egg freezing

Freezing your eggs is a major life decision, and choosing the right clinic is the first important step. But not all fertility clinics are created equal. Some have more expertise in elective egg freezing (otherwise known as “social egg freezing”), while others primarily focus on IVF and only occasionally perform egg freezing cycles.

This guide will help you know what to look for, what to ask, what benchmarks to examine, and how to evaluate a clinic’s experience, lab quality, and transparency, so you can compare clinics. Ultimately, we hope to help you choose the best setting for your reproductive goals, and feel like you’re in great hands. 

Check the clinic’s egg freezing volume

Volume matters. A clinic that freezes eggs frequently is more likely to have refined protocols, experienced staff, and consistently strong outcomes.

Ask the clinic:

• How many elective egg freezing cycles do you perform per year?
• How has that volume changed in recent years?

While there’s no universal “perfect” number, the average clinic does around 100 cycles per year.  Clinics with very low egg freezing volumes may not have fully optimized their stimulation and vitrification protocols.

That said, clinic size is a personal choice. Some people prefer a smaller, more intimate practice with tailored attention, while others feel most comfortable in a larger program with multiple doctors and high throughput. Clinic culture is important, but the key is ensuring the clinic’s experience with egg freezing specifically, not just with IVF.

Lab and process specifics

The lab is the heart of the egg freezing process, and even the most experienced doctor cannot overcome a poorly equipped or understaffed lab. When evaluating egg freezing clinic lab standards, ask:

• Do they use vitrification?
  Vitrification is the ultra-fast freezing method that has revolutionized egg freezing outcomes, improving post-thaw survival rates to around 90–95%, compared to about 75% with older slow-freeze methods.
• Is freezing done in-house or outsourced?
  In-house labs maintain greater control over handling, which reduces potential risk.
• What’s their egg thaw survival rate?
  Top-performing labs report survival rates in the 90%+ range, though rates between 70–90% can be common depending on patient age and egg quality. Always ask for the clinic’s own data.
• How many embryologists are on staff?
  Look for labs with experienced embryologists who routinely work with eggs, not just embryos.
• Are they CAP or CLIA certified?
  CAP (College of American Pathologists) and CLIA (Clinical Laboratory Improvement Amendments) certifications are strong indicators of high lab quality and adherence to rigorous standards.

Use SART data, but know its limits

The Society for Assisted Reproductive Technology (SART) provides valuable public data on IVF cycles, pregnancy rates, and clinic volumes. While SART does not report egg freezing results specifically, the data can still serve as a proxy for lab quality.

While reviewing the SART data, look for clinics with consistently high IVF success rates and robust lab volume. You can use this as a starting point, but always request the clinic’s own egg freezing success rates, including post-thaw survival, fertilization, and live birth outcomes for patients who returned to use their frozen eggs.

Consider who will manage your cycle

Beyond lab quality, the human element matters. Some clinics assign one doctor to oversee your stimulation protocol, monitoring, and egg retrieval, while others rotate providers or hand off parts of the process to nurse practitioners. 

While schedules and clinic demand may not always allow one constant point of contact, continuity of care allows for better communication and timely adjustments if your body responds unexpectedly during stimulation. Ask upfront how the clinic structures patient care and who will be your main point of contact throughout the process.

Expect transparency

A trustworthy clinic will set realistic expectations from the start, including guidance on how many eggs you can expect to freeze there, based on your age. For example, research suggests that freezing 15 eggs at age 36 provides about a 78% chance of at least one live birth, while freezing 15 eggs at age 40 provides only about a 42% chance of live birth. Thus, freezing your eggs at a later age will require you to freeze more eggs in order to achieve a live birth. 

The clinic should also plan to provide a clear post-cycle summary detailing how many mature eggs were frozen, where they are stored, and whether another cycle might be beneficial. Costs, both for the initial procedure and for ongoing storage, should be discussed openly, with no hidden fees.

Red flags

Speaking of hidden information, although most clinics are committed to patient care, some warning signs can signal trouble, and vague or evasive answers about survival rates, lab methods, or protocols should be taken seriously. 

Be wary of unrealistic promises, such as guaranteeing 100% success with just a few eggs. The American Society for Reproductive Medicine (ASRM) estimates that even women under 38 have only about a 2–12% chance of a live birth per egg, so it’s important to manage your expectations and never consider egg freezing a true “insurance policy,” despite clinic marketing. Poor follow-up after consultations and high-pressure tactics without evidence-based reasoning are other red flags.

Summing it up

Choosing where to freeze your eggs involves more than finding the closest or cheapest option. It’s about balancing lab excellence, experienced staff, clear communication, and a culture that prioritizes your needs.

At Cofertility, not only can you freeze your eggs for free through our Split program when you donate half to another family who can’t conceive, you’ll also gain in-depth guidance through every step of the process, from egg freezing clinic comparison to understanding lab standards. We’ll hold your hand along the way, so that you can make informed, confident decisions about your future.

Curious to learn more and see if you qualify for the Cofertility Split program? Click here!

If you’re an active-duty service member or spouse and thinking about freezing your eggs, you’re not alone. Many women in the military are interested in preserving their fertility, especially given the demanding nature of military life. Between deployments, relocations, and irregular schedules, starting a family may not be a priority right now—but that doesn’t mean you want to close that door entirely.

In this article, we’ll walk through how egg freezing works for military personnel, what TRICARE does and doesn’t cover, which military hospitals offer reproductive services, and how egg sharing programs like Cofertility’s can help bridge the gap if you're looking to freeze your eggs for personal (non-medical) reasons. We’ll also get into what to expect logistically, how to time your cycle, and what options exist if you don’t qualify for military benefits.

What TRICARE covers—and what it doesn’t

Let’s start with the basics. According to TRICARE, the health plan for active-duty service members, retirees, and their families, elective egg freezing is not covered under standard military insurance benefits. That means if you’re freezing your eggs for non-medical reasons—like delaying parenthood, focusing on your career, or preserving your options—you’ll have to pay for it out of pocket. This includes all parts of the process: medications, monitoring, the egg retrieval procedure, and long-term storage.

TRICARE does cover fertility preservation (including egg retrieval and storage) if your fertility has been impaired by a serious or severe illness or injury related to your service. This includes things like combat injuries that affect your reproductive organs or chemotherapy received during active duty. In these cases, coverage is provided through the Supplemental Health Care Program, which falls under a different category of military healthcare and applies to both male and female service members.

To qualify under this medical exception, you must:

• Be an active-duty service member
• Have a Category II or III illness or injury sustained during active duty
• Be unable to conceive or carry a pregnancy without assisted reproductive technology (ART)

If you meet those criteria, TRICARE will cover services like egg retrieval, sperm retrieval, IVF, and intrauterine insemination. And according to TRICARE, if you paid out of pocket for any of these services after March 8, 2024, you may be eligible for reimbursement.

Where you can get fertility care in the military system

Even though TRICARE doesn’t generally cover elective egg freezing, some military hospitals do offer ART services at a significantly reduced cost. These services are available to eligible service members and beneficiaries on a first-come, first-served basis, depending on availability.

As of now, eight military hospitals offer reproductive endocrinology and infertility care through their graduate medical education programs:

• Walter Reed National Military Medical Center (Bethesda, MD)
• Tripler Army Medical Center (Honolulu, HI)
• Womack Army Medical Center (Fort Liberty, NC)
• Madigan Army Medical Center (Joint Base Lewis-McChord, WA)
• Brooke Army Medical Center (Fort Sam Houston, TX)
• Naval Medical Center San Diego (San Diego, CA)
• Naval Medical Center Portsmouth (Portsmouth, VA)
• Wright-Patterson Medical Center / 88th Medical Group (Greene County, OH)

While these programs prioritize care for service members with qualifying medical conditions, some do accept elective patients on a limited basis. Costs are often significantly lower than in the civilian market, but availability is highly variable, and waitlists are common.

Why egg freezing may still make sense, even without coverage

Military life is unpredictable. You might be deployed overseas with short notice, move across the country every few years, or find yourself in leadership roles that demand your full attention. Fertility doesn’t hit pause while you or your spouse serves—and unfortunately, egg quality declines with age regardless of your fitness level or overall health.

For many women in the military, freezing eggs can be a way to create flexibility down the line. It gives you more reproductive options, especially if you’re not ready (or able) to start a family during your service years. Even if you don’t end up using those eggs, having them stored offers a sense of security.

How Cofertility’s Split program fits in

If you’re interested in egg freezing but can’t afford the costs out of pocket—and don’t qualify for ART coverage through TRICARE—Cofertility’s Split program may be a great option. Through this program, you can freeze your eggs for free if you qualify and donate half of the eggs retrieved during your cycle to a family who needs them.

Here’s what’s covered through Split:

• All fertility clinic fees
• Medications and monitoring
• Egg retrieval procedure
• Storage for your half of the eggs for up to 10 years

In exchange, the other half of your eggs are donated to intended parents who are ready to grow their family. You’ll never be asked to pay for anything out of pocket, and you’ll receive personalized support from our team throughout the process.

Eligibility and what to expect

Unfortunately, not everyone will be eligible for Split. Like all egg donation programs, Cofertility requires certain medical and personal criteria, including:

• Age 21–33
• No smoking or significant reproductive health issues
• Willingness to undergo genetic testing and psychological screening
• Ability to provide a biological family medical history

If you were adopted or donor-conceived and don’t have access to your biological family’s health history, that may affect your eligibility. If that’s the case, you might consider freezing your eggs through our Keep program, where you keep 100% of your eggs and pay out of pocket, but get access to discounts and dedicated support.

How to time your cycle around military life

Timing is one of the biggest concerns for active-duty service members. An egg freezing cycle typically takes about two weeks of daily hormone injections, during which you’ll need to visit the clinic several times for bloodwork and ultrasounds. Then comes the egg retrieval itself, which is a minor surgical procedure with a short recovery time.

If you’re on active duty, here are a few ways to make it work:

• Plan around a block of leave or light-duty status
• Schedule during a stateside posting or training pause
• Coordinate with your supervisor for time off (how much you share is up to you)
• Stay near one of our partner clinics for the duration of your cycle

We understand that flexibility is limited in the military, but we’ve seen it work when there’s advance planning and support in place.

