Should I freeze my eggs

Egg freezing is the set of medical procedures aimed at the preservation of a woman`s fertility. It has already gained worldwide popularity due to the effectiveness and the freedom to better get prepared for motherhood. However, it is still worth spreading the word and educating women about such a possibility whenever possible.

What is egg freezing?

Egg freezing stands for the cryopreservation of a woman`s oocytes and their storage for a fixed amount of time until a woman decides to use them. Each woman has her own ovarian reserve which diminishes with each year and the quality of the eggs themselves decreases as well. A woman is considered to be most fertile before her she is 30-35 years old, then, the chances to get pregnant and have smooth pregnancy go lower. In addition, the risk of having a baby with chromosomal abnormalities becomes bigger with the age.

A large number of women have no possibility, time or desire to become mothers before that age, that is why they resort to egg freezing. This technique includes the following steps:

1. Making a decision.
2. Diagnostics (fertility evaluation).
3. Preparation.
4. Ovarian stimulation.
5. Egg retrieval.
6. Vitrification of the oocytes.

Women decide to freeze their eggs for different reasons. All of them share the same desire - to postpone motherhood for some time and increase chances to conceive in the future. For some women it is important to focus on their education, career, other ones feel they are not ready yet and want to spend more time exploring themselves and the world. There is also a medical reason why women need to freeze oocytes: egg freezing is an effective way to preserve fertility after being diagnosed with cancer. The stimulation and egg retrieval are done before the course of chemotherapy or radiation therapy.

When the decision is made, a woman visits a fertility doctor who provides necessary information and lists the medical tests to be done. On their basis, the doctor offers the way to continue and gives a rough estimation of the possible number of eggs to expect after the retrieval. The preparation for the stimulation includes adhering to the doctor`s advice and taking birth control pills if prescribed. 

Ovarian stimulation or ovarian induction therapy aims at the growth of the follicles which is achieved with the help of hormone injections. The type of medication and dosage is prescribed individually on the ground of the fertility testing. These are subcutaneous almost painless injections that can be easily administered by any woman on her own. The stimulation takes around 10 days and 3 ultrasound scans.

The next step is egg collection - a minimally invasive procedure performed under mild sedation intended for the collection of all the eggs grown after the hormone administration. The collection is done by a thin aspiration needle inserted into a woman`s ovary. It is painless because a woman is being sedated at that time and doesn`t feel anything.

Once all eggs are aspirated, they are taken to embryology where specialists wash them and select the mature ones. Not viable oocytes are never subject to fertilization or vitrification, only mature ones will be vitrified and put in the cryo tank for storage.

Success rates

The success of egg freezing can be judged from the results of IVF cycles where these eggs are used. It greatly depends on the age when a woman freezes her eggs - the younger she is, the bigger her chances are in the future. Fertility doctors state that the best quality can be achieved if a woman freezes her material before she is 35 years old.

Every woman should be well aware of the fact that egg freezing doesn`t give any guarantee for easy conception in the future, therefore, it should be perceived as an extra help rather than a solution. In addition, average success rates for cycles with frozen own eggs are almost twice lower than with donor eggs.

Other factors include the woman`s age when she is warming and fertilizing her oocytes, the total number of eggs retrieved, the number of stimulations, the health state at the moment of uterine lining preparation and embryo transfer, fertility health, qualification of the medical staff, etc. Doctors always recommend proceeding with fertilization and embryo transfer as soon as possible while worldwide data shows the women`s tendency to use frozen eggs in their 40s. 

The number of ovarian stimulations plays a crucial role in specific cases as every woman is interested in freezing as many eggs as possible. There are women with high ovarian reserve of young age who can produce 20+ eggs during one cycle while other women can hardly get 5 for stimulation. Considering every case is different, fertility doctors should recommend the optimal number of retrievals based on individual peculiarities.

Some factors are not connected with a woman`s body such as the quality of semen used for the fertilization. 40-50% of all infertility issues are related to the male factor. The abnormal results of semen analysis may show problems with motility, morphology, the concentration of spermatozoa, etc. These conditions result in a decreased number of embryos after their culture or even the absence of embryos. 

According to the researches from HFEA, one out of five cycles with the use of previously frozen eggs will result in pregnancy. However, it is impossible to set the exact success rates as they all depend on too many factors which are pretty different with every case.

The best age for egg freezing

As recommended by IVF specialists, the best age for cryopreservation of a woman`s reproductive cells is between ages 25 and 35. According to the most recent studies, the ideal age for egg freezing is between 25 and 30 years. This is connected with the fertility decline after 30, although some women can be still fertile at age of 35 or 40. Some women, on the contrary, can be diagnosed with a diminished ovarian reserve in their early 20s. That is why there is no universal age for each woman and it is worth visiting an IVF specialist to be aware of your biological clock.

