Egg freezing: What you need to know

What is egg freezing?

Freezing your eggs is a way to extend your fertility by harvesting and banking eggs to use when you're older.
This relatively new type of assisted reproductive technology, known to doctors as oocyte cryopreservation, has the potential to give women more options for having children later in life. Since the first baby conceived with a frozen egg was born in 1986, an estimated 1,000 to 2,000 children have been born using the technique.
And interest in freezing eggs is growing: Technological advances have dramatically improved success rates, leading more women to explore egg banking as a means of extending their childbearing years. A recent survey found that half of American fertility clinics offer egg-freezing services, and many more plan to do so soon.
Proponents say that freezing eggs gives women more control over their fertility. But the American Society for Reproductive Medicine (ASRM) says there isn't enough information yet to recommend freezing eggs to delay motherhood. The ASRM advises paying close attention to a clinic's success rates before going through with the process.

Why would I want to freeze my eggs?

There are three main reasons women consider freezing their eggs:
To buy more time. Most women who freeze their eggs aren't ready to get pregnant. These women want to improve their chances of having children when they are ready, later in life.
Women postpone childbearing for any number of reasons. For example (to name just a few scenarios): They're waiting to have more financial security, they want to finish school, or they're still looking for a suitable partner.
Say you're in your 30s and not ready to have children. If you freeze your eggs now, you can preserve them while they're still viable. Then you can thaw them and use them when you're ready to get pregnant, whether it's in your late 30s, 40s, or even 50s.
To protect fertility during medical treatment. Chemotherapy and radiation treatments for cancer can leave you infertile. If you remove and store some of your eggs before treatment, you may have the option of fertilizing and transferring the eggs to your uterus after recovery.
To avoid discarding embryos during in vitro fertilization (IVF). Extra embryos from IVF are usually frozen and transferred at a later time, or discarded. Egg freezing allows you to fertilize only as many eggs as necessary for IVF and freeze unfertilized eggs for possible later use.

What's the best age to freeze my eggs?

The younger you are when you freeze your eggs, the better. As you age, your eggs age too. The result? Your fertility declines, and the risk of having a baby with chromosomal abnormalities increases. There are other factors in both of these, but older eggs are the main culprit.

How are eggs harvested for egg freezing?

The process is similar to the initial stages of in vitro fertilization and takes two to four weeks. Here's what happens:

• Near the beginning of your menstrual cycle, you take fertility drugs to stimulate your ovaries to produce multiple eggs at once. (Normally your body releases only one egg a month.)
• You visit your clinic or doctor's office every few days for a checkup. Your progress is monitored via ultrasound and by checking your blood hormone levels to determine when the eggs are ready to be removed.
• When your eggs are mature, they're retrieved during an outpatient procedure that takes up to 30 minutes. First you're given an anesthetic. The doctor then withdraws your eggs with a needle inserted through the vaginal wall, using ultrasound for guidance.
• A single harvest typically yields five to 20 eggs.

You can go home after an hour or two, but you should take it easy for at least a day. You may experience cramping for a few days.

How does egg freezing work?

Your eggs are frozen immediately and can be stored indefinitely. The more you freeze, the better your chances of having an egg that survives the process of freezing, thawing, fertilization, and being transferred to your uterus.
When you're ready to try to get pregnant, your eggs are thawed. As with IVF, eggs that survive thawing are combined with sperm in a laboratory to create embryos. The embryos are then placed in your uterus, typically one to four at a time.
You may want to go through the harvesting process a few times to make sure you have enough eggs stored. Experts recommend that a woman who's 33 years old bank about 20 to 25 frozen eggs for a good chance at having a child later. Women older than that should freeze more, because they have fewer healthy eggs to harvest.

What are egg freezing success rates?

Data are very limited, but the few studies available find that anywhere from one-third to nearly two-thirds of fertility treatments using frozen eggs result in pregnancy.
Some things to keep in mind:

• In general, the younger you are when you freeze your eggs and the more you freeze, the better your chances of ending up with a baby. A recent analysis of multiple studies found that a 30-year-old woman who freezes two to six eggs has a 9 to 24 percent chance of having a baby later. That's why women are encouraged to freeze so many eggs.
• Success rates with frozen eggs have improved steadily as technology has improved, but freezing embryos is a better bet if you have the option. Frozen embryos survive the freezing process better, so they're more likely to lead to a successful pregnancy.
• Studies suggest that eggs preserved with a flash-freeze method called vitrification may be more viable than eggs preserved with a more conventional, slow-freeze method.
• Using frozen eggs doesn't appear to increase the risk of birth defects or chromosomal abnormalities.

What's the cost of freezing eggs?

In the United States, the cost of freezing your eggs is comparable to a round of in vitro fertilization.
A single cycle, including harvesting the eggs, can cost $5,000 to $13,000. (Subsequent treatments may cost slightly less.) Medications may tack on about $3,000 more.
You'll also pay an annual fee of roughly $400 to $500 a year to store your eggs. And if you try to get pregnant, you'll pay about $5,000 to thaw and fertilize your eggs and transfer the resulting embryos.
Insurance doesn't cover infertility treatment in most states, and you're especially unlikely to get help paying for an elective procedure. But you might qualify for coverage if you're preparing for cancer treatment. Contact your insurance provider to find out for sure.