A prospective controlled study. Fertility and Sterility, 2014
  2. Birch, PK., et al. Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan. Human Reproduction, 2015
  3. Cobo, A., et al. Oocyte vitrification as an efficient option for elective fertility preservation. Fertility and Sterility, 2016
  4. Fiedler, K. and Ezcurra, D. Predicting and preventing ovarian hyperstimulation syndrome (OHSS): The need for individualized not standardized treatment. Journal of Reproductive Biology and Endocrinology, 2012
  5. Forman, EJ., et al. In vitro fertilization with single euploid blastocyst transfer: a randomised controlled trial. Fertility and Sterility, 2013
  6. Franasiak, JM., et al. Aneuploidy across individual chromosomes at the embryonic level in trophectoderm biopsies: Changes with patient age and chromosome structure. Journal of Assisted Reproduction and Genetics, 2014
  7. Goldman, RH., et al. Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients. Human Reproduction, 2017
  8. Kucera, R., et al. Effect of long-term using of hormonal contraception on anti-Mullerian hormone secretion. Gynecological Endocrinology, 2016
  9. Lekamge, DN., et al. Anti-Mullerian hormone as a predictor of IVF outcome. Reproductive BioMedicine Online, 2007
  10. Mesen, T., et al. Optimal timing for elective egg freezing. Fertility and Sterility, 2015
  11. Practice Committees of American Society for Reproductive Medicine. Mature oocyte cryopreservation: a guideline. Fertility and Sterility, 2013
  12. Schoolcraft, WB. and Katz-Jaffe, MG. Comprehensive chromosome screening of trophectoderm with vitrification facilitates elective single-embryo transfer for infertile women with advanced maternal age. Fertility and Sterility, 2013
  13. Scott, RT., et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in intro fertilization implantation and delivery rates: A randomized controlled trial. Fertility and Sterility, 2013
  14. Sunkara, SK., et al. Association between the number of eggs and live birth IVF treatment: An analysis of 400 135 treatment cycles. Human Reproduction, 2011
  15. Yates, AP., et al. Anti-Mullerian hormone-tailored stimulation protocols improve outcomes whilst reducing adverse effects and costs of IVF. Human Reproduction, 2011
  16. Zhang, B., et al. IVF outcomes of women with discrepancies between age and serum anti-Mullerian hormone levels. Journal of Reproductive Biology and Endocrinology, 2019

🧠 Contributors

  • ✏️ Words
    Courtney Goudswaard

  • 🧪 Science
    Dr. Vamsee Thalluri

  • 🎨 Illustrations
    Amelia Hanigan