Can it be too late for egg freezing?

When a woman decides to freeze her eggs, the first step she makes is the meeting with the fertility doctor. This specialist checks fertility health and can offer a plan for egg freezing to follow. Unfortunately, there are cases when it is impossible to suggest anything. The most frequent reason for this is the extremely poor ovarian reserve.

The diminished ovarian reserve doesn`t always depend on age, woman can get diagnosed at the age of 20. A woman is born with around 2 million eggs and this number decreases with every year so at the beginning of menopause it reduces to 1 thousand. The number isn`t the only thing that reduces, the same can be said about the quality. The older the woman, the worse is the quality of her eggs. The use of bad quality oocytes harms embryo development. It can also result in birth defects.

In the case of empty follicle syndrome, the stimulation and egg collecting gives no material for vitrification. Empty follicle syndrome is a medical condition as a result of which no oocytes are retrieved during the egg collection. It is always more than frustrating due to the impossibility to predict such an outcome before or during the stimulation and it becomes a very unpleasant surprise on the day of retrieval. In such cases, women resort to egg donation or embryo donation to be able to conceive and give birth.

What is involved in egg freezing?

Every woman who is interested in egg freezing should get a full understanding of its duration and all the related processes. It can be roughly divided into four stages: preparation, ovarian stimulation with vitrification, storage and IVF. 

Preparation may take from 1 to 3-4 months depending on the results doctors receive. In case they detect something that prevents a woman from starting the stimulation right away, some time will be needed to get rid of the problem. For example, in the case of a sexually transmitted infection, you need to treat it first before the start.

On average, it takes a maximum of 2 weeks from the first shot till the egg collection day. You should be prepared to make several injections (up to 3 shots) every morning. The type of medication, dosage and the number of injections is prescribed individually by a fertility doctor. After all the follicles are aspirated, eggs will be washed and vitrified. Vitrification is a relatively new method to freeze biological material. It is an extremely fast way to freeze eggs, sperm or embryos which has proven to give excellent results after its warming.

After being frozen eggs are stored in the liquid nitrogen in the cryobank or egg bank of the clinic where the collection had been done. You can decide on transporting them to any other medical facility at any point of the time or come for IVF to the same place. The yearly storage fee is something you need to bear in mind as a part of your expenses.

When a woman is ready for motherhood she needs to start the IVF process unless the natural way to conceive doesn`t work. Any IVF requires pretesting which is done to make sure a woman`s body is ready for stimulation of her lining and pregnancy. Partner`s semen is tested as well to see the quality and select the fertilization method or additional techniques. 

Regular IVF program normally lasts three weeks from the day of warming until the embryo transfer. Oocytes are fertilized on the same day they are warmed. Then, when they grow into viable blastocysts, they can be transferred. The woman is being prepared for this transfer three weeks in advance and the day of warming is selected following her progress. During checkups, the doctor assesses the growth of her endometrium and defines the day for warming and embryo transfer.

The cost of egg freezing

It is extremely important for any woman who starts an egg freezing program to know the price and be financially prepared. Egg freezing includes fertility evaluation, stimulation and vitrification. However, these aren`t all costs. It is worth remembering that these eggs can only be used in the IVF program, which must be kept in mind before freezing your eggs. In addition, the storage fee isn`t something that is taken into account at the very beginning and it may become a problem to pay a monthly fee for long years.

The average cost depends on the country. Due to the development of medical tourism, women now have more choices and can decide on the most affordable destination. Ukraine is one of the popular countries for egg freezing due to several money-related reasons. The overall cost of ovarian stimulation and oocyte retrieval is around 2500-3000 EUR; in comparison with the USA, Ukraine offers at least twice lower numbers. Another motive is the storage for a reasonable price - you can store material for 250-300 EUR per year.

Most clinics in Ukraine don`t include stimulation medication into egg freezing programs, that`s why injections need to be bought additionally. Due to the similarity in pricing, there is almost no difference in where to buy it. However, those women who decide to be in Ukraine for the whole stimulation, are more likely to purchase meds in Ukraine to avoid transporting issues.

Egg freezing and health effects

While talking about the health effects of egg freezing, we can differentiate between long-term and short-term ones. There is no convincing evidence or scientific studies on the long-term consequences due to the relative novelty of egg freezing. According to the information available, children, born using warmed eggs have the same chance of having genetic diseases as naturally conceived babies. 

The most widespread short-term effect is the one from the stimulation drugs. Ovarian hyperstimulation syndrome (OHSS) develops in 10% of all stimulations and can be extremely dangerous. Some women may even require hospitalization and special medical care. Other effects include discomfort or pain as a result of egg collection. Infections or damage to other internal organs is something that rarely occurs.