As a woman, you are born with two ovaries, each containing resting eggs or follicles. At 20 weeks gestation, you have about 6 million eggs, which is the largest amount of eggs you will ever have in your lifetime. At birth, you will lose approximately half of your eggs, and by the time you reach puberty, you will only have about 200,000 eggs left. As you age, your egg quantity will continue to decrease, and the quality will as well. Understandably, diminished egg quality and quantity can significantly impact your ability to conceive.
EGG FREEZING BY VITRIFICATION
Egg freezing represents a way to suspend your fertility in time, preventing the decrease in quality and quantity that inevitably comes with age. You will, of course, still continue to age. But the eggs that you freeze will stay suspended in time at the quality you possessed at the time of the freeze.
Vitrification, or flash-freezing, is a very efficient and effective method of freezing your eggs that demonstrates strong survival, fertilization, and embryonic development rates after your frozen eggs have been thawed. By applying this newer technology, Shady Grove Fertility has seen a sharp increase in survival rates of the eggs after thaw. Pregnancy rates have also been reassuring. This technology is instrumental in helping you freeze enough mature eggs now, so that when you are ready to use them, you will have multiple opportunities to become pregnant in the event that a cycle is unsuccessful.
WHEN TO FREEZE YOUR EGGS
On average, the most optimal time to freeze is in your early to mid-30s while your fertility potential is still near its peak. However, at our practice, you can freeze your eggs between the ages of 30 and 40. It’s about finding a balance. Some women may need to freeze younger, while some have more time. This is dependent on medical history and ovarian reserve function.
The reason these age guidelines exist is due to female fertility’s age-based decline. In your early 20s, fertility begins to decline, but conception rates remain high into the 30s. By your mid-30s, this decline accelerates to reach minimal pregnancy potential. In addition, women in their late 30s and early 40s have an increased risk of age-dependent changes in egg quality, sometimes resulting in miscarriage and/or genetic abnormalities in their children.
WHAT TO EXPECT
NUMBER OF EGGS TO FREEZE
Human reproduction is quite inefficient—many are surprised to learn that the chance of conception each month is only around 10 to 20 percent, depending on age. As a result, the average couple takes 5 to 7 months to conceive naturally. At the beginning of each cycle, several follicles containing an egg are present, with only one that will develop, mature, and release through ovulation. The remaining eggs die off and are no longer available for conception. Not every egg will result in a pregnancy when couples try to conceive on their own, and the same truth applies when you freeze your eggs. Thus, we recommend that women 37 or younger who have excellent ovarian function freeze between 15 to 20 mature eggs. For women over 38, or women at any age with diminished ovarian function, we recommend freezing 25 to 30 eggs. This provides you with multiple attempts to conceive if a cycle is unsuccessful.
EGG-FREEZING CYCLE TIMELINE
After you complete ovarian reserve testing, attend the physician consultation, and decide to move forward with egg freezing, you will work with your physician and nursing team to determine a timeline of when to start an egg- freezing cycle. On average, the entire process takes 1 month, but the most time-intensive portion lasts for only 10 to 12 days. The cycle is comprised of five main steps:
Birth Control (2 to 3 weeks)
We use birth control pills to initiate your cycle and help follicles grow at the same rate. We may also use birth control pills to manipulate your cycle based on when you want your egg retrieval to take place. Upon selecting a retrieval week, we can work backwards to select a start date.
Cycle Day 1 (10 to 12 days; 6 to 9 monitoring appointments)
Upon the start of your menstrual cycle, you will initiate daily injectable medications. The medications are higher doses of hormones that replicate the natural hormones your body produces to mature one egg. Our goal is to stimulate a larger number of eggs (than what your body would do naturally) in order to freeze. During this time, you will come to Shady Grove Fertility for regular monitoring appointments—which include bloodwork and ultrasound—to ensure follicles are growing appropriately and to change medication dosages, if necessary.
