egg freezing
BMI and Egg Freezing: What Do I Need to Know?
Wherever you’re at on your egg freezing or donation journey, it’s possible that your BMI may come into question. Let’s dive into BMI as a health metric, why some clinics rely on it for fertility treatment eligibility, and why its roots can be problematic.
Maybe you’ve just begun to explore egg freezing or donation and heard about Body Mass Index (BMI) as a clinical measure of eligibility for the procedures. Or perhaps you’ve already applied to donate your eggs and were told you did not qualify on the basis of BMI. Wherever you’re at on your egg freezing or donation journey, it’s possible that your BMI may come into question. You may be wondering what one has to do with the other, and if this criteria is even legit.
BMI is a tool that categorizes intervals of body fat based on a person’s height and weight, with the associated categories being “underweight,” “normal weight,” and “obese.” Labels we really don’t love…but are used by the medical industry nonetheless. In the case of fertility clinics, BMI is often used as a requirement for egg freezing and donation. Most clinics have set a BMI threshold, meaning women considered overweight or underweight are often disqualified from receiving fertility services without any investigation into the rest of their medical profile. Because Cofertility is a matching platform and partners with fertility clinics, their guidance is what informs our policy.
Let’s dive into BMI as a health metric, why some clinics rely on it for fertility treatment eligibility (the TLDR: correlating anesthesia risks), and why its roots can be problematic.
A quick primer on BMI
The formula for calculating BMI is weight in kilograms divided by height in meters squared.
It has been widely used by medical professionals as a quick way to assess a person's overall health and risk of various health conditions, such as heart disease, diabetes, and certain cancers. Despite its imperfections as a metric (and the flaws of relying on any one measure to look at the big picture), historically, BMI has been used by the medical community to more easily identifying certain comorbidities.
Why fertility clinics take BMI into account
For better or for worse, fertility clinics — like other medical establishments — often look to BMI as one requirement when evaluating someone’s eligibility for egg freezing or donation. Here’s a bit more about the why.
What is the recommended BMI range for freezing or donating eggs?
First, let’s clarify what BMI requirements for egg freezing or donation even entail. They can vary by fertility clinic, but most criteria are based on CDC and WHO classifications of “normal weight.” At Freeze by Co, your BMI must be between 18-29 in order to qualify as a Split member — where you can freeze your eggs for free if you donate half of the eggs retrieved to another family who can’t conceive. If you feel like your BMI does not reflect your health, because you’re an athlete or otherwise, please send us a note. We also review lots of other health profile criteria as part of your application and understand that BMI is not always indicative of a person’s overall health.
If you’re a Keep member — where you can still freeze your eggs more affordably and keep 100% of them for your own future use — you may also be subject to similar BMI requirements as set out by clinic partners. It is worth noting that clinics’ BMI parameters for egg freezing may be more flexible than those for donation.
Does weight and BMI affect the retrieval cycle itself?
It can. Probably the biggest reason fertility clinics are reluctant to conduct egg retrievals on those outside the “normal” BMI range is that your BMI may affect your overall risk profile for the stimulation and procedure. Throughout the time that you are taking hormone stimulating meds, your doctor will monitor your ovaries through an ultrasound to measure follicle growth. Women with higher BMIs may have more abdominal tissue; thus, it can be harder for your doctor to visualize the ovaries and ensure that everything is progressing as expected.
Further, the American Society of Anesthesiologists notes that a high BMI increases the risk of surgical and anesthetic complications. While some clinics are finding ways to safely perform the procedure under local anesthesia (eliminating many risk factors), fertility clinics don’t all necessarily have the same equipment you’d find at a hospital, and many are simply not comfortable with this risk for safety reasons.
Women with very low BMIs may also be at risk of complications and side effects from ovarian stimulation, too. For example, some studies indicate that individuals with low BMI are at higher risk of developing Ovarian Hyperstimulation Syndrome (OHSS).
According to Cofertility Medical Advisor, Dr. Meera Shah,"Research does suggest that obesity is associated with impaired fertility and decreased live birth outcomes with assisted reproductive technologies. Some studies have demonstrated a correlation with increased BMI and lower oocyte yield, mature eggs, and blastocyst development. Obesity may also increase procedural risks including anesthesia related complications and procedural complexity. From a clinical perspective, it is important to balance these risks with a woman's autonomy to preserve her fertility. It is important that this patient population seek extensive counseling regarding such risks and are referred to centers equipped with the resources to provide safe and compassionate care.”
Does weight and BMI affect egg retrieval outcomes?
Maybe. A systematic review of 13 studies found that women with higher BMIs are less responsive to hormone stimulating medications. While these studies pertained to ovulation-inducing medications (like clomid) vs. medications specifically involved in egg freezing, it still indicated a potential need for higher total doses of follicle stimulating hormones for those with higher BMIs.
Another large cohort study has shown that, relative to women of normal weight, overweight women (BMIs > 25) have fewer eggs retrieved per cycle. While we do have some data about the hormonal implications of very low BMIs — ASRM reports that very low BMIs can cause irregular menstrual cycles and may cause ovulation to stop altogether, impacting a woman’s fertility overall — evidence of the effects of low BMI on actual retrieval outcomes is more varied. We’ll continue to keep tabs on that data as it becomes available, but this heterogeneity may be due to smaller sample size of underweight groups or the influence of biological differences such as ethnicity (more on that below).
On the flipside, there is a single study on BMI and egg freezing (373 elective egg freezing cycles), which found that egg yield actually increased by 2% per increase of BMI measured. This study also illuminated the fact that the existing research on women with known infertility issues cannot be easily extrapolated to egg donors and freezers, because they are unique populations.
Does weight and BMI affect egg quality?
It can. Although there is not absolute consensus, some studies have shown that obese women can experience poorer egg quality. Because women are born with a limited number of eggs, the environment in which those eggs develop is critical. A study published in the Journal of Assisted Reproduction and Genetics stated that obesity impairs egg maturation. It can also induce elevations in insulin, glucose, or fatty free acids, all of which appear to impact the development of the egg.
Another study done at Washington University in St. Louis looked at the effects of obesity on the egg quality of infertile women. They found:
- Oocyte quality: six studies found an adverse effect, one found no effect
- Fertilization: three studies found decreased rates, eight found no difference
- Embryo quality: two found decreased quality, two found no difference
As we review this study, though, we’ll need to remember that findings on infertile populations can’t necessarily be applied to egg freezers. Plus, fertilization and embryo quality have unrelated confounding factors like semen quality.
Why do you need a certain BMI in order to freeze or donate eggs?
Most doctors set BMI parameters in response to data on outcomes and the complication risks shared above. In most cases, BMI limits are in place to protect your bodies and reduce the risk of complications.
Also, when it comes to egg donation, specifically, since families needing egg donors have generally already been down a difficult, and expensive road, their doctors want to reduce any potential risks and increase chances of a successful retrieval. Given what you are putting your body through in order to stimulate and retrieve the eggs, this can be beneficial to all parties involved in the process.
Why BMI can be a problematic metric
Clearly, there is a lot of contradictory research when it comes to BMI’s impact on fertility outcomes — our heads are spinning, too! Despite this, BMI is still widely used by fertility clinics to determine a woman’s eligibility for both freezing and donation.
In recent years, more and more researchers and medical professionals have argued that BMI is a flawed method of body measurement. And while we need to comply with and respect the BMI parameters put in place by our clinic partners, we also have a few issues with BMI as a metric.
Looking at the full picture
As the Cleveland Clinic points out, BMI does not distinguish between excess fat, muscle, or bone mass. This means it is inaccurate in certain populations such as athletes (who have a lot of muscle mass) or those who are very tall or very short. Similarly, BMI does not provide any indication of the distribution of fat in the body. And we know that the location of body fat in someone’s body is an important variable in assessing their full health picture.
Because the freezing and donation processes follow similar steps up until the point of retrieval, the fertility clinic you ultimately work with will likely ask you about your BMI as part of the Split and Keep programs. We want you to be prepared, and while there is a push for clinics to evaluate BMI as part of the full picture, for our Split program in particular we do need to ask about BMI on our initial intake questionnaire. Reason being: we would hate for someone to spend valuable time and energy on the program’s full application, only to be told by a fertility clinic that they would not qualify for egg donation based on this metric.
Reliance on BMI can further perpetuate racial inequities
Relying solely on BMI to assess health also has the potential to lead to increased racial bias. Although the BMI calculation was primarily based on White body types and not necessarily an appropriate measure for people of other ethnicities, Black and Latina women are more likely to face infertility than white women, and may benefit the most from fertility preservation.
Yet, because of BMI cutoffs, these populations face more obstacles when it comes to receiving fertility care. The prevalence of obesity is higher for women of color due to myriad social determinants of health and differences in body composition. Therefore, women of color are disproportionately impacted by BMI requirements. Obesity prevalence in the U.S. in 2020:
- 39.6% of white women
- 45.7% of Hispanic women
- 57.9% of Black women
This doesn’t mean that the potential egg freezing risks associated with BMI described above should be disregarded, but we should acknowledge that this data does have the potential to perpetuate racial inequities. The AMA itself even states that it has “issues with using BMI as a measurement due to its historical harm, its use for racist exclusion, and because BMI is based primarily on data collected from previous generations of non-Hispanic white populations.”
The need to preserve reproductive autonomy
If a clinic denies someone access to egg freezing services based on her weight alone, this essentially denies her the opportunity to preserve her fertility and her reproductive autonomy. Egg freezing may be even more important for people with high BMI, who are statistically more likely to struggle with infertility down the road. This can have devastating consequences for women who may want to delay pregnancy for personal or medical reasons, such as cancer treatment.
Insufficient data about BMI and egg donation
Ultimately, there is just insufficient data to make a conclusive assessment of the relationship between BMI and egg retrieval outcomes. And, when it comes to egg donation in particular, there are zero studies on the effects of BMI upon donation outcomes, since women with BMIs over 29 have largely been denied the opportunity to donate.
So, how should we look at BMI?
The bottom line is that BMI evaluated in isolation does not provide an accurate picture of one’s overall health. And although we ask about our applicants’ BMI due to clinical compliance, we believe in improving accessibility to egg freezing for all.
Despite being bound by clinical parameters for egg donation that we must screen for, we believe that BMI as a single measure should not disqualify someone from egg freezing or donation. Our hope is that fertility clinics instead consider patient health more holistically — in addition to taking BMI into account as one metric.
What industry governance *does* say
An ASRM committee opinion on obesity and reproduction, ASRM directly states, “Obesity should not be the sole criteria for denying a patient or couple access to infertility treatment.” Further, neither the Food and Drug Administration (FDA) nor the American Society for Reproductive Medicine (ASRM) provide specific guidance around the use of BMI. In fact, ASRM has recently voted to adopt the new AMA policy urging that “the use of BMI be in conjunction with other valid measures of risk.”
Our hope is that fertility clinics consider these messages in assessing a patient’s overall profile. This could look like counseling and support for women who may be struggling with weight-related issues, or the exploration of alternative methods for assessing fertility, such as ovarian reserve testing.
Moving forward, we hope that more fertility clinics focus on providing evidence-based care that is tailored to each individual’s unique needs and circumstances. One thing we can all agree on: the outcomes of holistic healthcare will always eclipse those grounded in the use of a single number.
What are your options?
If you’ve been told you can’t move forward with egg freezing or donation due to your BMI, we know how disheartening this must feel. But this does not have to be the end of the road for you.
If your BMI is above the appropriate range, available data suggests that as little as 5%-10% weight loss can improve fertility outcomes. Notably though, in order for weight loss to be most effective, it must be gradual and sustained. If your BMI is below the appropriate range, ASRM recommends working with your doctor to understand the cause of the situation and develop a plan to correct it.
At Cofertility, our mission is to make egg freezing accessible, but we never want to compromise the health and safety of our members. If you’re interested in our Split or Keep programs but have concerns about your BMI impacting your eligibility, we recommend that you reach out to your doctor to discuss further.
In addition, please don’t hesitate to reach out to us with any questions about our program qualifications. Even if you have to put your application on pause, we may still be able to help you get ahead of other requirements. And no matter what, we’ll be here for you as soon as you’re ready to move forward.
Is Egg Freezing Tax Deductible?
Providing some much-needed clarity on whether egg freezing is tax deductible.
Today, more than ever, women are choosing to delay parenthood for various reasons, including focusing on career advancement, establishing financial stability, and finding the right partner. To help with this, many are turning to egg freezing, also known as oocyte cryopreservation. Egg freezing has grown in popularity, with a 46% increase in egg freezing cycles from 2020 to 2021 alone!
If you’re considering egg freezing, you may be wondering: Is egg freezing tax deductible? Let's delve into this topic to provide some much-needed clarity.
The basics of egg freezing
Egg freezing, also known as oocyte cryopreservation, is a procedure where your eggs are extracted, frozen, and stored for later use. Because younger eggs are, on average, healthier, the egg freezing can increase your chances of conceiving a biological child in the future, even as your fertility naturally declines over time.