Privacy and confidentiality

Understandably, many service members want to keep their fertility planning private. With Cofertility, all of your care is coordinated through private clinics—not the military medical system. Your participation in the Split or Keep programs is confidential and never reported to TRICARE or your command.

That said, if you’re requesting leave or modified duty to attend appointments, you may need to give some explanation. Some choose to share openly, while others keep it general and simply say it’s for a medical procedure. Either is completely fine.

Read more in Should I Tell My Boss I'm Freezing My Eggs

What if you’re based overseas?

If you’re currently stationed abroad, your options are more limited. While some countries offer fertility care for military personnel at allied clinics, elective egg freezing is unlikely to be available through TRICARE or DoD channels. In most cases, you’ll need to wait until you're back in the U.S. to start the process—or coordinate a trip home during leave.

Bottom line

According to TRICARE, egg freezing for non-medical reasons is not covered under standard benefits. ART services, including egg retrieval, are only available to service members who sustained a qualifying injury or illness during active duty that impairs fertility. However, eight military hospitals do offer ART services at reduced cost, and may accept elective patients when space allows.

If you don’t meet the medical criteria but still want to freeze your eggs, you’re not out of options. Programs like Cofertility’s Split offer a path to free egg freezing when you donate half your eggs to another family. For many women in the military, this can be a way to take control of their reproductive future without waiting for policy to change.

Military service asks a lot—and family planning often gets pushed to the back burner. But if you’re thinking ahead, egg freezing might help create the space you need to build the life you want, when the time is right. We're here to help you explore that, every step of the way.

Egg freezing is an empowering option for family planning, but sometimes ovarian cysts can throw a wrench in the timing or progression of a cycle. Ovarian cysts are common and usually benign, yet their presence can influence how your body responds to ovarian stimulation, how many follicles develop, and even the egg retrieval process. 

In this article, we’ll explain what ovarian cysts are, highlight the types most relevant to fertility (functional cysts, endometriomas, and dermoid cysts), and discuss how each type might delay or impact an egg freezing cycle. 

What are ovarian cysts?

Ovarian cysts are fluid-filled sacs or pockets that develop within or on the surface of an ovary. They can occur in women of all ages and are often discovered during routine pelvic ultrasounds, including the baseline ultrasound that precedes an egg freezing cycle. The good news is that most ovarian cysts are benign (non-cancerous) and many are even a normal part of the menstrual cycle.

For example, every month, a follicle (which appears as a small cyst on ultrasound) grows to release an egg at ovulation; afterward, that follicle develops into a corpus luteum, a cyst-like structure that produces hormones. These are called functional cysts, and under normal conditions, they resolve on their own. Cysts vary in size and type. Small cysts often cause no symptoms, while larger ones can sometimes cause bloating, pelvic discomfort, or menstrual cycle irregularities.

In the context of egg freezing or donation, cysts are quite commonly seen – either as part of the intended ovarian stimulation (growing multiple follicles that look like cysts on the ovary) or as unexpected cysts present before stimulation begins. 

It’s usually the unexpected, “abnormal” cysts that may need management. Key factors are the cyst’s type, size, and whether it produces hormones. Depending on those factors, a cyst can be simply observed over time, treated with medication, drained, or surgically removed.

Types of cysts that can affect egg freezing

Functional cysts

As shared above, functional cysts are the most common. These include follicular cysts (which form when a follicle doesn’t release its egg) and corpus luteum cysts (which can form after ovulation). These are usually temporary and often resolve on their own within a few weeks or with a short course of birth control pills. But if a functional cyst is present at your baseline ultrasound and is producing hormones like estrogen or progesterone, it could throw off your hormone levels and interfere with proper follicle development. In those cases, your doctor might delay the cycle until the cyst clears.

Dermoid cysts

Dermoid cysts (also called teratomas) are benign growths that often contain a mix of tissue types, like hair or skin. They don’t produce hormones and are not typically associated with impaired egg quality. However, large dermoids can take up space in the ovary or increase the risk of ovarian torsion during stimulation. Research shows that ovaries with dermoid cysts—or with a history of dermoid removal—tend to have fewer follicles than the unaffected ovary, with about a 40% reduction on average. Open surgery may reduce ovarian reserve more than minimally invasive approaches like laparoscopy. Still, studies have found no significant differences in IVF outcomes such as eggs retrieved or pregnancy rates. Most of the time, small dermoids don’t interfere with egg freezing, and many doctors recommend freezing eggs first and addressing the cyst later if needed.

Endometriomas

Endometriomas are cysts caused by endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus. According to a meta analysis of nine published studies, these cysts can damage ovarian tissue, reduce ovarian reserve, and create an inflammatory environment that might impact egg quality. They can also make retrieval more technically challenging. Depending on the size and symptoms, your doctor may recommend moving forward with egg freezing before having surgery to remove an endometrioma, since the surgery itself can reduce egg count.

Cystadenomas

Cystadenomas are benign growths that develop on the surface of the ovary and can be filled with either a watery fluid (serous cystadenomas) or a thicker, mucous-like substance (mucinous cystadenomas). While they are typically non-cancerous, they can grow large and take up space within the ovary, which may impact the number of follicles that can develop during stimulation. Depending on size and symptoms, your doctor may recommend monitoring or surgical removal—usually after completing egg freezing.

Ovarian cancer 

Ovarian cancer is rare in people undergoing egg freezing, especially in younger age groups. However, if a cyst has suspicious features on ultrasound, your doctor may order additional imaging or tumor marker tests to rule out malignancy. If there’s any concern, your cycle may be delayed until further evaluation is complete. Malignant ovarian cysts require a different treatment path, and fertility preservation planning would need to be closely coordinated with an oncologist.

How cysts can impact your egg freezing cycle

Cycle delays

The most common impact of a cyst is a delay in starting your egg freezing cycle. If a cyst is producing hormones, your doctor might wait until your hormone levels normalize before beginning stimulation. This is typically just a short postponement, often one menstrual cycle or less.

Hormonal interference

Cysts that secrete estrogen or progesterone can disrupt the hormonal baseline necessary to begin a successful cycle. Your fertility doctor may choose to monitor the cyst or prescribe birth control to suppress ovarian activity until hormone levels return to the ideal range.

Fewer eggs or more complex retrievals

If a cyst is taking up space in the ovary, there may be fewer follicles able to grow on that side. Inflammatory cysts like endometriomas can also compromise egg quality. Some cysts, depending on their location and size, can make the egg retrieval procedure a bit more complex, but fertility doctors are trained to manage these situations safely.

Cyst management is individualized

In most cases, a cyst won’t ruin your egg freezing cycle—but it might delay it or reduce the number of eggs retrieved from one ovary. Your doctor will take into account your ovarian reserve, hormone levels, and any symptoms you’re having. If treatment or surgery is needed, you can make a plan together about when to proceed with egg freezing.

The bottom line

Cysts are common, and most won’t derail your fertility plans. In some cases, they may delay your cycle or slightly lower your egg count—but with good monitoring and a proactive plan, you can still have a successful egg freezing experience. If your clinic spots a cyst on your baseline ultrasound, they’ll talk you through next steps based on its type, size, and impact. You’re not alone in this—your care team is equipped to navigate cysts while helping you reach your egg freezing goals.

When you're navigating a chronic autoimmune condition like lupus, rheumatoid arthritis, or Hashimoto’s thyroiditis, your health may feel unpredictable. Amid treatment plans and flare-ups, it’s natural to wonder: Can my immune system affect my fertility? And if so, what options do I have to preserve my ability to grow a family in the future?

Egg freezing is an empowering step for anyone, and if you’re just beginning the process, there are lots of considerations to think about. But for people living with autoimmune disorders, unique factors need to be taken into account. In this article, we’ll walk through how autoimmune diseases may impact fertility, why egg freezing timing matters for those affected by autoimmune disease, and what to know before freezing your eggs if you have one of these conditions.

What are autoimmune disorders?

Autoimmune diseases occur when the body’s immune system mistakenly attacks its own healthy tissues, leading to chronic inflammation and tissue damage. There are over 80 known autoimmune diseases, which can affect nearly every system in the body, including joints, skin, nerves, blood vessels, and internal organs.

Some of the most common autoimmune conditions include:

• Systemic lupus erythematosus (SLE or lupus)
• Rheumatoid arthritis (RA)
• Multiple sclerosis (MS)
• Hashimoto’s thyroiditis (hypothyroidism)
• Graves' disease (hyperthyroidism)
• Type 1 diabetes
• Inflammatory bowel disease (Crohn’s, ulcerative colitis)

Unfortunately, these conditions disproportionately affect women, especially during their reproductive years. In fact, according to the CDC, nearly 80% of people diagnosed with autoimmune disorders are women.

Can autoimmune disease affect fertility? 

Many autoimmune conditions or their treatments can also affect fertility. A 2019 Best Practice & Research Clinical Endocrinology & Metabolism study found that women with autoimmune diseases such as lupus and RA had increased risks of infertility or “subfertility.” That being said, there may be various potential causes of this, direct and indirect, including physical conditions, age, and increased rates of antiphospholipid antibodies (aPL). 

Autoimmune diseases (or their treatments) have been shown to impact fertility in a few ways:

1. Impact on ovarian reserve and menstrual cycles

Some autoimmune diseases can cause direct damage to the ovaries. According to the World Journal of Experimental Medicine, in conditions like lupus or autoimmune oophoritis, the body may mistakenly target ovarian tissue, leading to reduced ovarian reserve or premature ovarian insufficiency (POI).

Medications also play a significant role. Cyclophosphamide, a chemotherapy agent often used in lupus and vasculitis, is known to be gonadotoxic, meaning it can damage the ovaries. Glucocorticoids and immunosuppressants can also impact hormone levels and cycle regularity as well.

2. Inflammation and immune dysfunction

Even without direct ovarian damage, chronic inflammation and dysregulated immune activity can interfere with ovulation, fertilization, and implantation. Gynecology and Obstetrics Clinical Medicine notes that elevated cytokines and autoimmune antibodies may impair follicular development or increase the risk of miscarriage.

3. Increased miscarriage risk

According to Nature Reviews Endocrinology, autoimmune conditions (along with other abnormalities in the female immune system) can interfere with reproductive success at various levels. Conditions involving the thyroid, as well as antiphospholipid syndrome and the presence of antinuclear or antithyroid antibodies have been linked to increased miscarriage risk. 

