Answers to Your Questions – What is egg freezing?

Perhaps you have heard about the concept of egg, or “oocyte”, freezing and have wondered if it’s right for you. Maybe you need more information about this treatment option and how it might benefit you or you and your spouse/partner.

Though egg freezing is not an overly complicated process, it is something about which you should understand all of the facts and ramifications before making a decision. To get you started, we have provided some answers below to our most commonly asked questions about it, in hopes that we can offer enough information to either pique your interest or even decide it might actually be the right option for you to pursue at this time.

What is egg freezing?

Alternatively referred to in medical terms as oocyte cryopreservation, egg freezing is a process in which eggs are retrieved from a woman’s ovaries, subsequently frozen (unfertilized), and then stored for later use as may be needed. In essence, this process preserves and prolongs reproductive potential in women of childbearing age. In other words, it allows a woman to get pregnant in the future with her own biological eggs, even if at that time viable eggs are not present in her body for one reason or another.

A frozen egg can be safely thawed, combined with sperm in a laboratory, and then implanted in the uterus using in vitro fertilization (IVF) techniques. As a result, a successful pregnancy can occur.

Egg freezing is not a new phenomenon. It was first performed successfully nearly 40 years ago in 1986. Since that time, methods of freezing the eggs have improved and more and more eggs are successfully thawed so that they are still viable. Furthermore, the American Society for Reproductive Medicine no longer considers egg freezing an experimental procedure, which is a true testament to its ever-growing success rate and applicability.

Why would a woman choose to freeze her eggs?

You might consider cryopreservation of your eggs for any number of reasons.

• You may have a personal reason for delaying childbearing until a later time. Freezing younger eggs will yield a better chance of conception down the line.  
• You are going to be undergoing surgery that could potentially damage your ovaries.
• You have been diagnosed with cancer and have been told that chemotherapy or pelvic radiation that may damage your fertility is necessary at this time.
• You have been diagnosed with a non-cancerous ovarian condition that may nevertheless damage your ovaries.
• You are at risk for premature ovarian failure due to a family history of early menopause or as a result of having chromosomal abnormalities such as Fragile X syndrome or others.
• You have a genetic mutation (like the BRCA gene) that may require the removal of your ovaries.
• You wish to eventually have a baby that is genetically yours but through a surrogate/gestational carrier who would carry the baby for you.

What is the process for egg freezing?

Before egg freezing is even considered, some screening tests will need to be done to assess whether you are a good candidate for this procedure. This will likely begin with some simple tests, such as infectious disease screening to check for diseases like HIV, Syphilis, and Hepatitis B or C.

Ovarian reserve testing, which checks the quantity and quality of your eggs, will be performed as well. This checks the concentration of follicle-stimulating hormone (FSH), Anti-Mullerian Hormone (AMH), and Estradiol in your blood and is done on days three to four of your menstrual cycle. Results help predict how your ovaries will respond to fertility medications, as well as which dosages and combinations will be needed in your individual case to optimally maximize your egg yield.

In addition, an ultrasound of the ovaries will be performed to achieve a more complete picture of your ovarian reserve status.

Once it has been determined that you are a good candidate for egg freezing, you will begin taking hormonal fertility medications to stimulate egg recruitment and maturation, much as you would for a round of in vitro fertilization. This will induce multiple eggs to mature rather than the single egg that normally develops each month during ovulation. You will also be monitored to measure your response to the medications. This monitoring will include blood tests to measure certain hormones as well as vaginal ultrasounds. Finally, when it is determined that the eggs are ready for retrieval, you will be given an injection of either a human chorionic gonadotropin (HCG) derivative, or a gonadotropin-releasing hormone agonist (lupron) to achieve final egg maturation.

The egg retrieval procedure is then done under sedation anesthesia, through transvaginal ultrasound aspiration, with the goal of aspirating as many eggs as are available. They are then cooled to subzero temperatures and frozen (cryopreserved) via a rapid vitrification technique to be stored for future use.

What happens when you are ready to use them?

When you have determined that you are ready to use your frozen eggs, whether it may be two years from now or ten years from now, they will be thawed and fertilized in the embryology laboratory. A procedure known as Intracytoplasmic Sperm Injection or ICSI is performed, which involves injecting a single healthy sperm directly into the thawed, mature egg. This procedure is required in cases of frozen eggs as it has been shown to be the most successful for fertilization potential.

In general, your chances of becoming pregnant after implanting a thawed, fertilized egg ranges from about 30 to 60 percent. Success often depends on your age at the time of egg retrieval, not the time of implantation. The older you are at the time of the freezing, the less viable your eggs are and thus the less likely you may ultimately be to achieve pregnancy. This is why it is important to freeze your eggs as soon as you recognize that it might be the right option for you.

What are the risks of egg freezing?

Before you choose to freeze your eggs, it is important to recognize that as with all such measures, egg freezing does carry certain, albeit rare, risks, both physical and emotional.

• The egg retrieval process itself carries a minimal risk of damage to surrounding organs, though problems are extremely rare, being estimated at less than one in 5,000.
• If not monitored appropriately, some women may have a sensitivity to the injectable fertility drugs that are used to stimulate egg maturation. Ovaries could become swollen and painful due to ovarian hyperstimulation syndrome (OHSS), though with the modern-day use of the Lupron medication to induce final maturation, OHSS has essentially disappeared as a potential side effect.
• Needless to say, any fertility treatment may bring with it the possibility of disappointment. Women may hang their hopes of an eventual pregnancy on the process of egg freezing for a later time, but success cannot definitively be guaranteed in every case.
• Furthermore, some women who freeze their eggs may never actually need them as they may either conceive on their own in the future, or they may decide not to have children for some unforeseen reasons.

Is egg freezing expensive?

As with any form of fertility therapy, a lot of what is and what is not covered will depend on your health insurance. More and more, companies are offering insurance policies that provide some, if not full, coverage for fertility procedures. In addition, there are plans that will cover the initial assessment but perhaps not the procedure itself. It is always in your best interest to call your healthcare insurance provider for the exact details of your individual policy before you begin the process.

We hope this answered some of your questions about the exciting and highly rewarding therapeutic option of egg freezing. As one physician who underwent this treatment a few years ago herself so eloquently stated, “It’s an insurance policy… I spent all this money on my education…my reproductive future is relatively inexpensive”. At Advanced Reproductive Medicine, we are eager to help you better understand this procedure and how it can benefit you now and in the future. For more information or schedule a consultation, call us at 732-339-9300.