Despite the positive possibilities it offers, egg freezing is not an inexpensive procedure. The overall cost depends on the clinic you’re going to, where you are located, the medications you are prescribed (it differs based on your age and body), and where/how long you store the eggs. In the US in 2023, on average, the process can cost anywhere from $10,000 to $20,000 per cycle, not including annual storage fees. Thus, it's only natural for individuals to explore avenues for financial relief, such as tax deductions.
Understanding medical expense deductions
According to the Internal Revenue Service (IRS) in the United States, certain medical expenses are eligible for tax deductions. The IRS's guidelines state that one can deduct medical expenses that exceed 7.5% of one's adjusted gross income for the year. So, if you have a significant amount of qualifying medical expenses in a year, you could potentially benefit from this tax deduction.
Egg freezing and tax deductions
Is egg freezing considered a deductible medical expense? The answer is complex and largely depends on your individual circumstances. As a baseline, the IRS has traditionally considered fertility preservation treatments, like egg freezing, to be tax-deductible only when they are deemed medically necessary. This typically refers to situations where a medical condition or treatment (such as chemotherapy for cancer) could cause infertility.
When it comes to egg freezing for elective, non-medically necessary reasons (such as delaying childbearing for personal reasons), the situation becomes more nuanced. And unfortunately, as of writing this article, the IRS has not issued definitive guidance on whether egg freezing for non-medical reasons qualifies as a tax-deductible medical expense.
Given this ambiguity, if you're considering egg freezing for elective reasons, it's highly recommended to consult with a tax professional. They can provide advice tailored to your specific situation and keep you informed of any changes or updates in tax law.
Employer benefits and HSAs
Another important aspect to consider is employer-provided benefits. Some progressive employers are starting to cover egg freezing as a part of their employee benefits package, in which case the question of tax deduction might be moot.
If you have a Health Savings Account (HSA) or a Flexible Spending Account (FSA), you might be able to use these pre-tax dollars to pay for egg freezing. However, the rules surrounding these accounts are complex and constantly evolving, so you’ll want to check with your plan administrator or a tax professional to ensure that this is a viable option for you.
Freeze your eggs for less – or even for free – with Cofertility
Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:
- Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure — medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
- Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community. An important note: even if you do have insurance or benefits coverage through work, you’re still able to participate in the Keep program. We’ll work with you to make sure all of your care is handled in a way that you remain eligible for the associated benefits.
The benefits of working with Cofertility include:
- Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
- Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
- Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
- Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
- Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.
Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.
Summing it up
Egg freezing is an empowering choice for those who want to preserve their eggs for future use. However, its high cost can be a barrier. While certain tax deductions may apply for medically necessary procedures, the applicability of tax deductions for elective egg freezing is less clear. You’ll want to seek personalized advice from a tax professional to understand your options fully.
In the quest to make egg freezing more accessible, every avenue of financial relief counts. As the conversation surrounding egg freezing continues to evolve, so too may the tax implications. It’s an ever-changing landscape that we’ll be keeping a close eye on moving forward.
What Does a Low AMH Result Mean?
A low AMH level is usually related to natural aging, but it can also have other causes. In this article, we’ll explore what a low AMH result means and answer some common questions that can come up.
Anti-Mullerian hormone (AMH) is a hormone produced by the follicles in the ovaries (the fluid filled sacs that contain eggs). It requires a simple blood draw and is most often used as a marker of ovarian reserve. Ovarian reserve is the term for the number of healthy eggs left in your ovaries. Since people with ovaries are born with a fixed number of eggs, this number naturally declines over time.
A low AMH level is usually related to natural aging, but it can also have other causes. In this article, we’ll explore what a low AMH result means and answer some common questions that can come up.
AMH and its role in fertility
So what exactly can AMH tell you about your fertility? As mentioned, your AMH level is positively correlated with the number of follicles you have in your ovaries. Simply put, the more follicles you have, the higher your AMH level typically is. As a result, AMH levels have been shown to be a good predictor of ovarian reserve and someone’s expected response to fertility treatments.
In fact, several studies have shown that there is a strong correlation between what your AMH level is and the number of mature eggs retrieved during an egg freezing or in vitro fertilization (IVF) cycle. To learn more about those studies, check out AMH and Egg Retrieval Outcomes.
What your AMH level can’t tell you is the exact number of eggs you have left in your ovaries or what your chances of pregnancy are. There are a number of other factors like your age, overall health, and genetics that also affect the number and quality of eggs and your overall fertility. So while AMH can be a useful tool in assessing your fertility, it shouldn’t be the only factor when making decisions about fertility treatments.
What is a low AMH result?
As with most things in medicine, there’s no absolute answer here. What is considered a low, normal, or high AMH level depends on your age and the lab where you take the test. Since there is no international standard, it’s best to use the reference ranges that come with your test results.
In general, an AMH between 1.0 and 3.5 ng/mL is considered to be in the “normal” range, which means you’re likely to have a good response to fertility treatments. Anything below 1.0 ng/mL is considered low and a sign of a declining ovarian reserve.
What does a low AMH mean?
Having a low AMH level can be a sign that your ovaries are making less of the preantral follicles. The lower the number of follicles, the lower your ovarian reserve is.
So what does this mean in terms of fertility?
First, having a lower AMH does not automatically mean you aren’t ovulating regularly or that you won’t be able to get pregnant naturally or with assisted reproductive technologies. However, research has found that what AMH is good at predicting is the response to ovarian stimulation and the number of eggs retrieved, regardless of a person’s age. So, someone with a higher AMH is generally expected to be able to get more eggs in one cycle than someone with a lower AMH. Because of this, fertility doctors typically use AMH levels (along with other information) to figure out the drugs and dosages you’ll need to maximize your response to ovarian stimulation medications.
If you’re trying to conceive naturally, you’ll be glad to hear that multiple studies have shown that AMH does not correlate with how likely you are to actually get pregnant. In fact, one study looked at levels of AMH, FSH, and another ovarian hormone, inhibin B and tracked people for a year. They found that there was no correlation between someone’s ovarian reserve and their ability to conceive and that a low ovarian reserve was not associated with lower fertility. As a result, they did not recommend the use of FSH or AMH levels to “assess natural fertility.”
Reasons AMH would be low
There are a few reasons that could explain a low AMH. Let’s explore them.
Natural decline with aging
By far, the most common reason for a low AMH is age. People with ovaries are born with all the eggs that they’re going to have in their lifetime. These eggs are then slowly used up over time as you ovulate during each menstrual cycle until menopause is reached. As a result, ovarian reserve naturally decreases over time, meaning the AMH level also decreases.
Hormonal birth control
Research suggests that hormonal birth control may affect AMH levels but it depends on the type of birth control. Specifically, birth control use is associated with a lower average AMH level than for people who are not on birth control, with the exact effect depending on the type of birth control.
The amount of time you’re on birth control may also be a factor. Multiple studies have shown that AMH doesn't change if you use combined oral contraceptive pills for less than six months. However, you may have a lower AMH if you’ve been a long-term user of the pill (or other hormonal methods). Thankfully, this is temporary – AMH levels typically rebound after a person stops using birth control.
You can learn more about birth control and AMH here.
Tobacco use
Studies have shown that tobacco use, usually cigarette smoking, decreases AMH levels. This effect appears to be reversible though–it was only seen in people who were active smokers, not people who had previously smoked.
Less common causes
There are several other, less common causes for a low AMH level. These include:
- Genetic disorders that affect the X chromosome.
- Medical treatments like radiation or chemotherapy.
- Having surgery on your ovaries.
- Losing one or both of your ovaries.
- Autoimmune conditions.
Can I still donate my eggs with a low AMH?
If you are looking to donate your eggs, minimum AMH requirements are usually 2.0 or above. With Cofertility’s Split program, we require a minimum AMH of 2.0, though clinics may have their own unique requirements. This is to increase the chances of retrieving enough eggs to actually split, to ensure positive outcomes for both parties involved.
What to do if you have a low AMH result
Finding out you have a low AMH can be disheartening, especially if you had future fertility plans that you’re worried may be affected. While there’s unfortunately not much that can be done to reverse a low AMH, there is still hope for starting a family someday even with a low AMH. With the exception of birth control or cigarette smoking, most studies have shown that lifestyle changes like diet or supplements have an insignificant effect on AMH levels but despite this, I promise it’s not all gloom and doom.
Let’s go through a few things you can do as you move forward with this new information.
Lean on your village
The first thing to do is take a deeeeeep breath… There are a lot of nuances involved here which can make it hard not to get lost in the weeds. Fertility is impacted by so many different things that you can drive yourself crazy trying to manage all of them.
Having friends, family, and mental health specialists available to support you when you need it is going to be crucial. Navigating fertility is hard no matter what, so having people around you who you can lean on on bad days and celebrate with on good days will help immensely.
Consult a fertility specialist
Speaking of your village, it should definitely include a fertility specialist. Consulting with a fertility doctor can help you better understand your reproductive health and provide guidance on any concerns or questions you may have. They’ll be able to review your specific options and work with you on a plan that helps you reach your family-building goals. This treatment plan will depend on a lot of things including how soon you want to have a child, how many children you want to have, your finances, and your desire to have a child who is genetically related to you.
So does this mean I have to freeze my eggs ASAP?
This is typically the first question people ask and the answer is not necessarily. As mentioned before, there are many other factors involved in assessing your fertility and modern technology has allowed for advances that make family building a possibility for virtually everyone. Your fertility specialist will be able to discuss all the options for starting a family based on your unique family-building goals. This could certainly include freezing your eggs for later use but it could also mean trying to conceive unassisted, undergoing IVF with your own eggs or with donor eggs, using a gestational carrier, or even options beyond these. Again, this is something that will require you to examine your personal goals and work with your provider to figure out the best way to reach them.
You are not a number
Repeat after me: you are more than one number! Your AMH level provides valuable insights into your ovarian reserve, but it’s just one piece of the puzzle when it comes to your fertility. AMH is always used as part of a full fertility evaluation, which often includes information about your medical history and age, a partner semen analysis, an ultrasound of the pelvis, an x-ray of the uterus and fallopian tubes, and/or additional lab work.
If that sounds like a lot, it is. This process can be overwhelming but focusing on the things that you can control can help you feel more grounded during your fertility journey, whatever that may look like.
How Cofertility can help
Cofertility is here to help you every step of the way on that journey. Our Split program offers women a chance to freeze their eggs for free when donating half the eggs retrieved to a family who cannot conceive otherwise. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure — medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
In our Keep program, you can freeze and store your eggs for your own future use, with lower prices on things like storage and medication. as well as our team’s support and access to our community.In addition, you’ll have access to our team’s support and access to our community where you can engage with other people freezing their eggs at the same time!
Your journey is uniquely yours and our team is here to help you through it in whatever way you need.
What Exactly is Antral Follicle Count (AFC)?
In this comprehensive guide, we will walk you through the intricacies of AFC. We'll discuss what an antral follicle is, how AFC is measured, and what a normal AFC looks like based on age.
If you're considering or embarking on the path of egg freezing, you may have come across the term "Antral Follicle Count" (AFC) during your research. AFC is a crucial tool in assessing ovarian reserve and predicting the success of fertility treatments, including egg freezing. In this article, we delve into the world of AFC, exploring its significance, measurement techniques, and its role in optimizing your egg freezing journey.
In this comprehensive guide, we will walk you through the intricacies of AFC. We'll discuss what an antral follicle is, how AFC is measured, and what a normal AFC looks like based on age. Additionally, we'll explore the relationship between AFC and the egg freezing process, shedding light on how this information can guide and optimize your fertility journey.
What is an antral follicle?
Antral follicles are small fluid-filled sacs found within the ovaries that contain immature eggs. These follicles serve as the building blocks of our fertility. Each month, a group of antral follicles starts developing in response to hormonal signals. Among this group, one follicle becomes dominant and eventually releases a mature egg during ovulation.
How do you measure AFC?
There’s only one way to measure the antral follicle count: through a transvaginal ultrasound, which allows for a close examination of the ovaries. During this procedure, a specialized ultrasound probe is inserted into the vagina to visualize the ovaries and count the number of antral follicles present in both ovaries (the definition of antral follicles varies across fertility clinics. Some clinics count follicles that measure 2–10 mm in diameter, while others focus on follicles ranging from 3–8 mm).
The AFC measurement is typically taken during the early follicular phase of the menstrual cycle when the antral follicles are at their most visible and measurable state. But it can be done anytime of the cycle.
What can an antral follicle count test tell you?
The antral follicle test holds a wealth of valuable information that can shed light on your reproductive health. So, what exactly can an antral follicle test tell you?
