female fertility

Deciding to freeze your eggs can do more than put you in the driver’s seat of your reproductive journey. Going through the process of retrieving and freezing your eggs can give you insights into your health, offer you peace of mind about how you’ll accomplish your goals, and allow you to create a blueprint for building the family you’ve always dreamed of.

As you and your doctor work together to ready your eggs for retrieval you’ll end up learning valuable information about the state of your fertility and what you need to know before you’re ready to take the next steps. 

You could get a heads up about certain reproductive concerns

As part of the preparation for freezing your eggs your doctor will likely do ovarian reserve testing which uses a blood test called Anti-Mullierian Hormone (AMH). Using a blood sample collected on the third day of your period your doctor will be also able to see how much estradiol and follicle-stimulating hormones are present during this key window in your reproductive cycle.

AMH levels are generally higher during your childbearing years and then they begin to decline as you head towards menopause, becoming almost nonexistant afterwards. 

You’ll get a better picture of your reproductive schedule

According to the Mayo Clinic, after you’ve decided to move forward with the process you’ll begin taking hormone injections. These hormones will have two distinct jobs—ovarian stimulation and preventing premature ovulation—which your doctor will achieve using a variety of medications. 

Your doctor will begin monitoring you and checking two very important levels:

• Estrogen (an increase means your follicles are developing)
• Progesterone (low levels will mean you haven’t ovulated yet)

Not only will you discover how your body reacts to stimulation (giving you a great deal of information about how your egg production is going) but you’ll also have an idea of when you should ovulate. Knowing exactly when the clock starts ticking—your eggs will be ready for retrieval after 10-14 days—will let you know what you can expect for this cycle. 

Your doctor will find out how many follicles you have

Speaking of follicles, these are the sacs where your eggs will stay until they have matured. Your doctor will likely use a vaginal ultrasound to check the status of your ovaries to see how many follicles have developed, indicating how many eggs you’ll likely have for retrieval. That number is going to be very important (and very exciting) for both you and your doctor. 

To give you an idea of why that number matters so much, you’ll need to know how many eggs you need to increase the potential for a live birth. A 2020 study in the Journal of Assisted Reproduction and Genetics found that a woman under the age of 35 averaged 21 eggs on their first round of egg retrieval. At that age, you would need approximately 9 eggs to ensure a 70% chance of a live birth. Once you find out how many follicles you have you might have a better idea of your pregnancy success rate when the time comes. 

There will be additional health screenings 

Another thing you’ll learn about your fertility is whether you have any diseases that you can pass onto a future child, via a genetic carrier screening test. Your doctor will also likely have you undergo an infectious disease screening—which will check for things like HIV and certain varieties of hepatitis—as part of your work up. These tests are different from genetic screenings, which looks for the potential changes in your genetic blueprint indicating heredity conditions that can be passed onto your child.  

Some people who freeze their eggs may do genetic testing ahead of time, whether because they already know that certain conditions run in their family or because they have a limited understanding of their family history. According to the Centers for Disease Control and Prevention (CDC), genetic testing can even give you information about some types of cancers that could impact your reproductive system, making it another important tool in your fertility arsenal. 

Getting proactive can save you money

By being proactive about your fertility journey you not only get to make the decisions about what your future family will look like based on your terms, but you’ll also be able to get an idea of what may lie ahead for you if you decide to have a child.

Of course, freezing your eggs can be expensive. It costs an estimated $10,000-20,000 per cycle. Fortunately, there are egg freezing programs like Freeze by Co that can help you navigate financial pain points that may make planning for that future family a little bit harder by offsetting some of the costs associated with freezing your eggs. Freeze by Co offers members two different options for freezing their eggs. Split Members may qualify to freeze their eggs for free when they donate half of their eggs to other families looking to conceive.

There are even benefits for those who want to use the Freeze by Co’s Keep program. As the name indicates, Keep Members keep all of the eggs collected during retrieval while still benefiting from discounted costs in the way of less expensive medications and more. 

Becoming an egg donor can be a meaningful and empowering experience, but unfortunately, not everyone who wants to become an egg donor will qualify. That’s because the process is highly regulated to ensure the health and safety of the donor, the success of the donation cycle, and the long-term well-being of any future children. Medical organizations and regulatory agencies set clear guidelines around who can donate based on age, health history, genetic background, and more.

If you’re thinking about egg donation—especially through Cofertility’s Split program, where you can freeze your eggs for free when you donate half to a family who can’t otherwise conceive—it’s helpful to understand what might stand in the way.

Some disqualifications are set in stone, like those enforced by the FDA. Others are recommended by professional groups like the American Society for Reproductive Medicine (ASRM) or based on clinic-specific rules. Here, we’ll walk through the most common reasons someone might be disqualified from egg donation, what they mean, and what your options might be if you don’t meet certain criteria right now.

Age

Unfortunately, most doctors will turn away an egg donor over age 33. The reason for this age limitation is because data shows that, on average, those over 33 tend not to respond to fertility medication as well and therefore may not produce enough eggs to donate. Also, research shows that, unfortunately, egg quality declines with age. 

If you are over 34, you are still eligible to participate in our Keep program, where you can freeze your eggs and keep 100% of them for yourself. Also, if you are over 33 and donating for a family member or friend, a doctor may approve you for egg donation on a case-by-case basis. 

Per ASRM guidelines, we also do not accept Split members who are under 21. If you’re younger than this and you’d like to participate, please reach out and we’ll get back in touch after you turn 21.

General health

As a preliminary step in the process, we will review several health-related factors before you can be approved for egg donation. Any issues that would make the egg freezing and donation process risky for your health is a disqualification. 

A few health-related factors can disqualify someone from egg donation, including certain heart problems, chronic diseases, HIV, hepatitis B or C, and certain transmissible diseases. 

Also, and this sounds random, but if you lived in Europe for over five years, or in England for over three months between 1980-1996, the FDA has determined that your risk of mad cow disease would also disqualify you.

These requirements help protect your health and ensure a safe donation process for all involved.

Reproductive and sexual health

For starters, you’ll need to have two ovaries, and you cannot have taken a Depo Provera shot, which can interfere with hormonal medications, within the past 6 months. 

Due to these hormonal medications you’ll need to take during egg freezing, you also cannot be currently pregnant or breastfeeding. However, if you plan to stop breastfeeding within the next six months, you can still go through with your Split application. You’d just need to hold off on your actual freezing cycle until then.

As part of the process, you will get your hormones tested. If your hormone levels are outside of recommended limits or the doctor has concerns about your ability to produce sufficient eggs, you would not qualify (more on AMH below).

You will also not qualify for egg donation if you’ve had a sexually transmitted disease within the past 12 months (but you can apply after 12 months of treatment). You also will be disqualified if you’ve been refused as a blood donor due to other infectious diseases or medical conditions. Same goes if you’ve ever had a blood transfusion.

Anti-Mullerian hormone (ovarian reserve) levels

As you likely know, women have a set egg quantity present at birth. Your eggs mature in ovarian follicles, and each of these follicles produces the anti-Mullerian hormone (AMH). Over time, this hormone level drops, and eventually, women naturally develop what's known as a diminished ovarian reserve (DOR).

Your AMH level can help predict how well medication may work to stimulate your ovaries to produce eggs. It also tells doctors what dosage of drugs may be needed to do so. The higher the AMH level, the more eggs generally produced. 

At Cofertility, if you appear to have low ovarian reserve at the time of screening, you will be ineligible for our Split program. We only accept Split Members with a higher AMH level as it helps mitigate the possibility of a second cycle to obtain enough eggs that could result in a live birth down the line (for yourself and for intended parents). Nevertheless, it is important to note that, even with high AMH levels, there is always a chance of having to do another cycle to improve the odds of a live birth. In the Split Program, once you are matched with intended parents, you’ll undergo your physical screening, which will include AMH-reading bloodwork. 

If you’d rather get a sense of your AMH ahead of matching, talk to us about helping you set up an initial egg freezing consultation at a local fertility clinic. While it’s not required until this later phase of the screening process, it can help you better understand your fertility outlook. We may offer discounted consult options in your area, and this could give you upfront peace of mind about your choice to pursue Split, Keep, or neither.  

As you likely know, women have a set egg quantity present at birth. Your eggs mature in ovarian follicles, and each of these follicles produces the anti-Mullerian hormone (AMH). Over time, this hormone level drops, and eventually, women naturally develop what's known as a diminished ovarian reserve (DOR).

Your AMH level can help predict how well medication may work to stimulate your ovaries to produce eggs. It also tells doctors what dosage of drugs may be needed to do so. 

At Cofertility, if you appear to have low ovarian reserve at the time of screening, you will be ineligible for our Split program. We only accept Split Members that meet a threshold AMH level as it increases the chance of success for you and the intended parents.

Read more in AMH 101: Everything You Need to Know

BMI

Body mass index, or BMI, is one of the criteria used during egg donor screening—and we understand that this can be a sensitive and sometimes controversial topic. Most clinics require a BMI between 18 and 29 to be eligible for egg donation, and we follow these clinic requirements at Cofertility.

This range is largely based on concerns about procedural risk and egg retrieval outcomes. People with a higher BMI may face increased risks during anesthesia or complications related to egg retrieval. On the flip side, very low BMI can raise the risk of ovarian hyperstimulation syndrome (OHSS) and may affect hormone levels or cycle response.

That said, BMI alone is not a full picture of someone’s health. It doesn’t account for muscle mass, body composition, bone density, or ethnic and genetic differences. For athletes, for example, BMI can be especially misleading. And since BMI calculations were originally based on white, male body types, their use across populations can perpetuate racial inequities—especially among women of color, who are already disproportionately affected by both infertility and barriers to care.

If your BMI is currently outside this range, you’re welcome to reapply in the future. And regardless of your eligibility, we’re here to support you in exploring all your fertility options.

Read more about BMI and egg freezing here.

Medical and family history

Because donor-conceived children share your genetics, your personal and family medical history matters. If you’re adopted and can’t access your biological family’s health history, that’s unfortunately considered a disqualifier.

Though not an exhaustive list of every condition that may disqualify a member, when reviewing your personal and family medical history, doctors look for personal and/or family history of:

• Cancer
• Heart/blood disease
• Neurological diseases 
• Some mental health disorders
• ‍Genetic disease
• Reproductive disease
• Autoimmune disease
• Respiratory disease
• Metabolic disease
• Gastrointestinal disease
• Kidney disease
• Birth defects

Our medical team  reviews your personal and family medical history as a whole. When reviewing, we consider the severity of the disease/conditions, number of relatives with the disease/condition, age of diagnosis, as well as that relative’s relation to you. 

