As women age, we should be mindful that their bodies undergo physiological changes; these have profound implications on our fertility. Because the success of natural conception declines with age, we need to identify our family planning goals and institute timely action.
Egg freezing gives you the option of pausing that ticking clock and potentially preserving your fertility for the future. Each fertility journey is distinctive and contingent upon personal objectives and circumstances, such as overall health, familial fertility history, financial considerations, family plans, and relationship status. It is crucial for us to be well-informed about the available options before making the appropriate decision. The aim of this guide is to walk you through everything you need to consider about egg freezing to help you to make decisions best suited to your circumstances.
What Is Egg Freezing and How Does It Work?
Egg freezing, or oocyte cryopreservation, is the process in which a woman’s eggs (oocytes) are extracted, frozen, and stored for later use. When a woman is ready to have children, the eggs can be thawed, fertilised, and transferred to the uterus as embryos. This offers women the option of bearing their biological children at a time of their choice while not succumbing to the natural decline in fertility with age.
The egg retrieval process begins with ovarian stimulation using injectable fertility drugs to induce ovulation. Once the eggs have matured, they are retrieved through a minor surgical procedure under sedation. The eggs are then cryopreserved using a process called vitrification, which helps to preserve their integrity for future use. At a future time, when a woman is ready to start a family, her eggs are thawed and fertilised in a lab using in vitro fertilisation (IVF). The resulting embryos are then transferred to the uterus.
Some key factors to consider before opting for egg freezing include:
- Age – Younger women have better ovarian reserve and egg quality and have a higher chance of success during harvest. Multiple medical studies have shown that the best results are obtained when women harvest and store their eggs before age 35.
- Storage – Eggs can be stored for many years following cryopreservation. However, prolonged storage may result in egg quality deterioration and incur storage fees. There may also be legal considerations regarding the disposal of the eggs if they remain unused before an unplanned demise. Discussing these issues with your healthcare provider at the start of your journey helps you plan for these scenarios and make better-informed decisions.
- Success rates – Survival of thawed eggs and IVF success rates are high but are typically lower than using freshly-retrieved eggs. Pregnancy rates from stored eggs have been reported to be 7-12% per transfer. Do have realistic expectations about your chances of success and discuss this with your fertility specialist.
- Cost – Egg freezing can cost between SGD$10,000 to $24,000 per cycle. Additional fees for storage and egg thawing/fertilisation are required to apply.
Who Should Consider Egg Freezing?
Some groups of individuals may experience significant benefits from egg freezing. These include
- Women who require medical treatments like chemotherapy or radiation therapy that could damage the ovaries or reduce fertility. Oocyte cryopreservation before the commencement of such treatments allows these women to bear biological children in the future potentially.
- Women who want to delay childbearing for various reasons. Egg freezing gives women more flexibility and control over their reproductive timing.
- Women who have not found the right partner and are concerned about age-related fertility decline. For women, fertility decreases rapidly after age 35 and drops more steeply after age 40. Oocyte cryopreservation at a younger age provides women more security that they can have children in the future with higher-quality eggs that were harvested at their prime age.
In summary, the ideal candidates for egg freezing are females concerned with preserving their fertility and reproductive choices for the future. Although egg freezing does not guarantee future pregnancy, it preserves the future possibility of bearing one’s own biological children. By taking proactive measures to protect your fertility today, you are investing in fulfilling your future family-building goals.
How Effective Is Egg Freezing? Success Rates and Live Birth Rates
Numerous factors can influence the outcomes of the procedure. Therefore before deciding to undergo egg freezing, it is crucial to understand the process of conception. Many steps are involved in oocyte retrieval and eventual pregnancy, each with its own success rate.
Oocyte Survival Rate
The typical survival rate of oocytes following vitrification (fast freezing) is 90-95%. However, it is more relevant for the woman to consider fertilisation, implantation, clinical pregnancy, and live birth rates.
Fertilisation rate refers to the percentage of eggs that become fertilised after insemination with sperm. The factors that affect fertilisation success rate include the oocyte survival rate following thawing, the egg and sperm quality, and the insemination technique. With cryopreserved eggs, the success is around 60-70% compared to > 70% for freshly-harvested eggs. The fertilised embryos are then implanted into the uterus.
