In the final season of The Mindy Project, Dr. Mindy Lahiri (played by my fave, Mindy Kaling) opens her own fertility center and targets her business toward young women, encouraging them to say, “Later, baby,” and freeze their eggs for the future. In the episode, her first clients, all college-age women, gather in a slumber party–esque setting to discuss fertility. It’s not too far from reality: Egg-freezing parties are gaining popularity across the U.S. as more women consider delaying a family for a slew of personal and professional reasons. Until pretty recently, freezing eggs was still considered an experimental treatment, a sort of last resort to save a woman’s fertility. But in 2012, the American Society for Reproductive Medicine approved wider use of egg freezing and no longer considers the procedure to be experimental—allowing women to preserve and extend their fertility. So should you freeze your eggs? Here’s everything you need to know about freezing eggs before you decide whether to put your eggs on ice.
Why would I want to freeze my eggs?
“As a family law attorney for more than 15 years, I was never quite sure if I wanted to start a family,” Evie Jeang, founder of Surrogacy Concierge, tells HealthyWay of her decision to freeze her eggs. “I did not have the time and had not found the right person,” Jeang continues. “I felt that if I went on maternity leave, I would lose a partnership opportunity because I chose to have a child. I was 30 when I first froze my eggs, and at that time, people thought I was crazy. As you get older, doctors and studies show you that your eggs become less viable. So I decided to freeze my eggs again at 35, when my career was a little more established.” “I wanted to extend the time I have to decide on when I want to have children,” says Stacy Bean, who also made the decision to freeze her eggs. “My husband and I are getting a bit older, however we’re still extremely focused on our careers and not quite ready to have a baby. Freezing my eggs gave us a bit more time to focus on our careers before moving on to having a family.” While we’re told that modern women can have it all and no longer have to choose between kids or a career, Jeang and Bean made the choice to delay having a family for the sake of their careers. A report recently published in The New York Times revealed that while most opposite-sex couples are likely to have similar earnings, after a woman has her first child, the pay gap between spouses almost doubles (and not in Mom’s favor). What’s more, women who have children between the ages of 25 and 35 are almost never able to regain equal pay, even if they go back into the same field. Though this study just looked at couples in opposite-sex relationships, all women—regardless of their sexual orientation—who have kids are affected by the gender pay gap. Other studies have shown that women with kids make less than their childless peers (both men and women) in general. Depressing, right? An amazing career is just one reason a woman might consider delaying kids and freezing her eggs, though. Freezing your eggs “offers an opportunity for a woman to act as her own egg donor, should she need it in the future,” says Briana Rudick, MD, director of third party reproduction at Columbia University Fertility Center and assistant professor of obstetrics and gynecology at Columbia University Medical Center. “Freezing eggs allows a woman to delay childbearing so that she is free to pursue career, life, whatever she desires.”
What is the egg-freezing process like?
The egg-freezing process isn’t exactly easy. In fact, it’s a lot like IVF treatments (so if you don’t like getting shots, brace yourself). “The process of egg freezing (also known as oocyte cryopreservation) starts with [the] first day of menses,” explains Alin Lina Akopians, MD, PhD, a fertility specialist at the Southern California Reproductive Center (SCRC). “Patients visit a reproductive endocrinology and infertility (REI) specialist on either the second or third day of menses for evaluation. Evaluation generally entails a transvaginal ultrasound to check the ovaries and blood work to check the hormonal status. The patient is then started on a short course of birth control pills for approximately 10 to 12 days. The purpose of birth control pills is to ensure synchronous growth of follicles.” What this really means is that doctors want to be sure you have the best chance of egg retrieval, and the birth control pills help sync egg follicle growth for maximum egg production. After a two-week cycle of birth control, you’ll be ready to officially begin hormone injections to stimulate egg production, a process that typically lasts about two weeks. “Our bodies make only a small amount of those hormones so that we grow only one egg every month (our bodies don’t want us having many babies at once),” explains Rudick. During the egg-freezing process, “we have to override that with higher doses of those hormones so that we can get many eggs to grow at once. The hormones are called gonadotropins, FSH and LH.” Once the hormones start working, you’ll start taking a suppressant medication like Cetrocide about halfway through the egg-freezing cycle. It seems counterintuitive, but this “antagonist” medication actually stops the body from ovulating too quickly during the cycle. If the eggs are released too soon, they can’t be retrieved and frozen. During the final phase of the cycle, one to two days before egg retrieval, you’ll receive a “trigger” medication that basically tells your ovaries it’s go time. This injection is sometimes the pregnancy hormone hCG. Human chorionic gonadotropin (hCG) overrides the sex hormone suppressant so that the ovaries can release eggs. The time between injecting hCG and retrieval is critical; wait too long and the eggs may be irretrievable. That’s why most doctors will harvest your eggs within 35 hours of administering the hCG. The actual egg retrieval is considered surgery, but it’s minimally invasive. Still, you’ll probably be sedated for the procedure, so make sure you have a pal to drive you home and bring you post-op cookie dough ice cream. The whole procedure should only take about a half hour to complete. The eggs are deposited in a test tube immediately and handed over to an embryologist, who will be freezing your eggs. You can expect light bleeding, cramping, and soreness for a couple of days after an egg retrieval, but in most cases, you’ll be back to normal the next day.