Psychological screening

Mental and emotional wellbeing are also part of the screening process. You’ll complete a psychological evaluation, and while a history of manageable anxiety or depression doesn’t automatically disqualify you, more severe conditions might.

For example, a history of physical, sexual, or substance abuse or having family members with psychiatric disorders that could be passed down, may make it more difficult to be approved than, for example, having had some mild depression or anxiety. Per ASRM guidance, agencies - including our own - will, however, exclude those with a personal or first-degree (parents, siblings, offspring) family history of:

• Bipolar disorder
• Schizophrenia
• Schizoaffective disorder
• Severe depression
• History of alcoholism or drug abuse

Learn more in What Happens During Psychological Screening to be an Egg Donor

Genetic screening

As part of the evaluation process, you will also be required to do genetic testing via blood test or saliva sample. This helps increase the chance that embryos resulting from your eggs lead to a viable pregnancy and that a child won't be born with severe disease. 

But even for serious diseases, not all disease-related genes are deal breakers. For example, if your tests reveal that you have a copy of a gene that can lead to cystic fibrosis, spinal muscular atrophy, or thalassemia, this may disqualify you depending on the clinic. Even if two copies of the gene are needed in order for the condition to occur, clinics each handle this differently.

In line with ASRM guidance, in most cases where carrying one copy of a particular gene won't impact the child themselves, you can still donate.

State-specific qualifications

Some states do maintain their own specific requirements for women who are donating eggs. These requirements will extend to those in our Split program and would be determined by the location of the clinic at which you would be conducting the retrieval. 

Any state-specific egg donation qualifications will be evaluated at the time of your physical examination. 

Additional disqualifying factors

In addition to the above, there are several factors that, unfortunately, would disqualify you from our Split program (and in many cases, per ASRM and/or FDA guidance, egg donation in general). These include if you:

• Have served jail time for more than two days
• Have undergone body piercing and/or tattooing within the past twelve months in which sterile procedures may not have been used
• Do not have a high school diploma 
• Have Indigenous American ancestry and are associated with a tribe—this is due to the Indian Welfare Act 
• Show indicators of possible drug use (needle tracks, for example) or exposure to needles in non-sterile conditions

If one or more of the above applies to you and you’d still like to participate in our Split program, reach out to us. We’d be happy to chat with you about your fertility options, including your ability to re-apply in the future. 

The net net

We know this sounds like a lot, but these disqualifiers are in place to respect the health and wellbeing of our Split members and intended parents. If you have any questions about Split—including the factors outlined here—don’t hesitate to connect with us. 

You have tons to offer, and whether you qualify for the Split program is in no way reflective of your value. The most important thing is that you feel one hundred percent comfortable in any decision you make. This is a big one, and we’re with you every step of the way.

Click here to learn more about Cofertility's programs and see if you qualify.

Your uterus creates extra tissue each month to create a cushy home for your potential baby. But if you have endometriosis, your uterine tissue grows wild, and can end up in places you don’t want it to be—including places where it could cause some serious fertility issues. In fact, a recent Journal of Assisted Reproduction and Genetics study estimated endometriosis is to blame for between 25% to 50% of all infertility cases. 

What is endometriosis?

Endometriosis develops when your body grows uterine lining (a tissue called endometrium) in places where it doesn’t belong. Most often, it shows up in areas near your uterus—your fallopian tubes and ovaries, on the outside of the uterus, in the vagina or cervix. In a few rare cases, it can even end up in other places, like your bladder. 

It may feel like you’re the only person in the world dealing with these symptoms, but the truth is, it’s just that people don’t talk about their symptoms. Endometriosis is extremely common. According to the Office on Women’s Health, more than 11% of women between the ages of 15 and 44 have developed it. Of those women, 30% to 50% experience some form of endometriosis infertility challenges. This is most common in women who: 

• Are in their 30s and 40s, especially those with family members who have had it 
• Started their period at a younger age
• Have never had children
• Have extremely long or short menstrual cycles

Signs of endometriosis

The most common red flag that you might have endo is severe cramping and pain, especially during your period. Here are some of the other telltale signs that you’re growing uterine tissue in odd places:

• Pelvic pain: Women with endometriosis often develop chronic severe back and pelvic pain. They may also experience severe menstrual cramps, pain when they pee, and even painful sex (which will definitely be a fertility hurdle). 
• Digestive upset: Stomach cramping, diarrhea, constipation and bloating occasionally accompany endometriosis, especially if you have your period. 
• Heavy periods—and spotting in between them: Women with endometriosis may bleed outside their typical menstrual cycle, or develop heavy bleeding when they have their period. Fun times! 
• Infertility: Scarring and excess tissue can literally cause a roadblock that can keep eggs and sperm from meeting, or even prevent a fertilized egg from implanting in the uterus.

How endometriosis can affect fertility

In case its other symptoms didn’t suck enough, endometriosis can also cause infertility, thanks to the scarring and excess tissue buildup. Ironically, all that uterine tissue that your body is producing for a baby could actually block the pathways to conception. 

“Endometriosis is thought to cause infertility because of the scarring and adhesions that result when endometrium grows on pelvic organs,” says Dr. Nataki Douglas, M.D., Ph.D, director of translational research for the Department of Obstetrics, Gynecology and Women’s Health at Rutgers University in New Jersey. The more extensive the disease and scarring, the greater the negative impact on fertility. “For instance, the adhesions can make it more difficult for an egg to be swept up by a fallopian tube and become fertilized.”

Can and should I freeze my eggs if I have endometriosis?

Absolutely. Some doctors will recommend egg freezing for women with endometriosis, while they're young and the condition is still in the early stages. Because some surgeries for endometriosis can actually worsen fertility by inadvertently removing healthy ovarian tissue or compromising vascular supply to the ovary, egg freezing should be done before any such surgeries.

If you are interested in freezing your eggs, we can connect you with a fertility specialist for a consultation to discuss your specific situation. Our Freeze by Co is making egg freezing more empowering, positive, and accessible — even free — when you give half of the eggs retrieved to a family who can’t otherwise conceive. 

What your doctor might recommend

The good news is, endometriosis can often be treatable. Depending on your situation, treatment might include:

• Hormone therapy: Often in the form of birth control pills, this prevents additional tissue growth and damage. 
• Pain relievers: Over-the-counter pain relievers can help manage the pain that comes with endometriosis at certain points in your cycle.
• A diagnostic workup: Thankfully, some women with endometriosis are still able to conceive, but talk to a reproductive endocrinologist if you don’t get a positive pregnancy test on your own within 6 to 12 months. A full diagnostic workup might be a good idea. Dr. Marra Francis, MD, FACOG, an OB/GYN in The Woodlands, TX, notes that this workup would likely include both diagnostic procedures for endometriosis and a hysterosalpingogram (HSG), which will show if your tubes are blocked. This may prevent pregnancy or increase the risk of an ectopic pregnancy, so you’ll want to work with your doctor on figuring out the best course of action.  
• Surgery: This is one of the most effective methods for treating endometriosis and preserving fertility, according to Dr. Douglas, but also the most invasive. These surgeries can remove adhesions and ovarian cysts, clearing tissue out of the fallopian tubes and making pregnancy a real possibility. 

Still, you might need a little boost to make that baby happen. While there are tons of treatments out there, depending on a host of factors—age, number of years trying, status of fallopian tubes, status of sperm—women can proceed with standard fertility treatments, like oral medication and IUI. However, while it is the most invasive, “IVF has the best results in the majority of women with endometriosis,” says Daniel Kort, associate medical director and practice director at Neway Fertility in New York City. 

Bottom line

Endometriosis can be a real pain—literally and figuratively—and infertility is one of the most common complications associated with it. Fortunately, with a little help from a reproductive endocrinologist, it’s still possible to conceive if you’ve developed endometriosis infertility.

You probably never saw yourself using the words cervical mucus, much less pulling down your pants and checking to see if you’ve got any. But here you are. You’re trying to conceive, and your best friend told you that you’ve absolutely got to start checking it out if you want to figure out the best time for baby-making sex.

It might sound like an old wives tale that refuses to die, but it turns out tracking cervical mucus really can help some women get a better handle on their cycle. Here’s why you might want to start paying attention.

What's cervical mucus, anyway?

If it sounds like the stuff that comes out of your nose when you’ve got a bad cold, you’re halfway right…only this isn’t snot, and needless to say it’s not coming out of your nose.

Your cervix is located at the lower part of your uterus, says David Diaz, MD, reproductive endocrinologist and fertility expert at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif.

Dr. Diaz describes the cervix as a sort of bridge between the vagina and the uterus, and as an entry portal for sperm when a heterosexual couple has sex during the female partner’s most fertile time of the month—when she’s ovulating.  

Now comes the mucus part.

The cervical canal, which Dr. Diaz describes as, “a tunnel passing through the cervix,” is lined with glands that excrete a clear, slippery mucus during ovulation. The mucus actually helps sperm make its journey toward the egg for fertilization. Aren’t our bodies amazing?

Because the mucus is only set up for aiding sperm during ovulation, its consistency changes throughout your cycle. So just like the arrival (and blessed departure) of your period can tell you that you’re absolutely not ovulating, the arrival of the right kind of mucus can tell you when you are. Which leads us to…

Checking your mucus

Some folks ovulate like clockwork, and they don’t need no stinking mucus to tell them they’re fertile. But if you’re not one of those lucky ladies, you may not need to run to the doctor to find out if you’re ovulating. You can try to do a check on your own to see if your glands are pumping out that slippery liquid.

Dr. Diaz suggests inserting two fingers into the vagina and feeling for something wet and slippery. Pull them out, and take a look at your fingertips:

• Totally dry to just slightly damp: This is typical of the days right after your period ends, when fertility is at its lowest for most women.

• Mucus that’s slightly thick and sticky and either yellowish or whitish: Although you’re still not ovulating, this indicates your body is either preparing for ovulation or has just finished.

• Mucus that’s almost totally clear and stretchy: If the mucus has the consistency of egg whites and can stretch a few inches between your fingers, your ovulation window has arrived! It’s time for frequent sex, Dr. Diaz says.

Do you really have to?

So all this is well and good, but do you really need to stick your fingers into your vagina and feel around for mucus to help you get pregnant?

Well, that’s up to you, but consider this: When scientists at the University of North Carolina, Chapel Hill and the University of Utah in Salt Lake City monitored more than 300 women on their fertility journey for a 2014 study, the women who opted to check their cervical mucus regularly were found to have a statistically significant increased chance of conceiving over women who didn’t bother to check. And theirs was far from the first study to find a solid link between tracking cervical mucus and conception! The science on cervical mucus is pretty well-regarded by the experts.

