Be informed, plan for your future

Biologically, you should have children earlier, as your fertility begins to decline in your early thirties.¹

Ideally, women would have children sooner, but that isn’t always an option. Many women are not in the right situation to start a family or have not found the right partner to settle down and start a family with.²

Egg freezing is a method of preserving your fertility. Individual eggs are collected and frozen. This will enable a woman to try and have children at a future date.^3,4

The intention of the procedure is that, in the future, you may choose to have the eggs thawed, fertilized, and transferred to your uterus as embryos to facilitate a pregnancy. The procedure’s success rate (being the chances of a live birth using frozen eggs) varies depending on the age. Therefore, the earlier the egg freezing is performed, the higher the success rate.⁵

Egg freezing has existed for decades^6,7 and was initially for women undergoing medical treatment that threatens future fertility or for genetic reasons.

As lifestyles have changed the procedure is now also being used by women who aren’t ready to have children immediately.⁸ You may find that egg freezing removes some of the pressure that surrounds important life choices, e.g. education, career, or even finding the right partner.

Egg freezing has the potential to give you the best possible chance of conception in the years ahead – when the time is right and you feel ready.

The latest report from the Human Fertilisation & Embryology Authority (HFEA) in the UK, has successful birth rates of 26%⁸ but cautions heightened expectations since their findings are from a small number of ‘thaw cycles’.

Other studies conducted in Europe on frozen eggs from donors under 30 found that pregnancy rates ranged from 36–61%.⁹

It is important to ensure a clinic is experienced in the procedure and compare their recent success rates for women of different ages.

The treatment involves an approximately two week cycle of daily hormone injections to stimulate the ovaries to produce several eggs. The eggs are then collected, vitrified (fast frozen) and stored in tanks at very low temperatures. When the time is right, a designated number of a woman’s frozen eggs will be thawed and the fertilisation process can begin.⁴

Eggs can be fertilised by the sperm of the woman’s partner or of a donor through either an IVF (in vitro fertilisation) or ICSI (intra-cytoplasmic sperm injection) procedure. During an IVF procedure, eggs and sperm are placed together in a dish until fertilisation occurs. When ICSI is performed, a single sperm is injected directly into the egg.¹⁰

Fertilised eggs (embryos) then grow in the laboratory for up to 5 days. One or two are then selected for transfer to the womb. ¹⁰

A pregnancy test will be done 14 days after embryo transfer. ¹⁰

Retrieving and freezing eggs at a younger age can help to ensure that eggs are of the highest quality, therefore making it more likely that they will be viable.¹

Data taken from Age-specific Probability of Live Birth With Oocyte Cryopreservation: An Individual Patient Data Meta-analysis (2013) Cil et al., Fertility & Sterility

Treatment decisions are the responsibility of the clinician. Every country has their own laws and regulations. Make sure you check your national health website for up to date information.

As a precaution, you will also be tested for infectious diseases, e.g. hepatitis or HIV, before treatment begins. Positive results will not limit your freezing ability – however, eggs will be stored separately to prevent any contamination.²

Each individual clinic may have different treatment guidelines or patient criteria, so it is important to speak directly with clinics to understand their policies.

Freezing eggs earlier in life does not decrease a woman’s chances of conceiving naturally.¹

The likelihood of natural conception was tested in a Belgian study of 194 women, in which 95% of those who pursued natural conception after egg donation became pregnant unassisted – mostly within 12 months. ¹

Age influences fertility but the egg freezing process itself does not.^{3, 4}

There are no higher risks during the fertilisation process for older women, but the chance of success is lower (meaning an adequate number of good quality eggs that may result in a successful pregnancy one day). In addition, the higher the age of the mother, the more risky the pregnancy is to both mother and baby. In part, this is due to changes to the reproductive system and the probability of health issues as people get older.⁵

You should always seek the medical advice of a healthcare professional when discussing your fertility preservation options.

Physically, the ideal candidates for egg retrieval are healthy women under the age of 30. One European study found pregnancy rates as high as 36–61% in this group.⁶

The process starts with simple blood tests. These measure fertility hormone levels and give an indication of a woman’s ovarian reserve.

There are many reasons why a woman may wish to freeze her eggs.  They may be focused on their careers or have goals beyond immediately starting a family – and of course, there is increasing evidence that women delay starting a family because  they have not yet met the right partner.

