By Dr. Wael Salem, CCRM Fertility
Many future parents opt for fertility preservation on their journey to create a family. Fertility preservation, sometimes called egg freezing, refers to a procedure that allows you to retain your fertility at a younger age, freeze your eggs, and use these eggs in the future. Egg freezing has become one of the most common methods people use in reproductive medicine and while it’s a great option, it’s very important to remember a pregnancy and live birth is not necessarily guaranteed. There’s a lot of information out there, so Dr. Wael Salem, Fertility Specialist with CCRM Fertility of San Francisco, helped us determine what is fact and what is fiction when it comes to egg freezing. First, let’s answer some common questions about egg freezing.
What is egg freezing?
Egg freezing is a process that allows you to grow multiple eggs during one menstrual cycle and then have them frozen for future use with IVF. The biggest advantage of egg freezing is that it allows you to store eggs at a younger age when they are generally of higher quality. A higher quality egg is one that is more likely to divide normally after fertilization and eventually give you a higher chance of a successful pregnancy in the future.
How should someone start the process?
The beginning of any egg freezing process is best started by finding a fertility clinic. There are many ways to find a fertility clinic, but it’s generally best to explore options through your insurer if it’s a covered benefit. Furthermore, there are many employer-sponsored programs like Progyny that may provide a fertility advocate or fertility nurse. These resources will help you think through the most important parts of the process before you even have your first appointment.
Two things to consider prior to the egg freezing process
- How likely is this to benefit me personally (i.e how many eggs do I need vs how many can I realistically expect in one cycle)?
- Am I in a place where I have the time, bandwidth and financial ability/insurance coverage to go through this process?
The egg freezing process
Egg freezing always starts with a general fertility evaluation. This is typically as simple as a blood draw to look at some of your reproductive hormones, in addition to a transvaginal ultrasound. Following that, you will take IVF medications for an average of 8-14 days. These are almost always injectable medications (under the skin). It sounds intimidating to most people, but it’s easy to learn how to give yourself these medications (video demonstrations are available on Progyny’s YouTube channel). At the end of this process, the eggs are harvested (retrieved) during a procedure where your doctor will go in with an ultrasound and a needle. They will be able to see the growing follicles and gather the eggs. During this procedure, you’ll be under anesthesia and won’t feel any pain. At the end of the procedure, the eggs will be identified in the lab and quickly frozen afterwards. Recovery is generally fast, but you may feel bloated for a few days to a week after your procedure.
How many eggs can someone expect to get during a round of egg freezing?
This is highly dependent on your age and your ovarian reserve. The fertility evaluation should give you insights into a rough estimate of the number of eggs you can anticipate. This is a great question to ask your doctor after they’ve completed your fertility workup.
How does someone store eggs that they’ve frozen?
This process takes place in the IVF lab at your clinic. Eggs can be stored for years before they are used. Depending on your clinic, you may have the option of storing the eggs at an offsite facility. Sometimes, this can be cost effective in the long term. You can then have your eggs shipped to different IVF centers when you’re ready to use them in the future.
What happens when you’re ready to use your frozen eggs?
Once you’re ready to start a pregnancy, it’s generally best to connect with your fertility clinic where you had your eggs frozen. They will be able to give you personalized guidance on whether using your frozen eggs is the best option. Remember, many times individuals who have frozen eggs are still perfectly fertile and can conceive on their own. This is again a space in which a personalized approach and shared decision making between you and your doctor is very important.
5 egg freezing myths
- Egg freezing uses up all your eggs
Egg freezing does not mean that you won’t be fertile in the future. This notion is totally false. Eggs are only harvested that would have been naturally absorbed by your body. It does not reduce your overall egg count.
- Egg freezing guarantees I’ll be able to have a pregnancy in the future
It’s critical that you have a conversation with your doctor about the number of eggs that they recommend you freeze. Even once you hit that target number, it’s never a guarantee, unfortunately, as the biology of reproduction can take unexpected twists and turns.
- Egg freezing and embryo freezing are the same
Egg freezing and embryo freezing largely involve the same steps for the individual undergoing the procedure. However, with embryo freezing you are going through the process of fertilizing the egg in the lab with sperm. You then will have the embryos frozen at the end of 5-7 days of growth in the lab. One of the biggest differences between egg and embryo freezing is the concept of reproductive autonomy. In short, freezing eggs gives you the opportunity to defer into the future the decision about where the sperm will come from. Furthermore, there are some legal pitfalls to be aware of when an embryo is frozen vs when eggs are frozen.
- Egg freezing Is the best option for everyone
Many individuals are good candidates for egg freezing but that still doesn’t mean it’s right for everyone. It’s very important to have an honest conversation with your fertility doctor about your future reproductive goals. For example, how many children would you ideally want? When would you like to have a pregnancy?
- Egg freezing is always necessary
For many individuals who are young and planning on having a pregnancy in the near future, egg freezing may not be necessary. Again, I encourage you to have an honest conversation with your doctor about your natural fertility rates at the age you hope to start a pregnancy.