So, if you’re having trouble nailing that ovulation window but don’t yet want to take the plunge into ovulation test kits, this could be just the thing you need.

Maybe you’re ready to start trying to conceive, or perhaps you’re just done with taking hormonal birth control. Regardless of the reason, this can be a super big change leaving you wondering what the heck happens next, especially if you've been on it for a while. Will your skin break out like crazy? Will your cycle get wonky? Rest assured, we're here to answer all your questions about going off birth control.

How birth control works

The type of birth control you're quitting will dictate the type of things to expect when going off it. To understand the potential effects, it helps to understand exactly how the different methods work.

A hormonal method, like the pill, Depo shot, hormone patch, uses hormones to trick the body into not ovulating.

A copper or hormonal IUD makes changes to the cervical mucus and the uterine lining that prevent pregnancy.

A barrier method—think condom or diaphragm—blocks the sperm from meeting the egg and really doesn't affect the human body before or after its use.

Why someone might go off of birth control

There are a few different reasons you may go off birth control:

• Ready for pregnancy. If you're ready to start trying to have a baby, you obviously have no need for that IUD or NuvaRing any more.
• Health risks. We are all for birth control when it’s needed. It’s a beautiful thing! But people taking hormonal birth control are at a slightly higher risk for blood clots, migraine, high blood pressure, and cardiovascular disease. It’s important to keep in mind that in the absence of underlying risk factors (ie. older age, high BMI), most of these complications are exceedingly rare. For example, the risk of having a blood clot on birth control for a healthy, young, non-smoker is significantly lower than the risk of a blood clot during pregnancy. 
• Abstinence. Hey, if you're not having sex, then you really don't need birth control. You probably want to have a plan in case you start back up though.

Whatever the reason, talk it over with your doctor if you're taking prescription birth control. You could get pregnant as soon as you go off it, says Lilli Dash Zimmerman, MD, Fertility Specialist at Columbia University Fertility Center. So you should truly be prepared for that possibility. Some patients go off hormonal methods a few months before they want to try, and that's fine, but you'll want to use a barrier method, like a condom, until it's go time, she says.

Birth control side effects, nasties and other things to expect

It's common for people to experience acne, heavier periods, or irregular periods when they stop hormonal birth control, but those aren't exactly side effects from ditching the pill or patch. Rather, they're much more likely to be things that you experienced before you started birth control, that the medication was actually suppressing, says Zimmerman.

Remember: If you're on a hormonal birth control method, you're not actually getting a period, since you're not ovulating. Instead, any bleeding you get every month is not a true period—it's a withdrawal bleed that happens when you take a week of placebo pills.

"I see a lot of patients that say, 'Oh, well, I've been regular for the past 20 years on birth control pills. Then I came off and only for the past year, I've been having irregular periods,'" says Zimmerman. "Well, their birth control may have been hiding issues with anovulation or irregular cycles because they've been on birth control pills for so long."

Do I have to get off hormonal birth control for egg freezing?

Yes, you will need to stop taking the pill or remove the patch before freezing your eggs. That’s because hormonal birth control is intended to prevent ovulation, but during freezing you want to do exactly the opposite. If you’re on the pill or use the patch, some doctors will have you stop during your egg freezing cycle, and some may have you stop for the month leading up to the retrieval. 

If you have an IUD, you can keep it in. Although if you’ve been meaning to take it out, ask the doctor if they can do it during your procedure. 

Do I have to get off hormonal birth control to become an egg donor?

At Cofertility, our donors freeze their eggs for free when they give half to a family who can't otherwise conceive. This means the egg donation procedure is the same as the egg freezing procedure. As stated above, you will need to get off the pill but an IUD is fine.

Trying to conceive after going off birth control 

Now, we bet you're wondering just how quickly you can become pregnant after going off birth control and the answer is it depends on the type of birth control you've been using.

If it was a barrier method, you can start baby making right away, since the only thing preventing sperm from meeting egg was that physical barrier you've removed.

With a hormonal method, it depends—and it can be tough to predict. Some people's bodies need time to adjust to life without the birth control hormones and so they don't ovulate for about the first one to three months. When it comes to the Depo-provera injection, it is given once every three months, so the hormones stay in the body for about three months. Therefore, it is very unlikely to become pregnant until at least three months after your last injection.

As for the progesterone containing and non-hormonal copper IUD, these methods are immediately reversible. 

The best thing you can do, once you're off birth control, is to track your period to ensure you are ovulating regularly. There are several different apps that allow you to log Aunt Flo's visits. You'll probably want to invest in an ovulation predictor kit, too. This is a pee-on-a-stick test that helps you pinpoint when you're ovulating, which is the time each month you can get pregnant.

Be prepared

For some people, the conception process happens fast. "We see a lot of pregnancies within that first month of coming off birth control," Zimmerman says.

But we know first-hand that others may be in it for the long haul. If your periods are irregular, you don't get them, or you just...have a bad feeling, go with your gut and chat with an OB/GYN or a reproductive endocrinologist. We're rooting for you!

If your doctor told you that you have uterine fibroids—or even if you just think you might have them—you’re probably wondering if they’re going to mess with your chances of getting pregnant down the line, or if they’ll impact your ability to freeze your eggs. 

The good news is that fibroids are pretty common. The better news is that in most cases, they’re no problem at all. Here’s the 411 on fibroids and egg freezing.

What causes fibroids?

Fibroids are technically tumors, but they aren’t cancerous and shouldn’t increase your risk of uterine cancer, according to the Office on Women’s Health. Yay, right? Slightly less yay: there’s no clear answer about why these growths appear, but doctors do think there’s a genetic component. 

“Fibroids develop when one cell starts to divide and grow,” explains Dr. Anthony Propst, reproductive endocrinologist at Texas Fertility Center. According to Dr. Propst, they can be as small as a marble or as big as a volleyball. (Yup, you read that right. A volleyball—yikes.)

Dr. Propst says that 50% (!!!) of reproductive-age women have one or more fibroids, and that they’re more common among African American women. A 2013 study in the Journal of Women’s Health showed that African American women were more likely to experience severe fibroid symptoms (like heavy periods) and more likely to report that fibroids affect their physical activities.

What symptoms will I have?

Infertility is one symptom of fibroids, says Dr. Propst, but if you haven’t been trying to conceive yet then you may be totally in the dark about these little suckers. If that’s the case, here are some other symptoms to look out for:

• Heavy bleeding during menstruation
• Prolonged and/or painful periods
• Pelvic pain or pressure 
• Lower back pain
• Painful sex

UCLA Health reports that about one-third of fibroids are large enough to be detected by your OB/GYN during a physical, so don’t blow off those annual exams, ladies. 

How do I know if I have fibroids?

An ultrasound is the best way to tell if you have uterine fibroids. It will also reveal their location and size. Depending on your doctor, this may be an abdominal ultrasound or a transvaginal one. If you haven’t had one of those yet, we know it might sound intimidating, but trust us, it’ll be super helpful in getting a really good look around. 

So, can and should I freeze my eggs if I have fibroids?

Yes, you can freeze your eggs if you have fibroids. In fact, some people opt to freeze their eggs before certain fibroid treatments. 

However, some fibroids can make it difficult to access the ovaries during the egg retrieval. If you are interested in freezing with Freeze by Co, we will set you up with a fertility doctor for a consultation where they can give you more personalized advice.

Will fibroids affect my fertility?

Fibroids can affect fertility now or in the future. Approximately 5% – 10% of infertile women have fibroids, but most women with fibroids will not be infertile. According to Dr. Mark Trolice, infertility specialist at Fertility CARE: The IVF Center in Florida, it’s not the size of fibroids but the location that determines their overall effect on fertility.

“Unless the uterine cavity is affected by fibroids, we leave them alone,” he says. “But if there’s a distortion of the cavity—like if the fibroid is growing there, or is pushing into the cavity—then surgery is recommended,” since that might affect fertility.

Dr. Propst adds that fibroids growing within the muscle of the uterus (also called intramural fibroids) can impact your pregnancy chances, because fibroids within the womb can prevent implantation of an embryo. 

Can fibroids affect egg quality?

Fibroids can affect whether sperm and egg meet (by blocking the pathway) and if the embryo has room to implant in the uterus. Fibroids can also affect the growth and positioning of the baby if you do get pregnant. But there’s not much known about if fibroids can impact egg quality, and it’s likely that there’s no correlation. 

Do I need to do something about my fibroids?

Once more, for the people in the back: it depends on where they’re located. 

“With those intramural fibroids, the bigger they get, the more likely they are to affect fertility,” says Dr. Propst, who recommends surgery in those cases. So if your fibroid is large and located in the uterine muscle, you’re gonna have to problem-solve.

According to the Mayo Clinic, surgery for fibroids could include: 

• A noninvasive ultrasound procedure (done inside an MRI scanner)
• A minimally invasive procedure, like a laparoscopy or myomectomy (you’ll go home the same day)
• A traditional abdominal surgery (you’ll have to stay overnight...but get to eat lots of Jell-O)
• A hysterectomy (not good, but don’t panic...this is a worst-case scenario)

Whether or not to undergo fibroid surgery is a decision you’ll have to make with your doctor, but there are pluses and minuses, so make sure you’re well-informed. 

You may not be thrilled about surgery (especially if your fibroids aren’t causing symptoms), but Dr. Trolice says that there are risks of pregnancy complications with fibroids, especially larger ones, and a 2014 study published in the American Journal of Obstetrics and Gynecology backs this up: it suggests that the size, number, location, and type of fibroid can contribute to higher rates of preterm birth, cesarean delivery, and postpartum blood loss and hemorrhage.

What’s the bottom line with fibroids and fertility? Location, location, location. You might never know you have them, and even if you do, you might never need to do anything about them—unless they’re in a spot where they could interfere with a future pregnancy, in which case you’ll have a few mostly-not-terrible surgery options to choose from. 

So can you freeze your eggs if you have fibroids? Yes, you can still pursue egg freezing. And we’re here to help you freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive. Plus, our inclusive online spaces allow you to connect with others going through the process. Learn more!

Polycystic ovarian syndrome isn’t just a single issue, but a constellation of symptoms that many women have. And if you have a messed-up menstrual cycle, significant weight gain, or infertility, there’s a chance you may have it. You can thank an imbalance in your male and female hormones (androgen and progesterone) for getting you on this crazy train.

Even if you don’t have PCOS, it’s likely you know plenty of people who do—one in 10 women of childbearing age have the syndrome. And while any woman can develop PCOS, you’re more likely to have it if your mother or sisters had it, or if you’re overweight or obese. For some women, the symptoms start as soon as they get their first period, while others develop the syndrome later on—after significant weight gain, for instance.