At the end of the stimulation period, you will get a trigger injection. This injection helps the eggs mature and signals the body to release the eggs.
Two days following the trigger injection, you will go to one of our three ambulatory surgery centers for your egg retrieval. This transvaginal procedure takes a total of 20 to 25 minutes while you are under anesthesia.
Recovery will take about 30 minutes and you will be able to walk out on your own. It’s important that a responsible adult drive you home after the procedure, as it is unsafe to drive after receiving anesthesia. The person who is driving you will need to stay at our center during your procedure—he or she should anticipate being at our center for approximately 3 hours in total.
Freezing the Retrieved Eggs
Once your eggs are retrieved, embryologists in the laboratory evaluate the eggs to determine which ones are mature. We will then freeze these eggs using vitrification, or fast-freeze technology, and store them in liquid nitrogen. We will contact you the following day to let you know how many of your eggs we were able to freeze. Two weeks later, you can expect to have your period.
FAQ FREEZING EGGS
How can I prepare my body for egg freezing?
The main thing we tell our patients is to maintain a healthy diet and lifestyle. Other factors that can hinder your fertility include: excessive caffeine, smoking, drugs, and alcohol. If you are a current smoker, we recommend quitting at least 3 months prior to starting a cycle.
What are the side effects of hormone medications?
The side effects of hormone medications are largely dependent on the individual. Some women may experience heightened symptoms similar to what is experienced during premenstrual syndrome (PMS); others may feel increased bloating and some discomfort related to the enlarged ovaries.
Do you offer assistance with injections?
Yes. We offer injection training classes and work with a company who offers at-home injection services.
How many cycles will it take to reach the recommended 15 to 20 or 20 to 30 mature eggs?
Women who are 37 years or younger and have a normal ovarian reserve will retrieve an average of 13 eggs per cycle. Therefore, it will likely take women two cycles to reach the desired 15 to 20 mature eggs. Statistically, 17 percent of women will achieve the desired number of eggs with the first cycle, 47 percent will achieve this by the second cycle, 25 percent will achieve this by the third cycle, and 10 percent will achieve this by the fourth cycle.
On average, women with poor ovarian reserve or women over 37 will need three cycles to achieve 25 eggs.
Is there an age limit on egg freezing?
We do not recommend egg freezing after the age of 41 but the decision needs to be individualized based on many factors.
Read more egg freezing FAQs here.
FAQ USING FROZEN EGGS
How many eggs do you thaw at a time?
Our embryologists freeze and thaw eggs in batches typically ranging from 6 to 8 eggs—this increases your chances of developing a high-quality embryo with strong pregnancy potential. If you have previously frozen 20 mature eggs, this should provide you with multiple attempts at achieving a pregnancy, and possibly have even more than one child. Depending on how many eggs from each batch fertilize, you could even have multiple pregnancy attempts possible from a single batch.
What are the pregnancy rates using frozen eggs?
Women who are 37 and younger who freeze the recommended 15 to 20 mature eggs have a 70 to 80 percent chance of taking home a baby.
Women who are 38-40 years old who freeze the recommended 25 to 30 mature eggs have a 65 to 75 percent chance of taking home a baby.
What is the process of using frozen eggs?
We recommend that you first try to conceive on your own, however if you are over 35 and have been trying for 6 months, the first step would be to schedule an appointment with your physician and your partner would need to complete a full fertility workup.
Once you are ready to use your frozen eggs, you would use medications to prepare your uterus for implantation. We would thaw and fertilize your eggs and then transfer an embryo.
How do I use donor sperm?
We work with several certified sperm banks and can help you get started with the process. Once you select a sperm donor, the process is the same preparing your body and eggs for transfer.
Read more egg freezing FAQshere.
COST TO FREEZE EGGS
Considered elective by the majority of insurance companies, coverage for elective and OncoFertility egg freezing (also known as oocyte cryopreservation) is rarely covered by insurance. With that in mind, diagnostic or ovarian reserve testing, as well as a provider consultation, is largely covered by Shady Grove Fertility’s 30+ participating insurance companies. In fact, approximately 90% of our elective egg-freezing patients have coverage for this part of the process.