The publication also notes that impaired maternal immune tolerance and premature ovarian insufficiency — which, as mentioned above, can be caused by autoimmune conditions — can further compromise pregnancy outcomes. Because of all of this, early identification of autoimmune conditions is incredibly important for women who would like to have children down the line.   

Why egg freezing matters for people with autoimmune disease

If you have already been diagnosed with an autoimmune disorder, you have options. Freezing your eggs can provide an important degree of future flexibility.

Benefits of egg freezing

• Preserve fertility before starting treatments like chemotherapy or immunosuppressants
• Bank eggs during periods of remission while your health is stable
• Protect against future fertility decline, especially if your condition may lead to premature ovarian failure

Egg freezing is most effective when done earlier in life — ideally before the age of 35 — for anyone, with or without autoimmune disease. However, according to Advances in Reproductive Sciences, age is a particularly important consideration for those with lupus and other conditions known to accelerate ovarian aging.

Egg freezing success rates

To understand the impact of autoimmune conditions upon egg freezing success rates, let’s first establish what constitutes “success.” When it comes to egg freezing, the goal is a combination of the quantity of mature eggs retrieved, along with quality (which unfortunately cannot be determined until a fertilization attempt through IVF). 

Egg freezing for those with lupus

In one retrospective cohort study examining women with systemic lupus erythematosus (SLE) undergoing egg freezing, the incidence of Diminished Ovarian Reserve (DOR) for those with SLE were much higher than for those without (42.2% vs. 10.8%, respectively). While maturation rates were similar between the groups, those with SLE also made fewer viable embryos (76.6% vs. 86%), even when freezing their eggs while in remission. 

Egg freezing for those with rheumatoid arthritis (RA)

A 2018 study in The Journal of Rheumatology found that women with RA did not have statistically significantly lower AMH levels, menstruation regularity, or ovulation rates than age-matched controls. If freezing their eggs, RA patients should expect modest reductions in ovarian reserve, but stimulation protocols can likely proceed without major adjustment. This is especially true if the patient is in remission. 

Egg freezing for those with Hashimoto’s Thyroiditis (and thyroid autoimmunity)

A 2022 study featured in Clinical Thyroidology for the Public found that women with TSH in the upper-normal range had lower AMH levels and fewer ovarian follicles than those with lower-normal TSH. Diminished ovarian reserve (DOR) occurred in 5.1 of high-normal TSH autoimmunity cases vs. 3.5% in lower normal. 

Similarly, a BMC Women’s Health study demonstrated a negative correlation between TSH levels and AMH, implying that even slight thyroid dysfunction could lower ovarian reserve. 

What about egg donation?

While the process of ovarian stimulation and retrieval is the same for donation as it is for freezing, eligibility for egg donation for individuals with autoimmune disorders depends on the specific condition and its severity.

Most clinics disqualify potential egg donors with lupus, multiple sclerosis, and Graves’ disease (hyperthyroidism), because these conditions may have a genetic component or increase health risks during ovarian stimulation. However, Hashimoto’s thyroiditis, a common cause of hypothyroidism, may be allowed if it’s well-managed and mild. Please reach out to our team, and we can help you understand if you qualify for egg donation. 

Key considerations before freezing your eggs

If you’re considering egg freezing while managing an autoimmune disorder, planning ahead is key:

Timing around flares

Ovarian stimulation requires hormonal medications, which may not be safe during disease flares. It’s best to pursue fertility preservation during a period of remission or low disease activity.

Specialist involvement

Work with a reproductive endocrinologist who has experience treating patients with autoimmune conditions. Coordination with your rheumatologist or primary specialist ensures medications are adjusted appropriately and risks are minimized.

Tailored medication protocols

You may require modified stimulation protocols or extra monitoring during the egg retrieval process. For instance, those with lupus may need to avoid certain estrogen-based protocols to reduce clotting risks.

Emotional and practical considerations

Living with a chronic illness while making fertility decisions can be emotionally complex. You may experience *all* the things: anxiety about the future, grief over limited control of your body, pressure to “act now” before health declines…the list goes on. You're not alone—and your feelings are valid.

Mental health support (from a therapist, support group, or community like ours) can be invaluable. Don’t hesitate to seek resources to help process your journey.

On the practical side, you’ll also need to consider financial implications. Egg freezing costs can be high, but some insurance plans may cover fertility preservation when tied to medically necessary treatments (e.g., chemotherapy).

And opportunities like the Cofertility Split program offer ways to freeze your eggs for free when you donate half to another family (note: eligibility will depend on medical history).

How Cofertility can help

At Cofertility, we’re committed to making egg freezing more accessible, affordable, and inclusive — and this extends to those managing complex health conditions.

Whether you’re exploring egg freezing before starting immunosuppressants, wondering if lupus affects fertility, or curious about your eligibility to donate, we’re here for you. Our platform:

• Offers personalized support through every step of the process
• Helps match you with the right fertility clinic for your needs
• Provides transparent guidance around eligibility and medical requirements

We believe fertility care should reflect the diversity of women’s lived experiences, including those with chronic illness.

Final thoughts

If you're living with an autoimmune disease, your fertility may feel uncertain, but it doesn't have to be out of your hands. With the right team and a clear plan, egg freezing can offer hope, agency, and peace of mind.

Want to learn more about your options? Reach out to us. We’re here to walk this journey with you.

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Sources:

• National Institute of Environmental Health Sciences. (n.d.). Autoimmune diseases. NIEHS. https://www.niehs.nih.gov/health/topics/conditions/autoimmune
• Autoimmune Diseases Coordinating Committee. (2004). Progress in autoimmune diseases research. Emerging Infectious Diseases, 10(11). CDC. https://wwwnc.cdc.gov/eid/article/10/11/04-0367_article
• Falconer, H., et al. (2019). Fertility preservation and ovarian function in women with autoimmune diseases. PubMed. https://pubmed.ncbi.nlm.nih.gov/31837981/
• Komatsu, M., et al. (2005). Autoimmune oophoritis and infertility: Implications for premature ovarian insufficiency. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121274/
• Sammaritano, L. R. (2016). Fertility preservation in women with autoimmune disease. BMJ Case Reports. https://gocm.bmj.com/content/4/1/e000011
• Somers, E. C., et al. (2013). Autoimmune diseases and reproductive health: Impact and risks. PubMed. https://pubmed.ncbi.nlm.nih.gov/24189508/
• Elshafey, E. M. (2015). Systemic lupus erythematosus and ovarian dysfunction. Scientific Research Publishing. https://www.scirp.org/journal/paperinformation?paperid=63755
• Zhao, Y., et al. (2023). Immune imbalance in infertility: Mechanisms and implications. Frontiers in Immunology. https://www.frontiersin.org/articles/10.3389/fimmu.2023.1132045/full
• Wallenius, M., et al. (2018). Rheumatoid arthritis and ovarian reserve. The Journal of Rheumatology. https://www.jrheum.org/content/early/2018/11/12/jrheum.180176
• American Thyroid Association. (2022). Thyroid hormone levels and ovarian reserve. Clinical Thyroidology for the Public, 15(10), 9–10. https://www.thyroid.org/patient-thyroid-information/ct-for-patients/october-2022/vol-15-issue-10-p-9-10
• Meng, L., et al. (2023). TSH and AMH levels in women with autoimmune thyroiditis. BMC Women’s Health. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02725-1

We’re thrilled to share this guest post from Emily Oster, acclaimed economist, author, and founder of ParentData. In this piece, she answers a direct question from her own community that we often hear too: Are there long-term risks to donating eggs?

Whether you're thinking about freezing your eggs for your own future or donating to help someone else build their family, this one’s for you.

Q: I love the idea of donating eggs to help others grow their families. The short-term side effects are documented, but I’m having trouble determining if there are long-term side effects. Infertility and certain cancers are sometimes mentioned as long-term side effects, but honestly those claims appear to be unfounded. Long-term side effects of IVF are sometimes used as a stand-in, but the reality is that egg donors and IVF patients are vastly different populations (race, socioeconomic status, age, etc.). I’m wondering what nuanced light you, as a vagina economist, may be able to shed on the long-term side effects of egg donation. Thank you! - Egg Donor Hopeful

A: First of all, bravo to you for this instinct. It is lovely. Egg donation is often criticized and concerns are raised about payments for eggs, but I believe that this desire to help others underlies a huge share of these donations. Because mostly people are good!

Egg donation is, as you know, a much more involved procedure than sperm donation. Medications are used to stimulate ovaries to produce multiple eggs in a cycle, and then the eggs are surgically harvested. The surgery is done “transvaginally” — no cuts — and under sedation (but typically not general anesthesia). This is the same procedure that is used if you are freezing your own eggs or harvesting eggs for IVF. The primary short-term medical concerns are overstimulation of egg production, which can cause ovarian pain, and infection from the procedure. This latter concern is quite minor; the nature of the procedure makes it very unlikely, but all medical procedures carry a bit of this risk. 

In terms of longer-term risks, the one that generates the most “panic headlines” is cancer. Because the procedure for stimulating the ovaries involves estrogen, and because estrogen can feed some cancers, there is a theoretical reason that one might consider a link — especially with breast, ovarian, or uterine cancer.  

Concerns about this have been raised largely based on anecdotal evidence. There are people who donated eggs and then developed cancer while relatively young. Of course, cancer also develops in young people who haven’t donated their eggs. Even though cancer in young people is fairly rare, it is not unheard of. Pointing to single anecdotes is not helpful.

The best data we have on this comes from large-scale analyses of people who had the procedure done for IVF purposes. This isn’t a perfect population to learn from, since they are going to be on average higher-risk than healthy young egg donors, but it is our largest source of data. And it is reassuring.

This article, from 1995, compared a group of about 5,000 women who were referred for IVF and underwent egg stimulation with a similar-size group who were referred and did not. The researchers did not find an elevated risk of breast cancer or ovarian cancer, although there were so few cases of the latter, they urged caution in interpretation. 

In the end, there is no affirmative evidence to suggest there is a long-term cancer risk from egg donation.

If you’re considering egg donation or egg freezing yourself, check out Cofertility’s programs. Whether you’re looking to freeze your eggs for your own future or help grow another family through donation, we’re here to make it more accessible, informed, and empowering for everyone involved.

