Egg freezing is an increasingly popular measure for fertility preservation, with media attention largely focusing on the rise of ‘social’ egg freezing in the past decade. But what does egg freezing involve, who is it suitable for, are there any risks and will it result in pregnancy when the time comes?
At our Brisbane fertility clinic, we see many women considering egg freezing for fertility preservation. It’s a complex and often emotive issue and, understandably, we’re faced with a barrage of questions. Below, we answer some of your questions around egg freezing – and attempt to clear up some common misconceptions.
What is egg freezing?
Egg freezing aims to increase a woman’s chances of future pregnancy by preserving a number of mature oocytes (eggs) via a rapid cooling process known as vitrification. While one mature egg is usually released each month, egg freezing (or oocyte cryopreservation) involves stimulating the ovaries with hormones to trigger the production of additional eggs, which are then extracted by your fertility specialist. (The idea being, more eggs = greater chance of future pregnancy.)
The egg freezing process mimics an IVF cycle, up until the point of retrieval. Once harvested from the ovaries, all mature eggs are frozen and then stored, rather than being fertilised with partner or donor sperm as in the case of IVF.
Why freeze eggs?
There are various social and medical reasons women might consider egg freezing to preserve fertility.
Social egg freezing
Women who pursue social egg freezing are doing so because of non-medical reasons to do with their life circumstances. They might know they wish to have children in the future (or want to keep their options open), but not be in the position to do so now. They may not have met the right person, might by financially insecure, or be concentrating on their career, for example.
It’s common knowledge that fertility declines with age (more rapidly after the age of 35), and the savvy social egg freezer wants to take steps today to preserve their fertility for when they are ready to start a family.
Medical egg freezing
There are also a number of medical reasons for egg freezing, including cancer. Medical treatments such as radiation and chemotherapy can impact fertility and trigger early menopause. Therefore, women undergoing cancer treatment may be advised to freeze their eggs if they’re considering starting a family. Similarly, egg freezing may be medically appropriate for women at risk of early menopause.
What’s the best age to freeze eggs?
Both your age and the number of eggs retrieved and frozen will impact your chances of a successful future pregnancy with those eggs. Statistics suggest that under the age of 35 is the best time for freezing eggs. This is because younger eggs are generally better quality, meaning fewer eggs are required to give a better chance of pregnancy in the future.
While it varies between individuals, older women may need to do more rounds of ovarian stimulation to obtain sufficient eggs for the best chance of future pregnancy.
How many eggs should I freeze?
The optimal number of eggs differs between age groups, with younger women requiring fewer eggs for the same odds of achieving pregnancy. While a large number of eggs is desirable, your fertility specialist needs to balance that objective against the risk of ovarian overstimulation (OHSS) and the financial and emotional burden of unnecessary cycles.
Can you tell how many eggs will be retrieved?
The short answer is no. There are, however, tests and exams that can provide an indication. These include the Anti Mullerian Hormone (AMH) test and ultrasounds. The AMH test (or Egg Timer test) measures the level of anti-mullerian hormone in the blood. Produced in the ovaries, AMH is considered a good – but not guaranteed – indicator of a woman’s ovarian reserve (the number and quality of remaining eggs within the ovaries). It also plays a role in predicting how she will likely respond to stimulation.
During stimulation (i.e. while you are taking fertility medications to stimulate your ovaries), your fertility specialist (FS) will take regular ultrasounds. Your FS will count the number and size of follicles (egg sacs) on each ovary, which can give an idea of the number of eggs expected at retrieval. However, follicle count is not a foolproof indicator as not all of these fluid-filled sacs will necessarily contain an egg.
Are there any cases where egg freezing is not recommended?
Egg freezing may not be feasible for women with a very low ovarian reserve (as indicated by the AMH test). It may also not be advisable for older women whose likelihood of pregnancy in the future with frozen eggs would be low. Egg freezing may also be discouraged in women for whom IVF would be dangerous.
What are the success rates for egg freezing?
Egg freezing technology has come a long way, with over 95% of eggs surviving the defrosting process. Whether these eggs will then fertilise depends on a number of factors, including both egg quality and sperm quality. There are predictive graphs that can try to predict chances of pregnancy in the future, based on your age. However, your fertility specialist will be able to give you the most realistic picture given your unique circumstances.
What does the egg freezing process involve?
Each IVF protocol will be different depending on factors such as age, health and ovarian reserve. However, the basic process will involve self-administering different drugs to stimulate the follicles (as per a normal IVF cycle) for around 10 days. You will need to have a variable number of blood tests and appointments with your fertility specialist or nurse for scans. These scans will show how the follicles are growing and allow your specialist to adjust your treatment plan if necessary.
Once the follicles are a good size, eggs are picked up in a procedure in the operating room, under either general anaesthesia or twilight sedation. The whole process is usually around two weeks duration. On the day of egg pick-up, you will need to take the day off from usual work and rest. In most cases, you will be able to return to regular activities after 24 hours.
What are the costs of egg freezing?
While costs differ between states and fertility clinics, egg freezing is not an inexpensive process. You can expect to pay around $8000 – $11,000. This fee includes IVF consultations and counselling, medications, scans, hospital day surgery fee, anaesthetist fee and doctor’s fee for retrieval. You will also be required to pay an annual storage fee.
However, if egg freezing is done for medical reasons Medicare will rebate a significant proportion of your costs. Your fertility specialist will let you know if you are eligible for this.
What are the potential risks and side effects of egg freezing?
It’s very important to understand that egg freezing is no guarantee of pregnancy in the future. If you are in the position to get pregnant today, be wary of delaying your decision to start a family – regardless of whether you have frozen eggs in the bank. There are still a multitude of steps prior to a successful pregnancy and live birth which have not been tested just because eggs have been frozen!
There are also some potential side effects of IVF stimulation, such as mood swings, tiredness and bloating. You will need to be available for a number of appointments and be comfortable injecting yourself/ being injected. If you are not responding to stimulation, your IVF cycle may also need to be cancelled. And, as with any medical procedure, egg pick-up itself carries a small risk.
However, the most common complication is Ovarian Hyperstimulation Syndrome (OHSS). OHSS can occur in response to the injection of hormones, leading to symptoms including abdominal pain, bloating, nausea and weight gain. OHSS occurs in approximately 3-5% of all IVF treatment cycles, with most sufferers experiencing mild OHSS that resolves in a few days. While very rare, severe cases of OHSS can require hospitalisation.
Egg Freezing – First Steps
If you are considering preserving your fertility with egg freezing, your first port of call should be your GP. They may order some initial testing, such as the AMH test, then refer you to a fertility specialist for further discussion and an initial examination. This will help you decide if it is worthwhile going ahead with egg freezing and give an indication of how many eggs may be harvested/ cycles will be required.
To enquire about our Brisbane egg freezing and assisted reproduction services, please call 1300 833 560.