Ovarian reserve assessment
The number of antral follicles detected during the test directly correlates with your ovarian reserve. This information can help your fertility doctor understand the quantity of follicles remaining in your ovaries in relation to your age. As we age, the number of antral follicles typically decreases, reflecting a decline in ovarian reserve. Understanding this relationship can help in making decisions about family planning and fertility preservation options. Learn more about ovarian reserve here.
How your body would respond to egg freezing
Antral follicles are a key determinant of how your ovaries will respond to ovarian stimulation during fertility treatments such as egg freezing. In fact, AFC correlates directly with the number of eggs retrieved at egg collection. By assessing your AFC, your healthcare team can tailor the stimulation protocol to optimize your chances of success.
Best timing for egg freezing
The antral follicle count can also assist in determining the ideal timing for initiating fertility treatments. By assessing the AFC, your fertility doctor can guide you on the optimal time to start treatments, maximizing your chances of a successful outcome.
Premature ovarian failure (POF)
POF, also known as premature menopause, refers to the loss of ovarian function before the age of 40. Antral follicle testing can help in the diagnosis of POF by revealing a significantly reduced antral follicle count. A diminished AFC can indicate a decline in ovarian reserve, which is a characteristic feature of POF. This information is crucial in understanding the reproductive potential and considering appropriate fertility treatment options for individuals with POF.
Polycystic ovary syndrome (PCOS)
PCOS is a common hormonal disorder that affects women of reproductive age. It is characterized by hormonal imbalances, irregular menstrual cycles, and the presence of multiple small follicles on the ovaries. Antral follicle testing plays a vital role in assessing PCOS by revealing an increased number of small antral follicles during the scan. This high AFC, along with other diagnostic criteria, helps in confirming the presence of PCOS and guiding appropriate management strategies.
The antral follicle test is a powerful tool in assessing your fertility health, but it is just one piece of the puzzle. It should be considered alongside other diagnostic measures and discussions with your fertility doctor to form a comprehensive understanding of your fertility health.
What is a normal AFC by age?
The normal range of antral follicle count can vary depending on your age. In general, younger women tend to have a higher number of antral follicles, indicating a larger ovarian reserve. As a woman ages, the number of antral follicles naturally declines, reflecting the diminishing ovarian reserve.
While the specific numbers can vary, a typical AFC for a woman in her 20s and early 30s may range between 10-20 follicles, in her late 30s around 8-15 follicles, and by her 40s, it could further decline to under 10 follicles. It's important to remember that these numbers are approximate and can vary based on individual factors such as genetics and overall reproductive health.
One study of infertile women looked at exactly how antral follicle count declines with age, finding the median AFC to be:
- 14 at age 25
- 12 at age 30
- 10 at age 35
- 8 at age 40
- 6 at age 45
AFC and egg freezing
When it comes to assessing ovarian reserve and predicting the number of eggs that can be retrieved during egg freezing, the antral follicle count (AFC) is a very helpful biomarker. It may even be the most important of ovarian reserve measures. A meta-analysis of 11 studies found that the AFC scan was as accurate as using multiple markers to predict ovarian response to stimulation. AFC outshined its counterparts like anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) as the predictor of ovarian response to egg freezing stimulation.
So, when it comes to determining the potential success of your egg freezing journey, keep an eye on AFC. It can guide you through the uncertainties and help your healthcare team tailor the stimulation protocol to maximize your chances of a fruitful outcome.
What does low AFC mean?
A low AFC can indicate a lower ovarian reserve and may have implications for fertility. When the AFC is low, it suggests that there are fewer follicles available in the ovaries, which can impact the number of eggs that can be retrieved during fertility treatments such as egg freezing.
But having a low AFC does not necessarily mean that pregnancy is impossible, but it may suggest that the response to ovarian stimulation during fertility treatments could be lower than average. With fewer follicles available, there may be a reduced number of mature eggs that can be retrieved for fertilization. This can affect the overall success rates of fertility treatments, as the quantity and quality of eggs play a crucial role in achieving a successful pregnancy now or down the line.
Remember that AFC is just one piece of the fertility puzzle, and other factors such as age, hormone levels, and overall reproductive health matter.
What does high AFC mean?
A high AFC typically indicates a greater ovarian reserve and can be a positive indicator of fertility health. When the AFC is high, it suggests that there are a larger number of antral follicles present in the ovaries, which can potentially result in a higher number of eggs available for retrieval during egg freezing.
Having a high AFC is generally associated with a better response to ovarian stimulation during fertility treatments. With more follicles available, there is a greater likelihood of obtaining a larger number of mature eggs for fertilization. This can potentially increase the chances of success in achieving a pregnancy now or down the line.
A high AFC alone does not guarantee pregnancy or fertility success. Other factors such as the quality of the eggs, age, overall health, underlying reproductive conditions – as well as the health of the sperm – can also influence fertility outcomes.
AFC is just one piece of the puzzle
The antral follicle count is a valuable tool in the realm of fertility assessment. By providing information about your ovarian reserve, it assists in predicting the response to ovarian stimulation and guides decisions regarding fertility preservation options like egg freezing.
The AFC measurement, combined with other diagnostic tests and a thorough evaluation of an overall reproductive health, helps paint a comprehensive picture of your fertility health. Armed with this knowledge, you can make informed choices about your reproductive journey and take proactive steps towards preserving your fertility and achieving your family planning goals.
You are not a number
With all the nuances involved here, it’s important not to get lost in the weeds. Fertility is impacted by so many factors that you can drive yourself crazy trying to manage all of them. Remember, you are more than any number. This process can be overwhelming, but focusing on the things that you can control can help you feel more grounded during your fertility journey, whatever it may look like.
Cofertility is here to help you every step of the way on that journey.
Our Split program allows qualified people between 21 to 34 years old (with an AMH of 2+) to have the chance to freeze their eggs for free when donating half of the eggs retrieved to a family that can’t otherwise conceive.
Or, if you’re over 34, you can still participate in the Keep program up to age 40. In the Keep program, you’re able to freeze your eggs and keep them all for yourself, on your timeline. In addition, you’ll have access to our online support community, the Nest. This valuable resource lets you engage with other people freezing their eggs at the same time!
Whatever your journey looks like, our team is here to guide you through it and keep your family-building options open.
Sources:
- Antral Follicle. Science Direct. URL
- Verhagen TE, Hendriks DJ, Bancsi LF, et al. The accuracy of multivariate models predicting ovarian reserve and pregnancy after in vitro fertilization: a meta-analysis. Hum Reprod Update 2008;14:95–100. URL
- CAROLE GILLING-SMITH, STEPHEN FRANKS, CHAPTER 28 - Ovarian Function in Assisted Reproduction, The Ovary (Second Edition), Academic Press, 2004, Pages 473-488, ISBN 9780124445628, https://doi.org/10.1016/B978-012444562-8/50029-X. URL
- Almog B, Shehata F, Shalom-Paz E, Tan SL, Tulandi T. Age-related normogram for antral follicle count: McGill reference guide. Fertil Steril. 2011;95(2):663-666. doi:10.1016/j.fertnstert.2010.08.047 URL
What Medications and Supplements Affect AMH Levels?
There are certain medications that can potentially influence AMH levels, raising questions about the accuracy and interpretation of AMH testing while on them. In this article, we will explore the relationship between medications and AMH levels, shedding light on the impact of specific drugs and discussing their implications for women's reproductive health.
Anti-Müllerian hormone (AMH) has gained significant attention in the field of reproductive medicine as a valuable marker of ovarian reserve. It provides insight into egg quantity and can be useful in assessing fertility health and predicting the chances of egg freezing success.
However, there are certain medications that can potentially influence AMH levels, raising questions about the accuracy and interpretation of AMH testing while on them. In this article, we will explore the relationship between medications and AMH levels, shedding light on the impact of specific drugs and discussing their implications for women's reproductive health.
What is AMH?
AMH is a hormone produced by the cells within ovarian follicles. Its primary role is to promote the growth and development of follicles. AMH levels are generally stable during the menstrual cycle, making it a reliable marker for assessing ovarian reserve. It is measured through a simple blood test and has become an important tool in fertility evaluations and treatment planning.
What causes AMH to change?
AMH levels naturally decline as we age. The highest levels of AMH are typically found in women during their early reproductive years, and the levels gradually decrease as we approach menopause… making age the most common reason for AMH to change.
But there are other reasons AMH may change over time. The most common reason is simply age. Since AMH is considered a reliable marker of ovarian reserve, which refers to the quantity of eggs remaining in the ovaries, this hormone naturally decreases as we get older.
Certain medical conditions, such as ovarian tumors, can also affect AMH levels. Additionally, treatments like chemotherapy or radiation therapy that target the ovaries can significantly reduce AMH levels.
While the direct impact of lifestyle factors on AMH levels is not yet fully understood, some studies suggest that factors such as smoking, obesity, and extreme exercise may be associated with lower AMH levels. However, more research is needed to establish definitive conclusions.
Lastly, certain medications can impact AMH levels. For example, oral contraceptives and drugs like clomiphene citrate used in fertility treatments can temporarily decrease AMH levels. On the other hand, supplements like DHEA (dehydroepiandrosterone) and vitamin D have been associated with increased AMH levels. We’ll go more into detail about these below.
Remember that individual variations exist, and AMH levels should be interpreted in conjunction with other fertility assessments to gain a comprehensive understanding of your reproductive health. If you have concerns about your AMH levels or fertility, it's best to consult with a fertility doctor for personalized guidance and recommendations.
What medications can affect AMH levels?
Several medications have been found to influence AMH levels, potentially complicating its interpretation as a marker of ovarian reserve. Here are some examples:
Oral birth control
Oral contraceptives are commonly used for birth control and to regulate menstrual cycles. Studies have suggested that oral contraceptive use may lead to decreased AMH levels in the short term.
One study compared the AMH levels of 228 hormonal contraception users and 504 non-users. They found that users of birth control had 29.8% lower AMH concentrations. Because of this, the authors concluded that AMH may not be an accurate predictor for women using hormonal contraception.
You may want to consider the timing of the AMH test when using hormonal contraceptives. Estrogen can suppress the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are necessary for the development and maturation of follicles.
As AMH levels are influenced by FSH and LH, you could wait for a few weeks after discontinuing birth control before measuring AMH levels for a more accurate assessment of ovarian reserve. Or, you could take the test knowing the results may be lower due to birth control. It’s best to discuss this with your doctor.
Metformin
Metformin is a medication commonly used in the treatment of polycystic ovary syndrome (PCOS), a complex endocrine disorder associated with metabolic and reproductive disturbances, and for managing insulin resistance. Research has shown that metformin use may be associated with decreased AMH levels.
Clomiphene Citrate
Clomiphene citrate (brand name Clomid©), is a medication used to stimulate ovulation in women who are trying to conceive. Similar to metformin, clomiphene citrate has been associated with decreased AMH levels. When undergoing fertility treatments involving clomiphene citrate, you’ll want to take this potential impact into account when interpreting AMH results.
What supplements can affect AMH levels?
Dehydroepiandrosterone (DHEA)
DHEA is a natural hormone that can be converted into other hormones in the body, including testosterone and estrogen. Some studies have suggested that supplementation with DHEA may lead to increased AMH levels. These findings suggest that certain nutritional interventions may have a positive effect on ovarian reserve.
Vitamin D
Vitamin D is essential for overall health and has been linked to various biological processes in the body, including reproductive health. Some research indicates that vitamin D supplementation may lead to increased AMH levels. However, more studies are needed to fully understand the relationship between vitamin D and AMH levels.
Is there anything I can take to increase AMH levels?
While there are medications and supplements that have been associated with changes in AMH levels, the impact of these medications is typically temporary or specific to certain conditions.
Currently, there is no definitive medication or treatment specifically designed to increase AMH levels. However, there are lifestyle factors that may positively influence overall reproductive health, such as maintaining a healthy weight, adopting a balanced diet, managing stress levels, and avoiding smoking and excessive alcohol consumption. These lifestyle choices can contribute to optimal ovarian function and potentially support healthy AMH levels.
Summing it up
AMH testing has revolutionized our ability to assess ovarian reserve and guide fertility treatment decisions. However, it's crucial to consider the potential influence of certain medications on AMH levels. Understanding how specific drugs and supplements may affect AMH results can help you interpret the findings accurately and make informed decisions about fertility treatments.
Remember that these effects are usually temporary or specific to certain conditions. It's always best to consult with your fertility doctor who can provide personalized guidance based on your specific situation.
Better yet, focusing on maintaining a healthy lifestyle, managing stress levels, and adopting a balanced diet can contribute to overall reproductive health and support optimal ovarian function. By staying informed and working closely with your healthcare team, you can navigate the complexities of AMH testing and make informed decisions about your fertility journey.
Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. With our Freeze by Co platform, women can freeze their eggs for free when they donate half of the retrieved eggs to a family who can’t otherwise conceive. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.
Can You Really Measure How Many Eggs You Have?
