Fertility On Your Terms: Understanding Egg Freezing and Fertility Preservation

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In recent years, advancements in reproductive medicine have allowed couples and individuals to create new paths toward becoming parents through fertility preservation techniques such as egg freezing. Egg freezing offers the possibility to pause the biological clock, providing peace of mind when it comes to timelines for family planning. Whether motivated by personal circumstances, medical challenges, career aspirations, gender affirmation, or simply timing, egg freezing empowers people with the choice to embrace parenthood when the time feels right.

We spoke with Dr. Michael Guarnaccia, Medical Director at Pinnacle Fertility, Manhattan, to learn all the ins and outs of fertility preservation.

Understanding Egg Freezing

When considering fertility preservation options, you’re likely to have many questions. How does it work? Am I too young or too old? Is it safe? What does it entail? As we dive deeper into the process of egg freezing, we’ll look at the intricacies of fertility preservation, the technology behind it, and more. The idea of freezing your eggs may sound complicated, but it’s actually pretty straightforward! The process can be broken down into a few steps:

  • Preparation: You will start by seeing a doctor at a fertility clinic and completing ovarian reserve testing to get an idea of the number of eggs you have remaining in your ovaries. Then, you’ll start taking medications that will stimulate your ovaries to mature multiple eggs at once. This medication is the same as the hormones your body normally produces to begin ovulation, but at a greater level. These medications will typically be self-administered injections taken daily for 8-14 days depending on your body’s response.
  • Egg Collection: 36 hours before your scheduled egg retrieval, a “trigger shot” will be administered to ensure your eggs are mature and ready for collection. Then, you will undergo a minor procedure to collect the eggs from your ovaries. During the procedure, a doctor will insert a needle through your vagina and into your ovaries to collect the mature eggs. The procedure is done under anesthesia, which means you will be asleep for the whole thing.
  • Cryopreservation: Your eggs are then rapidly frozen using a technique called vitrification. This method of freezing is essentially like hitting the pause button on your eggs when they’re at their best, so whenever you’re ready for pregnancy in the future, the quality of your eggs will be the same as the day you froze them.
  • Storage: Your preserved eggs are then stored in specialized cryogenic tanks that ensure their viability until you are ready to use them to attempt pregnancy.

Egg freezing is widely considered safe. The process does not impact your natural ability to become pregnant or your menstrual cycle. The egg retrieval process focuses on collecting eggs that would otherwise have been naturally lost during your normal menstrual cycle, so it does not impact your ovarian reserve or impair your ovaries’ ability to produce eggs in the future.

After freezing your eggs, your body will continue its natural menstrual cycle and you should be able to conceive naturally if you wish to as long as everything else is in good working order.

Are there any side effects from the egg freezing process?

As with any medical procedure, the egg freezing process may cause mild side effects. These side effects come from the administration of medication, the effects of hormonal medications used to stimulate the ovaries, and the procedure itself.

Medication side effects may include mild bloating, mood swings, and discomfort at the injection site. After the egg retrieval procedure, some people may experience cramping or spotting and some drowsiness, dizziness, or nausea while recovering from the anesthesia. Serious complications are rare, but they can occur, such as ovarian hyperstimulation syndrome (OHSS), where the ovaries become swollen and painful. Mild OHSS can be treated with rest and pain medication, but severe OHSS may require hospitalization to treat more severe symptoms. Your care team will monitor your response to your medications and procedures to minimize risks accordingly.

Who should consider freezing their eggs?

Many factors may lead someone to consider freezing their eggs. Among them can be age, medical necessity, and personal relationships.

Although there is technically no age limit for this type of fertility preservation, the highest chances of successful pregnancy happen with eggs frozen in a person’s late 20s to early 30s. Fertility decreases over time, especially when it comes to ovarian reserve and egg quality. As you age, your ovarian reserve – a term that refers to the total number of eggs available in the ovaries – naturally diminishes. This decline is not only about the quantity of eggs but also their quality. Egg quality refers to the potential of an egg to develop into a healthy embryo, and this too faces challenges with age. This can vary due to genetics, environmental exposures over time, and other factors.

By the mid to late 30s, the decline in both egg quantity and quality becomes more pronounced. This is why it is recommended that individuals interested in fertility preservation pursue treatment sooner rather than later.

Some individuals may turn to fertility preservation methods because of medical challenges such as cancer. Treatments such as chemotherapy and radiation can permanently destroy or damage ovarian reserve, and egg freezing can provide a path to having a biological family after recovery. People with medical conditions such as endometriosis and PCOS, and those with certain autoimmune disorders requiring medication that can impact fertility, may also benefit from freezing their eggs.

Egg freezing can also help empower members of the LGBTQ+ community to build their families by offering a pathway to biological parenthood. For transgender and non-binary individuals contemplating gender-affirming treatment, egg freezing provides the opportunity to preserve fertility before undergoing procedures that might affect reproductive capabilities, such as hormone replacement therapy or gender-affirming surgery.

Even after gender-affirming treatment, egg freezing can be a valuable tool, especially for people who did not have the chance to preserve their eggs beforehand. Although certain treatments can impact fertility, many individuals still have viable eggs that can be retrieved and frozen. This process opens doors to various family-building options, including IVF and gestational surrogacy.

What happens when I want to use my eggs?

When you’re ready to build or grow your family, achieving pregnancy typically involves in vitro fertilization (IVF). First, your frozen eggs are thawed and fertilized with sperm in a laboratory setting to create embryos. Then, the healthiest embryo is chosen and transferred to the uterus with the hope that it will successfully implant and grow into a healthy pregnancy.

With IVF, you have the flexibility to conceive a child in a few different ways. If you choose to conceive with a partner, depending on their anatomy you may use their sperm or work with a sperm bank. If you choose to conceive without a partner, you can use donor sperm. You may also choose to use a gestational surrogate to carry your pregnancy, in which case your fertilized egg would be transferred to a surrogate’s uterus instead of your own to carry to term.

Egg freezing is a remarkable scientific advancement that opens up a world of opportunities for individuals and couples who might not be ready to start a family. Whether you’re someone facing an unexpected turn in life or simply planning ahead, the reassurance it provides can ensure that you can pursue parenthood without the pressure of a ticking biological clock. It can be an investment in your future family and provide a sense of autonomy, allowing you to build your family when and if you’re ready to do so. As reproductive technologies continue to evolve, the technology behind egg freezing will continue to improve, advance, and expand its ability to support diverse pathways to parenthood.