If you choose to pursue egg freezing, Shady Grove Fertility offers several egg freezing financial programs, including:
Single Cycle Package
Women who are comfortable pursuing one cycle at a time, the cost per egg freezing cycle is $7,500.
Assure 20Women with favorable ovarian reserve can freeze their eggs for a flat fee and receive up to four cycles or 20 mature eggs, whichever comes first.
Women with favorable ovarian reserve can freeze their eggs for a flat fee and receive up to five cycles or 30 mature eggs, whichever comes first.
The cost of each cycle and program includes: monitoring appointments, cryoperservation, and the first year of storage
* If ReproSource or outside reference lab is in-network with your insurance plan, then you are only responsible for your typical in-network co-pay, assuming you have met any required deductibles according to your plan. If the outside reference lab is out-of-network with your plan, you will receive a discounted price of approximately $60.
** Medication costs will vary from $4,500 to $8,500 based on ovarian function and insurance benefits.
HeartTomorrow from Ferring Pharmaceuticals provides a discounted price for MENOPUR for eligible cash-paying patients who are undergoing controlled ovarian stimulation (“COS”) for planned oocyte cryopreservation. This discount may be available for eligible patients with a minimum initial prescription for 25 vials of MENOPUR and a signed and submitted physician attestation form. Terms and conditions apply. To request additional information and for full program terms and conditions, please email [email protected].
COST TO USE FROZEN EGGS
Two financial options are available for returning Shady Grove Fertility egg freezing patients when they are ready to conceive and need to use their frozen eggs.
Single Cycle Package
The cost for one cycle using your frozen eggs is $6,500.
- Included: ultrasound and hormone monitoring, egg thaw, fertilization using ICSI, and the embryo transfer.
- Other financial considerations: outside lab testing, medications*, second year of storage of remaining embryos, re-freeze of additional embryos, and future subsequent frozen embryo transfers (FET).
- Other financial considerations: outside lab testing, medications*, and storage fees for remaining eggs and/or embryos once you take home a baby.
Shared Risk 100% Refund Program for Returning Egg Freezing Patients
Women with favorable ovarian reserve at the time of their egg freezing may be eligible for our guarantee option–have a baby or receive a 100% refund. The cost for women returning to use their frozen eggs, who were 37 or younger at the time of freezing, is $15,000. The cost for women between the ages of 38-40 at the time of freezing is $18,000.
- Included: ultrasound and hormone monitoring, egg thaw, fertilization using ICSI, embryo transfer cycle, re-freeze of additional embryos, subsequent frozen embryo transfers (FET).
Of the women who have pursued egg freezing, a limited number have returned to use their eggs to date making success rates using frozen eggs difficult to find. Shady Grove Fertility is one of the only fertility centers in the U.S. with published egg freezing pregnancy data.
In a recently published study, Shady Grove Fertility assessed the performance of 1,171 egg freezing cycles for 875 women. At the time of the study, 117 of these women had returned to undergo 128 egg thaw cycles, using a total of 1,283 frozen eggs.
The results from these 128 egg thaw cycles included 51 viable pregnancies, resulting in 55 children and 8 more on the way at the time of the study (12 of the pregnancies were twins). In addition, 62 good quality blastocysts remain in storage from these warming cycles for future attempts.
70 to 80% Chance of Taking Home a Baby
For women younger than 38, we recommend freezing 15 to 20 mature eggs, which is estimated to provide her with a 70 to 80 percent chance of at least one live birth. For women 38 to 40 years old, we recommend freezing 25 to 30 mature eggs, giving them a 65 to 75 percent chance of at least one live birth.
