The 411 On Freezing Your Eggs
Photograph by Audrey Shtecinjo via Stocksy
In a world where motherhood is portrayed as goddess-like, many women who aren’t ready to start a family or who might not even have a desire to do so, often times feel a societal pressure to put their eggs on ice for a later date or just to simply keep their options open.
Freezing your eggs has been presented as an expensive but painless way to prolong the start of motherhood. As women approach what doctors consider “geriatric pregnancy” (hello, 35), many have deemed it their ultimate backup plan. But it’s hardly a simple one. We spoke both with an infertility specialist and a mother who has been there to get the down low on the process, as well as the probability that putting your eggs on ice will net you a baby if and when you decide it’s time to try for one.
For those of you who are unfamiliar, Human Oocyte Cryopreservation or “egg freezing” is a procedure to preserve a woman’s eggs. This technique enables women to postpone pregnancy to a later date — whether for medical reasons such as cancer treatment, or personal reasons, such as their career, relationships, or simply not being ready to embark on their parenting journey.
The common misconception is that once you fork over the cash and retrieve your eggs, doctors will just place them back into your body whenever you’re ready and baby-making will be no problem. But that’s over-simplifying a super complicated process. We chatted with one mother, Merissa, who eventually had a successful embryo transfer, but whose fertility journey was far from easy. She completed three retrieval cycles in her mid-30s and successfully retrieved 33 eggs, yielding five healthy embryos. She had those embryos frozen as a backup option, never really thinking she would have to use them. But after months of unexplained infertility issues, she took the plunge at 39 and made her first transfer.
Merissa’s story underscores how complicated the process can be. “We ran into some issues with preparing for the embryo transfer. I kept losing my uterine lining, so after some testing and fine tuning the medication protocol, we did our first transfer which resulted in a biochemical pregnancy (positive HCG, but embryo didn’t fully attach). Again, pretty devastating. We did transfer #2 immediately after our first failed transfer, which resulted in our beautiful baby girl, Gianna, who is now 6 months old.”
Despite her challenging to motherhood, Merissa’s advice to women considering egg freezing is an enthusiastic, “Do it!”
But to get the full picture and to debunk some of the myths surrounding this elusive process, I sat down with Lucky Sekhon, MD, Infertility Specialist at Reproductive Medicine Associates of New York, Division of Reproductive Endocrinology & Infertility in the Dept of OBGYN and Reproductive Science at the Icahn School of Medicine at Mount Sinai.
Which patients of yours are most likely to inquire and pursue egg freezing? “Anyone who is interested in preserving their future fertility, either because they plan to delay childbearing and/or are interested in having multiple children and are concerned about the effect of time of their fertility.”
Who do you generally encourage to pursue the process? “It can be useful for women who are not yet ready to have children and are thinking of delaying starting a family until their mid-to-late 30s, women with underlying medical conditions, or who are at risk of developing a condition…[where they] must undergo treatment with chemotherapy, surgery, or radiation, which may permanently damage their ovaries and deplete their egg quantity.”
What’s the process like? “Women will take injectable medications once or twice daily, for about 8-to-10 days. The purpose of the injections is to stimulate as many eggs as possible to grow, while blocking signals from your brain to your ovary that would normally provoke ovulation of the maturing eggs. We are effectively ‘trapping’ the eggs in the ovaries and stimulating them to reach the stage of development necessary to adequately freeze and one day fertilize the eggs.”
“Treatment requires frequent monitoring in the form of vaginal ultrasounds and bloodwork to measure estrogen levels and to assess overall response to treatment. Once it is determined that the medications have gotten as many eggs to respond as possible, we will extract or retrieve the eggs vaginally. This egg retrieval process takes anywhere from 5 to 10 minutes.”
“Once the procedure is over, a patient will wake up in the recovery room almost instantaneously. It is normal to feel groggy and tired and want to sleep for the next 3 to 6 hours. The day of the egg retrieval is the one single day during this process that requires time off of work or school, due to the fact that it requires sedation. About 1 to 2 weeks after the egg retrieval, patients will get their period and their ovaries will shrink back down to their normal state.”
How much does it cost? “It can vary from clinic to clinic. In general, out of pocket costs for an egg freezing cycle (including doctors visits, medications, the procedure to extract eggs, and lab procedures) ranges from $10,000 to $15,000. Thankfully, many companies and insurance plans are beginning to provide coverage for fertility preservation.”
What are the risks? “The procedure is considered very low risk. But as with any surgery, there is a very minor risk of bleeding from the procedure. The risk of any serious bleeding from the egg retrieval is thought to occur in less than 1/10,000 cases.”
Are there any common misconceptions about egg freezing? “One of the most common questions I get asked is whether egg freezing diminishes the overall quantity of eggs a women will have for future cycles. The answer is no—treatments like IVF or egg freezing, which involve stimulating and then extracting eggs from the ovaries, do not impact overall egg quantities or reserves.”
What varies from clinic to clinic? “Choosing the clinic where you freeze your eggs is one of the most important decisions you will make. It is a major factor determining your odds of achieving a successful pregnancy when you come back to use your frozen eggs. It is important to do your research on any clinic you are considering. I would urge patients to look at overall IVF success rates of the clinic they are considering—you want to make sure the place that freezes your eggs knows what to do with them when you come back to use them! Patients can visit www.sart.org to get validated, objective statistics on success rates from various clinics across the country.”
Anything else important to note? “There are two major ways that eggs can be frozen. The older, antiquated method, called slow-freezing, has largely been replaced by a newer method called vitrification. Vitrification involves rapid cooling, or ‘flash freezing’, which minimizes harmful ice crystal formation and had led to improved rates of success with both egg and embryo freezing. There may still be places where the older method is used, despite the fact that numerous studies have shown vitrification to be the superior method.”
“Additionally, many patients do not understand the major differences between egg and embryo freezing. While no fertility preservation strategy can provide you with a guarantee of success, embryo freezing will always provide a woman with the best chance of success when coming back to use them versus frozen eggs. So, for women in long-term relationships or those who are open to using a sperm donor to conceive later down the road, embryo freezing offers some key benefits, including an improved thaw survival rate. At our clinic, 98% or more embryos survive the thawing process, in contrast to an average of 85% thaw survival rate for eggs. Plus, we are able to genetically test embryos to determine which are capable of producing a healthy pregnancy with the lowest risk of miscarriage.”
Lucky Sekhon, MD is an Infertility Specialist at Reproductive Medicine Associates of New York, Division of Reproductive Endocrinology & Infertility in the Dept of OBGYN and Reproductive Science at the Icahn School of Medicine at Mount Sinai.
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