Implantation Rate and Clinical Pregnancy Rate
Implantation rate refers to the percentage of transferred embryos that successfully implant in the uterus; this typically ranges between 30-50% when cryopreserved eggs are used. The clinical pregnancy rate is the proportion of implanted embryos that result in a clinically detectable pregnancy (foetal heartbeat on ultrasound). Pregnancy rates are affected by factors like the woman’s age at the time of egg harvest and embryo implantation, the egg and embryo quality, and the number of embryos transferred. The clinical pregnancy rate is usually over 40% for cryopreserved eggs.
Live Birth Rate
The ultimate measure of success is the live birth rate: the percentage of embryo transfers that result in the birth of a baby. Live birth rates for cryopreserved eggs are usually over 30% for women under 35 but decline with increasing age at the time of egg retrieval. While egg cryopreservation is a highly reliable procedure with good success rates, live birth is more variable. The likelihood of success is dependent on the woman’s fertility and age.
Having an open and honest discussion with your doctor before commencing the egg-freezing journey can help you set realistic expectations. A consultation will help you comprehensively understand your circumstances and the potential outcomes associated with egg freezing. Your specialist will offer personalised guidance and address any specific concerns or questions you may have regarding the probabilities and success rates related to the procedure.
What Is the Egg Freezing Process and Procedure, and How Much Do They Cost?
Initial Consultation and Testing
The first step to egg freezing involves consulting a fertility specialist and undergoing necessary tests. During the initial consultation, the doctor will review your medical history and perform an ultrasound to examine your ovaries and egg supply.
Typically, a fertility assessment entails various components, including:
1. Blood tests: This involves testing hormone levels such as Anti-Mullerian Hormone (AMH), Follicle-Stimulating Hormone (FSH), and estradiol. Additionally, blood tests may be conducted to screen for any infections or other relevant factors.
2. Ovarian Ultrasound: An ultrasound examination is performed to assess the condition of the ovaries. This involves examining the number of follicles present, which are fluid-filled sacs within the ovaries that have the potential to develop into eggs. The ultrasound also helps identify cysts or other abnormalities that may impact fertility.
These diagnostic procedures play a crucial role in gathering essential information about hormone levels, ovarian health, and potential fertility-related issues, assisting your doctor in formulating an appropriate treatment plan tailored to your needs.
The initial consultation and fertility tests typically cost between SGD$300 to SGD$800.
Egg freezing involves the following key steps:
The journey starts with daily self-injections of two hormones, FSH (follicle-stimulating hormone) and LH (lutenising hormone). These medications stimulate the ovaries to produce multiple eggs. The medication for egg freezing mimics the natural menstrual cycle but in larger quantities. The fundamental distinction is during a typical cycle, only one egg develops from a follicle, while the remaining follicles are lost. Conversely, successful stimulation results in a greater number of eggs for retrieval.
The stimulation process spans two weeks and entails daily injections (administered 2-3 times) and 2-5 office appointments for transvaginal ultrasounds and blood tests.
At the appropriate time, you will be given a final injection to prepare for oocyte retrieval.
On occasion, stimulation commences with birth control to normalise follicular growth, ensuring that all follicles grow equally and at a synchronised pace. This approach aims to collect more eggs of comparable size during the egg-freezing cycle. If one egg dominates the process and suppresses the development of other follicles, it may be necessary to cancel or modify the cycle.
Your doctor will provide you with an estimated date for the procedure based on your ultrasound findings, and the precise time is determined two days prior to the retrieval. Once the eggs have reached the desired size, a “trigger shot” will be administered, and the procedure will be scheduled 24-48 hours thereafter. You are advised to refrain from consuming food or beverages after midnight on the day preceding the egg retrieval, as this procedure is normally done under sedation.
The medications required to stimulate oocyte development and the follow-up visits cost an average of SGD $3,000 to SGD $8,000.
Egg Retrieval Procedure
The egg retrieval procedure is a minor surgical procedure performed at a fertility clinic. The doctor will extract your eggs using an ultrasound-guided needle inserted through the vagina during this procedure. Local anaesthesia and/or intravenous sedation are administered to ensure your comfort. The procedure typically takes less than 30 minutes, and you will be discharged after a short observation period. Mild cramping and bloating are common temporary side effects.