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Your period can tell you a lot about your reproductive health—so when it’s irregular, it’s normal to wonder what that means for your fertility. The good news? An irregular cycle doesn’t automatically mean something’s wrong. But it can be a signal worth paying attention to, especially if you’re thinking about freezing your eggs or trying to conceive in the future.

Let’s break down what “irregular” really means, what might cause it, and how it may or may not impact your fertility.

First, what counts as an irregular period?

A textbook menstrual cycle is 28 days, but plenty of people fall outside that exact window. In general, a cycle is considered regular if:

• It occurs every 21–35 days
• Bleeding lasts about 2–7 days
• The pattern is relatively consistent month to month

When people say they have “irregular periods,” they might be describing a wide range of experiences. Medically, irregular menstruation can take several forms, each with its own terminology:

• Amenorrhea (ey-men-uh-REE-uh): When your period stops for at least three months and you're not pregnant or on birth control.
• Oligomenorrhea (ol-i-goh-men-uh-REE-uh): Infrequent periods, typically occurring more than 35 days apart.
• Polymenorrhea (pol-ee-men-uh-REE-uh): Frequent periods that occur less than 21 days apart.
• Menorrhagia (men-uh-REY-jee-uh): Very heavy periods—also known as excessive menstrual bleeding. This is different from anovulatory bleeding (bleeding without ovulation), even though the two are sometimes confused.
• Prolonged menstrual bleeding: Periods that last more than 8 days on a regular basis.
• Shortened menstrual bleeding: Periods that consistently last less than 2 days.
• Dysmenorrhea (dis-men-uh-REE-uh): Painful periods, often involving severe menstrual cramps.
• Intermenstrual bleeding: Spotting or bleeding that occurs between periods.
• Cycle variability: When your cycle length changes dramatically month to month, typically a variation of more than 20 days between your shortest and longest cycle.

Some of these patterns may be temporary or benign. Others may suggest that ovulation isn’t happening regularly, which can impact your ability to conceive or be a sign of an underlying condition like PCOS, a thyroid issue, or hormone imbalance.

Why ovulation still matters—even if you’re not trying to conceive right now

When your menstrual cycle is irregular, it often means that ovulation isn’t happening on a predictable schedule—or may not be happening at all. While you may not be trying to get pregnant right now, ovulation is still an important marker of how your reproductive system is functioning.

Ovulation is the process of releasing an egg from your ovary, typically once per cycle. If it’s not happening regularly, it could be a sign of a hormonal imbalance, conditions like PCOS, or other issues.

Irregular periods are common

You're not alone if your cycle doesn't run like clockwork. In fact, about 14% to 25% of women experience irregular menstrual cycles. This can mean that cycles are shorter or longer than average, the flow is unusually heavy or light, or that periods come with other symptoms like significant abdominal cramping. While some variation is completely normal, consistently irregular cycles, especially when paired with other symptoms, can sometimes signal an underlying issue worth discussing with a doctor.

What causes irregular periods?

There are a range of potential causes, and many of them are treatable. Some common reasons include:

• Polycystic ovary syndrome (PCOS): A common hormonal condition that affects ovulation. PCOS is one of the most frequent causes of irregular periods and infertility, but it’s also highly manageable with the right care.
• Thyroid disorders: Both hyperthyroidism and hypothyroidism can disrupt menstrual cycles and hormone balance.
• High levels of stress: Chronic stress can impact the hypothalamus (a part of your brain that regulates hormones), leading to missed or delayed periods.
• Excessive exercise or very low body fat: Athletes or those with low BMI may experience missed periods due to disruptions in hormone production.
• Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus, which can interfere with your cycle and cause painful periods.
• Uterine fibroids: Noncancerous growths in the uterus that can lead to heavy, prolonged, or unpredictable bleeding.
• Pelvic Inflammatory Disease (PID): An infection of the reproductive organs that can cause inflammation, scarring, and irregular bleeding.
• Certain medications: Including antipsychotics, chemotherapy drugs, and others that may interfere with hormone levels.
• Hormonal birth control: While many types of birth control regulate periods, some—like the contraceptive pill, IUD (coil), implant, or contraceptive patch—can cause irregular bleeding or even stop your period altogether.
• Perimenopause: In your late 30s and 40s, hormone levels begin to shift, often causing cycles to become less predictable.
• High prolactin levels: Sometimes caused by medications or pituitary issues, this hormone imbalance can affect ovulation and cycles.
• Pregnancy: It might seem obvious, but pregnancy is a common reason for a missed period—and often the first one that should be ruled out.

How irregular periods affect egg freezing

If you’re considering freezing your eggs, an irregular cycle doesn’t necessarily disqualify you. But it might make early fertility testing and planning even more important.

One of the key hormones used to assess fertility is anti-Müllerian hormone (AMH), which gives insight into your ovarian reserve—how many eggs you have left. An irregular cycle doesn’t always correlate with a low AMH, but in some cases (like with PCOS), AMH can actually be elevated.

If you're not ovulating consistently, your doctor may adjust your medication protocol or monitoring strategy during an egg freezing cycle to make sure it’s effective and safe. In fact, for some people with irregular cycles, egg freezing may be especially empowering—allowing you to preserve your eggs while figuring out what’s going on hormonally.

What does a long cycle mean?

If your cycle regularly stretches beyond 38 days, it’s considered long (or “infrequent menstruation”). This could mean that ovulation is happening later than usual—or in some cases, not at all. Conditions like PCOS or hypothyroidism are common culprits, both of which can interfere with regular ovulation.

Long cycles may result in fewer ovulatory events over time, which can impact your chances of conception if you’re trying to get pregnant unassisted. That said, having a long cycle doesn’t automatically mean you’re infertile. Some people with longer cycles still ovulate consistently, just on a different schedule.

When it comes to egg freezing, a longer cycle may influence the timing of your stimulation protocol, but doesn’t necessarily affect your ovarian reserve or how many eggs you can retrieve. Your doctor may monitor your hormones more closely or adjust your medication plan to sync things up.

What does a short cycle mean?

Cycles shorter than 24 days are considered short (or “frequent menstruation”) and may indicate that ovulation is happening too early, or not at all. In some cases, short cycles can signal a shortened follicular phase (the time between your period and ovulation), which may affect the quality of the egg released.

Short cycles can sometimes be linked to hormone imbalances, stress, perimenopause, or conditions like endometriosis. They don’t always mean your fertility is compromised, but they’re worth discussing with your doctor, especially if you’re seeing other symptoms like spotting, heavy bleeding, or severe cramping.

For egg freezing, short cycles may influence your monitoring schedule or how your doctor times your retrieval. As with long cycles, personalized care and hormone tracking can help ensure the process is effective, regardless of where your cycle falls on the calendar.

When to see a doctor

Consider seeing a fertility specialist or OBGYN if:

• You’ve had irregular cycles for more than 6 months
• You’re thinking about freezing your eggs and want to understand your cycle better
• You’re under 35 and have been trying to conceive for over a year, or over 35 and trying for six months
• You’re experiencing other symptoms, like acne, hair loss, weight changes, or pelvic pain

A few simple blood tests and an ultrasound can reveal a lot about what’s going on and help you make informed decisions about your reproductive health.

The bottom line

An irregular period doesn’t automatically mean something’s wrong with your fertility, but it’s worth paying attention to. It could be a signal that your hormones are out of sync or that ovulation isn’t happening consistently. Fortunately, most causes of irregular periods are manageable, and with the right support, many people go on to conceive or preserve their fertility successfully.

If you’re considering egg freezing and have irregular cycles, Cofertility can help you get clarity. Whether you’re looking to take control of your fertility now or just want to understand your options, we’re here to support you, no matter what your cycle looks like.

Freeze your eggs with Cofertility

We’d love the opportunity to support you on your egg freezing journey.

Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.

Through our Keep program—where you keep 100% of eggs retrieved for your own future use—we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help promote social justice and strengthen gender equality.

For women pursuing a career in medicine, the demands of training often overlap with the years when fertility is at its peak. Medical school, residency, and fellowship consume time, energy, and focus, leaving little space for starting a family. While this may feel like just part of the deal, the effects of delay on reproductive outcomes are often more significant than expected.

A recent study of nearly 200 female physicians at a large academic medical center in Massachusetts sheds light on how these choices play out over time. Many reported delaying childbearing for their careers, some faced infertility, and others expressed regret. The findings offer a window into what happens when professional goals and reproductive health collide—and they raise important questions for medical students and early-career physicians.

In this article, we’ll break down what the study found, including how common it is for physicians to postpone parenthood, what kinds of fertility treatments are later required, and why so few pursue egg freezing. You’ll also read about how specialty choice and workplace culture shape these decisions, and what early-career medical professionals might want to keep in mind as they plan ahead.

A closer look at the data

The study, published as a pre-print in Fertility & Sterility, surveyed 194 attending-level female physicians at the University of Massachusetts Chan Medical School. All participants had completed their training and identified as having a uterus. The median age was 42, and most respondents were white, heterosexual, and married. Though the study took place at a single institution, the results echo what smaller and larger studies across the U.S. have also found.

Some of the most surprising findings included:

• 64% intentionally delayed childbearing due to career considerations.
• 28% of those who had attempted conception sought fertility treatment.
• Only one respondent had pursued egg freezing, despite the high rate of delayed childbearing and infertility.
• 41% said their specialty choice influenced their family planning, and 10% would have chosen a different specialty altogether if they could reconsider based on reproductive factors.
• Nearly 60% of those who sought fertility treatment said their colleagues didn’t know about it, indicating stigma or reluctance to share these experiences in the workplace.

Among the group, 64% said they had intentionally delayed childbearing because of their careers. And while some were able to have children later, others struggled. Nearly 30% of those who attempted to conceive required some form of fertility assistance, such as intrauterine insemination (IUI), in vitro fertilization (IVF), or hormonal therapy. These experiences weren’t just clinical—they were emotionally and logistically draining. Respondents described fertility treatment as “a secret second job” and shared how hard it was to manage appointments and recovery while keeping up with demanding work schedules.

Why age matters more than most expect

One of the most consistent themes in the study was delayed family planning. The median age at first pregnancy among respondents was 32, with many stating they waited until after residency or even fellowship to start trying. The average age for American women overall is 27.3. While this may seem like a reasonable timeline, it often pushes conception into an age range where fertility begins to decline. Advanced maternal age—generally defined as 35 and older—is linked to increased risk of miscarriage, pregnancy complications, and infertility.