Freezing eggs earlier in life does not decrease a woman’s chances of conceiving naturally¹ – so a woman can choose natural conception in the future and is likely to become pregnant unassisted.

Each individual clinic may have different treatment guidelines or patient criteria, so it is important to speak directly with clinics to understand their policies.

The process starts with simple blood tests. These will measure hormone levels and give an indication of your ovarian reserve and all-round suitability.¹

When treatment begins, you can expect to take a course of hormone injections over approximately two weeks to stimulate your egg production.¹

Normally, you will self-inject at home. Your clinician or nurse will show you the correct technique.

You will then be monitored by ultrasound (provides images of the ovaries and growing follicles) at your chosen clinic to ensure the hormones are working as they should.¹

The third step is egg collection, under mild sedation. Under certain circumstances, and when medically indicated, general anaesthesia is recommended. Access is through the vagina and the procedure takes around 15 minutes.¹

Your eggs will then be quickly frozen (a technique called vitrification)¹ and stored in tanks of liquid nitrogen. In the last few years, vitrification has replaced slow cooling as egg survival rates are more reliable.¹

Many countries limit the time length that eggs can be stored for, so you must check the law in your own country. E.g. In Sweden, the time length is currently five years. This compares to ten years in Switzerland or the UK.^2,3

Individual response to fertility drugs varies and, therefore, the number of eggs collected.³ An antral follicle count involving an ultrasound scan of the ovaries can predict patients’ likely response to treatment.

Some clinicians advise two or three stimulation cycles to collect a larger number of eggs [over 20] for optimum chances of success.^4,5

Bloating, irritability and abdominal discomfort have all been associated with the hormone injections. No long-term side effects have been linked to the injections themselves.¹

Egg collection is normally performed under mild sedation as it may be uncomfortable.² In some cases, when medically indicated, general anaesthetic may be required.

After egg collection is completed, patients may experience some cramp-like pain for the next day or two.²

It’s a big decision. And for now, I want to be a bit less decisive.

Individual response to fertility drugs varies and, therefore, the number of eggs collected. An ovarian ultrasound scan can predict your likely response to treatment and your doctor can plan accordingly.²

Some clinicians advise two or three stimulation cycles to collect a larger number of eggs [over 20] for optimum chances of success.^3,4

Some time is required to attend clinic appointments. Most women return to work, or their normal routine, the day after the egg collecting procedure.

Egg freezing, like most IVF treatments, is generally safe. Some women do experience side effects from fertility drugs. In most cases, any reaction will be mild.¹

Ovarian hyperstimulation syndrome (OHSS) is a rare but potentially life-threatening response to some fertility drugs. This is when ovaries grow in size, combined with pain and fluid leakage into the abdomen.⁵

Before the start of any procedure you will need to provide certain consents and may be required to make some important long-term decisions:

• Time length of egg storage – typically 10 years, depending on the country where the procedure takes place
• Use of personal information
• Legal parentage – depending on individual circumstances
• What happens to eggs in the event of your death

You must discuss and agree with your clinic what happens to your eggs if you decide not to continue with treatment at any stage.

Clinics have different pricing plans and costs do vary. It’s important to have a fully costed plan before you begin, so you can be prepared for future expenditure.

Eligibility for health service funding depends on individual health status and specific criteria within individual countries.

Funding for egg freezing through choice, rather than medical necessity, is likely to be private. Many clinics offer monthly payment plans to help manage the cost of treatment.

A small number of health insurance policies do include egg freezing (or part of the investigative process) and some progressive businesses now include egg freezing as part of a benefits package for female employees.

Fertility services and associated costs can be expensive, so you will want to do your research to ensure a clinic is right for you. The list below gives an indication of the criteria you need to make a decision. Remember, success rates can vary year on year, so take a rounded view:

• Egg freezing procedure (vitrification or slow freezing)
• Success rates – birth and multiple birth*
• Price plans – including fertilising of thawed eggs
• Patient reviews – real experiences and ratings
• Good location – vital for repeated visits

Ask about the individual experience of the people who will provide your care and manage the eggs.

You may also wish to look for a clinic that offers access to counselling. When the time is right, we all hope for successful results but IVF is an intense emotional journey and support is invaluable.

*Multiple births can mean more than one baby at different times, or twins/triplets.

Download our guide to help you get the most out of your first consultation on egg freezing. It contains useful information on what to expect at your first visit, what to bring, and some questions that you might want to ask your doctor.

Download guide