Having someone available to accompany you after the procedure and stay with you for the remainder of the day is preferable. You are recommended to rest for the remainder of the day. While most individuals feel well after the procedure, severe symptoms are rare. However, if you experience any discomfort, promptly contact your clinic for guidance and support.
Your specialist or the clinic staff will notify you regarding the number of eggs collected and the quantity that has reached maturity, making them viable for freezing and fertilisation. In the usual instance, this information is made available to you the following day.
The egg retrieval procedure, or ovarian stimulation, is the most expensive part of the egg-freezing process. The cost ranges from SGD$ 5,000 to SGD$ 12,000.
Cryopreservation of the oocyte or embryo
Suitable eggs are evaluated and may be immediately cryopreserved as unfertilised eggs or fertilised using IVF techniques and stored as frozen embryos. The vitrification method is the process of rapid, deep freezing that avoids ice crystal formation within the cell and prevents its damage. The frozen eggs or embryos are stored in liquid nitrogen at -196°C for long-term preservation. The vitrification fees typically range from SGD$ 1,000 to SGD$ 2,000.
Storage of the eggs or embryos is done at a properly certified facility under very specific conditions to optimise their survival. Storage can be done indefinitely until they are retrieved for use at a time of the woman’s choosing. An annual storage fee is required. The annual storage fees for frozen eggs are around SGD$ 600 to SGD$ 1,000. If you choose to use and fertilise the frozen eggs in the future, thawing and fertilisation add another SGD$3,000 to SGD$ 5,000 to the total cost.
Egg cryopreservation and storage allow you to postpone pregnancy and have your own biological children when the time is right. An honest and open discussion with a fertility specialist is important to help you make choices that best suit your life plans and priorities.
Recovery After the Egg Retrieval Procedure
The recovery period typically lasts a week following the retrieval procedure. It is common to experience cramps, abdominal pain, and heavy vaginal discharge during this time, which is considered normal. Additionally, it is normal to feel bloated for approximately 7-10 days after the retrieval, and it is important not to panic if this happens.
For smooth recovery, it is recommended to take painkillers as prescribed by your doctor (this statement is a bit of stating the obvious). Constipation is a common symptom after the procedure, and staying hydrated while consuming protein shakes and electrolyte-enhanced liquids can help alleviate post-procedure bloating.
During the first week of recovery, it is advisable to avoid using tampons, inserting anything into the vagina, engaging in high-intensity exercise, using hot tubs, or having sexual intercourse. Some degree of bleeding is normal, but it is crucial to contact your doctor if it is excessively heavy or if you experience additional symptoms such as high temperature or significant pain.
Furthermore, it is important to reach out to your healthcare provider if you encounter nausea, dizziness, shortness of breath, decreased urination, intense pain, or a notable increase in weight.
The first menstrual period following the retrieval, typically within 7-10 days, may be heavier and accompanied by increased cramping. Painkillers can be used to alleviate discomfort during this period as well.
Breakdown of Potential Costs For the Egg Freezing Process
The entire journey ranges from SGD$15,000 to SGD$30,000, depending on individual needs and clinic rates. Despite the costs associated with the procedure, the potential intangible benefits that come along with it far outweigh the price tag. The following table is a quick summary of costs at each stage of this journey.
|Type of Expenses||Includes||Cost Range|
|Initial Consultation||Fertility test & medical history review||SGD$300-800|
|Ovarian Stimulation||Medication (birth control and hormonal medication)
Follow-up Consultation, Bloodwork & Ultrasound
|Egg Retrieval||Specialist fees, facility fees, anaesthesia and embryo lab fees (identification, vitrification & culture/sperm/hatching for embryos)||SGD$5,000-12,000|
|Initial oocyte storage||SGD$1,000-2,000|
|Oocyte storage||Annual recurring fees||SGD$600-1,000|
|Total cost of egg freezing cycle||SGD$10,000-24,000|
How Long Can Frozen Eggs Be Stored?