What’s more, fewer than half of the respondents said they had learned about their own fertility during medical training. Even within a field built on science, many felt unprepared or uninformed about how quickly fertility can decline. Several said they wished they’d received more specific information about fertility timelines and options like egg freezing much earlier.

Specialty choice plays a role

The study also revealed how much specialty selection can affect reproductive planning. Over 40% of respondents said their specialty impacted their ability to build a family. Some specialties—particularly surgical ones—were described as rigid and unforgiving when it came to parental leave or flexible scheduling. Others chose specialties they believed would be more “family friendly,” but still faced institutional obstacles.

About 10% of respondents said they would have chosen a different specialty if they’d considered family planning more carefully at the time. That number may sound small, but it reflects real trade-offs and missed opportunities. Specialty choice isn’t just about interest or aptitude—it also shapes lifestyle, hours, and how easily time off can be managed.

Fertility preservation: rarely used, often too late

Only one (!!!) respondent reported having frozen her eggs. That low number is striking, given how many delayed childbearing or later struggled with infertility. Some of this may be generational—egg freezing only became widely accessible and socially accepted in the past decade—but the responses also point to a lack of institutional support. Many said they didn’t have enough information about egg freezing during training, or that cost and time were major barriers.

Some respondents said they would have considered fertility preservation earlier if it had been encouraged or financially supported. Others described regret that they hadn’t understood how limited their options would become over time. Though the study didn’t focus on medical students, the findings suggest this is an area where awareness and access could make a difference.

The unspoken culture around fertility

One of the clearest messages from the study is that fertility and childbearing remain taboo topics in medicine. Among those who sought fertility treatment, 59% said they kept it from colleagues. Respondents cited fear of judgment, stigma, or simply not wanting to appear “less committed” to their work. Some described returning to work just weeks after giving birth, with little support or flexibility.

The stigma isn’t just about pregnancy—it extends to wanting to have children at all. Several respondents said they felt they had to choose between being seen as serious about their careers or open about their plans to have a family. Until this cultural tension is addressed, many physicians will continue to feel isolated in their family-building experiences.

What medical students and residents can take away

If you’re in medical school, residency, or just beginning to think about your future, this study offers both a warning and an opportunity. The warning: don’t assume you’ll figure it out later! Fertility isn’t something most people think about until they have to, but for women in medicine, waiting too long can close doors. 

The good news is that you still have time to learn, ask questions, and make decisions that align with both your career and your personal goals. Talk to mentors who have navigated these issues. Seek out unbiased information about fertility timelines and preservation. Consider how specialty choice, training length, and future lifestyle may intersect with your family plans. Advocate for work environments that honor and respect family building. During your job searches and contract negotiations, prioritize the benefits that will be important to you if you may need to take leave at some point. Most importantly, know that you’re not alone in thinking about this now.

Planning ahead doesn’t mean giving up on your ambitions—it means refusing to let biology, or outdated workplace norms, make the choices for you.

Read more:

• The Best Time to Freeze Your Eggs as a Medical Student
• How to Freeze Your Eggs for Free
• Does Donating Eggs Affect Your Fertility?
• What Medical Schools Offer Egg Freezing for Faculty?

If you’re preparing to freeze your eggs, you’ll be learning all about female fertility hormones, including estradiol. It’s one of the key hormones your medical team tracks throughout the process, and it plays a major role in how your body responds to the medications used during ovarian stimulation. 

This article breaks down what estradiol actually is, when and why it’s tested during your cycle, and how doctors use those numbers to make decisions along the way. We’ll also cover what different estradiol levels might suggest about how your ovaries are responding, what those levels tend to look like, and what to know if your levels come back higher or lower than expected. Whether you’re just starting to explore egg freezing or already in cycle, understanding estradiol can help you feel more confident in the process.

What is Estradiol?

Estradiol (E2) is the primary form of estrogen, the main female sex hormone. It is produced by the ovaries, specifically by the granulosa cells of growing ovarian follicles, and plays a central role in the menstrual cycle. 

Estradiol helps regulate the cycle and prepares the uterus for pregnancy by promoting the growth of the endometrial lining. In a normal menstrual cycle, estradiol levels rise during the follicular phase and peak just before ovulation, signaling that a mature egg is ready to be released. 

In an egg freezing cycle, injectable medications are used to stimulate the ovaries to mature multiple follicles simultaneously, and these growing follicles produce estradiol. So when your doctor checks your estradiol levels during a cycle, they’re using it as a real-time snapshot of how your ovaries are responding.

Each follicle contributes to your overall estradiol level. More follicles usually mean higher estradiol, which is why this hormone is so helpful for estimating how many eggs might be maturing. It doesn’t replace ultrasound (your team will still count and measure follicles via imaging), but together, these tools give a more complete picture of how your cycle is progressing.

Normal estradiol numbers during an egg freezing cycle

Estradiol is measured in a simple blood test throughout your monitoring appointments. Along with ultrasound measurements of follicle count and size (AFC), estradiol tracking helps the medical team gauge your response. These numbers can vary significantly depending on the number of follicles growing and how your body responds to the medications.

A note on letrozole and E2 levels: If your doctor is using letrozole (an aromatase inhibitor) as part of your stimulation protocol, be aware that this medication intentionally lowers estradiol levels in the bloodstream by blocking the conversion of androgens to estrogen. Because of this, your E2 levels may be significantly lower than the standard ranges described in this article—even if your follicles are growing well and your cycle is progressing normally. In these cases, estradiol is still monitored, but ultrasound findings take on even greater importance in tracking your response. If you’re taking letrozole, your care team will interpret your E2 values within that context.

Baseline: under <60-80 pg/mL

You’ll typically have your estradiol tested multiple times during your cycle, starting with a baseline blood test on day 2 or 3 of your period. At that point, your estradiol should be relatively low, usually under 50–60 pg/mL. A low baseline tells your doctor that your ovaries are quiet and ready to begin stimulation. If your baseline estradiol level is elevated, it may suggest a residual cyst from a previous cycle or indicate lower ovarian reserve. In those cases, your fertility doctor may postpone the cycle or monitor more closely.

Early stimulation: <300-500 pg/mL

As stimulation begins, you’ll take injections of hormones like FSH (follicle-stimulating hormone), which encourage your ovaries to mature more follicles. Clinics usually monitor estradiol every few days, especially around days 5, 8, and 10, as they adjust medication doses and decide when to schedule your trigger shot. 

Early in the cycle, E2 levels are very low, but as the follicles develop, estradiol rises exponentially because each growing follicle secretes estrogen.

Mid-cycle: under 500-1,000 pg/mL

By mid-cycle, estradiol increases to 500-1,000 pg/mL, reflecting the growth of multiple follicles (each follicle adds to the total estrogen output).

This rapid increase is an indirect measure of ovarian response – a stronger response means more follicles producing estrogen, leading to higher E2 levels. Doctors typically check estradiol and follicle measurements around the middle of stimulation (e.g. day 5 and day 8) to adjust medication doses if needed, and then more frequently as you approach the “trigger” day, to ensure estradiol (and follicle growth) is on track.

Trigger day: 1,500–3,000 pg/mL or higher

The final estradiol measurement is often on the day of the ovulation trigger (the injection that matures the eggs before retrieval). By this point, estradiol levels are at their peak for the cycle. 

Typical values can vary widely depending on how many follicles have grown. In a “normal” responding cycle, peak estradiol might be on the order of ~1,000–2,500 pg/mL. If you have an especially positive response (common in younger women with high ovarian reserve), E2 might exceed 3,000 pg/mL. 

In contrast, a poor or low response might only see a peak E2 in the low hundreds (<1,000 pg/mL). Clinicians use these levels in real time to guide the trigger timing and type. For instance, if estradiol is very high, indicating lots of mature follicles, they may opt for a special trigger (like a GnRH agonist trigger) to reduce the risk of ovarian hyperstimulation syndrome (OHSS). If estradiol is lower than expected, it might confirm a low-yield cycle, and the team might counsel whether to proceed to retrieval or consider canceling if the response is extremely poor. 

After the trigger shot, estradiol isn’t usually monitored immediately (because at that point the focus shifts to retrieving the eggs), but the peak level you reached is a useful summary of how well the ovaries responded to the stimulation medications.

Estradiol and egg yield: Is it predictive? 

Yes, there is a clear correlation between estradiol levels and the number of eggs retrieved. One often-cited rule of thumb is that each mature follicle contributes about 200–300 pg/mL of estradiol. So, if your estradiol is around 2,000 pg/mL on trigger day, you might expect about 8 to 10 mature follicles, and likely a similar number of eggs retrieved.

Several studies back this up. A 2021 study found that estradiol levels on trigger day strongly predicted both the number of oocytes retrieved and the number that reached maturity. Other research has found that higher estradiol levels are associated with greater egg yields and higher embryo formation rates in IVF, even across different age groups.

However, estradiol alone doesn’t tell the full story. For example, some patients may have high estradiol levels but still retrieve only a few eggs. This can happen if estradiol per egg is unusually high—something that’s been linked to poorer ovarian efficiency or lower egg quality, especially in older patients. That’s why estradiol is always interpreted alongside ultrasound findings and other hormone levels like LH and progesterone.

Most importantly, the number of follicles that measure 17mm or larger on ultrasound—the ones considered “in range”—is actually the most reliable predictor of how many mature eggs will be retrieved. Estradiol levels provide helpful supporting information, but it’s the follicle count and size that offer the clearest view of likely egg yield.

Fast vs. slow responders 

Estradiol should rise as you take stimulation meds. There’s no single “right” value mid-cycle, since protocols vary, but steady upward momentum is usually what we want. In general, doctors look for estradiol levels to roughly double every two days—a sign that your ovaries are responding appropriately to the medication.

For example, one guideline defined a “fast responder” as someone whose E2 topped 300 pg/mL by about day 5, whereas a slower responder might take until day 8 to reach 300 pg/mL. Don’t fixate on any one early number – it’s the trend that counts. 

If E2 is very slow to rise, the clinic might increase your medication dose or extend stimulation a bit. If it’s skyrocketing quickly, they might adjust doses downward or start preparing to trigger a bit sooner to avoid overshooting. Don’t be afraid to ask your clinic about your results; they will tell you if your hormone levels are as expected or if any changes are needed.