Can you truly measure how many eggs you have? Let's delve into the world of ovarian reserve testing and explore the possibilities and limitations.
In the world of reproductive health and fertility, there is a growing interest in understanding the quantity of eggs a woman has, also known as ovarian reserve. The concept of measuring ovarian reserve has gained popularity as more people seek to assess their fertility potential and make informed decisions about family planning.
But can you truly measure how many eggs you have? Let's delve into the world of ovarian reserve testing and explore the possibilities and limitations.
How many eggs do females have?
Females are born with approximately one to two million oocytes, and it only goes down from here since no new eggs are made. But here's where it gets interesting.
Once we reach puberty, a process triggered by a complex interplay of hormones, only about 300,000 of these oocytes will remain. These precious few will have the opportunity to mature and potentially be released as eggs during our reproductive years. Our bodies typically release just one egg per menstrual cycle, and this process occurs approximately 400 times throughout our lifetime.
These remaining oocytes are not merely passive bystanders. Each one resides within a protective structure called a follicle, where it lies dormant and suspended in the middle of a cell division. Remarkably, the lifespan of an egg is one of the longest among the body's cells. However, this extended duration can also increase the chances of damage and genetic abnormalities as we age.
At menopause, which is defined as one year after your last menstrual period, the pool of remaining oocytes steadily declines until none remain. This natural process signifies the end of our reproductive years.
Understanding the intricacies of egg development and the limited supply available underscores the importance of considering fertility and family planning at an earlier age. Each egg is a precious resource, and its quality and viability can impact the chances of achieving a successful pregnancy. Exploring fertility preservation options, such as egg freezing, can provide women with greater control over their reproductive future.
While the numbers presented here provide a general understanding, it's crucial to remember that everyone’s ovarian reserve is unique. Factors like genetics, lifestyle, and overall health can influence the rate of egg loss and fertility potential.
Egg count and age
As stated above, females are born with one to two million eggs. By puberty, only about 300,000 of these oocytes will remain. After starting the menstrual cycle, we lose about 1,000 immature eggs every month… meaning by age 37 there are around 25,000 eggs remaining. And by menopause, no more eggs remain.
Here is a rough chart of what this could look like for an individual. Keep in mind that everyone starts with a different number of eggs, and everyone’s rate of decline varies. This chart is just to give you an idea of what this egg count could look like:
Measuring egg reserve (aka ovarian reserve)
Ovarian reserve refers to the number of eggs remaining in a woman's ovaries at a given time. It is one indicator of a woman's reproductive health, and can help guide fertility treatment decisions. The idea of quantifying ovarian reserve has gained significance as women strive to gain insights into their fertility and make proactive choices about their reproductive journey. And at the same time, at-home tests make it easier to measure your ovarian reserve.
Keep in mind that the number of eggs you have does not necessarily equate to your ability to conceive. Other factors, such as egg quality, the presence of any reproductive disorders, and the overall health of the reproductive system, play significant roles in fertility. Not to mention the health of the sperm! Some people have lower ovarian reserve but still achieve successful pregnancies, while others with a seemingly healthy ovarian reserve may face challenges in conceiving.
How to measure ovarian reserve
One of the most commonly used methods to measure ovarian reserve is through a blood test that evaluates specific hormone levels. These hormones include anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol. AMH, in particular, has emerged as a reliable marker of ovarian reserve, as it reflects the number of small follicles in the ovaries that contain immature eggs. Low levels of AMH may indicate a diminished ovarian reserve, while higher levels may suggest a larger pool of eggs.
While ovarian reserve testing provides valuable insights, it is not a crystal ball that can predict fertility outcomes with absolute certainty. Ovarian reserve is just one piece of the fertility puzzle, and other factors such as egg quality, uterine health, and sperm quality also play crucial roles in the conception process. Additionally, fertility is influenced by various external factors, including age, lifestyle, and underlying health conditions.
Fertility testing can provide a snapshot of ovarian reserve at a specific moment in time. Ovarian reserve naturally declines with age, and the number of eggs available for fertilization decreases over time. Therefore, it's crucial to interpret the results in the context of your age and overall health.
Egg reserve testing methods
Another consideration when evaluating ovarian reserve is the variation in testing methods and reference ranges used by different laboratories. Each laboratory may have its own set of standards and measurements, which can lead to variations in results. You may want to consult with a fertility doctor who is knowledgeable in reproductive medicine to interpret the test results accurately and provide personalized guidance (if you work with Cofertility, we can help you set this up).
So, can you measure exactly how many eggs you have?
While ovarian reserve testing can provide valuable information, determining the exact number of eggs a woman has remaining in the ovaries is not possible.
Why? First of all, the number of eggs in the ovaries is not static but rather dynamic and constantly changing. We are born with a finite number of eggs, and this number gradually declines over time through a process called follicular atresia. This natural process of egg loss occurs throughout our reproductive years, and the rate of decline varies from person to person.
Second, the accuracy of measuring the exact number of eggs is hindered by the limitations of current medical technology. While imaging techniques like ultrasound can visualize the presence of ovarian follicles, they cannot precisely determine the number of eggs within each follicle. Additionally, even if the number of follicles can be counted, it does not equate to the exact number of eggs, as not all follicles contain a viable egg.
Ovarian reserve is just one piece of the puzzle
While ovarian reserve testing can provide valuable information, it is just one tool in the broader landscape of fertility assessment. A fertility doctor can consider your medical history, conduct a physical examination, measure your antral follicle count, and may recommend additional tests or imaging studies to provide a comprehensive assessment of your reproductive potential.
Cofertility is a human-first fertility ecosystem rewriting the egg freezing experience. With our Freeze by Co platform, women can freeze their eggs for free when they donate half of the retrieved eggs to a family who can’t otherwise conceive. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.
What is Ovarian Reserve?
If you are considering starting a family or have concerns about your fertility, understanding the concept of ovarian reserve is essential. Ovarian reserve refers to the quantity of eggs (oocytes) available for fertilization. It serves as a key indicator of your reproductive potential and can play a crucial role in fertility treatment decisions.
If you are considering starting a family or have concerns about your fertility, understanding the concept of ovarian reserve is essential. Ovarian reserve refers to the quantity of eggs (oocytes) available for fertilization. It serves as a key indicator of your reproductive potential and can play a crucial role in fertility treatment decisions.
In this guide, we will delve into the topic of ovarian reserve, exploring its significance, how it is assessed, factors that affect it, available options for optimizing fertility, and emotional considerations related to fertility journey.
First off, what does your ovarian reserve mean?
Simply put, your ovarian reserve is your fertility potential, which is influenced by a variety of factors, including age, genetics, and certain medical conditions.
As we age, our fertility naturally declines. This is totally normal, and due to fewer eggs in the ovaries, a decrease in egg quality, and an increase in chromosomal abnormalities of the remaining eggs. These collective factors contribute to lower pregnancy rates and higher miscarriage rates as we approach age 40.
While the decline in fertility happens to ALL of us, the specific age when we can no longer conceive varies from individual to individual. And in some cases, it may be earlier than we expected.
To assess your fertility potential, including your ovarian reserve, several tests are available that can give us clues to our reproductive capabilities. These tests can also help fertility doctors, like myself, evaluate the likelihood of successful pregnancy, and guide you in making informed decisions regarding family planning and fertility treatments.
How do I know my ovarian reserve?
If you want to know your ovarian reserve, it’s best to set up time for a fertility assessment with a fertility doctor (reach out – we can help with this!).
There are two ways a doctor can help assess your ovarian reserve, including:
Blood hormone tests
Hormone tests, including follicle-stimulating hormone (FSH), estradiol, luteinizing hormone (LH), anti-Müllerian hormone (AMH), and estradiol, provide valuable information about ovarian function and egg supply. While AMH can be taken any time, FSH and LH are typically performed on specific days of the menstrual cycle to obtain accurate results.
Antral follicle count
Transvaginal ultrasound is used to visualize the ovaries and count the number of antral follicles present. Antral follicles are small, fluid-filled sacs that contain immature eggs. The count of antral follicles serves as an indirect indicator of ovarian reserve.
By combining the results of hormone tests and ultrasound assessments, we can estimate your ovarian reserve and provide insights into fertility potential.
What is a normal ovarian reserve?
Determining what constitutes a “normal” ovarian reserve involves comparing your results to established reference ranges for your age. Age-specific reference ranges serve as benchmarks to evaluate your ovarian reserve relative to peers of the same age group. Keep in mind that ovarian reserve will gradually decline for everyone – it’s the timing and pace of change that differs.
For example, in younger women, a higher number of antral follicles (small fluid-filled sacs containing immature eggs) and lower levels of certain hormones like FSH may be considered within the normal range. However, as a woman ages, it is expected that the number of antral follicles will decrease and hormone levels, such as FSH, may increase.
While age is a significant factor, other individual factors should also be taken into account when interpreting ovarian reserve results. Factors such as medical history, previous fertility experiences, underlying medical conditions, and fertility goals play a role in assessing the overall fertility potential. These additional factors can influence the interpretation of ovarian reserve results and help guide fertility treatment decisions tailored to the specific needs of the individual.
What causes decreased ovarian reserve?
Decreased ovarian reserve can result from various factors, including:
- Age: As we age, the quantity and quality of eggs naturally decline. The aging process gradually reduces the quality of eggs and ovarian reserve, making it more challenging to conceive.
- Smoking: Cigarette smoking has been linked to a higher rate of diminished ovarian reserve. Chemicals in tobacco smoke can accelerate the depletion of eggs and negatively impact ovarian function.
- Cancer treatment: Some cancer treatments, such as chemotherapy and radiation therapy, can have damaging effects on the ovaries. These treatments may cause a decrease in ovarian reserve and compromise fertility.
- Pelvic Surgery: Surgical procedures involving the ovaries or other pelvic organs can inadvertently damage or remove ovarian tissue. This can lead to a decrease in ovarian reserve and potentially affect fertility.
- Autoimmune diseases: Certain autoimmune conditions, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis, can impact ovarian function and diminish ovarian reserve.
- Genetic conditions: Certain genetic disorders, such Fragile X syndrome, and other chromosomal abnormalities, can be associated with decreased ovarian reserve. These conditions may affect the development and function of the ovaries.
While these factors are known to contribute to diminished ovarian reserve, individual experiences vary. You may have none of the above conditions, and still face premature ovarian failure (POF). Or you may have one of the above factors, and have no problems at all getting pregnant. Sometimes, it just comes down to luck.
What does it mean if I have a high ovarian reserve?
A high ovarian reserve refers to a situation where there is an abundant number of eggs in the ovaries. While ovarian reserve naturally declines with age, certain factors can contribute to a higher ovarian reserve in some people.
One factor associated with a high ovarian reserve is younger age. Those in their 20s and early 30s generally have a higher number of eggs compared to those in their 40s, resulting in a larger ovarian reserve. Additionally, genetic factors can influence ovarian reserve, and some may have a naturally higher number of follicles and eggs in their ovaries.
Another factor that can contribute to a higher ovarian reserve is polycystic ovary syndrome (PCOS). PCOS is a hormonal disorder that can lead to the development of multiple small follicles on the ovaries. Those diagnosed with PCOS often have a higher number of immature follicles in their ovaries, which can translate into a higher ovarian reserve.
While a high ovarian reserve can be advantageous for fertility, it does not guarantee successful conception or a higher chance of pregnancy. Other factors, such as egg quality and hormonal balance, also play significant roles in achieving pregnancy.
At-home ovarian reserve tests
There are at-home options for ovarian reserve testing. However, keep in mind that most fertility doctors will want to re-do these tests. So taking a test at home, may mean paying for a test twice.
Here are some options:
- Natalist Women’s Fertility Test ($149) measures 5 hormones: estradiol, LH, FSH, TSH, and total testosterone
- LetsGetChecked Ovarian Reserve Test ($139) measures 1 hormone, AMH
- Modern Fertility Hormone Test ($179) measures 7 hormones: AMH, TSH, FSH, estradiol, prolactin, fT4, and LH
Ovarian reserve and egg freezing
Ovarian reserve plays a significant role in the process of egg freezing, also known as oocyte cryopreservation. Egg freezing involves the retrieval and freezing of your eggs for future use, preserving your fertility potential at a younger age.
Assessing ovarian reserve before undergoing egg freezing is crucial for determining the quantity of eggs available for freezing. Those with a higher ovarian reserve generally have a greater number of eggs suitable for freezing, increasing their chances of successful future pregnancy.
On the other hand, those with diminished ovarian reserve may have fewer eggs available for freezing, necessitating careful consideration of the potential outcomes and options. Understanding your ovarian reserve provides valuable information to help guide the egg freezing process and optimize the chances of achieving successful future pregnancies when the frozen eggs are thawed and used in assisted reproductive techniques.
Freeze your eggs with Cofertility
We’d love the opportunity to support you on your egg freezing journey.
Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:
- The Split program, which offers women a chance to both freeze their own eggs and donate half the eggs to a family who cannot conceive otherwise. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure — medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
- Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.
The benefits for of working with Cofertility include:
- Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
- Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
- Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
- Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
- Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.
Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.
Should I Freeze My Eggs If I'm Not Yet Sure I Want Children?
What if you’re not sure if you want kids? In this article, we will explore the ins and outs of egg freezing, helping you navigate the decision-making process and understand if it is the right choice for you.
The concept of family planning has evolved tremendously since our grandparents were in their reproductive years. Women are starting families later than ever. The latest U.S. Census Bureau figures show that, for the first time, the average age of women giving birth is now 30 in the U.S., the highest on record.
Couple this with tremendous progress in reproductive technologies, including egg freezing, and more women are opting to explore their career aspirations and personal growth before starting a family.
But what if you’re not sure if you want kids? In this article, we will explore the ins and outs of egg freezing, helping you navigate the decision-making process and understand if it is the right choice for you.
You are not alone
To delve into this topic, we asked over 16,000 women without kids aged 21-40 their perspectives on family planning. Our survey revealed fascinating insights into the desires and uncertainties regarding family planning. Among the respondents, 69% expressed a desire to have children in the future, while 25% remained uncertain and 6% firmly stated they did not want children. Women ages 21-25 were most likely to be unsure, whereas women ages 31-34 were most likely to answer yes.
What exactly is egg freezing anyhow
Okay so what is egg freezing exactly? Egg freezing, known as oocyte cryopreservation in the medical world, is a technique used to preserve someone’s fertility. Eggs are collected from the ovaries and frozen so they can be used in the future. If the person is unable to get pregnant unassisted in the future, the eggs are thawed and used in an assisted reproductive technology (ART) procedure, like in-vitro fertilization (IVF). Whether you know you want to have kids or you aren’t sure and want to give yourself more time to figure it out, think of egg freezing as a way to keep your options open for the future.
To freeze or not to freeze, that is the question
When trying to decide if you should freeze your eggs, it’s important to know that egg freezing is not an “insurance policy” for your fertility. While egg freezing can take some of the stress of having a baby right now off your shoulders, it is not a guarantee that you’ll have a baby in the future.
Why not? Well, for one, not all the eggs that get frozen will actually be viable. It’s expected that some eggs will not survive the warming process when it comes time to use the eggs. In addition, the chances of the eggs that do survive being successfully fertilized depends on a variety of factors, including how old you were when you froze them (more on this later).
This is not to sway your decision one way or another. Ultimately, only you and your doctor can decide if egg freezing is the right decision for you. But it's important to go in knowing that it’s not meant to be a done deal. As egg freezing has gotten more popular, many companies will gloss over this fact. We don't think that's right and want to be straight with you from the outset.
Freezing your eggs when you’re unsure if you want kids
Perhaps the biggest benefit of egg freezing is that it puts the decision-making power entirely in your hands. Whether you’re freezing your eggs because you want to focus on your career or you’re about to undergo medical treatment that may affect your fertility later on, or you’re waiting to find the right partner, freezing your eggs allows you to preserve some of your fertility independently.
While you might not be sure about having kids today, if you do decide you want kids down the road, especially if you’re in your mid- to late-thirties, having eggs on ice will increase the chances that you’re able to do so.
If I freeze my eggs, will it harm my fertility?
Freezing your eggs does not affect your ability to get pregnant otherwise. The egg freezing process and retrieval procedure simply rescue eggs that would have died with your next menstrual cycle. This means egg freezing does not affect your ovarian reserve (the number of eggs in your ovaries). Once you’ve completed the full process, your body will continue to ovulate and release an egg each month like normal.
What happens to the eggs if I don’t use them?
One study of egg freezing patients at UCSF found that 89% believed they would be glad they froze their eggs, even if they never used them to conceive a child. If you don't end up needing your frozen eggs down the line, there are a few options for what to do with them.
- Keep them in storage. Most storage facilities offer long-term storage options, allowing you to keep your eggs frozen for many years if necessary. This may be a good option if you're not yet ready to use the eggs but want to keep them as a backup plan. If you freeze your eggs with Cofertility, our storage partner offers our members exclusive long-term storage rates up to 80% less than what you’d see with individual clinics.
- Donate the eggs to someone else who may need them. Egg donation is a process of donating eggs to another person or couple who needs them, such as LGBTQ+ families or those suffering from infertility. This can be a wonderful gift for those who may not be able to have a child otherwise.
- Discard them. If you decide that you no longer need your frozen eggs and don't want to continue storing them or donate them, simply request that they are disposed of by the clinic or storage facility.
- Donate to science. Many research studies rely on donated eggs to investigate new techniques and treatments for infertility. Ask your clinic if this is an option.
Know this: most people do not regret freezing their eggs
We looked at five studies on egg freezing. The rates of regret reported in these studies varied, likely due to the sample size, study design, and the follow-up period. However, taken together, these studies suggest that the vast majority of those who freeze their eggs have zero regrets.
There also appear to be factors that reduce the chances of regret, including feeling fully informed beforehand, and getting adequate support during the egg freezing process. In other words, if you take the time to think things through and feel supported throughout the journey, you’re less likely to regret making this decision for yourself.
Freeze your eggs with Cofertility
Whether you know you want kids or you’re still figuring it out, we’d love the opportunity to support you on your egg freezing journey.
Cofertility is in the “family” business, striving to make egg freezing and third-party reproduction more human-centered and accessible for all. Our Freeze by Co platform empowers women to take control of their fertility timelines by making egg freezing more accessible. We offer two egg freezing programs:
Our Split program enables women to freeze their eggs for free(!) when they donate half of the eggs retrieved to a family who can’t conceive, including LGBTQ+ parents, couples facing infertility, and those with other fertility-impacting medical challenges, like cancer.
Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.
The benefits for of working with Cofertility include:
- Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
- Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
- Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
- Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
- Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.
Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.
Commonly asked questions
How do you decide if you want to freeze your eggs?
The decision to freeze one's eggs is deeply personal and multifaceted. Factors to consider include personal goals, relationship status, career aspirations, financial stability, and overall health. Seeking guidance from a fertility clinic, discussing your concerns and aspirations, can help you make an informed decision aligned with your values and future plans.
Is egg freezing right for me?
While egg freezing is an empowering option, it’s not for everyone. Factors such as age, ovarian reserve, and overall health play a role in determining the success of the procedure. A consultation with a fertility clinic will assess your individual circumstances and help determine if egg freezing is the right choice for you. (If you work with Cofertility, we can connect you with a fertility clinic for a consult).
What are my egg freezing options?
There are several egg freezing options available, including Cofertility's Split program. This innovative initiative offers the opportunity to freeze your eggs for free when you donate half of them to a family that could not otherwise conceive. This program not only provides a free egg freezing option, but also offers the chance to make a positive impact on others' lives.
What age should you freeze eggs before?
Age is a crucial factor when considering egg freezing. Generally, the quality and quantity of eggs decline with age, making earlier freezing more advantageous. Fertility experts recommend considering egg freezing before the age of 35 to optimize the chances of success. Read more in What’s the Best Age to Freeze My Eggs?
Can I freeze my eggs and have kids later?
Yes, egg freezing can offer a viable path to future motherhood. When you decide to use your frozen eggs, they can be thawed, fertilized with sperm through in vitro fertilization (IVF), and transferred to your uterus for pregnancy. While the success of pregnancy depends on various factors, including the quality of the eggs, freezing them increases the likelihood of having biological children later in life.
Why Do People Freeze Their Eggs? Should I Be Thinking About It Too?
With more and more women choosing to delay having children, it’s likely you’ve seen people sharing their egg freezing journeys on social media. Curious if you should be thinking about it too? You’re not alone. Let’s talk about some of the most common reasons people freeze their eggs, so you can decide if this is the right path for you.
With more and more women choosing to delay having children, it’s likely you’ve seen people sharing their egg freezing journeys on social media. Curious if you should be thinking about it too? You’re not alone. Let’s talk about some of the most common reasons people freeze their eggs, so you can decide if this is the right path for you.
First of all, what is egg freezing?
First things first, let’s talk about what freezing your eggs actually means. To keep it simple, egg freezing, or oocyte preservation, is a way to collect some of your eggs and preserve them for future use later. The process involves taking hormone medication to stimulate your ovaries, then undergoing a 30-minute medical procedure to retrieve the eggs.
If your brain is already spinning with questions, I hear you. When I chat with women interested in our program, these are some of the most common questions that I get:
Will freezing my eggs affect my ability to conceive in the future?
Long story short - nope! This is a very common misconception, but freezing your eggs doesn’t actually take away from your ovarian reserve. This is because the hormone medications involved in the egg retrieval process are essentially just telling your ovaries to allow all of the eggs released in a single cycle to mature, instead of just one. So rather than taking away from your ovarian reserve, egg freezing actually allows you to save some of the “extra” eggs that would have died off during your cycle! Pretty cool, right?
Read more:
Does Donating or Freezing Your Eggs Affect Your Future Fertility?
Is egg freezing safe?
While no medical procedure is totally risk-free, egg freezing is considered a highly safe procedure, and overall risk is minimal. One of the most-talked-about risks is something called Ovarian Hyperstimulation Syndrome (OHSS), which is a condition where the ovaries can become swollen and painful in response to the hormone medications used during stimulation. However, research shows that the percentage of egg retrievals complicated by OHSS is now only 0.34% (down from 1.2% in 2014).
Read more:
What is OHSS and What Are My Risks?
How much does egg freezing cost?
I’m not going to lie — egg freezing isn’t cheap, and it’s typically not covered by health insurance. The average cycle can cost anywhere from $9K - $15K, and that doesn’t even include the yearly storage fees.
At Cofertility, we know that the best time to freeze your eggs is often when you can least afford it, and we’re on a mission to give women egg freezing options that are accessible, empowering, and just plain better.
With our Split program, eligible women can freeze and store their eggs for up to 10 years entirely for free when they give half of the eggs retrieved to a family that can’t otherwise conceive.
Our Keep program allows women to freeze and keep all of the eggs retrieved for their own future use, with support and discounts to lighten the financial load.
Why do people freeze their eggs?
So we’ve covered the “what”, now it’s time for the “why”. Like I mentioned earlier, egg freezing is a way to keep your reproductive options open for later by preserving younger, healthier eggs for future use. I spend hours of my week chatting one-on-one with our members and when I ask them why they’re interested in freezing their eggs, almost everyone says the same things:
“I’m going back to school and focusing on my career right now.”
“I want to travel more first.”
“I haven’t found my ‘person’ yet, and don’t want to feel rushed to settle down just based on my biology.”
“I’m not even sure if I want to have kids or not, so I want to keep my options open.”
Seeing a pattern here? Nearly everyone who works with us knows that even if right now is the best time biologically to have children, it’s just not something they’re ready for yet. While you’ll never find us referring to freezing your eggs as an “insurance policy,” it does allow optionality for owning your future fertility by being proactive and giving yourself choices later in life.
How to decide if egg freezing is right for you
Now that you’re equipped with a basic understanding of what egg freezing is and some of the reasons why one may choose to freeze your eggs, you’re probably wondering if you should be thinking about it, too.
Unfortunately that’s not something we can answer for you, but we are firm believers that everyone deserves options for their reproductive health that work for them.
However, as you’re thinking this through, here are some questions you can ask yourself to help guide your decision:
“When do I want to start having children?”
If your answer is any time after age 30, you may want to consider freezing eggs in your 20s so you have younger, healthier eggs to use if you need them.
“What personal goals do I want to accomplish before building my family?”
Though I’m a firm believer that moms can do it all, sometimes there are things you may want to get done before children are in the picture, and that’s okay too. So if you have big dreams to travel the world, finish your degree, save money, or work your way up the corporate ladder, and want to do that before having kids, freezing your eggs can help you do that more confidently.
“When do I see myself settling down with a partner?”
Don’t get me wrong, being a single mom by choice is totally an option too, but if you see yourself wanting to raise children with a partner by your side, freezing your eggs gives you more freedom to find your person on your own timeline, without feeling rushed by the pressure of family-building.
“Am I even sure that I want to have children?”
I know: loaded question. But the truth is, a lot of us are in our “prime” baby-making years and don’t even know if we want to have children at all yet. Thankfully, we live in a time where egg freezing is a possibility, which means no one has to feel rushed to make that decision before they feel 100% confident that they’re doing what feels right for them.
The bottom line
To keep it simple — yes, more and more people are freezing their eggs (there was a 46% increase in egg freezing cycles in 2021!), and it’s probably something you should think about, too. While the decision to freeze your eggs is a highly personal one, being educated on the process and hearing about other people’s experiences can help ensure you’re making the most informed decision possible. If you decide you’re ready to take the next step in your egg freezing journey — we’re here to help make sure it’s a process you can feel good about — every step of the way.
