female fertility
How to Increase Egg Freezing Chances of Success
If you’re thinking about freezing your eggs, you probably have tons of questions. In this article, we’re going to focus on a very common question: “How can I increase my chances of success when I freeze my eggs?”
More and more people in the US (and the rest of the world) are taking control of their reproductive health and fertility by choosing to freeze their eggs. Whether this is so they can focus on a career, get an insurance policy with coverage for treatments, or because of medical reasons, this has allowed people to delay having children until whenever they’re ready to start a family.
If you’re thinking about freezing your eggs, you probably have tons of questions. In this article, we’re going to focus on a very common question: “How can I increase my chances of success when I freeze my eggs?”
Factors that can affect egg freezing success rates
Before an egg freezing cycle
Let’s start by going through what specific things make a difference in your chances of success before you even freeze your eggs.
Age
Age has been proven by countless research studies to be one of the biggest determinants of egg quality. As a person ages, their eggs are more likely to become aneuploid, meaning they’re genetically “abnormal.” This can lead to issues with both getting and staying pregnant (i.e, higher risk of miscarriages). On top of that, as a person ages, the number of eggs their ovaries contain continues to decrease naturally. Once a person reaches their mid to late thirties, the quality and quantity of eggs starts to go down more quickly. While there is no “perfect” age at which to freeze your eggs, freezing them before you reach your late 30s is considered ideal.
AMH level
Another important factor is your Anti-Müllerian hormone (AMH) level. This is a simple blood test that is commonly used to tell us a person’s reproductive potential based on the number and the quality of eggs they have left in their ovaries. AMH is released by antral follicles, which are small, fluid-filled sacs in the ovaries that each contain a single oocyte (immature egg). Your AMH level is positively correlated with the number of antral follicles you have in your ovaries. Simply stated, the more follicles you have, the higher your AMH level typically is. AMH naturally goes down as a person gets older until it reaches close to zero during perimenopause. While there is no international standard for what a normal AMH level is, some studies have tried to create models for what’s considered normal for specific ages. Check out this article to find out more about AMH levels at different ages.
Antral follicle count
Antral follicle count (AFC) is another number to be aware of before egg freezing. AFC is used in fertility assessments to estimate the number of developing follicles in someone’s ovaries at a specific point in the menstrual cycle using ultrasound. As mentioned before, the more follicles you have (the higher your AFC is), the higher your AMH level. And just like your AMH, your AFC will also naturally go down as you age.
How these values affect your egg freezing success
Unfortunately, there isn’t a lot that can be done about aging or about the decline in AMH and AFC that goes with it but there are a few things to know about how they affect your egg freezing changes.
- Ovarian reserve assessment. Age, AMH and AFC all provide valuable information about a person’s ovarian reserve. In general, younger age, higher AMH levels, and a higher AFC are good indicators that you have a larger pool of potential eggs in the ovaries. This means that you’re more likely to produce more eggs during an egg retrieval cycle, which increases the chances of a successful egg freezing cycle.
- Response to ovarian stimulation. Part of the egg freezing cycle includes taking medications to stimulate the ovaries to develop multiple eggs at once (as opposed to just one during a natural, unmedicated menstrual cycle). The response to these medications can vary based on age, AMH, and AFC. People who are younger and those who have a higher AFC/AMH tend to have a better response and produce more mature eggs during the stimulation. This increases the chances of retrieving a larger number of high-quality eggs for freezing.
- Number of cycles. In some cases, people with a lower AFC and/or AMH may have to go through more than one egg freezing cycle in order to get an adequate number of eggs. This can get costly and time-consuming pretty quickly.
- Future fertility potential. The number and quality of frozen eggs affects the chances of having a successful pregnancy when the frozen eggs are later thawed, fertilized, and transferred during an in vitro fertilization (IVF) treatment. A higher AFC and AMH can mean a higher number of frozen eggs, which increases a person’s chances of success in the future. However, neither of these numbers is the end-all-be-all here. In fact, while AMH does seem to have some association with live birth rates after IVF, its ability to actually predict a live birth is not that great, especially for younger people.