Your body on PCOS

PCOS is one of those issues that may require some detective work (and some testing) before you get a diagnosis. Some of the most common PCOS symptoms include:

• Irregular periods: Your period may not follow a set schedule, may not occur often, or it may extend long beyond the typical five to seven days (lucky you). Women may also experience painful periods or pain during ovulation, says Dr. Janelle Luk, medical director and founder of Generation Next Fertility in New York City. 
• Hormonal imbalances: The increased levels of androgen can cause male-like hair patterns—including male pattern baldness, facial hair, and excess body hair—along with severe acne. You may also have a lower than normal level of progesterone, a key female hormone associated with fertility.
• Blood sugar fluctuations: We all get hangry from time to time, but if you have PCOS, this goes one step further. “Sometimes, women may also experience sugar cravings and blood sugar fluctuations that physically manifest themselves in a lack of energy or feeling light-headed,” Dr. Luk says. These blood sugar issues can sometimes lead to weight gain that’s hard to lose. PCOS can also boost your chances of developing prediabetes or type 2 diabetes. 
• Polycystic ovaries: Normally, ovary follicles release eggs during ovulation. But if you have PCOS, the excessive androgen could be working against ovulation. Your ovaries may appear swollen, and may contain several follicles that are holding on to eggs and not releasing them. That said, this isn’t a dead giveaway that you have PCOS. Having cysts alone isn’t enough for a PCOS diagnosis, and your doctor should assess your menstrual cycle (or lack thereof), hormone levels, and weight fluctuation. 

And just because you don’t check the box for every symptom, doesn’t mean you don’t have PCOS or PCOS infertility. You don’t have to have all the symptoms to be diagnosed with PCOS, and sometimes PCOS actually flies a bit under the radar. Your best bet is to head to a doctor who can specifically check for PCOS. 

How PCOS could impact your fertility

If the PCOS symptoms—like that insane menstrual cycle—don’t suck enough, they can also do a number on your ability to become pregnant. According to Dr. Luk, PCOS often creates infertility issues due to its impact on periods and ovulation; if you aren’t ovulating, you aren’t releasing an egg.

PCOS can make getting pregnant challenging, but it’s hardly impossible. While it’s super common, it’s actually one of the most treatable causes of infertility in women. If you know you have PCOS, Dr. Douglas suggests talking to your doctor about proactive steps you can take to balance your hormones and create a plan if and when you decide to try to get pregnant. 

So can I freeze my eggs if I have PCOS?

Absolutely. Like others, women with PCOS may want to freeze their eggs to proactively increase their chances of having children down the road. It’s best to freeze when you are younger, in order to get the most high quality eggs possible. 

You’ll want to make sure you work with the best doctors, because women with PCOS are more susceptible to developing ovarian hyperstimulation syndrome (OHSS) during egg freezing. This is because they are likely to have more follicles, and the more follicles an ovary has the more likely it is to be overstimulated by HCG, one of the drugs used during egg freezing. One study of 2,699 women with PCOS undergoing IVF found that 75.2% had a normal response to controlled ovarian hyperstimulation (COH), while 24.8% developed OHSS.

Interested in freezing your eggs? We can help! Freeze by Co is a better approach to egg freezing, where you can freeze for free when you give half to a family who can't otherwise conceive.

What your doctor might recommend for managing PCOS

Medication is generally the first step to try to get everything moving. If you’re trying to conceive soon, progestin therapy might be used to level out your hormones. Metformin, a medication that is used to treat type 2 diabetes, can also help treat PCOS. Although metformin isn’t FDA approved for the treatment of PCOS, decreasing insulin resistance in women with PCOS has been shown to give spontaneous ovulation rates a boost, says Dr. Marra Francis, MD, FACOG, an OB/GYN in The Woodlands, Texas. 

Some women may need to move on to ovulation-inducing medications, like Clomid, but women with PCOS need to be carefully monitored if they do. If you have PCOS and take Clomid, you may be at increased risk of releasing more eggs than the one or two typically released with each Clomid cycle, which could result in twins. 

If these treatments still can’t help you conceive, your doctor may move onto other protocols. Get ready—here come the injections, like Follitism or Menopur. If the injections alone still don’t get you pregnant, IVF may be your best bet, according to Daniel Kort, associate medical director and practice director at Neway Fertility in New York City.

Summing it up

PCOS can lead to some really crappy symptoms. But fortunately, there are plenty of tools and treatments you can use to combat your PCOS and boost your chances of getting pregnant.

During the early days of building Cofertility — back then, just a content platform designed to demystify the fertility journey — I was also navigating my own complicated path to parenthood. I was pouring myself into startup life, while silently wondering if I’d ever be able to grow my own family. It’s ironic, really: as entrepreneurs, we’re trained to think long-term, take calculated risks, and invest in future value. But when it comes to our own reproductive futures, we often delay, deny, or deprioritize one of the most critical investments we can make: fertility preservation.

I co-founded Cofertility with two incredible women, with each of us facing our own fertility struggles and all of us wishing we could go back in time to freeze our eggs. But the truth is, the best time to freeze your eggs is when you can least afford it. Especially when you're self-employed or building a company from scratch. No one tells you that — until now.

This article is here to say: egg freezing can be possible for entrepreneurs. In fact, it might be one of the smartest personal and professional decisions you make.

Why egg freezing can be a smart move for founders

Flexible timing around your cycle

Unlike IVF, which often carries an immediate time pressure (usually due to medical diagnoses or age-related urgency), egg freezing allows for flexibility. Most people freeze eggs for elective reasons — meaning you can wait until the timing aligns with your personal or professional schedule. As a founder, this flexibility can be key. You can plan a cycle during a quieter month, or even preemptively book it ahead of a business lull. In most cases, you’ll be able to choose when your cycle starts based on your own timing needs, and your doctor can help coordinate accordingly.

Mental clarity and reduced stress

Founders are constantly juggling risk and uncertainty. Fertility shouldn’t have to be one more unknown hanging over your head. At Cofertility, one of the most consistent pieces of feedback we hear from our members is that freezing eggs provides a sense of mental relief — like you’ve bought yourself more time. That clarity alone can improve decision-making, reduce emotional burnout, and allow you to pursue your goals with more freedom.

Optionality for the future

Freezing your eggs doesn’t mean you’re delaying motherhood. It means you’re creating options for yourself and your future family. Whether you envision kids in a year or in a decade, fertility preservation allows you to decouple your reproductive timeline from your business growth curve. And while frozen eggs aren’t an insurance policy or a guarantee of a future baby, studies have shown they can significantly improve your chances depending on age at retrieval. According to the American Society for Reproductive Medicine (ASRM), future live birth success rates are highest when eggs are frozen before age 35.

How to balance egg freezing with startup life

How long it takes

The entire egg freezing process typically takes about 2–6 weeks:

• Initial consult and fertility testing: ~1 week
• Stimulation cycle with hormone injections: ~10–14 days
• Egg retrieval procedure: 1 day, with 1–2 days of recovery

While the time commitment is manageable, it does require planning, especially for someone with a packed founder schedule. You will also need to budget additional time to sort out things like insurance coverage, ordering your medication, and organizing your supplies.

Navigating appointments as a founder 

During the stimulation phase, you’ll have frequent early morning monitoring appointments (bloodwork and ultrasounds), often every other day for 1–2 weeks. These are very quick and usually happen before 9 am, so they can be built around your workday. However, I recommend avoiding major travel or high-stress events during this window in order to keep the process moving along. 

Some more specific tips for balancing your freezing cycle with founder duties include: 

• Avoid launching a product or closing a funding round that week: Egg retrieval week can be physically and emotionally taxing, so try to steer clear of high-stakes events that require intense focus, long hours, or crisis-mode thinking.
• Batch work ahead of time and delay non-urgent meetings: Front-load tasks that require deep work or decision-making so you’re not scrambling mid-cycle; non-time-sensitive meetings can usually wait a week or two.
• Communicate with your co-founders and team about your availability: Set expectations early by letting key team members know you'll be stepping back briefly — most people are supportive when you're transparent and proactive.
• Automate or delegate where possible: Use tools to automate repetitive tasks (like social media posting or email responses), and lean on team members, freelancers, or a virtual assistant to help keep things moving.

Support during retrieval week

The actual retrieval procedure itself is a short outpatient procedure performed under light anesthesia. You’ll need someone to drive you home and should block out at least one full day to rest. Some people feel back to normal the next day, others take a few days.

This is where your founder mindset helps: treat this like a product launch. Prepare, delegate, and trust your team. You may be surprised at how capable your support systems can be when you actually let them step in.

Costs and funding options for the self-employed

Out-of-pocket costs

Unfortunately, most U.S. insurance plans — including ACA plans for the self-employed — don’t cover egg freezing unless it's medically necessary (e.g. for cancer patients). That leaves many business owners paying out of pocket. Here's a ballpark of what to expect for costs of freezing your eggs:

• Initial consult and fertility testing: $350-$2,500
• Medication: $2,500-$8,500
• Egg retrieval cycle: $4,000–$10,000
• Storage fees: $600–$1,000/year
  

All in, a typical egg freezing cycle can cost anywhere between $10,000–$15,000.

Using HSA/FSA funds

If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), some parts of the process, like medications or diagnostic testing, may be eligible for reimbursement. You’ll need to check the specifics with your plan provider and may need a doctor’s note citing medical necessity.

Creative funding strategies

Entrepreneurs are no strangers to creative financing. Consider:

• Using a portion of business income if your structure allows owner draws
• Low-interest personal loans (including 0% APR credit card offers if paid off quickly)
• Crowdsourcing help from family or friends
• Joining a program like Cofertility’s Split model, where you can freeze your eggs for free when you donate half to a family who can’t conceive

Our mission at Cofertility is to radically improve access to egg freezing. We created the Split program to remove financial barriers and to build a more human, empathetic solution to family-building—for all parties involved. We also offer a Keep program, for those who want to freeze and keep 100% of their eggs, often at below-market rates with payment plans.

Final Thoughts

If you’re an entrepreneur who has ever wondered whether egg freezing was for “someone else” — someone richer, someone who isn’t launching a company, someone with better health benefits — know this: it can be for you, too.

I’ve walked this road and seen firsthand how overwhelming fertility decisions can be while you’re building a business, fundraising, and sacrificing everything for your dream. But your future family is worth protecting just as much as your company is. Freezing your eggs proactively could save many future founder headaches down the line in the event that you need to undergo fertility treatment to grow your family when you’re ready. 

Egg freezing for entrepreneurs is no longer out of reach. It’s just been out of the conversation. We’re here to change that. To learn more about the Cofertility Split program and see if you qualify, take our quiz today. It just takes one minute! 