Everything You Need to Know About Having a Baby With Your Frozen Eggs (If and When You're Ready)
Everything You Need to Know About Having a Baby With Your Frozen Eggs (If and When You're Ready)
In recent years, freezing eggs has become an increasingly popular option for those who want to delay having children and keep their options open. Whether it's to focus on their career, to wait for the right partner, or for medical reasons, egg freezing can give you more control over their reproductive futures. But what happens when the time comes to use those frozen eggs? In this article, we'll explore everything you need to know about having a baby with your frozen eggs, if and when you're ready.
Using your frozen eggs down the line
Before we dive into using frozen eggs, let's first review how egg freezing works. The process, called oocyte cryopreservation, involves harvesting your eggs and freezing them for later use. This is typically done through a process called controlled ovarian hyperstimulation, which involves taking medication to stimulate the ovaries to produce multiple eggs. The eggs are then harvested through a minor surgical procedure and frozen using a process called vitrification.
As part of our Split program, where you can freeze your eggs for free when you donate half of the eggs retrieved to another family that can’t conceive, our members get 10 years of frozen egg storage included for free. When the time comes to use those frozen eggs to have a baby, the process is called in vitro fertilization (IVF). IVF involves thawing your frozen eggs, fertilizing them with sperm in a laboratory, growing the embryos, and then transferring the resulting embryos to the uterus.
Here are the steps involved in using frozen eggs to have a baby:
- Thawing the eggs: The frozen eggs are carefully thawed in a laboratory to ensure their survival.
- Fertilization: Once the eggs are thawed, they are fertilized with sperm in a laboratory. This can be done using either conventional IVF or intracytoplasmic sperm injection (ICSI).
- Embryo culture: The fertilized eggs, or embryos, are then cultured in a laboratory for several days to allow them to develop.
- Embryo transfer: Once the embryos have developed, one or more are transferred to the uterus using a thin catheter. Any remaining embryos can be frozen for later use.
Choosing a fertility clinic
You do not have to use the same clinic you used to freeze your eggs to then fertilize those eggs and transfer the embryos. Some people choose to switch clinics because they moved or because they found a doctor they like better elsewhere. If you’re looking for a new clinic, you will want to review the clinic's success rates. The success rates can be found through the Society for Assisted Reproductive Technology (SART) website. Be sure to compare the success rates of the clinic to national averages. You can also look up the clinic’s reviews online, or ask friends for suggestions.
One thing to keep in mind when switching clinics is that different clinics may have different protocols and procedures for thawing and using frozen eggs. This is usually not a problem, but it will be important for your new clinic to know how your eggs were frozen.
Ultimately, the decision to use the same clinic or transport your eggs to another clinic is a personal one that should be made based on your individual needs and preferences.
Getting your eggs out of storage
If you’re staying at the same clinic, many clinics choose to store eggs in a long-term storage facility versus at the clinic itself. If that’s the case, the clinic is usually responsible for transporting the eggs back to the clinic and laboratory to create embryos.
If you’re moving clinics, you’ll likely need to coordinate getting your eggs out of long-term storage. Transporting frozen eggs is relatively straightforward and there are several carrier options you can use to safely get your eggs out of storage. If you worked with Cofertility to freeze your eggs, we can help put you in touch with the storage facility to coordinate moving the eggs to a clinic of your choice.
So how much will it cost for me to unfreeze my eggs?
The cost of using frozen eggs to have a baby can vary depending on several factors, including the location of the fertility clinic, the number of cycles needed to achieve a successful pregnancy, and whether you have any underlying medical conditions that could affect the process.
Here are some expenses you can expect when thawing your eggs:
- Egg thawing and fertilization
- Genetic testing (optional)
- Medication if necessary
- Embryo transfer
In total, this can range from $3,000-$10,000 totally depending on the clinic and the medication you may require pre-transfer. It’s best to reach out to clinics you are interested in to get real pricing.
Success rates with frozen eggs
The success rates of using frozen eggs to have a baby can vary depending on several factors, including your age at the time the eggs were frozen, the quality of the eggs, and the number of embryos transferred. Generally, the younger you were when freezing your eggs, the higher the chances of success.
Studies show that for a woman under age 35, nine eggs give you a 70% chance of at least one child. As medicine and technology advances, we hope to see this number increase even further!
Summing it up
Egg freezing provides the flexibility and peace of mind that comes with knowing your eggs are safely stored and available for future use while you live your best life. You may not even need those eggs to get pregnant down the line; but if you do, you’ll be so glad you froze them.
Freeze your eggs with Cofertility
Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:
- Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure — medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
- Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.
The benefits of working with Cofertility include:
- Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
- Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
- Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
- Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
- Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.
Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.
I Want to Freeze My Eggs: What's the Egg Retrieval Process Really Like?
Understanding how the egg retrieval process works and what to look out for can help ease some pre-procedure jitters.
Whether you’re about to go through the egg retrieval process for egg donation, egg freezing, or a full in vitro fertilization (IVF) cycle, you’re likely going to have some questions. While this procedure seems intimidating to a lot of folks, it’s actually not as scary as it seems. Understanding how the process works and what to look out for can help ease some of those pre-procedure jitters, so let’s break it all down.
Before
Questions for your provider
Knowing what’s coming is half the battle when it comes to medical procedures.Here we’ve listed some great questions to ask your provider before your egg retrieval.
- Can you walk me through the timeline for the egg retrieval, from when I give myself the trigger shot (a medication sometimes used to help your ovaries release mature eggs) to the recovery room after the procedure?
- What anesthesia options are available?
- What is your best estimate of how many eggs you think you’ll be able to retrieve?
- What are the most common side effects you see after the procedure? What do you recommend I do to manage those symptoms if I have them?
- Is there anything you recommend I do leading up to the procedure to minimize my risk of ovarian hyperstimulation syndrome (OHSS)?
- When and how will the clinic update me about the eggs after the procedure (e.g., phone, email, app, etc.)?
- How can I reach your clinic if I have questions or concerns?
- Who do I contact if I have a problem outside the clinic’s normal hours?
Depending on your particular situation, you may need to ask more questions, but this is a good place to start.
Anesthesia/sedation options
For egg retrievals, an anesthesiologist will be on site to provide your sedation. Most clinics use monitored sedation that is propofol-based. This is not the same as general anesthesia, which is used for longer and more invasive procedures and requires a breathing tube. With monitored sedation, a medication is given through the veins (IV) to make sure you feel no pain or discomfort during the procedure. No breathing tube is used, so you’ll be able to breathe on your own. This is commonly called “twilight” sedation—think of it as a really great nap!
Unfortunately for some folks, nausea can be a side effect of the anesthesia. If you’ve had anesthesia before and you know you’re prone to nausea, make sure to let the anesthesiologist know about it. There are a few other ways to help manage nausea due to anesthesia.
- Stay hydrated. Postop nausea is sometimes due to dehydration, usually because you haven’t had anything to eat or drink before your surgery. Dehydration leads to low blood pressure, which can make you even more queasy. As soon as you’re able to after your procedure, start rehydrating. Staying really hydrated up until the night before your procedure can also help.
- Take anti-nausea medicines. Some over-the-counter (OTC) options like antacids, ginger root tablets, and others can be helpful for mild to moderate nausea. Ask your doctor before using any of these though! Some medications can’t be taken together. If the OTC options don’t help, you can also ask your doctor about prescription options.
- Avoid activities that require too much movement or concentration. Things that involve concentration or changes in your perception (like reading or riding in a car) will often make symptoms worse. Closing your eyes and keeping your room dimly lit can help calm your nervous system while the anesthesia wears off fully.
You can learn even more about all the anesthesia and sedation options here.
Prep
Most clinics will go through their specific requirements and recommendations at your preoperative visit. The most important thing to avoid is having anything to eat or drink the day of the procedure.
A common question people ask is whether they need to shave before their egg retrieval. The answer is no—shaving (or not shaving) does not impact the procedure at all so come as you are! If you prep anything, it should be everything you need for when you come back home to recover. Here’s a checklist of things to have ready on the day of your procedure:
- Comfortable, loose clothes
- Heating pad(s)
- OTC medicines like Tylenol, stool softeners, and anti-nausea
- Plenty of fluids and electrolytes (water, Gatorade/Powerade, coconut water, etc.)
- Activities like audiobooks, movies, etc. that don’t require too much concentration
- Someone to take you home
During
Is egg retrieval painful?
This is the most common question we get and it’s totally understandable! Thankfully, with the anesthesia that’s given, you will be asleep so won’t feel or remember anything during the procedure.
What exactly happens during an egg retrieval?
Alright, let’s get into how this procedure actually works. First, the doctor will use a transvaginal ultrasound to find your ovaries, which should by now have clusters of tiny follicles. Your doctor will then gently guide a long needle through an opening in the ultrasound probe and into the vaginal wall. This needle is attached to a catheter and the catheter is attached to test tubes labeled with your name and unique patient identification number. One by one, the eggs will be drawn out of the ovaries using light suction and collected in the test tubes. These test tubes are then handed off to the embryologist, an expert in the science of oocyte cryopreservation (the technical term for egg freezing).
Once all the eggs that can be retrieved are collected, the doctor will remove the needle. They will examine your ovaries and your vaginal wall to make sure there isn’t too much bleeding. It’s normal for these sites to bleed a little–they did just have a needle inserted into them. Typically, your doctor will be prepared to apply pressure or, rarely, to use a cauterizing (heated) agent to control any bleeding.
That’s it! You’ll leave with no stitches or scars. Pretty cool, huh?
How long does an egg retrieval take?
The process described above may sound really complicated but in reality, it only takes about 15 minutes. That’s less time than most people spend scrolling TikTok while on the toilet.
After
Waking up
Immediately after the egg retrieval, you’ll definitely be a little groggy as you recover from the anesthesia. You’ll usually be told to rest for 30–60 minutes in the recovery area, where someone will monitor you as you wake up from the anesthesia. Most anesthesia takes about 24 hours to be fully out of your system, but you’ll feel close to normal by the time you leave the office.
During your recovery time, your doctor will come in to let you know how many eggs were successfully retrieved. They will also let you know how many eggs were deemed mature by the embryologist. What does that mean? Well, let’s go way back to middle school biology. Mature eggs have reached the metaphase II (M2) stage and are therefore considered to have “meiotic competence”. Meiosis is the process of cutting the number of chromosomes and genetic material by half so that when it combines with sperm, the resulting embryo has the proper number of chromosomes and all the genetic material it’s supposed to have.
Immature eggs are not capable of fertilizing because they are not “meiotically competent”. However, sometimes it is possible to have eggs mature in the lab (in vitro maturation or IVM) and then fertilize them. While this isn’t popular now, we do ask our partner clinics to freeze immature eggs for when this technology is more widespread in the future.
In our Split program, where you freeze for free when donating half, you keep half of the mature eggs PLUS 100% of any immature eggs if they are retrieved and vitrified.
Common side effects and how to manage them
After everything is said and done, the most common side effects people have are constipation, bloating, cramping, spotting, and pain. Rest, over the counter medicines like Tylenol and stool softeners, and staying hydrated are usually all that’s needed for these symptoms. Heating pads can also be really helpful for those who have cramping or pain. If you have any bleeding, make sure to use pads—not tampons—so you can monitor the amount.
The majority of people are back to their normal activities by the next day, but it’s recommended that you go home and relax for the rest of that day with another adult with you, just in case. You also should not drive for at least 24 hours after your procedure.
Your doctor may prescribe an antibiotic or other medications depending on your case. You may be asked to avoid sexual intercourse for a period of time or avoid things like taking a bath. Make sure to follow any specific instructions your provider gives you for your recovery.
Red flags
If you notice any of the symptoms below, report them to your healthcare provider asap:
- Temperature above 101 F
- Severe abdominal pain or swelling
- Severe nausea or vomiting that doesn’t go away
- Heavy vaginal bleeding (soaking through a pad in an hour; some light bleeding is normal)
- Difficulty urinating, or painful urination
- Fainting or dizziness
Good Luck!
If and when you decide to pursue egg freezing, Freeze by Co is here to help you every step of the way. As mentioned earlier, our Split program allows those who qualify to freeze their eggs for free! In a Split cycle, you donate half of the eggs retrieved to a family that can’t otherwise conceive and freeze the remaining half for yourself, so you get half the mature eggs and all the immature ones.
Don’t want to donate? We got you! You can still participate in the Keep program, where you’re able to freeze your eggs and keep them all for yourself, on your timeline. In addition, you’ll have access to our online support community. This is a valuable resource that lets you engage with other people freezing their eggs at the same time!
The best way to feel comfortable and confident about your egg retrieval is to know what to expect. The process won’t be exactly the same for everyone but with the tips we shared above, you’ll be more than prepared when the big day comes. Whatever you choose, our team is here to support you and help you feel empowered as you determine which family-building options are right for you!
How to Pay for Egg Freezing
In this guide, we'll discuss some of the most common ways to pay for egg freezing.