Again, all three of these factors aren’t necessarily things you can change so it can be easy to get discouraged if your values aren’t where you want them to be. Remember that each of these is just one value your provider looks at to assess your overall reproductive potential. No value by itself can completely predict your chances of conceiving naturally or define your fertility. A comprehensive assessment of a person’s fertility potential has to be done by a fertility specialist before jumping to any conclusions and making decisions about fertility preservation.
During an egg freezing cycle
Now, let’s go through the factors during an egg freezing cycle that can affect your chances of success.
Quantity and quality of eggs retrieved
The success rates of egg freezing cycles are significantly influenced by both the number and quality of eggs retrieved. The number of eggs retrieved is important because it directly correlates with the chances of developing viable embryos after thawing. This is definitely a case of “more is more”--the more eggs that are successfully frozen, the higher the probability of having viable embryos when the time comes.
However, the quality of the retrieved eggs is just as important. High-quality eggs have a better chance of surviving the freezing and thawing process than low-quality ones. So, as you can imagine, a cycle with lots of eggs that are all low-quality isn’t necessarily more successful than another cycle that produced less eggs but they’re all high-quality.
As a result, fertility providers will always aim to maximize both the quantity and quality of the eggs retrieved. This is essential for improving the success rates of egg freezing cycles so that, ultimately, we end up with healthier embryos and better chances of a successful pregnancy.
Type of freezing method used
There are two main techniques used for freezing eggs: slow freezing and vitrification. The slow freezing method involves gradually lowering the temperature of the eggs, which allows ice crystals to form within the cells. This process can damage the delicate internal structure of the eggs, which can lead to lower viability and success rates once the eggs are thawed. In contrast, vitrification is a freezing process that solidifies the eggs quickly without forming ice crystals. This method protects the cell’s internal structures better and has been shown to increase post-thaw survival rates. This in turn, means higher success rates during IVF treatments. It makes complete sense, then, that vitrification has become the preferred way to freeze eggs.
Tips to increase egg freezing success rates
Alright, so now that we’ve established what’s important when it comes to egg freezing, what exactly can you do to maximize these factors for yourself?
- Consider freezing your eggs at a younger age. There may not be much we can do about the fact that we’re all getting older but in terms of egg freezing, the general rule is that the younger you can do it, the better. According to the American Society for Reproductive Medicine (ASRM), the ideal time to freeze your eggs is in your 20s and early 30s, while you have more eggs and those eggs are healthier. So, whether you’re 25 or 35, your eggs today are still probably healthier than your eggs in one, five or 10 years!
- Optimize your fertility health before beginning the egg freezing process. This step will look a little different from person to person since everyone has their own unique medical history and concerns. Generally speaking though, optimizing your health will include following a balanced diet and making other healthy lifestyle choices. In some cases, you may want to consider adding certain vitamins and supplements to your regimen too. Make sure to talk to your fertility specialist if you’re not sure!
- Consider using a different type of freezing method. Ask your fertility provider which method they plan to use when freezing your eggs. Vitrification is the more common method now given its improved outcomes when compared to slow freezing but it doesn’t hurt to confirm that this is the method your particular clinic uses.
- Consider doing multiple egg retrieval cycles. If you have the resources and time to do multiple cycles, this can vastly improve the pool of eggs to choose from in the future. This is an especially helpful option for people who are older or have a low AMH level or AFC. If your fertility provider thinks more cycles will improve your chances, they’ll discuss those recommendations with you.
- Be particular about the clinic you choose. There are a ton of fertility clinics to choose from nowadays, so take the time to do some detective work and find one that works for your needs. If you know people who’ve used a fertility clinic, ask them for their honest opinions. Read reviews. Look up the providers’ credentials (usually listed on the clinic’s website). You can also find out the clinic’s success rates in terms of live births and other important statistics through their website. Schedule a couple consultations to compare your options. Make sure to come with questions and to actually ask them all. If you’re not sure what to ask, check out some suggestions here.
Emotional considerations
It’s important that we take a second to talk about the emotional side of this experience. For many people, the decision to freeze their eggs is tied to hopes of preserving future fertility. When a lab test or a cycle doesn't yield the desired results, there can be feelings of hopelessness, frustration, sadness, anxiety, and uncertainty about future family planning options. On top of that, this isn’t a cheap or simple process! So there can be disappointment stemming from both the financial and physical investments that have been made.
