Fertility care

The egg freezing journey: What to expect

Egg freezing, or oocyte cryopreservation, has become increasingly common in recent years, especially as more companies cover the procedure for employees. Originally developed for those undergoing medical treatments that could impact their fertility, today, people freeze their eggs for either personal or medical reasons. But while egg freezing has become more popular, surveys suggest that not everyone who undergoes the process reports feeling prepared for the emotional, medical, and financial challenges involved. At the same time, those who felt well informed are more likely to feel positive about the experience, regardless of whether they ultimately use their frozen eggs. Before freezing your eggs, it can be helpful to better understand who should consider egg freezing, what the process involves, and what to expect if you decide to use your stored eggs in the future.

Who should consider egg freezing?

Egg freezing for medical reasons

Some people choose to freeze their eggs before beginning certain medical treatments. Cancer treatments such as chemotherapy, radiation, and surgery can put fertility at risk. Surgical interventions for conditions such as endometriosis, ovarian tumors, and ovarian cysts can also impact fertility. Your doctor may recommend fertility preservation if you’re undergoing any of these procedures.

Elective egg freezing

In elective (also known as social) egg freezing, someone chooses to freeze their eggs for personal rather than medical reasons. In surveys, the most common reasons for freezing eggs include having more time to find the right partner and focus on career development. With age, the number and quality of eggs in a person’s ovarian reserve both decline. As people age, their eggs are more likely to have alterations or mutations in their DNA. These abnormalities make it harder to get pregnant and increase the risk of miscarriage or having a child with a genetic disorder. And while eggs decrease in quality and quantity with age, the uterus undergoes fewer age-related changes. Data shows that the likelihood of success from in vitro fertilization (IVF) depends more on the age of the egg than the age of the uterus. In this way, freezing eggs at a younger age may increase the chances of a pregnancy in the future.

Fertility preservation for trans men and transmasculine people

Trans men and transmasculine people can consider freezing their eggs before starting hormone replacement therapy (HRT) or before surgery such as removal of the ovaries (oophorectomy). Researchers don’t fully understand the long-term effects of hormone replacement therapy (HRT) on fertility, so doctors typically recommend preserving fertility before starting HRT. That said, a 2019 study found that trans men who retained their ovaries and underwent testosterone therapy had similar outcomes from egg retrieval cycles compared with cisgender women. This study suggests that transmasculine people who didn’t freeze their eggs before starting HRT may, in some cases, consider egg freezing as an option after starting HRT.

What to expect from the process

You may need to stop taking hormonal birth control

Hormonal birth control should not impact long-term fertility. However, if you’re on hormonal birth control, your doctor may advise you to stop taking it before starting treatment. Being on birth control recently can affect the results of your fertility assessment and suppress the body’s response to medication used during the egg freezing process. If you’re using a non-hormonal option such as a copper IUD, in most cases, your provider will not recommend removing it. These types of IUDs don’t change a person’s hormone levels or stop ovulation like hormonal birth control options.

You’ll undergo testing and start taking fertility medications

The egg freezing process starts with a visit to a fertility clinic for an initial consultation. After that, doctors typically request diagnostic testing to learn more about your overall and reproductive health to make sure you’re a good candidate. Next, you’ll start taking daily injectable medications to help your body mature multiple eggs for retrieval. Over the next one to two weeks, you may need to attend two to three (or more) doctor’s appointments to check the growth of your follicles (fluid-filled sacs that surround eggs) and blood tests to view changes in hormone levels.

When your follicles are ready, your doctor will give you a hormone trigger shot to prompt the eggs to go through their final maturation stage. Then, your doctor will schedule your egg retrieval, the surgical procedure to remove your eggs. After that, your fertility clinic will freeze the mature eggs retrieved. The number of eggs they’re likely to retrieve depends on several factors, including your age, how many eggs are in your ovaries (ovarian reserve), the amount of medication you take to stimulate the ovaries, and your body’s response to that medication. That said, the average person will retrieve approximately eight to 14 eggs on average each time they attempt a cycle. Some people may choose to go through multiple cycles of these procedures to increase the number of eggs they can freeze for later use.

To use your frozen eggs later, you, your partner, or a gestational carrier will go through an IVF and embryo transfer cycle

To ultimately have a baby, egg freezing is just part of the process; IVF is the next step. When you want to use your frozen eggs, they’ll be thawed and fertilized with sperm in a lab to create an embryo. The best-quality embryo will then be transferred to a uterus — this is also known as embryo transfer. The uterus could be yours or the person intending to carry the pregnancy, such as your partner or a gestational carrier.

Other considerations

Egg freezing can be expensive

In the U.S., the rates for a single egg freezing cycle vary by state and city. On average, people can expect to spend about $8,000 - $11,000 on an egg freezing cycle and between $500 and $1,000 a year to store eggs. If you have fertility benefits through Carrot, you can typically use your benefits to cover these costs. If you’re looking for support on your egg freezing journey and don’t have access to fertility benefits, Carrot can reach out to your employer on your behalf; simply fill out this form and we’ll get the conversation started.

It’s important to understand pregnancy rates when using frozen eggs

There are several hurdles a frozen egg has to overcome to result in a healthy pregnancy. First, the eggs must be successfully thawed. Typically, 85-95% of frozen eggs survive thawing. Then, one has to be fertilized with sperm in a lab and develop into a healthy embryo. This step has a 71-79% success rate. That embryo then has to implant in the uterus (a 17-41% success rate) and continue healthy development to lead to a pregnancy.

In theory, the younger you are when you freeze your eggs, and the more eggs you have to work with, the better your chances of a successful pregnancy. The live birth rate — the technical term for giving birth to a baby — per thawed egg is 4.5-12% for those who froze their years at age 30 or younger. The rate is 2-12% for those who froze their eggs at age 38 or younger. While egg freezing is not a guarantee of future pregnancy, it can help increase your chances of having a healthy pregnancy in the future.

Most people who choose to freeze their eggs feel empowered by the decision, especially if they reported feeling well informed about the process before starting. If you’re considering egg freezing but have questions, don’t hesitate to talk with your fertility provider. For Carrot members, our team is available to answer questions and help you take the next step. Schedule a chat with member of our Care Team.

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