How do real women feel during the egg-freezing process?
“The process was easy once I got the hang of it,” says Bean. “At first I was a little intimidated by the injections and making sure I understood exactly what to do and how to do it all. However, the staff at SCRC made that process very easy. They walked me through everything and were there whenever I had questions—even in the late hours of the evening. After the first night of injections, I felt very comfortable. “I went through two rounds of egg retrievals and felt pretty good through both cycles,” Bean continues. “The first time I didn’t feel any different in regards to mood swings, etc. My only issue was bloating (which was to be expected). My second round I was a little bit more emotional/moody but had less bloating. I think every round is different, but generally speaking, during both I felt just fine. I was able to go about my days like normal and no one knew that I was even going through the process.” For Jeang though, the process wasn’t as easy. “It was painful for me since I never liked needles or shots, and I was having an allergic reaction with the hormones,” she shares of her egg-freezing experience. “Still, I was lucky to know that I had options. Not all women are armed with this information and there is still a lot of educating that needs to be done—to healthcare providers, employers, etc.” Egg freezing will be different for every woman, but if you feel that something isn’t right during the process, be your own advocate, and let your doctor know how you’re feeling.
How do you get pregnant using frozen eggs?
“Once a patient is ready to conceive, we recommend them to try on their own initially,” says Akopians. If you have difficulty conceiving naturally, your doctor will recommend a round of in vitro fertilization (IVF) using your frozen eggs (which is why you froze them in the first place!). Before an IVF cycle, women who are planning to use their frozen eggs will take estrogen and progesterone supplements to ready the uterus for implantation. Once your frozen eggs are thawed, they’ll be mixed with sperm (either from the intended father or a donor). It takes less than a week for fertilization to occur, at which point the fertilized eggs (now embryos!) will be inserted into your uterus.
What’s the success rate of egg freezing?
There are two methods of freezing eggs: slow cooling and vitrification. Slow cooling has been the traditional method of egg freezing. During the slow-cooling process, eggs are subjected to cryoprotective agents (to prevent ice damage) and increasingly cold temperatures before finally reaching a freezing point of anywhere from –22° to –85° F. Once the eggs are at an optimal frozen temperature, liquid nitrogen is added for preservation. Alternatively, vitrification is a flash-freezing process in which eggs quickly reach freezing temperatures and are subjected to much higher levels of cryoprotective agents before being submerged in liquid nitrogen. Because vitrification has been shown to have much higher success rates, it has become the preferred method of egg freezing for most fertility centers. Still, the actual success rates of pregnancy using frozen eggs varies. Successful pregnancy using frozen eggs depends on how old the woman is when she freezes them and how many eggs she has frozen, says Rudick. “The overall success rate once we generate embryos from those eggs is similar to that of regular IVF (controlled for age). However, some of the eggs may not survive the thaw, and/or have a slightly lower fertilization rate—but once we get embryos from those thawed eggs, they tend to do as well as regular IVF.” Ideally, though, Akopians recommends freezing your eggs before you reach the age of 35 for the best chance of conception. “Pregnancy rates decline as women get older, and the first evidence of this decline is seen in the early thirties. Similarly, the outcomes after oocyte thaw and embryo development [are] largely dictated by the age at which the oocytes were frozen, which is why we generally recommend women to freeze their eggs before age of 35 in order to have the most optimal outcomes.”
How much does freezing your eggs cost?
Well, freezing your eggs isn’t cheap. Typically, it can cost between $5,000 and $10,000 for an egg-retrieval cycle, plus an extra $500 to $1,000 a year to store your frozen eggs. Then, when you’re ready to use your frozen eggs, just one round of IVF can cost between $15,000 and $20,000. If you’re lucky, your employer may help cover the cost of freezing your eggs as a work perk. Unfortunately, though, most insurance providers do not cover freezing eggs, but some insurance providers do cover the subsequent IVF treatments once you decide to use your frozen eggs.
What else should I know about freezing my eggs?
The most important thing to know about freezing your eggs is this: It’s your decision to make. Should you decide to use your frozen eggs, egg retrieval and the subsequent rounds of IVF cycles are no picnic. And the varying success rates show that frozen eggs may not always result in viable pregnancies. Still, if you’re on the fence about kids for professional or personal reasons, freezing your eggs is one option to safeguard your fertility for the future.