Because of all of this, seeking support and guidance throughout this process has to be a priority. Support from both loved ones and through professional counseling can make a huge difference when it comes to coping with the emotions you might be dealing with.
Establishing clear and open communication with your fertility providers also plays a key part in helping people cope with the challenges that might come up. Your providers know the ins and outs of your particular situation so they’re the most qualified to tell you what you need to prioritize (and what you can ignore) to improve the success of your egg freezing cycle(s).
With all the nuances involved here, it’s important not to get lost in the weeds. Fertility is impacted by so many factors that you can drive yourself crazy trying to manage all of them. Remember, you are more than any number.
Conclusion
To recap, there are several different factors that can affect the success of an egg freezing cycle including your age, AMH level, AFC, the number and quality of eggs retrieved, and the type of freeing method used. Some of these, you don’t have control over. For the ones you can control, there are a few things you can do.
Optimizing your fertility health before the egg freezing process, freezing your eggs at a younger age, doing more than one cycle, and using a safer freezing option are all ways that you can improve your chances of a successful freezing cycle. This process can be so overwhelming— focusing on the things that you can control can help you feel more grounded throughout your fertility journey.
Freeze by Co is here to help you every step of the way on that journey. With our Keep program, you’re able to freeze your eggs and keep them all for yourself, on your timeline. In addition, you’ll have access to our online support community, the Nest. This is a valuable resource that lets you engage with other people freezing their eggs at the same time!
How Rachel Liverman Crane Overcame Medical Anxiety to Freeze Her Eggs
Rachel Liverman Crane is the Founder & CEO of the East Coast skincare facial concept Glow Bar. She's also taken a bold step in her personal life by freezing her eggs — a journey made even more remarkable by overcoming medical anxiety, a common fear that affects many people facing medical procedures.
Rachel Liverman Crane is the Founder & CEO of the East Coast skincare facial concept Glow Bar. Yet, her dynamic life doesn't end with her professional achievements; she's also taken a bold step in her personal life by freezing her eggs — a journey made even more remarkable by overcoming medical anxiety, a common fear that affects many people facing medical procedures.
Medical anxiety is more than a fleeting concern; it's a genuine fear that can hinder individuals from pursuing necessary or elective medical treatments. In Rachel's case, it was a hurdle she had to conquer on her path to securing future family planning options.
Her journey reflects a blend of determination, pragmatism, and an unwavering belief in one's self, sending a strong message to others about the power of informed choices and the beauty of self-confidence. By bravely facing her fears, Rachel serves as an inspiration to others who may be on the fence about egg freezing. Whether it's expanding a skincare brand or planning for a future family, she navigates life with grace, wisdom, and a touch of humor, embodying the future's endless possibilities.
In a candid interview with us, Rachel shares this journey, opening up about her experience with egg freezing and how she overcame the anxiety that often accompanies medical decisions.
Deciding to freeze
At the age of 35, while single and deeply focused on growing her business, Rachel made the decision to freeze her eggs. Recognizing that she wouldn't be having children in the immediate future, she saw this as a way to retain her focus on her career without the looming pressure of biological timing. "I figured I would freeze my eggs so my focus could remain on my career and not have the pressure of having kids feel so strong."
The process resulted in a "lucky dozen" of 12 eggs, with nine being frozen. Her AMH was 1.81, and she candidly shares her experience, describing herself as an "open book."
Embracing the process even with medical anxiety
When asked what she was most nervous about, Rachel replied, “The shots, the blood draws every morning, the anesthesia, the IV, the recovery — I worried about it all!”
“But in the end”, she says, “it was so simple and my doctor and his team took such great care of me the entire way.”
Having seen friends go through it, she knew what to expect, although the physical discomfort and bloating after retrieval did surprise her. “The thing that surprised me the most was how bloated and uncomfortable that would feel after the retrieval process.”
What stands out, however, is the empowerment and strength she felt after going through this elective procedure, particularly given her medical anxiety. "I was really proud of myself for doing something that scared me for my future self!"
Rachel, we’re proud of you too!