According to fertility experts, frozen eggs can typically be stored safely for many years. Some studies have found that frozen eggs can remain viable for up to 15 years when properly stored under controlled conditions and in liquid nitrogen at -196°C.
It is recommended that frozen eggs are used within 5 years of retrieval. Using frozen eggs within 3 years provides the best odds of success. Cellular ageing continues even though the eggs are frozen at a much slower rate. Over time, the eggs become more fragile and prone to damage. during the thawing process required for fertilisation and transfer.
- Short-term storage (within 3-5 years): Highest pregnancy rates and egg viability. Generally considered the optimal timeframe for using frozen eggs.
- Mid-term storage (5-10 years): Pregnancy rates start declining slowly, but eggs can remain viable for many women. It is best to use eggs within this window when possible.
- Long-term storage (beyond 10 years): Pregnancy success significantly drops due to egg ageing and damage risks. Not ideal, but eggs may still be usable for some. Requires consultation with a fertility specialist.
While technology and techniques are improving egg freezing success over longer periods, there are still natural limitations. The biological clock continues ticking for frozen eggs. Aim to use your frozen eggs for fertility treatment within 3 to 5 years for the best chance of success. But take comfort in knowing that egg freezing provides hope and options for building your family, even if it takes longer. With rapid progress in reproductive medicine, the future looks bright.
Will Egg Freezing Affect My Future Fertility?
Egg freezing will not negatively impact your natural fertility or ability to get pregnant naturally. The procedure is designed specifically to preserve your fertility and reproductive options. However, there are a few considerations to keep in mind:
While egg freezing is a safe procedure, there are small risks of complications like infection, bleeding, or damage to the ovaries or fallopian tubes. When performed by an experienced specialist, these risks are minimal. Do discuss this with your doctor before commencing treatment.
Not a Guarantee
Oocyte cryopreservation does not guarantee a future pregnancy. The viability of eggs after freezing and thawing can vary; not all eggs will survive the process. The likelihood of success depends on factors like your age, the number of eggs retrieved and frozen, and the skill of the doctor performing the procedure. While success rates are improving, there is no definitive way to predict your success.
May Require Multiple Cycles
Depending on your age and ovarian reserve, multiple egg retrieval cycles may be required to freeze a sufficient number of eggs to enable maximal success in a future pregnancy. The exact number of eggs needed depends on many factors and can vary significantly between individuals. Your doctor can help to advise you based on your unique needs.
Future Use of Eggs
When one is ready for pregnancy, in vitro fertilisation (IVF) is performed. The resulting embryos are then transferred to the uterus. Although the success rates of IVF using cryopreserved eggs are slightly lower than fresh eggs, the odds are still reasonably high, especially if egg retrieval was performed at a younger age resulting in high-quality oocytes.
Pros and Cons of Egg Freezing: Things to Consider
Egg freezing is relatively costly. The estimated cost typically ranges from $10,000 to $15,000 for one round of egg retrieval and initial freezing. Some women require multiple cycles to obtain a sufficient quantity of high-quality oocytes. This does not include the annual storage fees, which usually cost a few hundred dollars annually. Some insurance plans may cover parts of the process. However, many women pay the full cost of the entire journey out-of-pocket. The cost of egg freezing and IVF can be a barrier for many, and financial planning is an important part of this entire process.
The chance of live birth from frozen eggs can vary greatly based on a woman’s age at the time of egg retrieval and the clinic performing the procedure. In general, younger women enjoy higher success rates. For women under 35, live birth rates of 30-50% per egg retrieval cycle are common. Over age 38, the live birth rates with frozen eggs drop to 10-15% per cycle. Ask about your clinic’s specific success rates to determine realistic expectations.
Before you invest in egg freezing, think about how and when you may want to use your frozen eggs. Do you hope to conceive on your own first and use them as a backup plan if needed? Or are you planning to delay pregnancy and use them in your late 30s or early 40s? Consider how long you want to store your eggs and the associated fees. Typically, eggs can be frozen for many years, but the odds of success may start to decline over time. Have a plan in place for what will happen to any unused eggs.
Egg freezing is a big decision with many factors to weigh. While the procedure gives women more control over their biological clock, it does not guarantee future success. Going into the process with realistic expectations and a well-thought-out plan can help you feel empowered in your decision. Discuss all your concerns openly with your doctor before moving forward.