Interpreting “low” estradiol

If your estradiol never climbs into the four digits by trigger day, it may indicate a lower-yield cycle. Don’t be discouraged – quality matters too! But know that a peak E2 of, say, 600 pg/mL might translate to only a few eggs retrieved. 

In an Extend Fertility study of egg freezing patients, those with peak E2 below 1,000 pg/mL (low responders) did have fewer mature eggs and a lower maturation rate compared to higher-E2 cycles. Your doctor might have a candid conversation about whether to proceed or consider another strategy if the response is very low. 

For women under 35, true low response is less common, but it can happen and may warrant investigating underlying factors. On the flip side, remember that even a low-yield cycle can still be valuable – each egg is a chance, and younger eggs (even if few) have high pregnancy potential. Your care team will help put this in perspective based on your goals.

The bottom line

Estradiol is your friend in the egg freezing process – it’s evidence that your ovaries are doing what we want them to do. By understanding the typical patterns (low at baseline, rising through stimulation, and peaking at trigger), you can better follow along with your cycle monitoring. 

Rather than getting anxious over an isolated lab number, look at the big picture: Is your estradiol increasing appropriately? Approximately how many follicles does it suggest? Your fertility team will interpret these values with the nuance they require. High or low, the estradiol levels guide your doctors in optimizing your cycle. And as an empowered patient, knowing what estradiol signifies helps you ask informed questions. For example, if you hear your E2 value, you might now recognize “Okay, that sounds like a strong response” or “Hmm, that’s on the lower side – what does that mean for my egg count?” 

Remember that every woman’s ovaries are unique and every cycle is unique. Use these numbers as informative benchmarks, but always discuss specifics with your doctor, who can correlate estradiol with your ultrasound findings and overall plan. With an evidence-based, well-monitored approach, you can feel confident that your estradiol levels – and the precious eggs they reflect – are being managed to give you the best possible outcome for the future.

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Sources:

• Deadmond A, Koch CA, Parry JP. Ovarian Reserve Testing. [Updated 2022 Dec 21]. In: Feingold KR, Ahmed SF, Anawalt B, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279058/
• Huang, W., Wei, L., Tang, J. et al. Impact of relative estradiol changes during ovarian stimulation on blastocyst formation and live birth in assisted reproductive technology. Sci Rep 15, 15617 (2025). https://doi.org/10.1038/s41598-025-00200-5
• Malathi, A., Balakrishnan, S. & B. S., L. Correlation between estradiol levels on day of HCG trigger and the number of mature follicles, number of oocytes retrieved, and the number of mature oocytes (M2) after oocyte aspiration in ICSI cycles. Middle East Fertil Soc J 26, 34 (2021). https://doi.org/10.1186/s43043-021-00080-5

When people think about choosing an egg freezing clinic, they often zero in on success rates, technology, and cost—and with good reason. Experience and outcomes absolutely matter. You want a clinic that knows what it’s doing, with a proven track record and a solid lab. But once you’ve narrowed it down to a few top-tier options, something more subjective can make all the difference: how the clinic makes you feel.

Clinic culture shapes your entire experience, from the way you're greeted at the front desk to how a provider handles your questions and concerns. It’s about whether you feel respected, rushed, dismissed, or truly supported. And since egg freezing is already a significant decision—one that touches on your body, your future, and your finances—it’s worth thinking about who you want by your side during the process.

This article explores what clinic culture actually looks like in practice, how to spot the good (and the not-so-good), what to do if you find yourself torn between a great doctor and a not-so-great clinic—or vice versa—and how to advocate for yourself along the way. We’ll also share how Cofertility can help you find a partner clinic that checks both the technical and emotional boxes.

What we mean by “clinic culture”

Clinic culture goes beyond mission statements and Instagram presence. It shows up in the details: how the front desk answers the phone, whether your provider gives you space to think, how questions are handled, and what’s prioritized in your consult. It's the difference between being treated like a partner in your care versus a sales lead on a spreadsheet.

Some of it is tangible—provider diversity, clear pricing, and how welcome you feel in the clinic. Some of it is harder to pin down, like the tone a doctor uses or whether the clinic feels collaborative or transactional.

If you’ve ever walked out of a medical appointment feeling unsure why you felt “off,” even when nothing was technically wrong, that’s culture in action.

For many egg-freezers, culture isn’t just a nice-to-have

Freezing your eggs is a medical procedure, but it’s also a personal experience. Feeling dismissed, judged, or pressured—even when everything goes “well” on paper—can leave a sour taste that lingers. On the other hand, feeling supported and heard can make the entire process feel more manageable, especially if you’re facing uncertainty. It can give you the confidence to advocate for yourself and achieve the best possible outcome. 

Research shows that patient satisfaction and trust increase when people feel emotionally safe and respected by their providers. That doesn’t mean you need a clinic with mood lighting and yummy snacks in the waiting room (though that doesn’t hurt). 

It means you want a place where you can ask questions without being made to feel naïve or annoying. A place where your concerns are met with clear information, not eye rolls or scare tactics.

Signs of a supportive clinic culture

There’s no universal checklist, but here are a few markers that can help:

• During your consult, the provider asks about your goals—not just what they think you should do.
• Pricing is transparent and accessible, without buried fees or surprise upcharges.
• You’re encouraged to take your time with the decision, not rushed into a multi-cycle package.
• The clinic offers emotional or counseling support, or at least acknowledges that egg freezing is more than just a transaction.
• Materials and communications are inclusive and don’t rely on fear-based language.

Likewise, watch for red flags like aggressive upselling, dismissive answers, or pressure to commit immediately. The way you're treated during a consult is often a preview of how you'll be treated throughout the process.

What if it’s the right doctor but the wrong clinic?

This happens more than you’d think. Maybe you’ve found a provider you click with, but the clinic feels disorganized or impersonal. Or the clinic has a stellar reputation, but your doctor brushes off your concerns. It’s a frustrating position to be in.

If you love your doctor, it’s worth seeing if they also practice at other clinics in the area—some occasionally do. If it’s the clinic you’re drawn to, consider asking for a second consult with a different provider there. One person doesn’t always represent the whole culture, and sometimes a different match can change your whole impression. Don’t ignore your gut. If something feels off, ask questions and advocate for what you need. 

Quality comes first, but your experience matters too

Let’s be clear: the most important thing is choosing a clinic with strong experience and good outcomes. That’s non-negotiable. But once you’re choosing between two or three clinics that are all technically excellent, culture becomes the tiebreaker.

In other words, you shouldn’t pick a clinic just because it has nice branding or a friendly receptionist. But if two clinics are equally reputable, the one where you feel more supported, heard, and safe is worth prioritizing.

At Cofertility, we partner with clinics that meet high standards for both medical quality and patient experience. If you’re unsure where to start—or you’ve had a consult that didn’t sit right—we can help connect you with options that align with your values and goals.

Bottom line

You’re not being high-maintenance for caring about how you’re treated. Egg freezing is about your future, but it’s also about your now—and the clinic you choose will shape both. The right culture won’t make a difficult decision easy, but it can make it a lot less stressful.

You deserve a clinic that sees you as a person, not a procedure. And if you're looking for one, we’re here to help.

Freeze your eggs with Cofertility

We’d love the opportunity to support you on your egg freezing journey.

Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.

Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also gain free access to our Freeze Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help promote social justice and strengthen gender equality.

‍

Read more:

• What to Look For in an Egg Freezing Clinic
• How to Increase Egg Freezing Chances of Success
• Researchers Followed 921 Egg Freezers; Here’s What They Found

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Thinking about egg freezing? It can be an empowering option for many women, offering the ability to better preserve your fertility by storing your eggs at their current state. It puts more control in your hands—allowing you to choose the right time to start a family, find the right partner, or focus on your career and personal aspirations without the added pressure of a ticking biological clock. That said, egg freezing is also a deeply personal and significant decision. It can stir up a range of complex emotions, from hope and relief to uncertainty and stress. That's why many women find therapy to be a valuable resource during this process—offering support, clarity, and emotional grounding as you explore what’s right for you.

As a therapist specializing in reproductive mental health and founder of Calla Collective, I work with many women exploring egg freezing. I often find that there are some big decisions to think about when exploring the option to freeze your eggs. Working with a therapist can help you unpack all of the complexities to make sure you are making the right decision for yourself!  

Some helpful areas to explore

1. Exploring and Understanding Your Motivation:

This might seem simple, but taking the time to delve deep into your reasons for freezing your eggs is crucial. It's a big commitment, involving multiple injections, medication management, doctor appointments, and uncertainty. Are there external pressures influencing your decision, such as medical factors, age, career, relationship status, or societal expectations? Understanding these motivations will help you make informed decisions that align with your personal values and goals.

‍2. Grappling with Cost and Accessibility

Egg freezing has traditionally been out of reach for many women due to cost—often totaling upwards of $15k or more when you factor in medications, procedures, and storage. That financial burden alone can make the decision feel overwhelming or even impossible. Fortunately, there are emerging models that are increasing access. Cofertility, for example, offers a program where you can freeze your eggs for free and store them for 10 years when you donate half to a family who needs them. This option can be incredibly meaningful and financially freeing—but it also requires that you feel emotionally and ethically aligned with the idea of egg donation. Working with a therapist who specializes in reproductive mental health can be a helpful way to navigate the decision making that comes along with egg freezing, and can help clarify your personal needs and values if you’re contemplating egg donation as a means to do so.

3. Addressing Feelings of Uncertainty and Grief:

For many women, egg freezing is an empowering experience, symbolizing control over their reproductive destiny. Yet, for others, it can also evoke feelings of uncertainty about the future, grief over the loss of particular timing for family building, not having the partner they hoped or imagined they would have at this stage of life, or guilt related to societal expectations to want or have children. Acknowledging and processing these complex emotions is vital in making a well-informed decision. Therapy can provide a safe space to explore these feelings and develop strategies for coping and decision-making.

‍4. Sharing Your Decision with Your Support System:

It’s exciting that more people are talking about egg freezing, and more women are getting access to this incredible medical resource.  That said, openly discussing egg freezing with your family and friends can be challenging. Some people may not understand, or may judge your decision. Finding ways to introduce the topic with sensitivity and understanding is important. These conversations can often lead to deeper discussions about your desires and the emotional journey you're undertaking. A therapist can guide you in communicating effectively and building a supportive network.