Probability of Taking Home More than One Child
Women 37 and under who freeze 15 to 20 mature eggs have up to 50 percent chance of having two children, and up to a 20 percent chance of having three children. Women 38 to 40 years old who freeze 25 to 30 mature eggs have up to 40 percent chance of having two children, and a 15 percent chance of having three children. And women 41 to 42 years old with 25 to 30 mature eggs frozen have up to 17 percent chance of two children, and a 4 percent chance of three children.
Fertility and Sterility Publication Details
In the February 2016 edition of the esteemed medical journal Fertility and Sterility, Shady Grove Fertility research which evaluated pregnancy rates of women who froze their eggs (for either elective or non-elective purposes), was published. This is the largest study in the U.S. that provides pregnancy rates from frozen, non-donor eggs. With this new information, women have a better idea of what to expect from their egg freezing cycles in regard to the probability of taking home one or more children based on her age and number of mature frozen eggs.
The study compared success rates based on the different stages of the process: from thawing the eggs, to fertilizing the eggs through intracytoplasmic sperm injection (ICSI), embryo and blastocyst formation, to implantation of the embryo, and then having a baby.
“We are very happy to have this new information for women who are thinking about freezing their eggs, those deciding how many to freeze, and those who have already frozen their eggs. These answers will guide their decision making and provide a sense of what to expect.” – Joseph Doyle, M.D.
USING FROZEN EGGS
When you are ready to use your frozen eggs, either some or all of your eggs will be thawed and then fertilized using Intracytoplasmic sperm injection (ICSI). ICSI is necessary as the coating that surrounds the egg is hardened when it’s frozen. Therefore, we need to select a single sperm and inject it into the egg in order for it to fertilize.
Prior to thawing the eggs, you will be given estrogen to thicken the endometrial lining–preparing your uterus for the embryo to implant and grow. When the lining is thick, you start progesterone and we time it to in relation to when the eggs are thawed and fertilized. After you have been on progesterone we transfer the embryo inside the uterus.
The embryo transfer is a simple procedure that takes about 5 minutes to complete. There is no anesthesia or recover time needed following an embryo transfer.
The first step to using frozen eggs would be to schedule an appointment with you Shady Grove Fertility physician to discuss your course of treatment, timeline, and how many eggs to thaw. If you return with a male partner, they would need to also attend the consultation.
Should you not have a partner but are ready to use your frozen eggs to have a baby, donor sperm is an option. In this case, you would need to schedule an appointment with your physician as well as a social worker to discuss the emotional aspects of using a donor. SGF works with several certified sperm banks where you are able to select a donor. Following your consultation, both you and your partner (if applicable) would need to complete basic diagnostic testing. While we have the eggs, we also need to evaluate your uterus, Fallopian tubes, as well as your partner’s sperm count and quality. Should you be using donor sperm, you would only need to complete the female fertility evaluation.
Female Fertility Evaluation
- Hysterolanpingogram (HSG)
- The HSG is an x-ray test that measures your ability to carry a child to term by evaluating your uterus and Fallopian tubes.
- Are your fallopian tubes open?
- Is your uterus a normal shape?
- Does your uterine cavity have fibroids, polyps, or scar tissue that could impact the ability to carry a pregnancy?
- Mock Embryo Transfer
- This procedure is a practice run before the actual embryo transfer and allows the doctor to test the size and placement of the catheter with your particular anatomy before the big day. During the procedure, an ultra-thin catheter is inserted into the uterus while a sonogram guides the process on a monitor. Many patients compare the mock embryo transfer to a Pap smear, as it is relatively painless and takes only a few minutes.
- Infectious Disease Bloodwork
Male Fertility Evaluation
A semen analysis is completed to evaluate the sperm’s potential to fertilize an egg.
Call today to get started using your frozen eggs. 1-877-411-9292 or fill out this brief form to schedule an appointment.
ON-DEMAND WEBINAR: EGG FREEZING
Interested in pausing your biological clock? Watch this on-demand webinar and learn more about egg freezing.
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A Beginner’s Guide to Testing Your Fertility, What You Should Know Before Egg Freezing