Side Effects of Egg Freezing
Egg retrieval for egg freezing can cause some side effects, though they are typically minor and temporary. The most common side effects are physical discomfort, pain, and bloating in the ovaries and lower abdomen. This is normal and to be expected, as the ovaries have been stimulated and eggs have been removed. The discomfort should only last a few days up to a week. Over-the-counter pain relievers can help relieve any pain. Abdominal bloating can also occur from fertility drugs and egg retrieval. This swelling will subside once the body recovers and menstruation resumes.
Ovarian Hyperstimulation Syndrome
There is a small risk of infection to the female reproductive organs during the egg retrieval procedure. Antibiotics are usually given before and after egg retrieval. Postoperatively, one should monitor for signs of infection like fever, chills, nausea or vomiting. If you are suspicious of possible infection, contact your specialist for an early review.
Future Fertility Impact
Egg freezing does not typically compromise future fertility or the ability to conceive naturally. However, there is a small chance of reduced ovarian reserve or response after the procedure. The fertility specialists will evaluate the ovarian reserve before beginning an egg freezing cycle to ensure the ovaries respond well to stimulation. They will also only stimulate the ovaries and retrieve eggs in a controlled manner to minimise risks to future fertility.
The risks of egg harvest are low if performed by experienced specialists, and the benefits of having your own younger eggs frozen for the future outweigh the risks of not doing it. Discuss any concerns you may have with your doctor before moving forward. They can give you a better idea of the risks based on your unique situation and medical history.
Egg Freezing FAQs: Common Questions About the Process Answered
What is the egg retrieval process?
Egg retrieval, also known as oocyte retrieval, is a minimally invasive surgical procedure where eggs are removed from your ovaries for the purpose of egg freezing or in vitro fertilisation (IVF). This procedure involves inserting a small needle through the vagina to retrieve the eggs from the ovaries. It is usually performed under local anaesthesia or sedation to ensure comfort. The retrieval typically takes less than 30 minutes, followed by a short period of post-procedural monitoring.
How many eggs can be retrieved?
The number of eggs retrieved can vary significantly between individuals and cycles. An average of 10 to 30 eggs are retrieved for most patients. The success of pregnancy depends both on the quantity of eggs, as well as their quality. Your specialist will determine the optimal number of eggs for retrieval based on your unique medical profile and situation.
What are the risks?
As with any medical procedure, there are some risks to be aware of:
- Infection: Though rare, pelvic infection is a small risk. Antibiotics are usually prescribed to minimise risk.
- Bleeding: Mild bleeding, spotting or cramping may occur after the procedure. This is normal and should subside within a day or two.
- Ovarian Hyperstimulation Syndrome (OHSS): OHSS occurs when the ovaries become swollen and painful in response to fertility drugs. Severe cases are rare but can lead to hospitalisation. Your doctor will closely monitor you to minimise the risk.
- Anaesthesia-related risks: Though unlikely, side effects or adverse reactions to sedation may occur. Your anesthesiologist will review risks based on your medical history.
- Damage to ovaries or other pelvic organs: Though rare, there is a small risk of damage or injury during retrieval—extensive testing and ultrasound monitoring aim to minimise risks.
If you have any concerns about the risks, discuss them with your doctor to determine if egg freezing suits and is safe for your situation. With close monitoring, egg retrieval is generally a very safe procedure, but being fully informed of the process and risks is important.
Advances in medical care now provide fertility options to women that have not been possible in the past. Egg cryopreservation permits women to harvest their oocytes at their prime age and retrieve them for use at a later time when necessary. This gives women the option of bearing biological children at a later time if desired. The decision to proceed with egg cryopreservation requires considering multiple factors, including a woman’s fertility goals, her biological and medical conditions, and her financial health.
This can be daunting for most women, and Zora Health is committed to helping you make the right choice for yourself. Zora Health also has a network of experienced partner specialists who will be able to deliver high-quality fertility treatments to optimise your chance of success. We believe that fertility treatments should be accessible to all women and we offer various financing options to help you realise your dreams.
Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.
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