Egg freezing

What is egg freezing?

Egg freezing is a multi-step process that involves stimulating the ovaries with hormones to produce multiple eggs, which are retrieved from the ovaries and then frozen. In the future, the eggs can be thawed and combined with sperm to create embryos that can be placed in the uterus for pregnancy.

Egg freezing gives you control over your reproductive timeline. It’s a choice for those seeking flexibility in family planning.

Why freeze my eggs?

• Biology: the quality and quantity of our eggs decrease over time, leading to lower pregnancy rates and higher miscarriage rates as we age. Egg freezing lets you freeze a group of good-quality eggs for future use.
• Reproductive autonomy: egg freezing lets you be proactive about your fertility and delay pregnancy until you are ready, personally, professionally and financially. Eggs can be frozen indefinitely and their quality is preserved.
• Medical reasons: treatment for certain medical conditions, such as various cancers, can affect the quality and quantity of the eggs in the ovaries. These treatments include chemotherapy, radiation and certain pelvic surgeries.
• Gender-affirming care: transgender individuals with ovaries may wish to freeze their eggs before starting gender-affirming treatment. This allows the most options once a couple or individual is ready to start or grow their family.

The ideal age for egg freezing

Ideally, you should freeze your eggs before you are 35, when egg quality and quantity are best. Egg freezing is still a good option for women over 35, but you will likely need to freeze more eggs to reach your family planning goals.

Am I a good candidate?

The most important predictors of success, meaning your chance of having a healthy baby, are:

• Age: the younger you are when your eggs are frozen, the better your chances of a healthy live birth in the future. Although eggs are ideally frozen before 35, egg freezing remains a good option for women over 35, especially if their egg number is good.
• Number of frozen eggs: the more eggs you have frozen, the better your chances in the future. Not all frozen eggs will survive thawing, not all thawed eggs will fertilize into embryos, and not all embryos will become a successful pregnancy. You may choose to do more than one cycle of egg freezing to make your pool of frozen eggs as large as possible.
• Ovarian reserve: a measure of the number of eggs in your ovaries, directly related to your age. We will do a full assessment of your ovarian reserve before deciding if egg freezing is right for you.

How do I check my ovarian reserve?

A simple blood test and ultrasound can give you an idea of your egg supply, or ovarian reserve. These tests do not give information on egg quality. The best predictor of egg quality is your age.

• Anti-Müllerian hormone (AMH): a hormone released from immature eggs in the ovaries into the bloodstream. It can be measured with a simple blood test at any time in your cycle. Your AMH level is the most accurate indicator of your ovarian reserve, the number of eggs remaining in your ovaries.
• Transvaginal ultrasound: an internal ultrasound that looks at the uterus and ovaries. It helps determine your antral follicle count, and can diagnose ovarian cysts, fibroids, polyps or other abnormalities.
• Antral follicle count (AFC): like AMH, a good marker of ovarian reserve for most people. It is the number of antral follicles in each ovary. Many follicles are too tiny to see, but once they reach the antral stage we can see them on ultrasound. The number of antral follicles is an indirect measure of the eggs remaining.

Five steps to freezing your eggs

1. Testing and screening. A series of blood tests and ultrasounds to check the quantity and quality of your eggs (your ovarian reserve).
2. Ovarian stimulation. You’ll inject medication to stimulate your ovaries to produce multiple eggs. This lasts 9 to 14 days, while your doctor monitors your ovaries’ response with blood work and ultrasounds.
3. Egg retrieval. Under sedation, your eggs are removed at the clinic using ultrasound guidance. The procedure itself takes only 15 to 20 minutes. Many patients feel cramping and pressure for 24–72 hours afterwards, but this varies from person to person.
4. Egg freezing. Your eggs are frozen the same day they are retrieved. Your doctor will tell you how many eggs were retrieved before you leave, and the embryologist will call you the next day to confirm how many viable eggs were frozen.
5. Recovery. After your retrieval, you’ll have a follow-up appointment with your doctor to review your cycle and decide your next steps.

Success rates by age

The chance of a future pregnancy depends on many factors, such as your age when your eggs are frozen and the number of eggs retrieved. This chart gives you an idea of the success of egg freezing at different life stages.