Egg freezing (oocyte cryopreservation) is becoming a popular medical procedure for women, but the biggest barrier is the high cost. We surveyed over 750 women about egg freezing, and 67% of them said cost was their main barrier.
That’s why we started Cofertility, and our Split program where eligible women can freeze their eggs *for free* when donating half of them to a family that can’t otherwise conceive. But we know that egg donation isn’t for everyone, which is why we also support women who want to freeze and keep their eggs. For these women, there are ways to make egg freezing more affordable. In this guide, we'll discuss some of the most common ways to pay for egg freezing.
First off, how much does it cost to freeze your eggs?
This is always a difficult question to answer, because it depends! It depends on the clinic you’re going to, where you are located, the medications you are prescribed (it differs based on your age and body), and where/how long you store the eggs. Average egg freezing cycle costs range from $10,000 - $20,000, plus annual storage.
How can I pay for egg freezing?
If you want to freeze your eggs and research all your options for paying for it, here are the main buckets of options.
Health insurance
Unfortunately, very few insurance plans today cover the cost of egg freezing, unless it is medically necessary. For example, if you have a medical condition that may impact your fertility, such as cancer, your insurance may cover the cost of egg freezing as part of your cancer treatment. Check with your insurance provider to see if they cover egg freezing and what the requirements are.
Flexible spending account (FSA) or health savings account (HSA)
If your insurance doesn't cover egg freezing, you can use pre-tax dollars from your FSA or HSA to pay for the procedure and medications. These accounts allow you to set aside a certain amount of money each year to pay for eligible medical expenses, including egg freezing.
Donate half your eggs
At Cofertility, our Freeze by Co Split program allows you to freeze and store your eggs *entirely for free* for 10 years, when you give half to a family who can't otherwise conceive.
Financing
There are a growing number of financing options, such as loans or payment plans, to help patients pay for egg freezing. These options allow you to spread the cost of the procedure over several months, making it more manageable.
Top egg freezing financing companies
If you’ve decided you want to go the loan route, you have many options to choose from. There are general lending companies as well as companies that specialize in loans just for fertility treatments.
Sunfish
Sunfish makes egg freezing (and fertility treatment in general) attainable for all types of families. If you're interested in egg freezing, Sunfish can help you explore low-interest loans and financial planning tools, including low-interest loans or lines of credit of up to $100,000, with terms ranging from two to 15 years.
Ally
Ally offers fertility financing solutions to cover the cost of egg freezing at select partner clinics. Fill out a form to see your lending options and choose from 24-84-month loan options with annual percentage rates (APRs) starting at 3.99%.
FutureFamily
FutureFamily offers egg freezing loans, and they handle paying all your bills so you have just one easy payment. Starts at $150/month* for 60 months based on your clinic, credit score, and approved egg freezing related expenses. While you can apply individually, the rates are better (0% APR) if you are freezing with one of their partner clinics.
Lending Club
Lending Club offers egg freezing loans that cover genetic testing, medications, and the medical procedure at select partner clinics. They forward payment directly to the providers within three business days. Monthly payments are as low as $263/month to finance $15,000 with a 7.99% APR for 72 months.
What to know about taking out a loan
When taking out a loan, you’ll want to understand the terms and conditions of the loan, as well as the responsibilities that come with borrowing a large sum of money. A lot of the websites listed above will have online calculators to help you get a sense for the terms and fees you can expect.
Loan amount: Consider how much you want to finance and whether they finance that amount. You could finance part, or all, of the egg freezing expenses.
Loan terms: Loan terms are the length of time you have to repay the loan, and they can range from a few months to several years. Shorter loan terms generally result in higher monthly payments, while longer loan terms result in lower monthly payments but a higher total cost over the life of the loan.
Interest rates: Interest rates are the fees charged by the lender for borrowing money, and they can have a significant impact on the total cost of the loan. Find out the current interest rate being charged, and if that interest rate will stay the same or change over time.
Loan fees: Of course, these lending groups need to make money, and they do this through loan fees. Loan fees are the additional charges associated with taking out a loan, including origination fees, application fees, late-payment fees, or prepayment penalties. You can use the annual percentage rate (APR) to compare average yearly fee and interest-rate expenses over the term of the loan. It's important to carefully review all loan fees and to make sure you understand the total cost of the loan.
Repayment options: Repayment options are the ways in which you can pay back the loan, including monthly payments, lump sum payments, or a combination of both.
Loan security: Loan security is the collateral that you provide to the lender to secure the loan, such as a home or a car. If you fail to repay the loan, the lender may take possession of the collateral. If you're taking out a secured loan, it's important to carefully consider the risks and responsibilities associated with putting up collateral.
Finally, if you’re quoted a monthly payment, remember to look beyond the monthly payment. Think about how long you will pay, and what fees and costs have been added.
Other ways to pay for egg freezing
Credit cards
Of course, if you have a high limit on your credit card, you could always put the cost of the procedure and medications on your credit card, as long as you feel comfortable paying this off. Think of all those points! However, keep in mind that credit cards typically have higher interest rates than personal loans.
Savings
Maybe you’re a high earner and had scholarships to cover college tuition. Or perhaps a family member left you money. If you have the cash in your savings, you can certainly put it towards egg freezing.
Crowdfunding
Using crowdfunding to pay for medical expenses is an increasingly popular option (thanks US healthcare system!). Crowdfunding is when you ask your friends, family, followers, and even strangers to chip in to pay for your medical expenses – usually through an app like GoFundMe.
Keep in mind that there is no guarantee of success with a crowdfunding campaign, and you may not be able to raise enough money to cover the cost of egg freezing.
Employee benefits
Some employers offer coverage for egg freezing as a benefit to their employees. Check with your handbook or HR department to see if this is an option for you.
Summing it up
If you want to freeze your eggs, know that you have financing options. Research and compare your options to find the best one for your needs. By taking the time to understand your options, you can take the first step towards preserving your fertility and achieving your family-building goals.
To see if you're eligible for our Split program, take our quiz to tell us more about yourself.
Years Later, Four Women Open Up About Freezing Their Eggs
If you are considering freezing your eggs, it might be helpful to talk to women on the other side of egg freezing. What was it like? How old were you when you froze your eggs? How many did you get? Did you end up needing them?
If you are considering freezing your eggs, it might be helpful to talk to women on the other side of egg freezing. What was it like? How old were you when you froze your eggs? How many did you get? Did you end up needing them?
We asked a few former egg freezers these questions to share with the world. In this Q&A – you’ll hear from real women who have undergone egg freezing to get a first-hand account of what it entails and if they’d do it again. So whether you're single, in a relationship, or just curious about the process, this Q&A is for you.
The egg freezers:
- Lauren is a 43-year-old healthcare executive who froze her eggs at 36 and used them in her 40s to have two children.
- Michelle is a 40-year old tech exec who froze her eggs at 35.
- Eliza is a 39-year old healthcare investor who froze her eggs at 34.
- Stephanie is a 39-year old non-profit fundraiser and mom of three. She froze her eggs at 35 to donate them to her sister.
How many eggs did you freeze?
Lauren: I froze 35 eggs across three egg retrievals when I was 36-38.
Michelle: I froze 19 eggs in one retrieval when I was 35.
Eliza: We ended up with 16 eggs and froze four embryos from one retrieval when I was 34.
Stephanie: I froze 14 eggs in one retrieval when I was 35.
Why did you freeze your eggs?
Lauren: I was recently divorced and focusing on my career and my own journey. I knew I wanted children, probably as a single mom, but wanted the flexibility to wait until I was ready.
Michelle: As I approached my 35th birthday, the startup I was working for got acquired, so I decided that was fortuitous timing to use some of the funds to invest in my future. I wasn't ready to have kids at the time, but wanted to keep my options open.
Eliza: I had PCOS and knew I could have trouble conceiving like some others in my family. My doctor suggested freezing embryos since I was in a relationship.
Stephanie: At the time, my younger sister had been diagnosed with a rare condition, which required major surgery and the removal of multiple large benign cysts from many of her organs, including near and on her reproductive organs. We weren't sure what the outcome would be, and I wanted her to know that even if she was unable to have children herself following the procedure, she would have my eggs waiting for her to use, ensuring that her own dna (adjacent) would be in the mix.
How would you describe the experience – both physically and emotionally?
Lauren: It was physically and emotionally draining. I ultimately went through three egg retrievals over two years. I am extremely lucky to have an incredibly supportive family (including my 96 year old grandmother!) and strong friends who encouraged and cared for me through every step of the process. It was actually beautiful to experience the love, kindness and support from so many wonderful people to help me achieve my dream.
Michelle: At the time, none of my close friends had frozen their eggs, so I did a lot of Googling and it was a little like navigating in the dark. I visited several clinics in NYC, and ended up choosing the clinic based on the doctor I felt the most comfortable with and one that guaranteed "at least 12 eggs in up to 4 cycles" for patients with a certain AMH level. To better educate and prepare myself, I created a spreadsheet to document visits, schedule, medicine dosage, etc -- and have ended up sharing this doc with multiple friends and colleagues over the years who have contemplated going through the process. The overall experience was relatively seamless for me physically (the hardest part was being home by 7PM for my shots!), and emotionally I felt empowered taking back some control over the dreaded "biological clock."
Eliza: It was an expensive process, and I took it very seriously. I took off work (which ended up being unnecessary) and educated myself as much as possible. I was afraid of the shots at first, but got used to them quickly. The actual retrieval was a breeze, although I was constipated for a few days after!
Stephanie: I think it was definitely different than what the average egg retrieval experience is because I wasn't going into it with the emotional stress or anticipation of hoping for a child at the end. I already had two healthy children and knew I would likely have one more down the line, but I think I was aware that there wasn't as much wrapped up in for me as most people experience. Physically, it was tiring. I experienced all of the symptoms I had read about - bloating, mood swings, tiredness....It was a weird month to say the least, but it was easy to tolerate because I was confident the pay off would be there. That said, I think the fact that I already had two healthy children without any fertility challenges meant that I wasn't too worried about my egg production. I know that so many of my friends who had already gone through it had the added stress of knowing that they may not produce very many viable eggs. The retrieval itself wasn't bad, and after a day or two of rest, I felt pretty much like myself, although the bloating took a bit longer to subside.
Did you end up needing to use the eggs to conceive? If not, what did you do with them?
Lauren: Yes! I used eggs from two different retrievals to create embryos for both of my extraordinary sons!
Michelle: I was very lucky to have conceived my son naturally at 39. I'm planning on trying to try for a second child, so I will save my eggs for that in case I need them. I'm so thankful to have that as an option!
Eliza: Yes – one of those embryos is my son!
Stephanie: The eggs are in storage as a backup plan if my sister needs them. Thankfully, it looks like they won't be needed, but until all of our families are complete, they'll hang out on ice.
If you could go back in time, would you do it again? Why or why not?
Lauren: Absolutely
Michelle: Absolutely would do it again. It was certainly a big investment but it was 100% worth it. I wish I could have done it a few years earlier, but I'm glad I did it when I did and that the public discourse around fertility has evolved over the years.
Eliza: Had money not been an issue, I would have tried to freeze even more. I actually have a friend who did two rounds – one to freeze embryos and one to freeze eggs. If I could go back, that’s how I would have done it.
Stephanie: I would do it a thousand times over. I would do anything to help my sister build a family, and knowing what the process is like, if I were in a position to consider freezing for myself (if my life story had played out on a different timeline) I would do it as well. It's a small price to pay for the peace of mind, if it's done as a preemptive measure, and an even smaller price to pay if it helps build your family.
What advice do you have for someone considering egg freezing?
Lauren: It changed my life and enabled me to become a mom on my own timeline. I would absolutely recommend it to any woman not yet in the right relationship!
Michelle: Sooner is better than later. If you think you might want to freeze your eggs, I’d go for it.
Eliza: I love the concept of Cofertility’s Split Program where you get to freeze your eggs for free in exchange for donating half of them!
Stephanie: Get a good support system. It helps to have a friend or partner who will gladly give you a shot in the bathroom of a bar (yes, this happened!) or a coworker who cuts you a little slack for a few weeks, or sends food over the next day. Find a clinic where you feel comfortable and cared for. Get a really comfy pair of sweatpants that you're cool wearing on repeat for a week. Remember that it is a limited time, it will be over soon, and it will be worth it.
Cofertility is in the “family” business, striving to make egg freezing and third-party reproduction more human-centered and accessible for all. Our Freeze by Co program allows you to freeze your eggs for free, when you give half to a family who can't otherwise conceive
Should I Freeze Eggs or Embryos?
More people than ever are thinking about preserving their fertility for the future. But what’s the difference between freezing eggs and freezing embryos? More importantly, which is the better option for you?
More people than ever are thinking about preserving their fertility for the future. But what’s the difference between freezing eggs and freezing embryos? More importantly, which is the better option for you?