‍5. Considering the Potential of Unused Frozen Material:

Freezing your eggs is an insurance policy, offering flexibility in family planning. However, it's essential to consider the potential outcomes. What would you do if your frozen eggs weren't used? Would you discard them, donate them to research, donate them to families in need, or transfer the ownership? This is a significant decision, and taking the time to reflect on your feelings will ensure you make choices that align with your values.

Egg freezing is a powerful choice that can offer women greater control over their reproductive journey. It's important to explore all aspects of this path, including your motivations, potential challenges, and support systems. Therapy can provide a valuable framework for navigating these complexities and making informed choices that are right for you.

Final Thoughts

If you're considering freezing your eggs, Cofertility is a great resource to help you explore your options. Their Split program allows you to freeze your eggs for free when you donate half to a family in need, while the Keep program offers the ability to self-fund and keep all your eggs—with access to discounts that help ease the financial burden. Click here to learn more, and visit calla-collective.com to learn more about their therapy services to support you along the way.

Deciding if, when, and how to start a family is one of the most personal and important decisions one will make in their lifetime. For those who are passionately involved in high-demand careers, this decision becomes even more complex. Women athletes face unique challenges in balancing their careers with family-building goals. From demanding training schedules, to the physical toll of pregnancy on one’s body, to lack of support for athlete-mothers, women athletes often feel forced to choose between their careers and their family-building goals. At Cofertility, we believe these women deserve better.

In honor of National Girls & Women in Sports Day, Cofertility, in partnership with &Mother and professional athletes such as Maria Sharapova, Missy Franklin, Alexi Pappas, Chelsea Sodaro, Carly Patterson, and more, launched an initiative called Level the Playing Field. Our goal is to create a world where women in sports can compete, thrive, and plan their futures on their own terms, without compromise. We conducted a study across hundreds of women athletes spanning various sports and levels of competition, and their voices are clear — it’s time for change.

Women athletes want options

We asked our survey participants where they currently are on their family-building journeys. Out of participants who have already begun having children, 82% of them had their first child by the time they were 35. However, of those who have not yet had children but plan to in the future, only 62% plan to do so in the same age range. Additionally, of all survey participants, 70% stated that they’ve postponed having children due to their careers. 

Delayed family-building is not a new concept, and an increasing number of women athletes are following this trend. For many women, the optimal window to start a family is closing before they feel ready, and they lack the support needed to navigate their options.

Women athletes need support

Women athletes are often competing against outdated systems that don’t support career excellence and motherhood. An overwhelming 95% of women athletes surveyed believe that having children negatively impacts their earning potential, while 90% feel it hurts their ability to succeed in their athletic careers. When asked about the biggest barriers they face, financial concerns were most commonly noted. Income disparity between female and male athletes is well-documented. The average woman athlete receives only 18% of their total income from salary, with 82% coming from endorsements. In contrast, male athletes receive on average 63%  of their income from salaries and 37% from endorsements. However, only 10% of total partnership dollars are directed toward female athletes. Paired with the woeful lack of paid parental leave offered by professional sports organizations, it’s not just about the impact on their ability to perform physically, but also a lack of financial support.

Women athletes deserve better

Fertility concerns weigh heavily for women athletes with nearly 90% expressing concern about their future fertility, but few are provided with support to address these concerns. Only 7% of women athletes surveyed reported receiving fertility support from their organization — a stark contract to the broader workforce, where 42% of US employers now offer fertility benefits. 

Due to this lack of support, egg freezing, a potential solution, remains out of reach for many. 65% of those who have not pursued egg freezing cite the cost or lack of education about the process as the reason why they have not. Additionally, 35% cite their athletic career as a barrier, noting that they would be unable to take the necessary time off from work to undergo the process, or that they don’t feel supported by their organization to do so.

It’s time to level the playing field

Women in sports — and everywhere — shouldn’t have to choose between their careers and family building goals. Out of all women athletes we surveyed, nearly 100% of them are unsatisfied with the level of support they receive from their organization. It’s time to build real solutions to empower these women to thrive: which is exactly what &Mother and Cofertility strive to do every day. 

It’s time to level the playing field for women athletes. To get involved in our mission, visit leveltheplayingfield.co.

About Cofertility

Cofertility is on a mission to increase access to egg freezing by breaking down the biggest barrier to entry: cost. With our Split program, those who qualify can freeze their eggs entirely for free when they donate half of the eggs retrieved to a family that can’t otherwise conceive. For those who don’t feel that egg donation is right for them, we also offer our Keep program, in which those interested can take advantage of exclusive perks and discounts to make their egg freezing journey more affordable, while keeping all of the eggs retrieved for their own future use. To learn more, visit cofertility.com/freeze.

About &Mother

&Mother, founded by olympic medalist Alysia Montaño, envisions a culture where motherhood is not a limiting factor in how women succeed professionally or personally. They are dedicated to breaking the barriers that limit a woman’s choice to pursue and thrive in both career and motherhood. To learn more, visit andmother.org.

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For professional and elite athletes, performance is everything. Every training session, competition, and recovery strategy is carefully optimized to maintain peak condition. Egg freezing provides women an incredible opportunity to thrive in their careers without compromising their family-building dreams and many athletes wonder if undergoing fertility preservation will impact their performance, either in the short term or long term. The good news? With the right approach, you can prioritize both your career and your family-planning goals.

The egg freezing process & your body

Egg freezing is a multi-step process, with the most physically demanding phase often being ovarian stimulation. In general, here’s what you can expect from a typical egg freezing cycle:

Screening (1-3 days)

A comprehensive hormone and physical screening  is done prior to beginning the process. Screening includes hormone testing, ultrasound, and physical exam.

Hormonal stimulation (10-14 days)

‍Daily hormone injections encourage the ovaries to mature multiple eggs. You may experience bloating, water retention, and temporary shifts in energy levels. During this time, you’ll also attend regular monitoring appointments with your care team to ensure everything is progressing as expected.

Egg retrieval (1 day procedure, 1-3 day recovery time)

‍A short outpatient procedure is performed under light sedation to collect mature eggs. While minimally invasive, some athletes may need a few days to recover before resuming full training.

What to expect physically

Egg freezing is generally considered to be safe, but no procedure is 100% risk-free. While every body responds differently, here are some common side effects to be aware of:

Increased bloating & water retention

Temporary weight fluctuations due to hormonal stimulation can occur.

Fatigue & recovery

‍Some athletes report feeling slightly more tired during stimulation, though normal activity can usually continue.

Temporary training adjustments

‍High-impact workouts may need to be modified to avoid ovarian torsion, a rare but serious complication.

When can you resume training after an egg retrieval?

Most athletes can return to light training within a few days post-retrieval, with full intensity resuming in one to two weeks. The key is to consult with your care team regarding your unique body and circumstances, and to listen to your body in order to allow for proper recovery.

Performance & long-term impact

One of the most common misconceptions is that egg freezing permanently alters your body. However, once the hormone medications leave your system, your body returns to baseline function. There is no evidence that egg retrieval negatively affects long-term strength, endurance, or agility.

Balancing fertility & athletic goals

Egg freezing is a temporary process, but your athletic career and family-building plans are long-term. By timing the procedure strategically and working with professionals who understand your physical demands, you can take charge of your fertility—without compromising your performance.

Benefits of egg freezing for women athletes

Everyone deserves the opportunity to pursue their careers and their family-building goals without compromise. Women athletes face unique challenges when it comes to this, due to the fact that their career and their fertility are often peaking at the same time, leading to many athletes believing they have to choose one path or the other. Egg freezing is an incredible tool that has allowed countless women to live life on their own terms. At Cofertility, we’re on a mission to create a world where anyone who wishes to pursue egg freezing can do so freely, without barriers.

With our Split program, we give members the opportunity to freeze their eggs entirely for free when they donate half of the eggs retrieved to help another family grow. With our Keep program, members can self-fund their egg freezing journey at a discounted rate with access to our network of partners and perks. With both programs, members get access to our members-only community to connect with others going through the process at the same time.

To learn more about how Cofertility supports women athletes, visit leveltheplayingfield.co

To apply for our egg freezing programs, visit quiz.cofertility.com

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Family-planning decisions are deeply personal, and for women athletes, there are many added layers of complexity. From rigorous training schedules and competition seasons to the physical demands of maintaining peak performance, many athletes choose to delay family-building. Egg freezing is an attractive option for many, giving women athletes the gift of time while allowing them to focus on the demands of their career. However, navigating the process can be a challenge. If you’re in this boat — this article is for you. Keep reading to learn more about the ins and outs of egg freezing as a woman athlete, allowing you the opportunity to take control of your reproductive future without sacrificing your career goals.

Why should women athletes freeze their eggs?

It is well-recognized that female fertility declines with age, beginning in one’s early 30s and more rapidly accelerating at age 35. Both egg quality and quantity start to decrease, making child-bearing more difficult the longer we wait. Given that many athletes extend their careers well into their 30s, egg freezing provides optionality for future family-building to female athletes who are prioritizing their professional careers during their peak reproductive years.

How to schedule an egg freezing cycle as an athlete

One of the biggest concerns for athletes considering egg freezing is when to do it. The process typically takes about two weeks, during which intense physical activity is often prohibited. This can make it challenging for those in physically-demanding careers, such as athletes, to find time to schedule their cycle. However, with proper planning, freezing your eggs as a woman athlete is very possible. Some considerations are:

• Off-season planning: Consider scheduling your egg freezing cycle during the off-season. That way, you’ll have time to focus on your retrieval without the added stress of balancing your training and competition demands.
• Recovery time: While egg freezing is a minimally-invasive procedure, it’s normal to experience mild to moderate symptoms post-retrieval, such as bloating, fatigue, or cramping. Giving yourself ample time to rest is key — so be prepared to take time off to recover.
• Impact of hormone injections: The process of freezing your eggs includes taking a series of injectable hormone medications in order to stimulate your ovaries to produce multiple mature eggs. When taking these medications, it is often advised to avoid high-impact physical activity, in order to reduce the rare-but-serious risk of OHSS. While most will be able to return to their full training quickly, it’s important to work directly with your care team on a plan to safely navigate cycling with your work schedule.