Read more about entrepreneurs embarking on their egg freezing journeys:

• Simmone Taitt
• Rachel Liverman
• Aagya Mathur

Fertility is one of those topics that most of us are taught to ignore until we’re actively trying to get pregnant. But as more women take ownership of their reproductive plans—whether through egg freezing or simply learning more about their options—there’s growing interest in testing fertility early. The promise of data is appealing: if you could find out where you stand, maybe you could make clearer decisions about your timeline, your body, and your future.

But the reality is a bit messier. Yes, there are ways to test aspects of your fertility. But there’s also a lot that can’t be measured—at least not with the kind of certainty many people expect. Some tests give useful insights. Others are often misunderstood. And some questions still don’t have reliable answers, no matter how many labs you send your blood to.

In this article, we break down what you can and can’t learn about your fertility from today’s most common tests, especially if you’re in your 20s and thinking about options like egg freezing. We’ll also cover how to think about those results, what they actually mean for your future fertility, and what they don’t tell you.

You can test your ovarian reserve

Let’s start with the most talked-about test: Anti-Müllerian Hormone (AMH). This is a hormone produced by small follicles in your ovaries. The more of these follicles you have, the higher your AMH level tends to be. That makes it a useful proxy for ovarian reserve, or the estimated number of eggs you have left.

AMH will not tell you the exact number of eggs you have remaining, but it can be used to reliably predict how you’ll respond to fertility treatment. If you’re considering egg freezing, for example, a high AMH might suggest you’ll produce more eggs during a stimulation cycle, which could mean fewer cycles overall. A lower AMH might signal the opposite.

That said, AMH doesn’t predict whether you can get pregnant unassisted. It also doesn’t reflect egg quality. Many people with low AMH conceive without issues, and many people with high AMH still face fertility struggles.

In short: AMH is helpful for understanding how your ovaries might respond to medication, but it’s not a fertility report card. It’s a piece of the puzzle, not the whole picture.

You can check your follicle count, but it varies

Another test used to assess ovarian reserve is the antral follicle count (AFC), which is done via vaginal ultrasound. AFC is the number of small follicles in your ovaries that are visible on an ultrasound at the start of your menstrual cycle.

• Antral = fluid-filled, early-stage follicles
• Follicle = a tiny sac that contains an immature egg
• Count = how many are seen on the scan

AFC gives your doctor an idea of how many eggs your ovaries might be able to produce that month and helps estimate your overall ovarian reserve. Like AMH, this gives a snapshot of the eggs your body might recruit that month.

A higher count usually means a better response to egg freezing medications. It can also confirm whether your AMH results are in line with what your ovaries are actually doing.

But this test depends a lot on timing and technique. Different providers might get slightly different counts, and the number can fluctuate month to month. So while it’s useful when paired with other data, it’s not always consistent on its own.

You can evaluate your hormone levels, but they’re not always predictive

In addition to AMH, your provider may check other hormone levels at the start of your cycle (It is especially important that FSH and E2 are tested in the early follicular phase, as they cannot be reliably interpreted if done at a random phase of the cycle):

• FSH (follicle-stimulating hormone): Higher levels can suggest your ovaries are working harder to produce eggs, which may point to lower ovarian reserve.
• Estradiol (E2): This form of estrogen is measured alongside FSH to interpret the results accurately.
• LH (luteinizing hormone) and TSH (thyroid-stimulating hormone): These are sometimes included to rule out other hormonal conditions.

These blood tests are relatively easy to obtain and often included in a fertility workup. But their meaning can vary depending on when they’re taken and your cycle regularity. Like AMH, they don’t offer a yes-or-no answer about whether you’re fertile, they just add context.

There’s no test for egg quality 

This is where things get tricky. While you can estimate how many eggs you might have, there’s no current test that can measure the quality of your eggs. Egg quality mostly refers to whether an egg has the correct number of chromosomes. As people age, their eggs are more likely to develop abnormalities that make fertilization or a healthy pregnancy less likely.

Right now, the only way to assess egg quality is by making embryos. But even then, it’s difficult to know if the quality issue is from the egg, sperm, or a combination of both. 

Statistically speaking, younger people are more likely to have higher-quality eggs. But that’s a generalization, not a guarantee. Two people the same age can have different egg quality, and there’s no blood test that can measure this with accuracy.

So when people say, “Your egg quality declines with age,” they’re right. But when someone says, “You can test your egg quality,” they’re overselling it.

You can’t test how long you’ll be fertile

This is another common misconception. You might think that by testing your AMH or other hormones, you can predict how many fertile years you have left. Unfortunately, fertility doesn’t follow a strict countdown clock.

AMH gives a rough estimate of ovarian reserve, but it can’t tell you exactly when you’ll hit menopause, or when your eggs will stop being viable. Some people with high AMH experience early menopause. Others with low AMH get pregnant without issue. There’s too much individual variation to make long-term predictions with confidence.

Egg freezing can give you more options in the future—but it’s not a guarantee. The number and quality of frozen eggs, your age at the time of freezing, and your overall health all factor into how likely those eggs are to result in a baby later.

You can assess whether your fallopian tubes are clear

One test that often gets less attention in fertility conversations—but can be important—is the hysterosalpingogram (HSG). This is a specialized X-ray that looks at the inside of the uterus and fallopian tubes. It’s typically done by injecting a dye through the cervix and using imaging to see how the dye moves through the reproductive tract.

The goal is to check whether there are any blockages or structural issues that could prevent sperm and egg from meeting. If the dye flows freely through the fallopian tubes and into the abdominal cavity, that’s a good sign. If it doesn’t, it could indicate a blockage that might affect natural conception.

An HSG doesn’t give information about eggs, hormones, or ovulation, but it does offer a window into the physical pathways that make pregnancy possible. If you’ve had pelvic infections, endometriosis, or abdominal surgery in the past, your doctor may recommend this test as part of your fertility workup.

What about at-home fertility tests?

You’ve probably seen ads for at-home fertility tests promising insights into your reproductive future. Most of these kits check AMH, and some also offer hormone panels that include FSH, LH, and estradiol.

These can be helpful for getting started, especially if you’re not ready to visit a fertility clinic. But they’re not a substitute for a full medical evaluation. They also shouldn’t be used to make major decisions in isolation. If a test shows low AMH, it doesn’t mean you can’t get pregnant. And if it shows high AMH, it doesn’t mean you’re off the hook for thinking about fertility down the line.

Think of these kits as entry points—tools to start a conversation with a qualified provider, not definitive answers.

So what should you do with this information?

If you’re in your 20s, you’re in a good position to be proactive. Even though you can’t test everything, there’s value in learning what you can and starting the conversation early.

AMH and AFC can help you understand how your body might respond to treatment. Hormone panels can uncover issues you might not be aware of. And a consultation can give you space to ask questions and make a plan that fits your goals—even if that plan is just to wait and check back in a year.

It’s okay not to have all the answers. The idea isn’t to predict your future. It’s to give yourself more room to navigate it with intention.

Final thoughts

Fertility testing has come a long way, but it still has limits. You can measure ovarian reserve, hormone levels, and follicle counts. But you can’t test egg quality, predict exactly how long you’ll be fertile, or know for sure whether you’ll get pregnant naturally.

Still, having more information can be empowering—especially if it helps you make decisions on your own timeline. Whether you’re thinking about egg freezing or just want to understand your body better, asking questions now can open more doors later.

At Cofertility, we’re here to make those conversations easier, more transparent, and less intimidating. If you're considering egg freezing and want to understand what testing can (and can't) tell you, we’re happy to help you get started.

If you’re thinking about freezing your eggs, you’ve probably heard about the concept of “egg quality.” Maybe a friend mentioned it, or your doctor brought it up during a consultation. It’s one of those fertility buzzwords that can feel vague and hard to pin down. What does “egg quality” actually mean? And more importantly, is there a way to find out what yours is?

Egg quality refers to how likely an egg is to result in a healthy embryo and, eventually, a live birth. It’s not something we can measure directly—there’s no perfect test or score that tells you how “good” your eggs are. But we do have tools to assess your fertility potential, and there are signs and indicators that can give us insight into how your body is responding.

In this article, we’ll walk through what egg quality really means, why it matters, how it changes over time, and the testing options available today. We'll also talk about what to consider when thinking about fertility preservation—and how Cofertility can support you in taking next steps.

What we mean by “egg quality”

In medical terms, egg quality refers to the genetic and cellular health of an egg. A high-quality egg is one that has the right number of chromosomes and is capable of being fertilized, developing into a healthy embryo, and implanting in the uterus.

Eggs with abnormal numbers of chromosomes—called “aneuploid” eggs—are less likely to lead to a successful pregnancy. These eggs may not fertilize, may result in failed embryo development, or may lead to miscarriage if implantation does occur. In some cases, chromosomal abnormalities that originate in the egg can carry through to a developing embryo and lead to a live birth with a genetic condition. Down syndrome (Trisomy 21) is the most widely known example of this, but there are many other conditions that can arise from chromosomal abnormalities. This is why egg quality plays such a big role in fertility, even for people who are ovulating regularly or who feel perfectly healthy.

Unfortunately, there’s no simple blood test or ultrasound that can tell us with certainty which of your eggs are chromosomally normal. Egg quality can only truly be confirmed by creating embryos and performing genetic testing on them, which isn’t part of the typical egg freezing process. But there are other ways to estimate your fertility potential.

Age matters most

Of all the factors that impact egg quality, age is by far the most significant. People with ovaries are born with all the eggs they’ll ever have, and both egg quantity and quality decline over time.

Most people see a gradual decline starting in their early 30s, with a more noticeable drop-off around age 35. By age 40, a higher percentage of eggs are likely to be genetically abnormal. That doesn’t mean you can’t get pregnant or that all your eggs are “bad”—but it does mean fewer of your eggs may be capable of resulting in a live birth.

To put this age-related decline into perspective, here’s what the numbers actually look like:

• At age 25, approximately 20-25% of eggs may be chromosomally abnormal.
• At age 35, this increases to about 40-50%
• At age 40, that figure is up to roughly 70-80%
• At age 43, over 90% of eggs may be chromosomally abnormal

Egg quality is the main reason that IVF success rates drop with age, and why freezing your eggs earlier can increase your odds of having more usable eggs down the road.

Egg quantity vs. egg quality

It’s easy to confuse egg quantity with egg quality, especially since both tend to decline together. But they’re not the same thing.

Egg quantity refers to the number of eggs you have left—your “ovarian reserve.” The most commonly used tests to assess this are AMH (anti-Müllerian hormone) and antral follicle count, which can give us insight into your egg supply. These tests are useful for predicting how many eggs you might produce during a stimulation cycle, which is helpful when planning for egg freezing or IVF.

