Flying solo, part 1: “Egg freezing — Is it for me?”
This post is the first in a series and will focus on a topic that has gotten a lot of media attention and that is at the forefront of many young women’s minds: egg freezing.
The Conception Diaries had an amazing inaugural event on 26 July 2017! We had a great turnout and discussed many options for young reproductive age women who are interested in their fertility.
For those of you who couldn’t make it, we will be posting a blog series here entitled “Flying solo: What are my options?”
This post is the first in the series and will focus on a topic that has gotten a lot of media attention and that is at the forefront of many young women’s minds: egg freezing.
When flying solo, many women wonder, “Where do I start?” These days, the first option that comes up is egg freezing. Your friends are doing it, you hear about it in the news and on social media, and some companies and insurances are even offering to help pay for it!
But what is egg freezing, how does it work, and can you afford it?
Here are the who, what, why and hows of freezing eggs:
What is egg freezing?
Egg freezing, also known as oocyte cryopreservation, is a method used to preserve reproductive potential in women. Eggs are harvested from your ovaries, frozen unfertilized and stored for later use. A frozen egg can be thawed, combined with sperm in a lab and implanted in the uterus. This happens using the assisted reproductive technique called in vitro fertilization (IVF).
Why should I freeze my eggs?
As a woman gets older, her fertility declines. This age-related decrease in fertility, or ovarian reserve, starts as early as age 30 and progresses more rapidly after age 37. This is due to a decrease in the quantity and quality of a woman’s eggs, or oocytes. As a women ages, her eggs have more genetic errors, putting them at higher risk for infertility, miscarriage and genetic abnormalities. Unfortunately, there is no way to prevent this loss in ovarian reserve — it is part of the natural aging process. However, egg freezing offers women the opportunity to preserve their fertility by freezing eggs while they are young for later use.
Women are delaying starting families for many reasons. Currently, the average age that women are having their first child is 35 to 36. Many women are taking time in their relationships (on average five years!) before they tie the knot or discuss having children. In the workforce, women are pursuing higher education and are more career-minded, achieving more secure, more demanding and higher-profile positions. Sometimes women want to delay childbearing for something as simple and fun as travelling or spending time trying to find the right partner. Whatever the reason is, egg freezing offers a viable alternative for women who wish to preserve their fertility.
Who should freeze eggs?
Although there are not strict criteria for who should freeze their eggs, certain women would likely benefit from egg freezing:
- women who want to delay childbearing;
- single women;
- women in relationships who are not sure whether they will want to have children in the future (and with their current partner!);
- women undergoing medical treatment that could significantly reduce their fertility;
- ideally, women under 36 to 37 years of age.
How does egg freezing work?
Normally, during a regular menstrual cycle, your body produces only one egg (oocyte) per month. During an egg-freezing cycle, by taking fertility medication in the form of daily injections (usually in the fat tissue of your lower stomach or in the muscle of your backside), your body will produce multiple eggs per month. After 10 to 12 days of injections, the follicles (or fluid-filled sacs that contain the eggs) are ready to be retrieved. The eggs are removed from the ovaries through a procedure called an egg retrieval. This procedure takes about 30 minutes and typically happens in the fertility doctor’s clinic, in the operating room and under sedation. It is performed by the fertility doctor using a transvaginal ultrasound and needle that goes through the vagina to remove the eggs from the ovary. Don’t worry: You won’t feel anything because you will be put to sleep with anesthesia given through an IV. Once the fluid and eggs in the ovarian follicles are retrieved, they are given to the lab to look for eggs and start the freezing process. After the egg retrieval, you would rest in the clinic for about an hour and then go home. The risk of any complications from the egg retrieval, such as bleeding, infection or damage to any nearby pelvic structures, is less than 1%, so it is a very low-risk procedure.
How are my eggs frozen and stored in the laboratory?
Most fertility clinics and labs use the rapid-freezing technique called vitrification to freeze eggs. It is the most popular method and causes the least damage to eggs by eliminating ice-crystal formation during the freezing process. Most centres store their eggs on site, and all fertility clinics should have backup generators to prevent eggs from thawing during unforeseen circumstances, such as power outages.
What are the risks of egg freezing, and is it safe?
Egg freezing is relatively safe. The complication risk is less than 1%, with the major side effects being secondary to hormonal changes. These include headaches, nausea, bloating, mild mood changes and breast tenderness, which typically occur during the stimulation process and dissipate once the cycle is completed. Doing one or two egg-freezing cycles does not increase your risk of cancer or any other long-term disease. Ovarian hyperstimulation syndrome (OHSS) is an uncommon but occasionally serious risk of fertility treatment, including egg freezing. OHSS results in lower abdominal bloating due to enlarged ovaries from fertility treatment, fluid retention in the belly, and electrolyte and blood-clotting abnormalities. Fortunately, with current stimulation protocols and careful observation during treatment, the incidence is quite low, and most cases are treated conservatively on an outpatient basis, and mild OHSS resolves within a few days of completing an IVF cycle.
How many eggs do I need to freeze, and how do I know these eggs will make a baby?
Although egg freezing success rates are increasing and many live births from frozen eggs have been reported, it is still not a guarantee. Most data show that you need approximately 16 mature eggs retrieved over 1 to 2 IVF cycles to achieve 1 live birth. For women under 36, this typically can be achieved in 1 cycle, and for women over 36, often 2 or more cycles are required. As the age at which eggs are frozen increases, the likelihood of a live birth from the eggs goes down with the highest success rates achieved when freezing eggs at age 30 to 34 (Cobo A. et al.).
How much does it cost?
The cost of an egg-freezing cycle varies from centre to centre, with an average cycle costing between $6,000 to $10,000. Medication is $2,000 to $4000 and might be covered by supplemental drug plans. Freezing costs range from $300 to $500 per year. The cost to thaw and fertilize eggs is $5,000 to $8,000. Currently, public funding for IVF, which covers one IVF cycle per person, does not cover egg freezing unless it is for a medical cause.
How do I start the egg-freezing process?
First off, congratulations on making the choice to consider this option! I always tell my patients that they have taken the first and most important step by coming in to discuss their options. Have your family doctor refer you to a fertility clinic of your choice, so that you can have a consultation and fertility evaluation to see if you are a good candidate for egg freezing.