Egg Freezing: Why, How & Misconceptions
A popular topic
Egg freezing, also known as oocyte cryopreservation, has become an increasingly popular option for individuals who want to take control of their fertility journey. Egg preservation may seem like a convenient, secure option but this post will give you an insight into exactly what you’d be looking at when deciding to preserve your eggs and if and how you might be able to use them in the future.
Why would you freeze eggs?
Treatments such as Chemotherapy or Radiation can pose a risk to your fertility. By freezing and storing your eggs or ovarian tissue prior to treatment, you can make decisions on your fertility later and have peace of mind now.
At Fertility North, we will fast track your egg retrieval and freezing as to not impact your cancer treatment.
Before hormone therapy or gender affirming surgery
Transgender people who undergo medical or surgical transition can be rendered infertile by their transition treatment. To preserve their option of having a genetic family it is recommended that they discuss their options before undertaking any transition therapy.
Future family planning
If you’re waiting to have children, haven’t found the right partner or just want to keep your options open, egg freezing can offer you time. While your body may be biologically ready for children, that doesn’t mean your life situation is.
So how is egg freezing done?
After seeing a fertility doctor to discuss your eligibility and options, you will undergo an egg retrieval cycle with the use of medications to stimulate the growth and maturation of several eggs, as opposed to the one egg that would naturally mature and be released through ovulation.
When your eggs are ready to be collected, marked by a peak in oestrogen, you will administer a trigger medication at a certain time. This determines the time of your egg collection, which is approximately 36 hours later.
The egg collection procedure is relatively quick and can be done using a local anaesthetic in our treatment rooms or under general anaesthetic in an operating theatre. The collected eggs are then processed by our lab staff and all mature eggs are snap-frozen in a manner that optimises their survival and integrity.
Cryopreserved eggs are securely maintained in our specialised facility, ensuring optimal storage conditions and security until you would like to take the next steps in your fertility journey.
Recovery after the egg collection procedure is generally well tolerated and you can resume most normal activity from within a day or two. It is recommended to avoid high impact activities including running, heavy exercise, and sexual intercourse. Some people experience fatigue, mild cramping and sometimes vaginal bleeding.
Pictured to the left is an ultrasound image showing what an ovary with multiple follicles looks like.
How many eggs do I need to freeze to have the best chance of success?
The biggest but most difficult question to answer, as the number of eggs varies for everyone. On average, if 10 eggs are collected, 8 may be suitable to freeze, 7 may survive the freezing and thawing process, 5 may fertilise to become embryos, of which only 1 or 2 may be suitable for transfer or freezing. This kind of attrition throughout the process is expected but unfortunately not as widely known by most people thinking of freezing their eggs. This could mean needing multiple egg collection cycles to have the best chance of creating suitable embryos.
Myths and misconceptions
While we’re on the topic, we’d like to bust some myths and reveal some common misconceptions around egg freezing.
1. Freezing eggs guarantees future pregnancy, or even live birth.
There is no guarantee of success in any fertility treatment. There are many factors that contribute to your chance of a successful pregnancy, such as your age at the time of freezing, the quality and quantity of eggs frozen*, the quality and processes of your treatment provider, and even small biological factors that may not present until later down the line, if at all; examples of these could include genetic disorders, biocompatibility with the sperm, sperm quality, receptivity of your endometrium at the time of transfer and more.
2. Egg freezing is for single people.
False! If you have a partner and wish to have children later in life, egg freezing may be a suitable option for you. Egg freezing is also the best way to preserve your fertility should you need to undergo a medical procedure or medical treatment that may affect your fertility; this could include chemotherapy, surgery on your reproductive organs, gender reassignment surgery or before commencement of hormone therapy for transitioning.
3. Egg freezing is dangerous.
Although egg freezing was labelled ‘experimental’ up until 2013, it had been practiced safely for decades before that. There is no evidence that ovarian stimulation and egg retrieval causes harm or has a negative impact on the patient’s long term health. There is also no evidence that egg freezing increases the risk of any pregnancy complications, birth defects or chromosomal abnormalities when compared to using fresh eggs in fertility treatment.
As with any medical procedure, there may be associated risks or side effects. There can be side effects to hormonal stimulation, although they are generally mild and similar to what someone might feel before or during a period, e.g. headaches, bloating, cramping and mood swings. Rare complications can include ovarian hyperstimulation syndrome (OHSS) or infection. It is essential to discuss the potential risks and side effects with your fertility specialist to make an informed decision.
4. Freezing eggs causes early menopause/infertility.
Many think that due to the process of collecting multiple eggs from the body, you are affecting your future reproductive capacity or even could cause early menopause. You will be happy to learn that there is no evidence to support this!
In every cycle the ovaries grow multiple follicles (a fluid filled sac that usually contains one egg). At normal ovulation, one of the follicles releases an egg for fertilisation. Any other follicles present are ‘lost’. This means you ‘lose’ multiple eggs every cycle anyway.
When we collect eggs for freezing, we stimulate the ovaries through medication to produce and mature more follicles than you naturally would. We then collect the eggs from all of them, essentially collecting eggs that would have naturally been ‘lost’ anyway. An egg collection cycle does not reduce your reserve of immature eggs.
5. Frozen eggs aren’t as effective as using ‘fresh’ eggs.
This is surprisingly not true! Studies [and even our own rates of success!] have shown that transferring frozen embryos, which includes embryos created from stored eggs, actually have a higher chance of success than using ‘fresh’ embryos (made from fresh eggs at the time of treatment) for people over 35 years old. This is because if you are older in age but using eggs that you froze when you were younger (or donor eggs), the eggs are still as young and healthy as they were when you froze them.
Another contributing factor is that when transferring frozen material, you have time on your side to ensure your body is at its optimal state to fall pregnant. When undergoing fresh fertility treatment, you generally have an embryo transfer in the same cycle that your eggs were collected in, potentially leaving your body (and your mind) in a suboptimal state of stress and with little time to recover. That’s not to say that doing a fresh cycle is bad, in fact the statistics show that in people < 35 years old, a fresh cycle is slightly more successful on average.
6. Age doesn’t matter when retrieving eggs.
Egg freezing has been successful in women of varying ages, however having your eggs collected in the best possible condition will significantly increase your chances of a successful pregnancy when using them later down the track. Egg freezing is recommended to those less than 35 years old but is ideal for those younger than 30 for the best quality and quality eggs to be retrieved.
Some more things you should know..
Egg freezing is not recommended for everyone, and you should consult a specialist to make sure this is suitable for your individual circumstances.
It is important to factor in that, according to current legislation (Section 23) for Western Australia, if you are freezing your eggs with the intention of using them later in life you may only access them to use in treatment if you are deemed medically infertile. Being deemed medically infertile involves investigations with a Fertility Doctor which may include attempts at ovulation induction or intrauterine insemination cycles. If you are deemed medically infertile you can use your preserved eggs in an ICSI cycle only, due to the methods of preserving the eggs. The costs involved in this can be unexpected when not you are not properly informed by your doctor or clinic.
People who wish to freeze eggs for social reasons without a diagnosis of infertility are ineligible for Medicare subsidised treatment and must bear all the costs themselves. There are also ongoing storage fees associated for those who preserve material at any clinic unless you are freezing for oncology or genetic purposes. For more information on our fees, click here or contact our team!
Check out our page on egg freezing here.