But these tests don’t tell us anything definitive about the quality of your eggs. It’s entirely possible to have a high AMH and still have a higher percentage of chromosomally abnormal eggs. On the flip side, someone with low ovarian reserve may still have good-quality eggs—it just may take more cycles to find them.

Can you test your egg quality?

Here’s where it gets tricky. There is no test that gives a direct readout of egg quality unless you’re creating and doing genetic testing on embryos. But here are some of the indirect ways we can get clues:

Age

As mentioned, this is the strongest predictor of egg quality. Most fertility specialists use age as a starting point when estimating how many eggs you may want to freeze for a future pregnancy.

Embryo development (in IVF)

If you go through IVF and fertilize your eggs, you can get information about how well your eggs developed into embryos. Some embryos can be biopsied and tested (PGT-A) to check for chromosomal normalcy. This gives a more direct window into egg quality—but it’s not part of standard egg freezing.

Ovarian reserve testing

While it doesn’t tell us about quality, ovarian reserve testing (AMH, FSH, AFC) gives us an idea of your egg quantity. If your numbers are unexpectedly low for your age, it may be worth exploring your optionsmore quickly, especially if you’re considering freezing your eggs.

Cycle response

If you go through an egg freezing cycle, how your body responds to stimulation medications (how many eggs mature, hormone levels during the cycle, etc.) can also offer insight. At Cofertility, we support you through every part of the cycle and help explain what your results might mean.

What affects egg quality besides age?

While age is the biggest factor, other things can also impact egg quality over time. Some are within your control, others aren’t.

• Smoking, whether that’s nicotine or marijuana, is consistently linked to lower egg quality and earlier menopause.
  
• Certain medical conditions, like PCOS, endometriosis, or autoimmune disorders, may affect egg health.
  
• Chemotherapy or radiation treatments can damage eggs or reduce ovarian reserve.
  
• Environmental exposures to endocrine-disrupting chemicals may play a role, although research is still ongoing.

There's growing interest in how lifestyle, diet, and supplements may support egg health. While there's no magic food or pill that guarantees higher-quality eggs, taking care of your overall health—getting enough sleep, avoiding smoking, managing stress, and maintaining a balanced diet—can support your fertility.

How Cofertility can help

If you’re thinking about freezing your eggs, understanding your fertility is the best place to start. At Cofertility, we’re here to guide you through the process with clarity and support—not pressure.

Through our Split and Keep programs, we offer egg freezing in a way that puts you in control:

• With our Split Program, you can freeze your eggs for free when you donate half to a family who can’t otherwise conceive. This model attracts people motivated by shared values—not just financial incentives—and gives donors a way to preserve their own fertility without the high cost.
  
  
• Our Keep Program is designed for those who want to freeze and keep all of their eggs. We help you navigate the process, connect you with partner clinics, and offer a support team to answer your questions at every step.
  

Our team includes experienced nurses (like me), fertility doctors, and donor coordinators who are here to help you feel informed—not overwhelmed. Whether you're ready to move forward or just want to ask questions, we’re here when you’re ready.

Final thoughts

There’s a lot of noise out there about egg quality—and it can be hard to separate fact from fear. While there’s no single test to measure it, your age, hormone levels, and cycle response can all offer clues. If you’re curious about your fertility, or planning ahead for the future, taking steps to learn more now can give you more options later.

Freezing your eggs isn’t the right decision for everyone. But if you’re considering it, Cofertility can help you do it in a way that’s empowering, transparent, and supported by people who care.

You deserve to make these decisions with clarity and confidence—not confusion. Let us help you get there.

For the 190 million people affected by endometriosis, family planning may look a little different. Endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, can impact fertility in various ways - from altered ovarian function to changes in egg quality. Recent medical advances have made egg freezing (oocyte cryopreservation) an increasingly reliable option for this population.

This article explores how endometriosis affects fertility, when to consider egg freezing, and what research tells us about success rates. We'll examine the specific challenges that people with endometriosis face during the egg freezing process, and provide evidence-based information to help inform your decision-making process.

Understanding endometriosis and fertility

Endometriosis affects between 2% to 10% of people, with rates as high as 50% among those experiencing infertility. The condition can impact fertility through several mechanisms, including inflammation, altered pelvic anatomy, and compromised ovarian function. These changes can affect both natural conception and assisted reproductive treatments. 

The chances of getting pregnant each month are approximately 10-20% for people without endometriosis, compared to 1-10% for those with surgically documented endometriosis.

Endometriosis and egg quantity

When it comes to egg freezing, people with endometriosis often have diminished ovarian reserve and fewer eggs retrieved. Research has found that this reduction is exacerbated after endometriosis surgery. 

Endometriosis and egg quality

Beyond affecting how many eggs are available, endometriosis can also impact egg quality. The chronic inflammation that comes with endometriosis can create an environment that may impact the health of your eggs. While standard testing can tell us about egg quantity (your ovarian reserve), there’s no single test that can measure egg quality before fertilizing them to make embryos. 

if you decide to use your frozen eggs in the future, the process of fertilizing the eggs to create embryos may give some insight into egg quality factors. People with endometriosis may experience lower rates of fertilization and have more difficulty developing normal embryos. It’s worth nothing that even fertilization results don’t tell the complete story about egg quality, as multiple factors can influence whether eggs fertilize and develop appropriately. 

This is why having a conversation with your fertility doctor about both egg quantity and potential quality concerns is important when you’re planning your fertility preservation goals. Many people with endometriosis do successfully create healthy embryos, particularly when eggs are frozen at a younger age. 

When to consider egg freezing if you have endo

If you have endometriosis, you may be wondering if you’re a good candidate for egg freezing. Research suggests that certain situations make egg freezing particularly worth considering for people with endometriosis:

• Those with large endometriomas (endometriosis cysts on ovaries)
• Those with bilateral endometriomas affecting both ovaries
• Before surgical treatment - some surgeries for endometriosis can affect fertility by inadvertently removing healthy ovarian tissue or compromising vascular supply to the ovary

Younger patients (under 35) with good ovarian reserve, particularly those who haven't yet undergone ovarian surgery, often see the best results. The best way to know if you’re a good candidate or if now is the right time to freeze your eggs is to talk to a fertility doctor. 

Success rates and research findings

A 2024 study published in Best Practice & Research Clinical Obstetrics & Gynaecology offers encouraging data. Among people with endometriosis who used their frozen eggs, 46.4% achieved live births. This may sound low, but there are two things to keep in mind.

First, this figure represents success only among people who actually returned to use their frozen eggs. This group was more likely to have additional fertility challenges beyond endometriosis - after all, they needed to use their frozen eggs rather than conceiving naturally. 

Second, for perspective, the overall live birth rate for a first IVF cycle across all people (regardless of diagnosis) is under 30%. This means people with endometriosis who froze their eggs achieved better outcomes than the general IVF population, even though they may have been dealing with multiple fertility challenges.

The study found that younger people (under 35) had better outcomes, and people without prior ovarian surgery had higher numbers of eggs retrieved.

The number of eggs frozen significantly impacts success rates. The study found that 22 frozen eggs yielded an 89.5% cumulative live birth rate, with people under 35 achieving a remarkable 95.4% success rate. Those over 35 still saw promising results with a 79.6% success rate.

The egg freezing process with endometriosis

The procedure follows similar protocols to standard egg freezing, but there are special considerations for people with endometriosis. Before starting, you'll need detailed ultrasound evaluation, hormone level testing, and discussions about timing relative to any planned surgeries.

The stimulation protocol uses hormonal medication and takes on average 10-14 days. Your medical team will carefully monitor your response and may adjust medications as needed. Some people are prescribed antibiotic prophylaxis during egg retrieval to prevent infections, as the retrieval needle passing through tissue affected by endometriosis may cause an increased risk of pelvic infection compared to patients without the condition. 

Cost considerations

People with endometriosis should be prepared for some financial differences in their egg freezing journey. Those with endometriosis may actually require more stimulation medications - one study found that people with endometriosis needed, on average, 20% more gonadotropins (the hormones used during the process) compared to people without endometriosis. Additionally, you may need multiple egg freezing cycles to reach the recommended number of eggs for good success rates.

The investment in egg freezing can be substantial, but many people with endometriosis find that the peace of mind and preserved fertility options are worth considering, especially given the progressive nature of this condition. 

Learn more about how to freeze your eggs for free through egg sharing with Cofertility.

Can I donate my eggs with endometriosis?

The answer depends on the severity of your endometriosis and your treatment history. People with mild endometriosis (Stage 1 or 2) may still be eligible to donate eggs, though acceptance is determined case by case and depends on ovarian reserve testing results along with other qualifications.

However, people with severe endometriosis (Stage 3 or 4) or those who have undergone surgery for endometriosis usually cannot donate eggs. This is because severe endometriosis and related surgeries can damage ovarian tissue, potentially reducing the number of eggs that would be retrieved during the donation process. Ultimately, it’s up to the fertility doctor screening your application. Egg sharing programs like Cofertility aim to maximize success rates for intended parents and egg donors while ensuring donor safety. 

Summing it up

If you have endometriosis and are considering egg freezing, here are the key points to remember:

• Timing matters: Consider freezing eggs before any planned surgeries for endometriosis, as surgery can impact ovarian reserve.
• Age is significant: people under 35 see the best success rates, with live birth rates over 95% when freezing enough eggs.
• Numbers count: Research shows having about 22 mature frozen eggs gives you the best chance of future success.
• Multiple cycles may be needed: people with endometriosis often require more than one egg freezing cycle to reach optimal egg numbers
• Consider your stage: If you have severe endometriosis or have had ovarian surgery, discuss your specific situation with a fertility doctor who can evaluate your ovarian reserve
• Success is possible: Recent research shows people with endometriosis who freeze their eggs have good outcomes.

While egg freezing isn't a guarantee of future pregnancy, it's an important option for people with endometriosis who want to preserve their fertility. Working with a fertility doctor who has experience treating patients with endometriosis can help you determine if and when egg freezing might be right for you.

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.

Choosing the right birth control method is about understanding your options and finding what works best for your body, lifestyle, and future plans. While effectiveness is a key factor, it's just one part of the decision. Other considerations include ease of use, potential side effects, cost, and whether you want protection against sexually transmitted infections (STIs).

This guide breaks down 13 birth control methods, ranked by their effectiveness at preventing pregnancy when used correctly. For each option, we'll explore how it works, possible side effects, and key factors to consider. Remember that what works well for one person may not be ideal for another and the considerations mentioned aren’t exhaustive, so consulting with your OBGYN is always recommended.