Facing the hard parts head-on
The journey wasn't without its challenges. The financial burden was a difficult aspect for her. As a startup founder, making such a significant investment had a real impact. Still, the sacrifice was worth it, even if it meant missing events like close friends' weddings abroad. "I don't have any regrets," she asserts.
Read more about paying for egg freezing:
Choosing Dr. Joshua Stewart at Dr. Joshua Stewart at Cornell for the procedure, she feels the decision has had a profoundly positive effect on her professional life. It allowed her to prioritize her career, team, and business without sacrificing personal aspirations.
Looking back and looking ahead
Looking back, the only thing she might have done differently is to take supplements or seek acupuncture to support her eggs. Yet, she considers the freezing of her eggs as part of her journey, jokingly referring to them as her "insurance plan" and the possibility of thawing these "cuties" to make babies if and when needed.
Rachel says that her relationships and dating life remained unaffected. Freezing her eggs just became "another part of me," not altering her approach to dating or personal relationships.
Advice for others
Her advice for others considering this path is wise and considerate. She urges people to talk to others who have undergone the process, ask questions, advocate for themselves, and not to push themselves if it doesn't feel right.
"Don't feel pressure to do this if it doesn't feel right for you. It's a serious and expensive procedure, so make sure that this is something that you really care about and feel is right for you and where you are today.” We couldn’t agree more!
Your Egg Freezing Care Team
Here, we'll break down the different members of your fertility team and what services they provide, to help you understand who you'll be working with on your egg freezing journey.
When you're freezing your eggs, it can feel like you're navigating a maze of unfamiliar terms and unfamiliar people. Who are all these people? What do they do? And when should you see them?
Here, we'll break down the different members of your fertility team and what services they provide, to help you understand who you'll be working with on your egg freezing journey.
Your Primary Care Physician (PCP)
For some, the dialogue about fertility begins with a conversation with their Primary Care Physician (PCP). This medical generalist can provide an overview of the fertility landscape and may guide you towards specialized care if your situation calls for it.
Obstetrician-Gynecologist (OBGYN)
As a specialist in women's reproductive health, an Obstetrician-Gynecologist (OBGYN) can offer nuanced insight into fertility and hormonal health. Although not directly involved in the egg freezing process, their counsel is often a valuable stepping stone to more specialized care.
Reproductive Endocrinologist (REI)
An OBGYN with additional training in reproductive endocrinology, your REI is the main person overseeing your egg freezing journey. Specializing in the hormonal and medical intricacies of fertility, they oversee and perform the egg retrieval process. Many people start their egg freezing/donation journeys with an REI consultation.
Nurse Coordinator
An RN serving as a lynchpin in patient care, the Nurse Coordinator organizes patient education, scheduling, and medication management. Their role varies by clinic but invariably serves to harmonize the efforts of the entire fertility team.
Embryologist
The Embryologist also works at the fertility clinic and is the scientist who helps fertilize and grow your embryos! They are in charge of making sure your eggs get safely frozen.
Egg Freezing Agency, such as Cofertility
For those seeking an additional layer of service and support, Cofertility helps streamline your journey. We help you find a clinic, connect with others freezing their eggs at the same time, and fill the gaps not covered by a standard fertility clinic.
Financial Counselor
Navigating the costs of egg freezing can be daunting. A Financial Counselor specializes in demystifying this aspect, helping you explore insurance coverage and financing options.
Fertility Courier
Responsible for the logistical challenge of safely transporting your frozen eggs, the Fertility Courier is a specialized service provider you may never meet but will trust implicitly.
Cryostorage Facility
A cryostorage facility serves as the vault for your frozen tissue. Specializing in the preservation of biological material, these facilities are where your eggs will reside until you decide to use them. We have a partnership with TMRW where we have negotiated discounted rates for our members.
Genetic counselor
Being a carrier doesn't mean you have the condition, but it can still be concerning when your genetic testing reveals you have a genetic predispositions to certain conditions. Your genetic counselor helps you understand the implications of your carrier status. They can explain the risks, potential impacts on future children, and provide guidance on family planning.
Third-party reproductive (TPR) care coordinator
A clinic employee who works in the field of assisted reproductive technology (ART) and reproductive medicine. Their primary role is to facilitate and coordinate various aspects of third-party reproduction, which involves using donated eggs, sperm, or embryos, as well as gestational surrogacy.
