Fertility preservation like egg or sperm freezing is steadily becoming a more common topic of conversation. Whether people choose to delay their pursuit of parenthood or are advised to consider preservation due to medical reasons, fertility preservation is being utilized more and more frequently. Yet, while the prospect of egg (oocyte), sperm (semen), or embryo freezing (cryopreservation) can often feel like something of an insurance policy for future family building (it isn’t!), there are a number of different factors to consider when pursuing either elective or medically indicated fertility preservation at any age.
When to get started with fertility preservation
Fertility is different for everyone but, generally speaking, age is one of the most important components to consider with elective fertility preservation. There is no magic number as to when people should begin, but there are some advantages to freezing eggs, sperm, or embryos at an earlier age. Generally speaking, the younger you are, the more likely you are to retrieve a larger number of quality eggs. When you go to use your eggs or embryos later, you’re also more likely to have better thaw outcomes, meaning more frozen eggs or embryos are able to be successfully thawed for use. There are also cost implications to consider, which we’ll touch on a bit later.
Egg freezing considerations
When do the experts recommend elective fertility preservation? For those considering egg freezing, the American Society of Reproductive Medicine (ASRM) recommends doing so in your 20s or early 30s, when ovarian reserve is higher and there’s a greater chance of retrieving quality eggs. For those who are over the age of 35 considering freezing their eggs, it’s important to consider success rates related to age — speaking to a fertility specialist and getting a fertility assessment can be very helpful in your decision making. Fertility specialists can also help you understand if the clinic, country, or region has restrictions on whether you are able to preserve eggs, sperm, or embryos and if there are any age or storage length limitations for future use that may impact you.
Sperm freezing considerations
For those considering sperm freezing, information is still being gathered on how age affects the quality of sperm. Studies suggest that complications can arise from declining sperm quality after the age of 40. It’s important to speak to a urologist, andrologist, or reproductive endocrinologist to understand what other factors (including lifestyle, environmental factors, or surgical history) may impact your reproductive health. Before moving forward, the specialist will likely suggest a fertility assessment including screening tests, such as blood work and semen analysis, to determine if preservation is a possibility.
Embryo freezing considerations
If you have a partner or donor, you may also choose to freeze embryos — eggs that have been fertilized with sperm. Historically, embryo cryopreservation has a higher pregnancy success rate than egg freezing following a thaw cycle; however, due to advances in technology, the outcomes (estimated pregnancy rates) are now becoming more similar. Although, as with egg freezing, it’s important to understand that age and individual health play a key role in successful outcomes at all stages of reproduction leading to a healthy live birth.
If you’re not sure if it’s time to consider preservation, many people find an overall fertility assessment to be helpful. By providing you more personalized information about your body and important factors like ovarian reserve and sperm health, as well as what to expect in terms of outcomes such as thawing, pregnancy rates, time to utilization, and age restrictions, you can make a more informed decision about if and how early you want to consider preservation. If you’re a Carrot member, our Care Navigation team can provide guidance on where to go to get started.
Legal and cultural considerations
While more people worldwide are pursuing fertility preservation, these procedures are not recommended nor available for everyone in every country. It’s important to understand legal and cultural restrictions since they can have major implications if you are considering a fertility preservation journey.
A few key things to note:
- In many countries with national health coverage, fertility preservation is not covered or may only be covered with a specific medical diagnosis.
- Financing options available through fertility clinics may vary depending on whether you’re a citizen of the country where you’re pursuing fertility preservation.
- Sometimes, cultural norms or regulations may impact access to fertility preservation. For example, in some locations, egg and sperm freezing may be legal, but the retrieval process or use of frozen materials may be limited to legally married individuals.
- Some countries have limitations on how long reproductive materials can be stored.
- For couples considering embryo freezing, it’s important to consider legal or ethical issues that may impact individuals or couples’ rights to reproductive materials in the event of a separation or divorce.
- Countries or regions may also have religious or cultural restrictions around freezing embryos that remain after a transfer, potentially having implications on an individual or couple’s pursuit of future parenthood and the future of any children born from the frozen embryos.
Carrot members can talk to our Carrot Experts to better understand how these restrictions may impact their decision-making.
Fertility preservation cost
Fertility preservation can be costly, and the costs are typically not covered by health insurance — one of the many reasons why we started Carrot to help make fertility care accessible to all. When working on a financial plan, the first step is determining if your situation would fall into the category of medically necessary fertility preservation. This is typically the case for people going through certain cancer treatments, surgical procedures, or gender reassignment. In that case, some national health programs or insurance providers will cover some of the costs. When fertility preservation is considered elective, this generally means that you’ll need to pay out-of-pocket.
Costs by type of fertility preservation
It’s important to understand the complete picture of costs based on what preservation option you are considering. For example, in the U.S., out-of-pocket costs for egg freezing range from $8,000 to $10,000 (often excluding the cost of medications, which can add hundreds or thousands of dollars to the overall cost). Embryo freezing ranges from $15,000 to $20,000, often excluding medications, as well. For both egg and embryo freezing, there’s also a chance that you may need more than one treatment cycle.
On the other hand, if you are pursuing sperm freezing, the average cost in the U.S. is around $1,000 to $1,300. For all of these options, you’ll also need to consider storage fees, which are typically around $500 a year and add up the longer reproductive material is stored. Lastly, you’ll need to think about the cost for treatments and services required when using your frozen material in the future. If only eggs or only sperm were preserved and not embryos, donor material may be needed. The costs of in-vitro fertilization (IVF) to create an embryo will also need to be considered.
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