If you, like me, are a consumer of a lot of media, you probably can remember at least one time when you learned something you didn't know from a magazine or tv. I first heard about menopause when I was nine after watching an episode of The Golden Girls. (I had to do some research.) Egg freezing is another one of those things; it seems like there are stories everywhere about celebrities who are seizing the day - and their ovaries - and freezing their eggs in the name of fertility preservation. Do these egg freezing experiences bear any resemblance at all to those of a non-famous person? What, if anything, can you learn from these stories? Is this as magical as it seems? Not necessarily, when one is negotiating how to afford the procedure, how to find the right fertility doctor, and how to accommodate a rigorous injection schedule on top of the rest of her life.
Egg Freezing: Let's Get Basic
Here's a super simplified overview of what the freezing process is and it works (Check out that link to our piece that goes into way more detail). Egg freezing is exactly what is sounds like - gathering the eggs that you have in egg retrieval procedure, and then literally freezing them until you want to combine them with sperm and grow a baby. Under the supervision of a doctor, you take a variety of hormones that promote the production of eggs, and in a procedure that takes about 15 minutes (not including the time you'll spend preparing or recovering), the eggs are collected, labeled, and frozen.
Although the procedure sounds straightforward, it definitely isn't. (It's not an "insurance policy" either, but more on that later) It's super amazing that reproductive medicine has gotten to this place, but that doesn't mean the procedure isn't tricky, invasive, and expensive. There are many things you should consider before undertaking egg freezing, including having a sense of when you want to get pregnant, how many eggs you'd like to freeze (your doctor can help you determine the number of eggs that would be best), and what you'd like to do with any remaining eggs.
Meet Hollywood's Egg Freezers
Here are just a few of the litany of famous women who have opted to go the egg-freezing route: Kaitlyn Bristowe, 33, of The Bachelor and The Bachelorette, announced on Twitter in March of 2017 that her decision to freeze eggs was rooted in the fact that, "As a woman there’s always pressure to have babies, and this puts my mind at ease for when I'M ready." Actress Olivia Munn, who's 38, froze her eggs back in 2016, so she, "wouldn't have to race the clock anymore," she told Anna Faris on Faris' Unqualified podcast.
Kourtney Kardashian, who's also 38, confessed to her sister Kim on a February 2018 episode of Keeping Up with the Kardashians that she didn't know if she was done having kids, but didn't want to eliminate the possibility altogether, and so she "should just do it so I don’t have to think, ‘Is this what I want, to have kids?’" Another reality tv star, The Real Housewives of Miami's Joanna Krupa, who was 35 when she froze her eggs and is now 39, did so because she wasn't yet ready to have kids when she got married in 2013.
Singer Halsey's reproductive health, even at the age of 23, dictates that egg freezing is the right move because her reproductive potential is already in question. In 2016, Halsey miscarried just before a performance. In 2017, she underwent surgery to treat her endometriosis, and in 2018, she appeared on the television show The Doctors to talk about her intention to freeze her eggs. "Doing an ovarian reserve is important to me because I’m fortunate enough to have that as an option, but I need to be aggressive about protecting my fertility, about protecting myself," she said. (Just an FYI - endometriosis doesn't guarantee that one wouldn't be able to conceive and have a successful pregnancy, but those with it often encounter challenges when it comes to getting pregnant.) Folks who have been diagnosed with cancer may also choose to freeze their eggs before beginning cancer treatment.
Let's be real - there's a stigma in talking about fertility, so any time we do externalize our experiences, we're chipping away at that stigma, and that is excellent. Breaking down the mystery that surrounds the process of egg freezing and in vitro fertilization (which exists specifically because people don't talk about it) is also super important. In a video of People magazine, Joanna Krupa provided a peek into what actually happens during the egg freezing process. You can see Krupa at the reproductive endocrinologist asking questions about injections and confessing that what she's most worried about is the water retention that can come with hormones she's taking to promote ovarian stimulation (she's a model, after all) and how these hormones will impact her day to day mood.
The video gets down into the details about follicles, endometrium, and "the worst case scenario," which Krupa wants to know. (That would be that eggs are retrieved successfully but aren't healthy- either because they weren't to begin with or they've reacted poorly to the hormones she's been taking.) You don't know which eggs will be successful until they're thawed, but according to this study published in 2010 in the journal Human Reproduction, there's no difference in success of pregnancy if, for IVF, you use frozen eggs and then went back to them at a later date than if you use eggs that were recently gathered ("fresh" eggs.)
Krupa is part of the group of women referenced above who undertook egg freezing as a "security blanket," as she calls it. Here's the thing - it's not a security blanket, or an insurance policy, because there's no guarantee that having some eggs frozen will lead to pregnancy. It's more complicated than just thawing them out and finding a sperm donor. For one, it depends on how old you were when you froze your eggs - we know that the quality of the eggs decreases with age, and the chances of having a live birth also decreases with age, if you're planning on carrying the child (as opposed to involving a surrogate).
According to the Society for Assisted Reproductive Technology, which collects data from fertility clinics in the US to assess the success of interventions like IVF and egg freezing, in 2014, women under 35 had the highest chance (42.7%) of giving birth using their own eggs that had been frozen and thawed. As women aged, that rate decreased, and women between the ages of 38 and 40 had a 33.7% chance of successfully conceiving. In other words, you shouldn't let those eggs chill indefinitely, because the age at which you decide to use them determines the likelihood of an effective pregnancy and birth.
Not all of the eggs you freeze will survive the thawing process, which is why your doctor will collect multiple eggs. And of course, there's the possibility of miscarriage, which is super common even for folks who aren't using frozen eggs. The success of egg freezing has to do with how many eggs you have in the first place (also known as ovarian reserve), how many you end up harvesting, how many are healthy and viable once they've been thawed out, how the process of implantation and fertilization process goes, and of course, if the pregnancy goes to term. It's tough to imagine what the future will look like, but keep in mind, if you're freezing your eggs with the goal in mind of using them at "some point," you'll have biology to contend with when the time comes.
Egg freezing costs are considerable - not just the procedure itself, but the storage fees for keeping them on ice. (We broke it all down for you in this piece on cost and the specifics, including insurance and what it does and doesn't cover.) While celebs make egg freezing look super accessible, the reality is that it's complicated, and can be cost prohibitive for many.
It's great that folks like Krupa are using their media presence to bust up the stigma surrounding egg freezing and reproductive technology. If you're thinking about egg freezing, educating yourself should be the first step. To get accurate information on how your unique body might respond to egg freezing, you can test your levels of AMH (anti-Mullerian hormone) through Modern Fertility's test. AMH is a means of assessing what your ovarian reserve could be, based on the level of the hormone you have that's secreted by the follicles inside your ovaries. In your results, we'll break down exactly what your levels mean and how they relate to choices and procedures like egg freezing.