If you participate in our Split program, there are even more people you will work with along the way
Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure — medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
Member Advocate
At Cofertility, the Member Advocate serves as your personalized concierge, easing communication among all the parties above and ensuring a smooth journey from start to finish. A Member Advocate plays a crucial role in supporting you through the complex and highly regulated process of egg freezing and donation, helping you navigate the medical, emotional, and logistical aspects of preserving your fertility with compassion, evidence-based research and trustworthy guidance.
Fertility Psychologist
Emotional support is invaluable. We have a Fertility Psychologist on our team to support the psychological and emotional aspects of your journey, offering screening and therapeutic support.
Third-party Reproduction Lawyer
When you match with a family, you will work with a Fertility Lawyer to ensure that all agreements, from donor agreements to future use contracts, are conducted within the bounds of the law. We can help you find a lawyer with expertise in this space, which is entirely free to you.
It's important to note that not everyone needs the same team or the same services. Your path will be as unique as you are; tailored to meet your specific needs and circumstances. Never hesitate to ask questions or advocate for yourself; after all, this is your journey, and you deserve a team that not only supports but champions your reproductive goals. The most important person on your fertility team is you.
At Cofertility, we have a preferred network of partners across the country that can help with every aspect of your egg donation journey, from the legal contracts to the embryo storage. While reading this list can feel overwhelming, if you work with us, know that we can handle most every interaction.
What’s the Deal with Acupuncture and Egg Freezing?
Can acupuncture really help improve egg freezing outcomes? Let’s find out.
If you’re considering freezing your eggs, you’re probably open to trying just about anything to make your cycle as successful as possible. You’re doing all the things: taking supplements, eating a healthy diet, and being mindful of your lifestyle choices. When it comes to acupuncture, though, you may have heard mixed advice. Can acupuncture really help improve egg freezing outcomes? Let’s find out.
What exactly is acupuncture, anyway?
Acupuncture is a medical treatment based on the disciplines of traditional Chinese medicine (TCM). It’s built on the theory that there are channels that flow through the body, kind of like the circulatory system.
When someone goes in for an acupuncture treatment, the practitioner inserts teeny-tiny, stainless steel, disposable needles into the patient’s body at specific points along those channels (typically between eight and twelve points, but sometimes up to twenty). Different points are used depending on any symptoms you might be experiencing — back aches, anxiety, acid reflux...you name it! — and practitioners view the body as totally interconnected. It is considered to be generally painless.
What does acupuncture (supposedly) do?
The goal of acupuncture is to regulate each of your systems to get them to work optimally and in harmony with each other. For example, a 2002 Fertility and Sterility study published by the American Society for Reproductive Medicine (ASRM) indicated that receiving regular acupuncture treatments can regulate patients’ endocrine systems (where sex, mood, and sleep hormones are manufactured).
Regulating your endocrine system via acupuncture can dial down your stress response, which may be heightened during an egg freezing cycle. But the question remains, will decreased stress translate to improvement in actual egg freezing cycle outcomes, in terms of quantity and quality of eggs?
Egg freezing and acupuncture: what the data says
Remember: beta endorphin levels regulate and balance a woman’s Follicle Stimulating Hormone (FSH) levels, which do impact the ability of her ovaries to grow and mature eggs. So when we see a 1998 Journal of Traditional Chinese Medicine study demonstrate dramatically increased beta endorphins among those who received acupuncture vs. those who hadn’t, that’s worth noting.
But by and large, when it comes to acupuncture and egg freezing, there’s a lot of misinformation out there. The vast majority of available studies focus primarily on IVF success measures: embryo fertilization, positive pregnancy results, and live births. While embryo fertilization is the primary indicator of egg quality, (though many other factors also contribute to fertilization), only looking at acupuncture’s relationship with IVF outcomes can be problematic, because we are viewing a limited population who already may have fertility challenges.
Some studies have explored the potential influence of acupuncture on the number of eggs retrieved during ovarian stimulation, the egg freezing phase during which a patient takes injectable hormone medications to stimulate her ovaries to mature more eggs for retrieval and freezing. This is helpful for us to explore, but it’s important to note if those studies are only looking at a population who needs to undergo IVF to conceive, as this is different from the population of those looking to electively freeze their eggs.
