The Most Common Questions About Freezing Your Eggs Answered

Last year, we watched Khloe Kardashian go through the process of freezing her eggs (also known as oocyte cryopreservation) on an episode of Keeping Up With the Kardashians. For many, that was the first glimpse into the fertility treatment women have undergone since its rise in popularity in 2012 — this is when the American Society for Reproductive Medicine (ASRM) removed the experimental label from egg freezing procedures. This fertility choice is sought out for reasons ranging from not being ready to have children to medical treatments or conditions that could negatively impact the ability to conceive.

According to TIME, when they collected data in November, “Shady Grove Fertility, which runs 36 clinics across the Eastern seaboard, had seen a 50% increase in women freezing their eggs since 2019. Doctors at NYU Langone saw a 41% year-over-year increase in women fertilizing their eggs. And Seattle Reproductive Medicine had conducted 289 egg-freezing cycles in 2020, compared with 242 in 2019, a nearly 20% jump.”

When the pandemic hit, many clinics expected to see a downturn in numbers. The time at home has created ideal conditions for women who were otherwise traveling or unable to take time from work to deal with the possible side effects experienced after the procedure.

To help those looking for information on this fertility choice, we spoke with Incinta Fertility Medical Director Dr. Mathew Macer to get a better understanding of the ins and outs of egg freezing.

What You Can Expect

Before freezing your eggs, what exactly can you expect? You’ll begin with several screening tests, including ovarian screening, to determine the quality of your eggs and check for infectious diseases. The egg retrieval process will be the same for women undergoing IVF.

Hormones will be prescribed to produce eggs, and once the follicles have matured, a shot to finish egg maturation and start ovulation will be given. Your reproductive endocrinologist will then remove the eggs through an ultrasound-guided needle, a procedure that takes about 15 to 30 minutes. Once the eggs are retrieved, they will be frozen using vitrification, a rapid cooling process that instantaneously freezes the egg in a glass-like structure.

Hormone Injections

To prep the eggs for retrieval, a round of at-home hormone injections is required to stimulate ovaries into producing multiple eggs in one menstrual cycle. This process lasts for approximately two weeks. Visits to the clinic will be frequent as the ovaries are regularly monitored by vaginal ultrasound to see how well the follicles (the sacs containing the eggs) are developing and to check hormone levels.

You will be responsible for handling the mixing and injecting medications once or twice a day. The idea of injecting yourself with needles can be daunting, but you’ll be given instructions from your doctor, and if you’re still not sure, you can reference online videos for help.

Best Age To Freeze

Age and egg quantity impacts the likelihood your egg freezing is successful. The younger the woman, the highest number of healthy eggs she’ll be able to freeze, and the higher the success rate of a live birth. The optimal age range for egg freezing is between 25 and 37. After 37, the percentage of abnormalities starts to increase, and the chances of a healthy live birth decrease. But there is an age that tends to be more cost-effective. Around 37 is where we see women who have undergone the procedure come back to use the eggs that were retrieved compared to women who are younger than that, Dr. Macer explains.

Pricing

The first question that usually comes to mind with any medical procedure is price—and this one is not cheap. Pricing depends on your location and is unique to the individual and the facility the procedure is taking place. According to Dr. Macer, pricing in LA ranges anywhere between $7,000 to $15,000 and is dependent on several factors such as consultations, preliminary testing, how many eggs are being retrieved, how many cycles you undergo, medication fees, egg storage fees, and more.

When comparing prices, please know that the more expensive a facility is, it does not automatically mean it’s the best place to go

Covering Your Bases

When searching for a clinic, be sure to price shop, negotiate, and ask as many questions as possible. Requesting an itemized list can help you determine exactly what a clinic’s package includes and what it does not. Also, check with your insurance to see if egg freezing is covered. As stated by the National Conference of State Legislatures, “Since the 1980s, 16 states have passed laws that require insurers to either cover or offer coverage for infertility diagnosis and treatment.” Knowing if your state covers or offers coverage can help alleviate the cost, but many consider it an elective procedure.

Tech companies such as Facebook, GitHub or Google, provide $10,000 a year to employees to cover procedures such as egg freezing, but if you aren’t covered, there are additional payment routes you can take such as fertility loans or signing up with a fertility financing company. Incinta Fertility also offers payment plans that work with the client to determine what they can pay and how often, shares Dr. Macer.

Possible Side Effects

Though egg freezing is a relatively safe surgical procedure, there are potential risks that can include infection, bleeding, or a reaction to anesthesia. These are associated with less than 1% of cases. Additionally, the hormone shots prescribed do carry a risk of Ovarian Hyperstimulation Syndrome, or OHSS, which affects 3%-6% of women.

There are different hormone medications you can be prescribed and if a woman with a large number of eggs, a number determined by genetics, is given a hormone treatment that triggers ovulation to a degree that leads to overstimulation, OHSS can occur. When overstimulated, the ovaries produce fluid in the abdomen leading to bloating and discomfort. Along with this, women can experience nausea, vomiting and abdominal pain.

There are different degrees to which OHSS can happen. Most women can spend this time at home and wait it out by ingesting enough electrolytes, eating a high protein diet and being monitored by their doctor. If the fluid buildup shifts to a different part of the body, this is when a trip to the hospital is necessary, Dr. Macer says. This is the very reason screening happens to detect those who are at risk before prescribing them hormones. Women who are most at risk for OHSS are those with PCOS and under the age of 35.

Recovery Period

After egg retrieval, the downtime is short. Clinics recommend that you rest at least 24 hours after your procedure, but that’s the extent of recovery. Women may experience some soreness in the vaginal area, abdominal cramping, or some spotting, which could last a few days.

Success Rate

As per UCLA Health, “Clinical pregnancy rates have been estimated between 4-12% per oocyte or immature egg cell.” The success rate in a live birth is determined by the woman’s age at the time of egg freezing and the number of available eggs, but there are no guarantees.

Longevity

Once eggs are successfully frozen, they can be preserved in this state for decades. Cryopreservation cools the eggs down to -196ºC, which is a temperature that stops aging, keeping the egg viable regardless of how much time has passed. As of now, the record is at least 20 years, Dr. Macer shares.

When You’re Ready

When you’re ready to use your eggs, the process similar to In Vitro Fertilization (IVF) is followed. The eggs are thawed, combined with sperm, and allowed to develop for three to six days. Once the eggs are fertilized and begin to divide, they are then ready to be transferred back into the woman’s body.