Egg freezing, also known as oocyte cryopreservation or fertility preservation, is a medical process where the follicles in your ovaries are stimulated and retrieved for future use. It can be done for a variety of reasons, including personal or professional reasons, medical conditions, or to preserve your fertility before undergoing treatments that may impact it. The egg freezing process involves the use of medications to stimulate the ovaries to produce multiple eggs during a cycle. In this article, we will discuss everything you need to know about egg freezing medications.
What happens during egg freezing?
The first step in the egg freezing process is to stimulate the ovaries to produce multiple eggs to be retrieved. This is done with the use of fertility medication, administered in the form of injectable hormones. These medications are designed to stimulate the ovaries to produce multiple eggs, rather than the one egg that is typically produced during your cycle.
After 10 to 12 days of stimulation, your fertility doctor will then retrieve the eggs which are immediately frozen for your future use.
An overview of egg freezing medications
What drugs do you take for egg freezing? Well, it depends on the specific protocol you are given that is personalized to you. While we can’t tell you specifically what drugs you’ll be taking, we can share more about the most common medications and how they work.
First, there’s the egg freezing medications that help your follicles grow
There are a few fertility medications, taken over a 10 to 12 day period, that cause your follicles in the ovaries to grow in a process called ovarian stimulation. The most commonly used are gonadotropins. These medications are self-administered as injections (shots).
As your follicles grow, the eggs inside start to mature and prepare for the retrieval. These egg freezing drugs may be used individually or together, based on your doctor’s personalized recommendation.
- Gonal-F and Follistm are two brands of the same medication, follicle stimulating hormone (FSH). They are from two different manufacturers, but are interchangeable.
- Menopur a combination hormonal medication (FSH and LH).
Then, there’s the egg freezing medications that make sure the eggs don’t get released too soon
At some point each cycle, your egg is released in what we call ovulation. While this is a normal part of your cycle each month, during egg freezing we want those eggs to stay put until they are retrieved by your doctor. This is where GnRH-agonists and GnRH antagonists medications come in. They are prescribed at just the right time to help block the LH surge from occurring so your eggs are not released prematurely. These include:
- Cetrotide and Ganirelix are two brand names of the same medication, gonadotropin releasing hormone (GnRH) antagonist. They both come in pre-filled syringes.
Lastly, the eggs get a final growth boost called a “trigger”
The last medication of your egg freezing journey stimulates your body’s natural LH surge and helps induce the final maturing of your eggs, preparing them for the egg retrieval. hCG medications help trigger ovulation within 36 hours, so the timing of this medication needs to be precise.
- Ovidrel, Novarel, and Pregnyl are all the same hCG drug that requires some mixing before administration.
- Lupron (also known as leuprolide acetate) is an alternative trigger to hCG.
Other meds you might take during egg freezing
- Omnitrope is a recombinant human growth hormone (HGH) used for eggs that may need a little extra help.
- Birth control may be prescribed for the weeks leading up to your cycle to both give more control over the timing of your egg freezing procedure, help your ovaries better respond to fertility drugs, and minimize the growth of cysts.
- Doxycycline is an oral antibiotic medication often prescribed to decrease your chance of infection.
- Prenatal vitamins or other supplements may be suggested to support ovarian and overall health.
How many injections are there for egg freezing?
Let’s just say you should be prepared for a lot of shots! The number of injections required for egg freezing can vary depending on the individual and the specific protocol used, but typically ranges from one to five injections per day for the duration of the stimulation which is typically between 10-12 days.
Where do these injections go?
Most fertility drugs are injected just underneath the skin in your belly or your thigh. Your clinic or pharmacy will give you specific directions for the shots. It’s really important to follow the instructions carefully. If you freeze your eggs with Cofertility, we’ll help guide you through this process.
What will the fertility medication dosage be?
Before and during your egg freezing cycle, you will have several “monitoring” appointments when you receive a transvaginal ultrasound and blood test for key hormones. These tests give your fertility team the information they need to determine your exact medication and dosage. This information will be then sent to your pharmacy, and you’ll either pick up or receive the medications in the mail.
What are some of the egg freezing protocols?
A protocol is a standard set of medications and timing that have been proven to work for patients. While your exact protocol will be personalized to what your doctor thinks will work for you, the protocol will fall into a certain bucket.
- Antagonist Protocol is the most commonly used because it requires the fewest number of injections and works for most patients.
- Long Protocol (aka Down Regulated Protocol) was the first protocol for egg retrievals. It takes 1-2 weeks longer than most protocols, making it more timely and expensive. It’s not as common these days, but is still used for certain types of patients.
- Microdose Flare Protocol uses Lupron’s dual properties to first activate follicles, and then prevent them from prematurely ovulating. It is used alongside gonadotropins to stimulate the ovaries. This protocol is often used for patients with diminished ovarian reserve or a poor response to other types of protocols.
- The Mini-IVF or Natural Protocol involves the retrieval of a single egg during a natural menstrual cycle, without the use of ovarian stimulation medications. It is sometimes used for women with a low ovarian reserve or for women who are unable to take stimulation medications.
Potential side effects of egg freezing medication
While fertility drugs for egg freezing are considered safe, they do occasionally cause mild discomfort from bloating.
The biggest risk to ovulation induction medication is ovarian hyperstimulation syndrome (OHSS) – a serious complication that can occur with the use of these medications. OHSS occurs when the ovaries become swollen and painful due to the overproduction of eggs.
How common is OHSS? Data suggest the incidence of mild OHSS is 20%–33%, moderate OHSS is 3%–6%, and severe OHSS occurs in 0.1%–2% of cycles. In rare cases, OHSS can be life-threatening, so it's important to be aware of the potential risks and to inform your doctor of any symptoms (abdominal pain, bloating, and nausea).
If you are at high risk of OHSS, your doctor may prescribe a trigger medicine called leuprolide instead of hCG, which can prevent OHSS. Another medicine called cabergoline also can help reduce the fluid accumulation. Or they may give you extra IV fluids at the time of egg retrieval.
How much do egg freezing medications cost, and will my insurance cover it?
The drugs required for egg freezing are not cheap. And unfortunately for most patients, they are not covered by insurance. Most patients should expect to pay $3,000 to $6,000 out of pocket, and it varies based on the dosage and duration of treatment.
There are ways to get better prices on medications:
- Price shop: The cost of medication can vary depending on your location and the pharmacy where you purchase the medication. Try using a tool like GoodRx to compare prices at different pharmacies to find the best deal.
- Freeze your eggs with Cofertility: In markets where our partners have discounts on meds, we pass those along to our Keep members.
- Look for manufacturer discounts and coupons: Some manufacturers offer discounts and coupons for their medications. Check out the manufacturer's websites to see if you qualify for any savings.
Summing it up
If you’re freezing your eggs, it’s helpful to get to know the medications that make it possible. Ovarian stimulation medications are designed to stimulate the ovaries to produce multiple eggs during a cycle, which increases the chances of a successful pregnancy in the future. The process is overall very safe and can be tailored to you to maximize results and minimize side effects and risks.