While both procedures have given people more choice around when they have children and how they conceive them, they’re not the same and there’s plenty to think about when trying to choose one over the other.
What’s the difference?
There’s one major difference between freezing eggs and freezing embryos. When you freeze your eggs, they stay unfertilized. We all know that to make a baby, you need an egg and a sperm because each of them provides half of the material needed. On its own, an egg can’t function (and neither can a sperm).
An embryo, on the other hand, is an egg that has already been fertilized by a sperm. Once they combine, the egg and sperm become a single cell. Over the next three to four days, the embryo divides several times, going from one to two to four to eight cells, and so on until it reaches the blastocyst stage and is ready to be frozen. Once an embryo has developed, there’s no going back– that is, there’s no way to turn that embryo back into a separate egg and sperm.
Things to consider
So how does this information help you figure out whether to freeze eggs or embryos? Well, there are two big factors to consider: your circumstances and the research.
If you don’t know who you want to have children with, then freezing your eggs may be the best approach. This option gives you the freedom to hold off on thinking about having a baby until you’ve met someone or are ready to choose a sperm donor.
On the other hand, if you are currently with a partner who you know you’d like to have children with but now isn’t the right time, then freezing embryos might be the way to go. The caveat here is to be 100% certain—stars like Sofia Vergara and more recently, Anna Kendrick, have run into trouble after freezing embryos with partners they didn’t end up with.
Now, let’s look at the research.
Is freezing embryos really better?
The short answer here is not necessarily. The long answer is that each case is unique so whether freezing embryos or eggs is the better option for you will depend on your specific situation and what your labs, imaging, and other health information suggest.
With that in mind, let’s break down the pros and cons of each method.
Pros and cons of freezing eggs vs embryos
Freezing/thawing process
Historically, embryos have been “tougher” than eggs and therefore, easier to freeze and thaw. Freezing eggs was much more of a gamble since they’re large cells with a lot of water inside. That water can turn into ice crystals during freezing which, in turn, can damage the chromosomes in the eggs and make them unusable.
But it’s not all gloom and doom for egg freezers! Researchers have continued to study the technology and the statistics have changed as newer and better freezing technologies have emerged. Nowadays, an excellent lab can expect 90% of the eggs that they freeze to survive compared to 95% for embryos.
But, let’s be clear, these numbers don’t mean that your chances of a successful live birth are 5% higher with a frozen embryo, it just means that embryos are a little more likely to make it to the next phase of IVF. The higher quality your frozen eggs (i.e. if you freeze your eggs relatively young and maintain a healthy lifestyle), the more likely they will have thaw rates that are just as good (if not higher) than that of embryos.
Quality
A major weakness of egg freezing is that there is no way to test the quality of eggs on their own–they still have to make it through the thawing process, fertilization, and develop into a healthy embryo that can be implanted into the uterus (not all of them make it this far).
This can lead to a situation where someone uses their eggs years after freezing them and those eggs don’t perform as well as they thought they would. By then, this person is older so their egg quality has declined even more. Not having that quality information upfront can make it hard to judge how many eggs need to be frozen to lead to an actual baby.
In contrast, embryos have to get past several important hurdles that give fertility specialists a much better sense of their quality and the chances of a baby later. That’s because turning eggs into embryos requires that they be successfully fertilized and that those embryos survive up to a point where they can be frozen (usually the blastocyst stage, around day 5 of development).
In addition, embryos are graded at each point in their development based on an embryologist’s opinion of whether they are high quality or not (embryologists are experts who study the development of embryos).
Finally, you have the option to run a genetic screening test on embryos, which can help more accurately predict whether they’re likely to become healthy babies. Research has shown that preimplantation genetic screening can result in lower miscarriage rates and higher live birth rates per embryo transfer. There is no such test for frozen eggs.
Chances of a healthy baby down the line
Recent studies comparing the likelihood of actual babies being born, known as the live birth rate (LBR), have shown that it’s now pretty even whether you’re freezing eggs or embryos. Before this, the LBR with frozen eggs was quoted at about 50% the LBR of frozen embryos.
A study published in May 2022 provides even more evidence to support this. The study, done at NYU, is the largest U.S. report of elective fertility preservation outcomes to date and is based on 15 years of real-life frozen egg thaw outcomes for people who had delayed having children and had natural, age-related fertility decline.
On average, study participants were 38 years old at the time they froze their first set of eggs. The study found that regardless of age, those who thawed at least 20 mature eggs had a 58% LBR. This was unexpected given that so many of the participants were past the optimal age to freeze eggs (35 years old or younger). People under 38 years old who thawed 20 or more mature eggs had a 70% LBR per patient. The length of frozen egg storage did not change the success rate.
Additionally, the study found that 39% of people between 27 and 44 years old (most were between 35 and 40 when they froze their eggs) had at least one child from their frozen eggs, which is comparable with age-matched in vitro fertilization (IVF) outcomes. Researchers also found that many of the participants studied had more than one child through egg freezing.
When compared to data collected by the Centers for Disease Control and Prevention (CDC) from the nation’s nearly 500 fertility clinics on people trying to conceive at age 40 using fresh eggs or embryos, only 30% who underwent IVF became pregnant and the LBR was less than 20%.
The final conclusion? For those starting families later, egg freezing and thawing at a later date provides a higher pregnancy success rate than using fresh embryos during assisted reproductive technology.
*One important point the researchers make about their study is that it was limited by the number of patients. More studies need to be done in the future that include people from a variety of geographic locations and center types.
Cost
Last, but certainly not least, is the financial side of this. Is embryo freezing more expensive than egg freezing?
Honestly, yes. The upfront cost of egg freezing is definitely less than that of embryo freezing (which requires in vitro fertilization before freezing). While egg freezing costs upward of $10,000 on average, creating and freezing embryos can add a few more thousand dollars to that bill. If you’re freezing embryos using a sperm donor, the sperm can add a further $300 to $4,000, depending on several factors. In both cases, you will also need to pay an annual fee to store your eggs or embryos until you use them. This can cost anywhere from $500-$1000 per year, depending on the clinic you use.
Depending on the type of medical coverage you have, your insurance may cover some of these costs, so make sure you reach out and see what support you can receive from them. Many clinics also offer financial plans and other forms of support so always ask!
TL;DR: Freezing eggs comes with a lower upfront price tag which makes it an easier and more accessible choice than embryo freezing, allowing more people to preserve their future options.
Additional Resources
Both the Centers for Disease Control & Prevention (CDC) and experts at Harvard Brigham and Women’s Hospital have developed calculators for assessing a person’s chances of success with artificial reproductive technology (ART). The CDC IVF Success Estimator helps estimate the chances of a live birth with IVF while the BWH Egg Freezing Counseling Tool helps to estimate the chances of at least 1 live birth based on your age and number of frozen eggs.
What do I ask my provider?
Use your health care provider as a support and resource. They should be able to answer any of your questions. Not sure what to ask? Here are a few questions to help you get started:
- How many eggs or embryos do you recommend I freeze, at my current age, to have the highest percentage chance of a live birth later on?
- How many treatment cycles will I need to do to get to this number? It’s totally normal to need more than 1 cycle, but it’s nice to know what to expect ahead of time.
- What is this lab’s rate of successful freezing and thawing of eggs vs embryos (“oocyte cryosurvival rate” is the medical term)? Are they closer to minimal or maximum competency?
- How much would each cycle cost?
- Are there any financial support options, plans, or advice?
- What are the health risks? What about common side effects?
- Is there an upper age limit for using my eggs or embryos in the future?
- How long can I store them and how much will it cost per year?
Do You!
At the end of the day, there’s no universal rule around the best approach to preserving fertility. Family planning is going to look different for every person so you need to do what’s right for you. When you’re ready, talking to a fertility specialist can help you make up your mind.
In the meantime, Freeze by Co is here to help you every step of the way on that journey. Our Split program allows those who qualify to freeze their eggs for free! In a “Split” cycle, you donate half of the eggs retrieved to a family that’s trying to conceive and freeze the remaining half for yourself. Or, if you don’t want to donate, you can still participate in the Keep program, where you’re able to freeze your eggs and keep them all for yourself, on your timeline. In addition, you’ll have access to our online support community. This valuable resource lets you engage with other people freezing their eggs at the same time!
Whatever you end up choosing for yourself, our team is here to guide you through it and keep your options open.
What “The Sex Lives of College Girls” Gets Right (And Wrong) About Egg Donation
Our team has been watching this season obsessively (and spending way too much time talking about it during our daily meetings), and are overall so appreciative of how Kimberly’s donation journey was portrayed.
Warning: This article contains spoilers for Season 2 of The Sex Lives of College Girls.
At Cofertility, we are so thrilled that conversations about reproductive health are making their way into the limelight. From Jennifer Aniston opening up about how she wishes she froze her eggs at a younger age, to the latest season of The Sex Lives of College Girls, where Kimberly decides to donate (or as she refers to it, “sell”) her eggs in order to pay her college tuition, we love to see women becoming more educated on their fertility.
Our team has been watching this season obsessively (and spending way too much time talking about it during our daily meetings), and are overall so appreciative of how Kimberly’s donation journey was portrayed. Creators Mindy Kaling and Justin Noble have taken what has been traditionally portrayed as an overly-clinical, overwhelming process and humanized it — showing the reality of what egg freezing or donation cycles can look like for the modern woman. Here are just some of our team’s favorite aspects of the portrayal of Kimberly’s journey:
You don’t have to put your life on pause.
The process of donating (or freezing) your eggs involves a medical procedure and should be taken seriously, but as Kimberly shows us (with the help of her roommate, Leighton) in Season 2 Ep. 5, that doesn’t mean you have to put your entire life on hold.
While there are some things you’ll have to avoid, such as heavy exercise, alcohol, and sex, you won’t be pinned to your couch for three weeks while you prepare for your retrieval. You’ll need to stay local to your clinic for your monitoring appointments, but other than that, keep doing you.
Overall, the medical process of donating your eggs is the same process as freezing your eggs. If you’re curious to learn more about what that looks like, (and even how you can freeze your eggs for free when you donate half) we’ve got you covered.
Egg banks often target women in tough financial situations
Kimberly first learns about “selling” her eggs after getting denied a student loan that she desperately needed. If the thought of this gives you the ick—you’re not alone.
It’s true that the egg donation industry has historically targeted individuals in poor financial situations, and we wholeheartedly agree with the American Society of Reproductive Medicine (ASRM)’s stance that financial compensation for egg donation opens the door for exploitation.
Additionally, $80K for a single cycle is a pretty unrealistic expectation, given that the average compensation is more like $3,500 - $5,000 per cycle.
However, women who donate their eggs are truly giving intended parents the invaluable opportunity to fulfill their family-building dreams, and that deserves to be recognized. That’s why we created our Split program, which eliminates the icky-ness of financial compensation by instead giving our members the opportunity to freeze their eggs for free for their own reproductive future when they give half of the retrieved eggs to another family that can’t otherwise conceive.
Your squad is everything
Though going through an egg retrieval is considered a low-risk procedure, it’s not something that you should feel like you’re doing alone. On the day of your retrieval appointment, you’ll need to bring a companion with you since you’ll be put under anesthesia, but as we saw in The Sex Lives of College Girls Season 2 Episode 5, having your crew on deck for emotional support makes all the difference in making sure you feel empowered through this epic journey.
It’s more than just “selling your eggs”
Donating your eggs is a huge decision—one that goes far beyond a bank deposit after the fact. When you donate your eggs, you’re not just donating your eggs, you’re donating genetic material that will someday be used to bring a new life into this world, so there’s a lot to be considered.
To quote straight from Kimberly’s pro-con list, the possibility that you’ll “run into future kids at a shopping mall” may sound crazy, but it hints at the reality that we live in a world where anyone can walk into their local pharmacy and purchase a DNA test off the shelf for less than $100, and there is really no such thing as a truly anonymous egg donation experience.
At Cofertility, we take a firm stance in our belief that anonymous egg donation is wrong. We have invested in consulting with the donor-conceived community and truly believe that disclosed relationships are in the best interest of all parties involved, especially the donor-conceived children. So if you’re considering donating your eggs, make sure to keep in mind that the child or children conceived from those eggs may want to reach out to you in the future.
Additionally, Kimberly’s pro of “a cute gay couple uses my eggs” is one that is definitely within the realm of possibility, and one that we wholeheartedly support. The way we build families is more dynamic than ever, and at Cofertility, we work with countless LGBTQ+ intended parents to help make their family-building dreams a reality. If you’ve ever considered donating your eggs to a gay couple who needs them, this is a great way to do that.
Summary
At Cofertility, we’re on a mission to make the process of donating and freezing your eggs more accessible, human-centric, and supported. If you’re thinking about this as an option for yourself, we want you to know that we’re here for you. To see if you qualify for our Split program, where you can donate your eggs while freezing half of the retrieved eggs for your own future use, click here to take our free, two-minute quiz.