All of this being said, there is some data out there that’s worth investigating.
Stress and fertility
In some cases, we may be able to triangulate studies about acupuncture’s impact upon stress and anxiety with studies about the impact of stress upon egg retrieval outcomes. But we need to acknowledge that these are assumptions and hypotheses, taking a transitive property into account rather than studying the direct impact of acupuncture upon egg retrieval outcomes.
Even then, when only looking at the impact of stress upon fertility and egg retrieval outcomes (largely related to egg quantity), the data is mixed:
- A 2011 British Medical Journal study noted that “pretreatment emotional distress was NOT associated with treatment outcome” (in this case, it’s important to consider that “outcome” = successful pregnancy and live birth using eggs from that treatment cycle).
- A 2009 Psychological Reports article showed a significant correlation between depression and number of eggs retrieved, with fewer eggs retrieved associated with higher instances of depression.
- A 2001 Fertility and Sterility article stated that “baseline (acute and chronic) stress affected biologic endpoints (i.e., number of oocytes retrieved and fertilized).”
- A 2015 General and Comparative Endocrinology study concluded that increased cortisol levels may cause anovulation in stressed mice.
- A 2016 Journal of Biomedical Science study showed that increased cortisol and oxidative stress levels affect our granulosa cell functions, possibly by inducing apoptosis — which results in changes to our estradiol hormones and egg growth, development, and quality.
Some more direct evidence
While there is lots of (mixed) data out there about the relationship between stress and fertility, and some data about how acupuncture reduces stress, there are a handful of studies that actually look directly at the correlation between acupuncture treatments, number of eggs retrieved, and potential egg quality conclusions based on fertilization and live birth outcomes. It’s important to remember that quantity does not necessarily translate directly to quality. Meaning, there is a chance you could have many eggs and very few (or even zero) could result in a fertilized embryo or pregnancy. The general principle is, the more eggs you retrieve, the greater chances you’ll have of having enough high quality eggs for future use.
One of the more applicable studies is a 2023 Frontiers in Endocrinology meta-analysis, which looked at seven clinical randomized controlled trials (RCTs) that ultimately included 516 women. Although the quality of those studies may have been questionable, this meta-analysis showed that the use of acupuncture increased the number of eggs retrieved and the antral follicle count, while improving the patients’ estradiol and FSH levels. However, there was no difference in fertilization rate or pregnancy rate. This analysis suggests that acupuncture does not improve the ultimate outcome most egg freezers care about: chances of a healthy baby down the line.
On the flip side, a 2006 Fertility and Sterility study of 273 women in Denmark showed no statistical difference in the number of eggs retrieved between those who received acupuncture and those who did not. For what it’s worth, this study did, however, show a substantial improvement in pregnancy and live birth rates among those who received acupuncture on the day of their embryo transfer.
What to expect at your acupuncture appointment
If you’ve decided to move forward with acupuncture, you’ll first need to find a local practitioner. At your first treatment, your acupuncturist will ask you tons of questions about your medical history, just like any Western doctor would. Then they’ll take your pulse and look at your tongue (seriously).
Here’s what they’re looking for: patterns of disharmony, which may be missed by your regular doctor because they don’t show up as illnesses. Let’s say you have trouble sleeping and you feel anxious and your skin is dry and your hair is falling out. In Chinese medicine, that grouping of symptoms together indicates a “blood deficiency.” It wouldn’t be severe enough for your main doctor to call it anemia, but there may be enough symptoms to show some imbalance is going on in your body. With that information, your acupuncturist can determine where to insert the needles to best address your individual needs.
When it’s time for your treatment, you may be asked to undress and put on a gown or cover yourself with a sheet and lay down or face up on a table, like you’re getting ready for a facial. The practitioner will then reenter the room and begin “tapping” the needles into the points they’ve selected specifically for your needs.
The insertion of the needles doesn’t usually hurt — maybe just a pinch — but it shouldn’t stay painful because the needles are as fine as a strand of hair. If you’re not comfortable, just let your practitioner know and he/she will make an adjustment. Comfort is key. Once all the needles are in, the acupuncturist will leave the room (ideally turning on some music or relaxing white noise) and you’ll rest there on the table for about 30 minutes. You may fall asleep right away, or you may need a couple of sessions to get used to it.