How to pay for egg freezing as an athlete

Having a plan for how you’re doing to pay for your egg freezing is an important planning step in your journey. A typical egg freezing cycle can cost anywhere from $11,000 - $15,000, in addition to storage fees. Considering that the majority of women athletes do not have access to fertility benefits, you will likely have to fund your egg freezing journey on your own — but you have options. Options like Cofertility’s Split program — in which members freeze their eggs entirely for free when they donate half of the eggs retrieved to a family that can’t conceive — help eliminate financial barriers while giving you the opportunity to help another family grow at the same time. Additional options include financing options through companies like Sunfish or using an HSA or FSA account.Give yourself the gift of optionsNavigating egg freezing as an athlete requires planning, but it’s an empowering step toward preserving future family-building options. If you’re considering the process, talk to a fertility specialist and map out a plan that works with your training schedule. Because every athlete deserves the ability to compete today—without sacrificing the family-building goals.

As the 2024 election approaches, reproductive rights have become one of the most pressing and widely discussed issues in the US. In fact, recent survey data found that 90% of American women are concerned about potential restrictions on fertility treatments. While much of the conversation has focused on abortion rights—especially with the overturning of Roe v. Wade—other areas of reproductive healthcare, including fertility treatments like egg freezing, could also be influenced by the election.

At Cofertility, we know our members care deeply about the future of reproductive health. As this election season unfolds, we’re closely monitoring how political shifts could impact egg freezing and other family-building options. While egg freezing itself may not be directly restricted, increased regulation on in vitro fertilization (IVF)—a vital next step after egg freezing—could influence access and affordability. In this article, we’ll walk you through what these changes could mean, so you can make the best choices to protect your options for the future.

Issues facing egg freezing and reproductive healthcare access

As the election nears, policies impacting reproductive healthcare access are top of mind for many of us, especially in states where abortion restrictions have already been passed or are under consideration. Fertility treatments, including egg freezing, could see indirect effects from these policies, as new legal rulings and proposed legislation raise questions around oversight, accessibility, and insurance coverage. Given these changes, it’s more important than ever for patients to stay informed and providers to remain adaptable to keep services like egg freezing accessible.

Understanding state-level impacts on egg freezing 

While egg freezing has not been specifically targeted by state legislatures, some worry that restrictive laws around abortion could spill over. In certain states, legislation such as personhood bills—like the recent Alabama Supreme Court decision granting human rights to fertilized eggs—could increase legal considerations for providers, potentially affecting service availability or affordability. In response, some fertility doctors and OBGYNs are moving their services to states with strong reproductive protections, leaving those in red states with decreased access to reproductive care. 

High costs and insurance gaps

Egg freezing comes with high costs and is rarely covered by insurance, leaving most patients to pay out of pocket. With cycles costing tens of thousands of dollars, many find the financial burden to be a barrier. Additionally, laws around insurance mandates for fertility benefits vary widely across states, with the vast majority of Americans having no insurance coverage for egg freezing.

While approaches like Cofertility’s egg-sharing model—where you can freeze your eggs for free when you donate half to intended parents who otherwise cannot conceive—are helping make egg freezing more accessible, discussions in the current election about healthcare access could result in policies that address critical cost barriers and potentially reshape insurance mandates for fertility preservation benefits.

Impact on LGBTQ+ individuals and family planning

Access to fertility treatment varies, and the LGBTQ+ community often faces extra hurdles, especially when insurance coverage is limited to heterosexual couples. These gaps make family-building even more challenging for LGBTQ+ families, adding financial and logistical stress. Additional restrictions on fertility treatments could widen these disparities, making it harder for many LGBTQ+ individuals and couples to grow their families.

This election season, inclusive policies that support equal access to fertility care are especially important. Policies that improve insurance coverage and access to family-building options for everyone—regardless of gender, sexual orientation, or marital status—could help make fertility care more supportive and accessible to LGBTQ+ families.

Egg freezing access amid political changes

Despite the intense political focus on other areas of reproductive healthcare, egg freezing has largely remained out of the spotlight and unaffected by restrictive legislation. For those considering egg freezing, this can be reassuring. 

Unlike other treatments, egg freezing is less likely to face regulatory scrutiny, allowing services to continue uninterrupted even in states with stricter reproductive health policies. In fact, some states are even expanding insurance coverage for egg freezing, acknowledging its vital role in family planning and long-term reproductive health.

However, for those who choose to freeze their eggs with plans to use them for future family building, additional considerations come into play as IVF has been more directly impacted by political shifts. To safeguard your options, completing your care in a state with strong protections for reproductive healthcare can help ensure you have the support and access you need when the time comes.

What to watch for this election season

As you consider your own family planning journey, here are a few key areas to keep an eye on this election:

1. Healthcare policy and reproductive rights: Any shifts in reproductive rights, particularly those affecting fertilized eggs, could have downstream effects on IVF and egg freezing. Even when specific treatments aren’t directly targeted, related legislation could influence healthcare providers’ ability to offer certain services.
2. Insurance and cost coverage: Some candidates may focus on expanding insurance mandates for fertility treatments, aiming to ease the financial burden for those seeking these services. Understanding candidates’ positions on healthcare mandates can offer insight into future coverage possibilities.
3. State-by-state differences: With much of the control over reproductive health laws being managed at the state level, where you live can have a huge impact on your access to family planning services. Following the election, it may be helpful to monitor your state’s legislative landscape for changes.
4. Access for LGBTQ+ families: Policies addressing the definition of infertility and coverage criteria could affect who qualifies for fertility treatments. For LGBTQ+ individuals, this remains an important point of advocacy, as inclusive access to family planning is essential for equity in reproductive healthcare.

How Cofertility can support you 

Reproductive health rights are at risk in the United States. Whether it’s abortion, IVF, or even egg freezing–there are policymakers who do not believe women should be able to make decisions about their own body. 

If you’re considering egg freezing, it’s helpful to be aware of broader policy implications that could affect your options. At Cofertility, we’re committed to supporting you throughout your journey, offering resources to help you understand your choices and advocating for accessible, value-aligned family-building options.

To further support our members, we’ve taken proactive steps including partnering with storage facilities in states with strong reproductive protections. Additionally, our clinic-agnostic model allows us to expand our reach in states with more open reproductive access, ensuring flexible, secure options for everyone.

This election, as you weigh your options, we encourage you to consider policies that align with your values and goals and to vote with those priorities in mind. Your voice—and your vote—can help create a future where everyone has the opportunity to build the family they envision.

Embarking on the egg freezing journey is a significant and deeply personal decision, often accompanied by a mix of hope, uncertainty, and anxiety. While it can feel empowering, the experience can also feel overwhelming due to the complex medical procedures, emotional ups and downs, and the many decisions along the way. Having the right kind of support—whether from medical professionals, a community of peers, or loved ones—makes all the difference in navigating this important chapter of your life.

Medical support: Your guiding light

When undergoing a medical procedure as intricate as egg freezing, timely and accurate medical support is crucial. Your nurses, doctors, and fertility specialists are the backbone of your support system, providing the knowledge and expertise to ensure your safety and well-being throughout the process.

Medical support is not just about managing the logistics of injections and appointments—it’s about having a trusted team to turn to when questions arise. Whether you're wondering, "What side effects should I expect?" or "Which needle should I use for my injection?" These are the kinds of questions that require prompt, clear answers. Unfortunately, doctors and medical teams can often have limited availability. Reaching out directly to a Cofertility member advocate, or becoming a member of  Conceive, a digital health platform that offers 24/7 fertility support services like text coaching, community support groups, and more, can help you get your questions, no matter how small, answered immediately. For those embarking on this journey for the first time, or anyone with lingering questions, resources like these can often provide added peace of mind.

Moreover, fertility journeys can be emotionally taxing. The uncertainty, the waiting, and the inevitable questions about the future can weigh heavily on your mind. Seek out a compassionate, communicative care team that can help provide you with reassurance and clarity and help to alleviate some of that emotional burden. You should feel informed and confident at every step of your journey.

Community support: The power of shared experiences

While medical support is essential, it's not the only kind of support you’ll want to lean on during your egg freezing journey. Connecting with others who are going through the same experience can be incredibly comforting. 

Being part of a community of people who are also freezing their eggs means you’re never truly alone. Sharing your experiences, exchanging advice, and offering each other encouragement creates a sense of belonging. This support provides a space to discuss the highs and lows openly, without fear of judgment. It's a reminder that what you're going through is significant and that others understand it on a deeply personal level.

In addition to emotional support, communities often become a source of practical advice. From tips on managing side effects to staying organized during the medication phase, the insights shared within these groups can be invaluable. They also serve as a reminder that the challenges you face aren’t unique—others have faced them and successfully come out the other side.

Through Cofertility’s Circle community, members connect with others who have gone through or are currently going through their program. It’s a safe space to exchange experiences and find support from those who truly understand the complexities of egg freezing. Conceive also offers an additional layer of support through intimate community groups, creating an environment where you can share experiences, receive tailored advice, and build lasting connections with people at a similar stage in their fertility journeys.

Personal support: Finding your anchor

For many, navigating the egg freezing journey is a deeply personal experience. While some may find comfort in family support, others choose to pursue this path independently or with a select few trusted friends or partners. It’s important to create a support system that feels right for you, whether that means leaning on close friends, a partner, or drawing strength from within.

As you navigate the decision to freeze your eggs, discussions about your future often come into focus. Whether your goals involve eventual motherhood or simply preserving your fertility options, it’s important to have people in your corner who respect and support your choices. These conversations—whether shared with a close friend, partner, or even a fertility coach—can help solidify your resolve and remind you why you embarked on this journey in the first place.

Recognizing that the need for support can come unexpectedly and at any time, Conceive provides 24/7 access to expert guidance and reassurance, ensuring you have the help you need as you plan for your future.

Embracing support on your journey

Egg freezing is a journey that’s as much about emotional resilience as it is about medical science. Having a solid support system in place—whether that support comes from your healthcare team, a community of peers, or your family—can give you the strength and reassurance you need to navigate this process with confidence.

With services like those offered by Cofertility and Conceive, you don’t have to go through this journey alone. With the right care and a strong support network, you can turn this experience into an empowering chapter of your life—one where you’re not just preserving your fertility but also nurturing your sense of self, strength, and future possibilities.