Implant (99%+ effective)

What it is: The birth control implant (Nexplanon) is a small, flexible rod about the size of a matchstick that's inserted under the skin of your upper arm. It releases progestin, a hormone that prevents pregnancy by stopping ovulation and thickening cervical mucus.‍

Protection against STIs: No‍

Duration: Up to 3 years‍

Considerations: Can cause irregular bleeding patterns (longer or shorter periods, spotting, or no bleeding at all). It’s reversible, and fertility returns quickly after removal. The implant can be felt under the skin.

Hormonal IUD (99%+ effective)

What it is: Hormonal intrauterine devices (Mirena, Kyleena, Skyla, Liletta) are small T-shaped devices placed in the uterus. They release small amounts of progestin locally, which thickens cervical mucus, thins the uterine lining, and often even suppresses ovulation, making pregnancy extremely unlikely. Certain brands, like Mirena and Liletta, can serve as emergency contraception if inserted within 5 days of unprotected sex.‍

Protection against STIs: No‍

Duration: 3-8 years‍

Considerations: Hormonal IUDs often lighten or even stop menstrual cycles over time, so they can be beneficial for people who have painful or heavy periods. They tend to be well-tolerated among all ages and can be preferred to the Copper IUD in people who haven’t given birth or have a smaller uterus, as these devices are generally smaller.

Copper IUD (99%+ effective)

What it is: A non-hormonal T-shaped device (Paragard) that uses copper's natural sperm-fighting properties to prevent pregnancy. It can also serve as emergency contraception if inserted within 5 days of unprotected sex.‍

Protection against STIs: No‍

Duration: Up to 10 years‍

Considerations: This is a good option for people who prefer or need to avoid hormonal birth control. Due to its larger size, though, it can be more challenging and/or painful to insert in people who haven’t given birth. It can also cause heavier, more painful, or longer periods.

Birth control shot (94% effective with typical use)

What it is: An injection of progestin (Depo-Provera) given every three months. It works by preventing ovulation and thinning the uterine lining, so there’s less chance an egg will attach to it.‍

Protection against STIs: No‍

Duration: 3 months per shot‍

Considerations:  Low-maintenance and minimizes user error. Can cause irregular bleeding and is associated with delayed return of ovulation and/or menses after stopping. Long-term use may lead to reversible bone density loss.

Birth control pills (93% effective with typical use)

What it is: Daily pills that come in two main types: combination pills (containing estrogen and progestin) and progestin-only pills (mini-pills). They prevent pregnancy by stopping ovulation and thickening cervical mucus.‍

Protection against STIs: No‍

Duration: Daily pill‍

Considerations: Many people prefer the pill as it’s non-invasive and can help control your cycle (i.e. skipping menstruation). Missing or taking pills at inconsistent times reduces protection, so consistent, daily use is important. Estrogen-containing pills should be avoided in people with certain health conditions, including history of blood clots, stroke, high blood pressure, migraine with aura, and people who smoke cigarettes.

Birth control patch (92% effective with typical use)

What it is: A thin patch (Xulane, Twirla, Zafemy) worn on the skin that releases estrogen and progestin. It's changed weekly for three weeks, followed by a patch-free week.‍

Protection against STIs: No‍

Duration: Weekly replacement needed‍

Considerations: Some brands could be less effective for individuals weighing over 198 lb. Also can cause skin irritation at the site of the patch. Shares the same estrogen-related risks as the pill and vaginal ring.

Vaginal ring (91% effective with typical use)

What it is: A flexible ring (NuvaRing, Annovera, EluRyng) inserted into the vagina that releases estrogen and progestin. It's worn for three weeks, followed by a ring-free week for menstruation.‍

Protection against STIs: No‍

Duration: 3 weeks‍

Considerations: Requires consistent timing for removal and insertion to be most effective. Shares the same estrogen-related risks as the patch and pills.

Male (External) condoms (87% effective with typical use)

What it is: A thin sheath worn over the penis during sexual activity, creating a barrier that prevents sperm from reaching an egg.‍

Protection against STIs: Some but not all (herpes, genital warts, syphilis, and mpox can be spread from skin-to-skin contact).‍

Duration: Single use‍

Considerations: Available without a prescription. Latex condoms are most common, but options are available for people who have a latex allergy or sensitivity. Must be applied correctly every time, stored properly, and be unexpired to be effective. Latex condoms can be broken down by oil-based lubricants, making them more likely to tear or rupture during use. 

Diaphragm (87% effective with typical use)

What it is: A shallow silicone cup inserted into the vagina before sex. Must be used with spermicide and left in place for at least 6 hours after sex.‍

Protection against STIs: No‍

Duration: No more than 24 hours‍

Considerations: Insertion and removal can be challenging. Increase risk of UTIs, especially when used with spermicide. Should be replaced every 1-2 years, or sooner if there are changes such as pregnancy or weight fluctuations.

Internal condoms (79% effective with typical use)

What it is: A polyurethane pouch inserted into the vagina before sex, creating a barrier that prevents sperm from reaching an egg.‍

Protection against STIs: Some but not all.‍

Duration: Single use‍

Considerations: May be more expensive and less widely available than male/external condoms. Should not be used with external condoms due to friction and breakage risk.

Spermicide (72% effective with typical use)

What it is: A chemical product that comes in various forms (foam, film, gel) and works by killing or immobilizing sperm and blocking the cervix.‍

Protection against STIs: No‍

Duration: Needs to be applied shortly before each act of intercourse‍

Considerations: May cause vaginal irritation. Frequent use of certain spermicides (containing an ingredient called nonoxynol-9) could actually increase risk of transmitting HIV. Less effective if used more than an hour before sex or not reapplied with repeated intercourse.

Fertility awareness methods (77-98% effective with perfect use)

What it is: Tracking fertility signs like basal body temperature and cervical mucus to avoid pregnancy during fertile days.‍

Protection against STIs: No‍

Duration: Ongoing daily tracking required‍

Considerations: Less effective with irregular ovulation and/or menstrual cycles. Things like stress, illness, and travel can impact ovulation and therefore effectiveness. 

Withdrawal method (78% effective with typical use)

What it is: Removing the penis from the vagina before ejaculation, also known as "pulling out."‍

Protection against STIs: No‍

Duration: Used during each act of intercourse‍

Considerations: Pre-ejaculate can still contain sperm. Free and always accessible. 

Making your choice

The effectiveness rates listed above refer to perfect use conditions. In real life, many factors can affect how well a method works, including user error, medication interactions, and timing. When choosing a birth control method, consider your lifestyle, health history, and comfort level with different options.

Consider talking with your OBGYN about:

• Your overall health and any medical conditions
• Current medications that might interact with certain methods
• Your menstrual cycle and any related concerns
• Your ability to follow the method's specific requirements
• Whether you need protection against STIs
• Your plans for future pregnancies
• Cost and insurance coverage

Remember that you can always switch methods if your first choice doesn't work well for you, and many people try several options before finding their ideal match. The best birth control method is one that you'll use consistently and correctly, fits your lifestyle, and helps you feel confident about your reproductive health.

Birth control pills have been a revolutionary advancement in reproductive health, giving millions of women control over family planning. I, myself, was on birth control for at least 15 years, originally starting as it helped alleviate debilitating cramping I experienced around my period.

When my husband and I were ready to start trying for a baby, I remember the rush of excitement I felt when I threw out my pack of birth control pills—like I was living on the edge and could get pregnant at any moment.  But I did have a nagging feeling in the back of my mind as I wondered how soon I could get pregnant after stopping birth control. Could my years of birth control use negatively affect my fertility? 

The good news is that scientific research overwhelmingly shows that no, birth control does not cause infertility. In this article, we’ll break down how birth control works, what happens when you stop using it, and what factors actually *do* influence fertility. 

How birth control works

Birth control methods vary widely in form and function, but the most common types include:

• Combination birth control pills: Contain synthetic estrogen and progestin, preventing ovulation and thickening cervical mucus to block sperm.
• Progestin-only pills (mini-pills): Prevent pregnancy primarily by thickening cervical mucus and sometimes suppressing ovulation.
• Long-acting reversible contraceptives (LARCs): Include intrauterine devices (IUDs) and implants, which provide extended protection without requiring daily adherence.
• Injectable contraception (Depo-Provera):  A progestin shot given every three months to prevent ovulation.
• Other hormonal methods: Such as patches, vaginal rings, and hormonal IUDs, all of which work through hormonal suppression of ovulation and sperm-blocking mechanisms.

These methods are designed to be fully reversible, meaning fertility should return once you stop using them. Your body may need a few months to regulate after stopping your birth control, but if your irregularity continues, consult your OBGYN. More on that below. 

Can being on birth control for years impact fertility? The answer is no

A common myth is that long-term use of birth control can lead to infertility. However, multiple studies have shown that birth control does not have a lasting impact on a woman’s ability to conceive.

A study published in Human Reproduction found that previous use of oral contraceptives did not impair fertility. Another recent comprehensive review in the British Medical Journal confirmed that conception rates among women who had used birth control were comparable to those who had never used it.

Ask any OBGYN, and they will tell you the same thing: birth control is safe, effective, and will not negatively impact your long-term fertility.

Return to fertility after discontinuing birth control

Many people worry: is it hard to get pregnant after years of birth control pills? 

The answer is no. However, while birth control does not directly impact your fertility, taking it might mask other cycle irregularities or symptoms you’d otherwise experience that may impact your ability to conceive. 

Depending on the type of birth control used, the potential time to get pregnant after stopping birth control may vary. If you take birth control pills or have an IUD (hormonal or copper), your fertility *should* (key word here) return anywhere between immediately and within a few weeks. If you have an implant, like Nexplanon®, ovulation usually resumes within one to three months after removal. Depo-Provera® users experience the longest delay, with some women taking up to 18 months for ovulation to return. However, eventual fertility rates remain unchanged.

All of this being said, a systematic review found that regardless of the contraceptive method, pregnancy rates after discontinuation were comparable to those who had never used contraception. 

Read more in I’m Going Off Birth Control. Now What?

Stopping birth control? Pregnancy is a risk

If you’re discontinuing birth control but are not trying to conceive, it’s important to use alternative contraceptive methods. Ovulation can return sooner than expected, even within days of stopping the pill or removing an IUD. To prevent unintended pregnancy, consider using barrier methods like condoms or exploring non-hormonal options until you are ready for a planned pregnancy.