To experience the full desired effects of acupuncture, some practitioners say it could take about 3 months of weekly treatments. Think of it this way: it takes about 100 days for red blood cells or sperm to mature, so according to acupuncturists, if you want acupuncture to make changes in your body’s functioning, you’ll want to give it the time it naturally needs. At the very least, you should leave your treatment feeling like you just got a really good night’s rest.
The TLDR on acupuncture and egg freezing
There’s so much more research to be done regarding the relationship between acupuncture and egg freezing outcomes. But, based on the scouring we’ve done through existing studies, there does not appear to be evidence that acupuncture could directly help your egg freezing experience. Acupuncture cannot influence structural issues, like fallopian tube blockages, for example.
But while it may not help you retrieve more eggs or increase your chances of pregnancy down the line, it may be something you want to do purely for relaxation. You can think about it like a massage or day at the spa.
With that in mind, the only nuisances may be appointment scheduling or dealing with insurance to see what’s covered. But, beyond that — the goal of acupuncture is to make your mind and body feel good. So, if you have the time and willingness to pay, we support that! In my case, I’m incredibly lucky; my insurance covers unlimited acupuncture visits throughout the year, including for pain or anxiety (note: I do not believe fertility is a billable reason for my acupuncture coverage). If you’re interested in pursuing acupuncture, it is definitely worth having a conversation with your acupuncture clinic and with your insurance provider. But if you can’t squeeze it in or justify the cost…please do not worry about it. You’ve got enough going on as it is.
Remember, when freezing your eggs with Freeze by Co, our team of medical experts (plus our free member community of others freezing their eggs, just like you!) will be with you every step of the way to answer questions like this and more. Our Split program even offers those ages 21-33 the chance to freeze their eggs for free! With a Split cycle, you would donate half of the eggs retrieved to a family that’s trying to conceive and freeze the remaining half for yourself.
If you’re over 34 or not interested in donating half of the eggs retrieved, you can still participate in our Keep program up to age 40. With Keep, you can freeze your eggs and keep them all for yourself, on your timeline while having access to valuable community support.
Regardless of which path you choose, our team is here to guide you through the process to keep your family-building options on the table.
Can You Actually Test Your Fertility At Home?
Whatever your reason for wanting to take an at-home fertility test, here’s what you need to know about what your options are, how they work, and what you can expect to learn.
Can you test your fertility from the comfort of your own home? The answer is a bit complicated. Isn’t it always when it comes to fertility? Yes, there are some tests that both men and women can take at home to get a better idea about some aspects of their fertility. But are they an acceptable substitute for an individualized appointment with a fertility specialist?
Unfortunately, no—while these tests are often fairly accurate, that’s not really the issue here, says Dr. Jaime Knopman, a board-certified reproductive endocrinologist. It’s all the medical expertise you’re missing out on when you test your fertility at home.
“The tests we run in our clinic are much more accurate because our job can’t be done completely by machine,” she explains. “It’s not just the tests, it’s the person interpreting them.”
But you still might not live close to a fertility clinic, have insurance that covers fertility appointments or testing, or even feel like you’re really at the point yet in your fertility journey where you need a formal eval from a specialist. We get that.
So whatever your reason for wanting to take an at-home fertility test, here’s what you need to know about what your options are, how they work, and what you can expect to learn.
How can I test my fertility at home: for women
When it comes to the ladies, there are two main varieties of tests you can do at home: you can check your ovarian reserve and you can do a broad panel screening for several different hormones that play a part in fertility health. Here’s the scoop.
Ovarian reserve tests measure the amount of follicle-stimulating hormone (FSH) in your blood with a pinprick. Typically, you collect a sample yourself and mail it back to the company so they can read and deliver your results. Very high levels of FSH can be a sign that you don’t have a lot of eggs, that they’re poor quality, or both, because your body is working overtime to produce enough FSH to release a healthy egg.
- Taking this test feels like a typical finger prick. It hurts for a sec and then you’re over it. You will have to squeeze out some blood into designated spots on a testing card, though, so if you’re blood-averse be prepared.
