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Dr. Roohi Jeelani, MD, FACOG answers the most common questions about egg freezing

Dr. Roohi Jeelani, MD, FACOG answers the most common questions about egg freezing

8 min read

So many factors help us decide when we’re ready to get pregnant: financial stability, relationship status, health, career trajectory — and that’s just scratching the surface. You don’t always know exactly when (or if) you’ll feel ready for kids… and the fact that the ability to conceive is so dependent on age only complicates the decision. For this reason, many people with ovaries have turned to egg freezing (in medical-speak: oocyte cryopreservation) to preserve the quality of their eggs during their younger years.

What exactly does egg freezing entail? It’s a fertility preservation technique in which eggs are extracted from the ovaries and frozen so they can be used for an assisted reproductive technology (ART) procedure like in-vitro fertilization (IVF) later in life.

We recently got the chance to speak with Dr. Roohi Jeelani, MD, FACOG, a reproductive endocrinologist at Vios Fertility Institute, about the most common misconceptions we’ve heard around egg freezing. Keep reading for answers to these questions:

  • Is egg freezing a good option for everyone?
  • How much does it cost to freeze your eggs?
  • How complicated is the egg freezing process?
  • When you freeze your eggs, does that guarantee future pregnancy?
  • Are there any tests that can help you predict egg freezing outcomes? What is AMH testing?

Is egg freezing a good option for everyone?

First off, egg freezing is an incredibly personal decision, and it doesn’t always guarantee that you’ll be able to use those eggs in the future to get pregnant (more on that later).

Age does play a factor in egg freezing — Dr. Jeelani says that freezing your eggs is not recommended if you’re younger than 21 or older than 46.

Some folks with certain medical conditions may not think egg freezing will be right for them, but Dr. Jeelani explained that many people with ovaries are good candidates, even if they’ve had medical issues in the past:

  • Hormone-dependent cancer patients (like those with breast cancer or ovarian cancer): Some may think that injecting themselves with more hormones is dangerous for their health, but egg freezing can be a safe option for them.
  • People with uterine fibroids (benign growths in the uterus): Similarly, some may assume hormone injections will worsen a uterine fibroid condition since there is data that showsa connection between hormone levels and fibroid development. However, because the increased exposure to hormones will only last for 10-14 days, it’s not enough time for fibroid growth to be affected.
  • People with endometriosis and polycystic ovary syndrome (PCOS): In the case of endometriosis, because it is an inflammatory disorder, fertility and egg quality may decrease over time. Preserving younger eggs may increase that person’s chances of a live birth in the future. With PCOS, an individual ends up with “a bunch of eggs in their ovaries that can’t fulfill the complete maturation process” due to the body’s inability to secrete FSH, Dr. Jeelani says. Egg freezing may still result in live births for PCOS patients, but you may need to retrieve a larger number of eggs to successfully develop embryos.

All of this being said, Dr. Jeelani explains that people with higher body-fat percentages, high blood pressure, or diabetes may experience health issues because of the stress the egg retrieval procedure puts on the body. But that doesn’t mean they can’t freeze their eggs — it just means it’s important to speak with their doctor about possible ways to lessen the procedure’s impact.

Another important thing to keep in mind when considering egg freezing is the costs, which might make it difficult for many people to afford. We’ll cover the costs in the next section… and include Dr. Jeelani’s recs for getting financial assistance if you’re thinking about freezing your eggs.

How much does it cost to freeze your eggs?

Dr. Jeelani says the exact price of egg freezing varies depending on your clinic and region, but the price range for the procedure alone is usually between $4,000 and $8,000. When the costs of injections and fertility medications are incorporated, the price of one egg freezing cycle goes up to about $10,000. This price usually includes one year of storage for your eggs: The price of long-term storage facilities or independent storage facilities is about $500-$1,000 annually. (Embryo creation and IVF treatments are closer to $8,000-$12,000 because the process requires more work.)

But there are ways to get financial assistance to cover the costs of egg freezing, Dr. Jeelani says. You can apply for fertility treatment grants from organizations like Baby Quest Foundation, the Cade Foundation, and the Hope for Fertility Foundation. Many grants also exist specifically for cancer patients who aim to preserve their eggs before cancer treatments. You can find more information about those grants at Livestrong Fertility, Team Maggie for a Cure, Verna’s Purse, and the Heart Beat Program. (And even more grant opportunities can be found at the Alliance for Fertility Preservation, The Samfund, and Fertility Within Reach.)

At the same time, more and more companies are including insurance coverage for these fertility treatments in their employee health benefit plans. If your employer-provided health insurance doesn’t cover egg freezing, Dr. Jeelani suggests reaching out to HR with examples of companies that do cover the procedure, as well as to ask about loans or Health Savings Accounts (HSA).

How complicated is the egg freezing process?

So... what’s the actual egg freezing process like? “One of the most common myths is that it takes a while — that it takes months and months of your life,” Dr. Jeelani says. “But it usually doesn’t.” The only major difference between the egg freezing process (which is performed by a reproductive endocrinologist specialized in infertility) and what your body’s hormonal cycle does on its own is that you will “super ovulate” due to hormone injections you receive prior to the egg retrieval procedure.