Factors that actually impact fertility

While birth control does not cause infertility, several other factors can significantly affect your ability to conceive:

• Age: Female fertility declines with age, particularly after 35, due to a decrease in egg quantity and quality. 
• Underlying medical conditions: Conditions like polycystic ovary syndrome (PCOS), endometriosis, and thyroid disorders can affect fertility.
• Lifestyle factors: Smoking, excessive alcohol consumption, obesity, and chronic stress can all impact reproductive health.
• Male fertility: Sperm health is equally important; issues like low sperm count or motility can affect conception rates.

If you’re concerned about fertility, speaking with your OBGYN or a reproductive endocrinologist (REI) can provide personalized guidance based on your health and family planning goals.

Preserving your fertility with egg freezing

Even if you’re unsure whether you want children in the future, freezing your eggs can help keep your options open. Advances in egg freezing have made it a viable choice for many women. However, due to cost, it’s still relatively inaccessible to many. 

At Cofertility, we can help you freeze your eggs for free when you donate half of the eggs retrieved to another family who can’t conceive. This approach, known as our Split program, allows women to preserve their fertility while helping others grow their family — like gay dads, those with infertility, and cancer survivors. Take our quiz to see if you qualify for free egg freezing today.

Summing it up

The belief that birth control negatively impacts long-term fertility is a myth. Research consistently shows that—for most women—fertility returns soon after discontinuing contraceptive methods, and birth control use does not make it harder to conceive in the future.

However, factors like age, medical conditions, and lifestyle choices play a significant role in fertility outcomes. If you’re thinking about your reproductive future, egg freezing with Cofertility could be a valuable option. Whether or not you’re ready to have children, taking steps to preserve your fertility today can provide some peace of mind for the future.

For many women of faith, the decision to freeze eggs involves the consideration of both medical and religious factors. While family-building is deeply valued in most religious traditions, the path to parenthood isn't always straightforward. Modern fertility treatments like egg freezing can raise discussions about how to balance religious teachings with personal reproductive choices.

This article examines how the major religions - Judaism, Christianity, and Islam - approach egg freezing, drawing from recent research on religious women's experiences with the procedure. We'll explore official religious positions, common concerns among religious women considering egg freezing, and how different faith communities are navigating and responding to this technology.

Religious perspectives on egg freezing

Recent studies show that, in general, most major religions have come to accept egg freezing as a permissible way to preserve fertility, though specific guidelines and restrictions vary between faiths. Here's how different religions, in broad terms, view the procedure:

Judaism and egg freezing

Jewish religious authorities generally support egg freezing, viewing it as compatible with the religion's emphasis on family building and procreation. Both Orthodox and Reform movements have issued opinions permitting the procedure, though some rabbis recommend consulting religious authorities about specific circumstances. Some even argue it is actually a religious obligation for orthodox Jews to preserve their fertility and their ability eventually to “be fruitful and multiply.”

Islam and egg freezing

Islamic perspectives on egg freezing vary across different regions and communities. While some Muslim countries, like Egypt, allow the procedure, others, like Malaysia, have religious rulings that prohibit single Muslim women from freezing eggs for future use. 

Some Islamic scholars suggest ovarian tissue freezing might be a more acceptable option, since it would allow eggs to mature naturally once a woman is married. Still, the topic of fertility preservation for single women remains an ongoing discussion among Muslim religious leaders, doctors, and scientists as communities work to balance traditional values with modern medical options.

Christianity and egg freezing

Views on egg freezing vary significantly among Christian denominations. The most notable divide exists within Catholicism, which stands as the main exception among Christian faiths in its prohibition of egg freezing for fertility preservation. Other Christian denominations have generally shown more acceptance of the technology, though specific guidelines vary by church.

Studies show that Christian women who pursue egg freezing often face similar challenges to women of other faiths - particularly in finding partners who share both their religious values and educational background. Some women have found ways to reconcile their faith with the decision to freeze their eggs, viewing it as a path to achieving family-building goals within their faith tradition.

Why religious women choose to freeze their eggs

Research shows religious women often face unique pressures around marriage and childbearing. A 2020 study of religious women who froze their eggs found several common motivations:

• Difficulty finding partners who share both their religious values and educational/professional achievements
• Strong desire to have children within marriage, as required by their faith
• Concern about declining fertility while waiting for the right partner
• Wish to avoid rushing into marriage solely due to fertility pressure

Many religious women viewed egg freezing as a way to honor religious teachings on marriage while preserving their fertility options. As one researcher noted, these women saw the technology as a tool that enabled them to continue seeking a faith-aligned partner without compromising their future chances of motherhood.

Common concerns among religious women

Research identifies several concerns specific to religious women considering egg freezing:

Religious compliance:

• Whether the procedure aligns with religious law
• How to handle unused frozen eggs
• Ensuring proper religious oversight of the process

Cultural factors:

• Community perceptions
• Family reactions and expectations
• Impact on marriage prospects
• Maintaining religious modesty during medical procedures

Practical challenges:

• Coordinating treatment with religious observances
• Finding religiously approved facilities
• Managing costs within religious lifestyle constraints

These considerations often lead religious women to seek out fertility clinics with experience treating patients from their faith background. Many find that working with medical providers who understand their religious needs helps make the process more comfortable and aligned with their beliefs.

Making the decision

For religious women considering egg freezing, several resources can help guide your decision-making process:

Religious consultation:

• Speaking with religious leaders familiar with fertility issues
• Consulting medical ethics committees within religious institutions
• Seeking guidance from religious fertility organizations

Medical guidance:

• Working with fertility specialists who understand religious concerns
• Finding clinics experienced in providing care for religious patients
• Discussing timing and procedures that accommodate religious practices

Community support:

• Connecting with other religious women who have frozen their eggs
• Joining religion-specific fertility support groups
• Accessing resources from religious family organizations

Ultimately, it’s your decision to make – one that is both medical and personal. By combining guidance and input from religious authorities, medical professionals, and others who share similar experiences, you can make informed choices that align with both your faith and reproductive goals.

Looking ahead: Religion and reproductive technology

As egg freezing becomes more common, religious institutions continue to refine their positions on this technology. Many faiths are working to create clear guidelines that balance traditional religious values with modern reproductive options.

Religious women who choose egg freezing often find ways to integrate the procedure into their faith practice, viewing it as a tool to achieve religiously sanctioned family building. While challenges remain, increasing dialogue between medical providers and religious communities is helping create more supportive environments for religious women exploring fertility preservation.

Key takeaways

For religious women considering egg freezing:

• Most major religions accept egg freezing, though specific guidelines vary
• Religious counseling can help navigate faith-specific concerns
• Many clinics offer religious accommodations
• Support resources are available through religious organizations
• Costs and practical considerations should be carefully evaluated
• Both medical and religious guidance can inform the decision

Egg freezing represents a new option for women hoping to preserve their fertility while adhering to their faith traditions. As with any medical decision, careful consideration of both religious teaching and personal circumstances can help guide this choice. We wish you all the best.

More young women are taking their time to decide about parenthood, and the numbers prove it. Those who do choose to become a parent are doing so later; the average age of first-time mothers in the United States has been steadily increasing over time. And more women are saying no to motherhood altogether. In 2023, the U.S. fertility rate reached the lowest number on record.

This shift reflects broader changes in how women approach major life decisions about family, career, and personal goals. In this article, we'll look at why more women are pressing pause on parenthood. We'll also explore how some women are proactively preserving their fertility options while they decide - and why that choice doesn't have to come with a six-figure price tag.

Why more women are waiting

The reasons for postponing parenthood vary, but recent data highlights some clear patterns. According to Pew Research, 44% of young adults without children want to focus on their careers and personal interests first. Financial considerations play a major role too, with 36% citing the cost of raising children as a significant factor.

But it's not just about careers and money. Among women under 50 who don't have children, 64% simply say they're not sure they want to be parents - notably higher than the 50% of men who say the same. This suggests women are becoming more comfortable acknowledging uncertainty about parenthood.

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Career goals and financial stability

For many women in their twenties and early thirties, establishing professional foundations takes priority. This often means pursuing advanced education, building careers, or starting businesses - goals that can conflict with immediate family planning. The data supports this approach: 61% of adults without children report more career success, likely due to increased flexibility and focus.

Environmental and global concerns

Young adults are also thinking bigger: 38% cite concerns about the state of the world as a major factor in their decision-making, while 26% specifically mention environmental worries. These numbers reflect a growing awareness of how personal choices connect to larger issues.

Turning to egg freezing to keep your options open

While some women know definitively that they don't want children, others aren’t sure and want to preserve their options while they decide. 

This is where egg freezing can play a role - but traditional egg freezing often costs $15,000 or more, putting it out of reach for many young women.

Programs like Cofertility's Split program are providing new options. Women can freeze and store their eggs for 10 years, entirely for free, by donating a portion to a family who needs donor eggs. This arrangement covers the medical costs of egg freezing while helping another family build their future.

Making informed choices

The decision about parenthood doesn't have to be made all at once. But understanding your options now can help you make better choices for your future. Here's what to consider as you think it through:

• Age and fertility: While women today have more options than ever, biology still plays a role. Fertility (specifically the quantity and quality of eggs) typically begins to decline in your early 30s, with a more pronounced drop after 35. This doesn't mean you need to rush your decision, but it's helpful to understand your personal fertility timeline through testing and medical consultation.
• Career planning: Think about your professional goals for the next 3-5 years. Are you pursuing additional education? Planning to switch industries? Starting a company? Consider how different paths might align with family planning, and what flexibility you want to maintain.
• Financial readiness: Beyond the immediate costs of fertility preservation, consider your longer-term financial picture. What would make you feel secure enough to make major life decisions? This might include emergency savings, retirement planning, or specific career milestones.
• Building your support network: Surround yourself with people who support your choices without pressure. This might include friends in similar situations, healthcare providers who listen to your concerns, and family members who respect your timeline.

Looking ahead

The rise in women taking time to decide about parenthood reflects broader social changes and increased options for family planning. Whether you ultimately choose to have children or not, taking time to consider your choices thoughtfully makes sense - especially when there are ways to keep your options open.

If you are interested in freezing your eggs, we can connect you with a fertility specialist for a consultation to discuss your specific situation. Our Freeze by Co platform is making egg freezing more empowering, positive, and accessible — even free — when you give half of the eggs retrieved to a family who can’t otherwise conceive.

TL;DR

• Nearly half of adults under 50 now say they're unlikely to have kids, up from 37% in 2018
• 64% of young women without kids say they're simply not sure about parenthood
• Career focus (44%) and financial concerns (36%) are top reasons for waiting
• Environmental concerns and global issues influence many young adults' family planning
• Cofertility's Split program lets women freeze their eggs by sharing them with a family in need, making fertility preservation more accessible
• There's no rush to decide - but understanding your options helps you plan ahead