By Maja Zecevic, PhD, MPH
There are 8 things you should know that will help you decide if to freeze your eggs.
At some point you may have asked yourself: “Should I freeze my eggs?
This might have been prompted by warnings from your mother about your “biological clock” quickly running out. Perhaps you’ve heard about a celebrity freezing her eggs so that she could continue her career during her prime time. Or maybe you have a friend who’s been talking about or has already frozen her eggs.
Your internet search has most likely taken you to fertility clinic websites that give the impression that freezing your eggs is a great option if, for example, you want or need to delay childbearing to pursue educational, career or other personal goals. Egg freezing, these websites promise, is an effective way for women to preserve their fertility.
Sadly, egg freezing is neither simple, straightforward, nor highly successful.
Eight things to consider from eggs to baby
- How it all started out — Egg freezing started decades ago as a fertility preservation procedure for women in their reproductive years who had received a cancer diagnosis and were about to start chemotherapy. In this case, egg freezing provided some of these women their only chance to become mothers after cancer.
- In vitro fertilization and egg freezing are not different procedures — In our society, in vitro fertilization has all the shameful, taboo connotations of infertility, whereas egg freezing has become trendy and socially acceptable. In vitro fertilization is a procedure suffered in silence, while egg freezing is cheerfully shared. But here’s the thing: frozen eggs are not put back inside the mother later to be fertilized: frozen eggs are always fertilized in vitro. Not only are in vitro fertilization and freezing your eggs both procedures for infertility: they are essentially the sameprocedure!
- The procedure is invasive and physically draining — Egg freezing is a process that spans four to six weeks. It starts with daily hormone injections that may involve cancer treatment drugs and requires frequent doctor visits for ultrasound monitoring and blood tests. Once the eggs have adequately matured, the next stage involves extracting the eggs from the ovaries, while sedated, using a long needle placed through the vagina, guided by ultrasound. The retrieved eggs are immediately frozen and then stored, possibly for many years, until the woman is ready to attempt a pregnancy. Sometimes the eggs are never used, for example, because the woman manages to conceive naturally after all, or because she is never ready for motherhood. In any case, the final stage involves egg thawing, in vitro egg fertilization with a sperm, embryo laboratory growth, and embryo implantation — which, by the way, requires even more hormone injections.
- Often multiple procedures are required — The egg freezing preparation process is often the first time that a woman has checked her fertility health status. The older you are, the more times you have to repeat the entire egg freezing procedure. Even in your mid-30s, you will have to undergo multiple treatments just to harvest the recommended number of viable eggs. This increases the expense and emotional and physical burden of the egg freezing procedure.
- The cost is astronomical — One cycle of egg freezing can cost as much as one round of in vitro fertilization, or as much as $15,000. Egg storage fees can be up to $1,000 each year.
- The outcome is worse than a standard in vitro procedure — The current recommendation is that a woman freezes up to 20 eggs per desired pregnancy. This is because one frozen egg from a woman under 38 has only a 2% to 12% chance of producing a live birth. This is compared to a 30% success rate for an average infertility in vitro fertilization cycle that uses embryos. Why? Using frozen eggs to produce a baby has additional hurdles. An egg needs first to survive the freezing and thawing process. Next, the egg must be successfully fertilized with a sperm, grow into a viable embryo in the laboratory, be successfully implanted, and grow inside a healthy uterus. Another reason for the lower success rate is that while there is a test to check the quality of embryos, there is no clinically available test to check the quality of an egg. This often means that what matters the most for the ultimate success of egg freezing is the total number of eggs frozen.
- A woman’s biological clock is not stopped — Even if your eggs are frozen when you are young, you are likely to attempt pregnancy from those frozen eggs later in life when you face many of the same risks that older mothers face. Later-in-life conditions, such as diabetes or high blood pressure, may impede implantation. And if pregnancy occurs, it is considered a high-risk pregnancy with increased chances of pregnancy-related complications such as miscarriage, gestational diabetes, preeclampsia, and preterm birth.
- We don’t know much about long-term health consequences — Only about 5,000 babies so far have been born using frozen eggs, compared to more than 5 million babies born through standard in vitro fertilization. It was only four years ago that the American Society for Reproductive Medicine (ASRM) removed the “experimental” label associated with egg freezing. Even then, the Society has raised concerns that studies “that support the safety, efficacy, ethics, emotional risks, and cost-effectiveness” of non-medically driven egg freezing for the purpose of circumventing reproductive aging are still lacking.
Egg freezing may be the right choice for some women, but for many it is not.
Many women may not need to freeze their eggs because their body’s ability to have a baby is intact and appropriate for their age. To determine if you fall into that classification, you should be doing periodic fertility check ups. On the other hand, for the many women who are choosing to pursue parenthood later in life, egg freezing may be attempted too late in life, when few or no eggs are left to preserve. If you are a woman who is considering egg freezing, you should start by gathering a detailed medical history, and obtain at least one expert opinion from a reputable reproductive endocrinologist to be absolutely sure that egg freezing is an appropriate, beneficial, and medically adequate path to motherhood for you.
Opionato (www.opionato.com) is your trusted go-to fertility expert accessible at anytime from anywhere. We assess your fertility potential and provide next-step fertility advice so your path to pregnancy is short and stress-free.
Opionato started with one woman’s personal fertility experience and the vision to give others what she lacked. Read Maja’s story here: https://www.opionato.com/blog/what-i-wish-i-knew-my-fertility-journey.