These will be the main steps of your treatment whether you are freezing your eggs for later use, attempting to create embryos immediately, or donating your eggs:

  1. Consultations: Your fertility specialist will first schedule appointments to learn about your body, egg quality, and hormone levels before injections start. This consultation period can last about one month.
  2. Injections: Dr. Jeelani says you are in no rush to begin injections after these tests, but if you choose to move forward, you will receive your initial injections of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) on the first day of your period, and then continue injecting those hormones for 10-14 days for ovarian stimulation and egg growth. “Most people yield 12-15 eggs per cycle,” Dr. Jeelani says, and one round of egg retrieval will follow one menstrual cycle.
  3. Extraction: The retrieval process begins at the point in your cycle when your eggs have matured and you’re about to ovulate. The extraction procedure is considered a surgery, albeit a low-risk one, that utilizes the same IV sedation as wisdom teeth removal. “There are no incisions,” Dr. Jeelani says. “We do a transvaginal ultrasound, and at the tip of the ultrasound wand is a little needle that enters through the vagina and ovaries. This sucks the eggs down into a test tube.” Pain level is dependent on each patient, but Dr. Jeelani says many of her patients only experience bloating a few days later, and adds that she personally felt no pain after her four egg retrieval treatments.
  4. Freezing: An embryologist will then use liquid nitrogen to “flash freeze” your mature eggs in a process called vitrification, which freezes cells instantly. Your frozen eggs will be stored in the lab or in an independent/partner facility until you are ready to use or donate them. Eggs can be preserved for a very long time — Dr. Jeelani says a woman was reported to have a live birth from thawing and using donor eggs that had been frozen the year after she was born to conceive.

However, the physical process of egg freezing is not the only thing to consider. “Make sure you have a good connection with your doctor,” Dr. Jeelani says. “It’s a very intimate process. You may get news you don’t like or get emotional because your hormones are being amplified.” If you’re considering egg freezing and are unsure where to find treatment, she suggests typing “fertility doctor near me” into Google.

When you freeze your eggs, does that guarantee future pregnancy?

The short answer is that nothing is a guarantee when you freeze your eggs, Dr. Jeelani says — and no, freezing your eggs doesn’t “pause” your “biological clock.” Rather, she says to think of egg freezing as a way to preserve younger eggs in hopes of giving yourself a better chance at having a live birth in the future. When these eggs are extracted, your doctor won’t know which eggs will result in viable embryos.

Here’s what the “funnel” looks like:

  • When retrieved eggs are frozen, approximately 80% of them will survive once thawed (though Dr. Jeelani suggests checking data from fertility clinics in your city to get exact numbers).
  • Of that 80%, about 60-70% of those eggs will fertilize.
  • Then about 40-50% of those fertilized eggs will develop into embryos.
  • But when your doctor genetically tests those embryos for chromosomal abnormalities that would prevent successful implantation or pregnancies, only half (or none) of those embryos may be healthy enough to use. That’s why multiple rounds of egg freezing means you are more likely to have a live birth, especially since your quantity and quality of eggs will be different each month. “Current data suggests you need 8-15 eggs for one live birth, ideally,” Dr. Jeelani says.

The thaw survival rate for frozen embryos is much higher than eggs at 98-100%, which is why fertility doctors will tell you that freezing embryos is “better” than only freezing eggs. But you shouldn’t let that statistic deter you from egg freezing, Dr. Jeelani says, because the embryo freezing process is much more complicated.

If you feel pressured to get donor sperm to fertilize your eggs and develop embryos, you can never again separate that sperm and egg. Plus, if you split up with a partner after freezing embryos together, many legal issues arise regarding implantation and pregnancy.

What if you want to freeze your eggs now but still try to conceive without assistance in the future?

Hormone injections and egg retrieval processes will not negatively impact your chances at natural conception, says Dr. Jeelani. The reproductive system naturally recruits 90-100 eggs each cycle before “feeding” 6-12 of those eggs with FSH to bring them to the “front line” for fertilization.

Increasing hormone levels with injections over short periods of time does not interrupt this process, regardless of how many retrieval cycles you’ve undergone. That’s because the inner workings of the reproductive system are more dependent on age than anything else.

Are there any tests that can help you predict egg freezing outcomes?

Fertility specialists test your anti-Mullerian (AMH) levels to help gain better insight into potential outcomes when freezing your eggs. AMH levels can tell you your ovarian reserve (aka how many eggs you have) and how that compares to other people your age.

“To a fertility doctor, these levels mean how many eggs I will get from your body after a retrieval cycle,” Dr. Jeelani says. “The higher the AMH, the more eggs a doctor will get.” If testing reveals very low AMH levels, your doctor will likely recommend several cycles of egg retrieval in order to retrieve enough eggs. You can plan for several cycles in a row if you can emotionally handle all those hormones. Otherwise, you can take breaks in between.

If you're curious what your AMH level might mean for egg freezing or IVF outcomes, we’ve got you covered with the at-home Modern Fertility Hormone Test. No matter what birth control you’re on, you can always measure your AMH (and up to six other hormones if you’re not on hormonal birth control) through our simple finger-prick blood test. In your *personalized* dashboard with your results (which you’ll get in your inbox ~10 days after sending in your sample), we’ll also include reports based on your hormone levels about your AMH, egg freezing, and more.

The fertility hormone test you can take at home | Modern Fertility
The most comprehensive fertility hormone test you can take at home to be proactive about your fertility.

Watch our full convo with Dr. Roohi Jeelani below and read more about the cost of egg freezing and personal experiences with egg freezing. Plus, stay tuned to Modern Fertility for the latest on reproductive health, right from the experts.

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Rachel Sanoff

Rachel Sanoff is a writer and editor in Los Angeles. She was previously an essays editor at O.school, a digital sex education platform, and the features editor at HelloGiggles.

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