- The tests themselves can accurately check your FSH level, but there’s more than one way to figure out what your ovarian reserve looks like. Only measuring FSH will give you a piece of the puzzle...but could also cause you to unnecessarily panic about your fertility. Try not to do that! Remember, these tests are useful, but not foolproof.
- FSH levels alone may not be a great way to assess your fertility in the first place. A 2017 JAMA study found that biomarkers like FSH aren’t the best predictors of future fertility in women with reduced versus normal ovarian reserves.
Fertility health screenings capture your FSH level but also a bunch of other hormones that impact your fertility in one way or another. The exact hormones measured in an OTC fertility test differ between companies, but you can usually find out your FSH level and any or all of the following:
- thyroid-stimulating hormone, or TSH a marker of thyroid health)
- estradiol (helps with ovulation)
- anti-mullerian hormone, or AMH (an indicator of egg reserve)
- prolactin (makes breast milk after birth)
- luteinizing hormone, or LH (regulates your cycle, especially ovulation)
- testosterone (helps make follicles, but too much may mess up your fertility)
These tests all work like the ovarian reserve test: you prick your finger, collect some blood samples, send the samples back to the company, and then wait for your results to come in. Usually, you’ll get factual data (like, “your TSH is off”) but also an explanation of what that might mean for your fertility.
Most companies allow you to see your results online and consult with an on-staff medical professional if you have questions or don’t understand your results. They’re pretty easy to order online, but many aren’t cheap—they’re usually about $150—and you’ll have to pay out of pocket.
How can I test my fertility: for men
The only kind of male fertility test that can be done at home is a sperm analysis. About half of all couples’ infertility problems can be caused by male infertility, so knowing if your swimmers are strong or not is a good place to start if you’ve been trying to conceive for a while.
There are actually several different kinds of sperm analysis kits; sometimes you collect a sample and send it through the mail for testing, sometimes you put some sperm on a slide and insert it into a testing device, and sometimes you can even use your smartphone (yes, for real!).
- Testing at home is private and confidential. You don’t have to worry about being unable to provide a sample at an unfamiliar clinic or doctor’s office.
- The kits you send off to labs via mail can be more accurate, but at the same time, there’s a lot that can go wrong here—like failure to keep the sperm stored at just the right temp, which can cause damage to the sample. At-home tests, while giving quicker results with no middle-man, have a lot of potential for both user and technology errors.
- Male fertility is about more than just the amount of sperm: there’s motility, shape, concentration...the list goes on. If your at-home kit is only looking at the number of sperm, your results may not be that helpful. Try to choose a test that looks at more than one type of factor—this will give you the most bang for your buck.
Don’t forget about ovulation!
While ovulation predictor kits only tell you if and when you’re ovulating, this can be very helpful if you’re actively TTC.
These kits work by detecting the presence of LH in the urine, says David Diaz, MD, reproductive endocrinologist and fertility expert. When your LH rises above a certain level, the test strip you’ve peed on will let you know that an ovary is just about to release an egg. This is a good time to get it on, since there’s a good chance that egg could become fertilized.
According to Dr. Diaz, these tests are about 85 percent accurate and available as digital and non-digital tests. If you have fairly regular menstrual cycles, an ovulation predictor kit can be a useful tool in identifying exactly when your fertile window is, but if your cycles are irregular (because of PCOS, pre-menopause, or even just your personal biology), it can be harder to rely on them unless you’re taking a test every day.
Next steps
Okay, you took an at-home test and got your results back...now what? Well, you might not like our answer, but here it is: you should probably still go see a fertility doctor. Yes, even if your results are “normal.” Why?
Because, like we told you upfront, a test you do at home gives you important data — but not the expertise and counsel of a doctor who has met you in person and knows your medical history. You’ll have the info, just not necessarily the context...and the context is super important when it comes to your fertility. At-home tests simply can’t paint the same kind of comprehensive picture that doctor-interpreted lab tests can.
But you’re here because you want to take an at-home fertility test...and TBH, we kinda don’t blame you! We’re curious, too! Just make sure you know what you’re buying, (Dr. Knopman says that you should make sure any OTC test you buy comes from a legit manufacturer with a fertility doctor on their medical review board), what the tests can tell you, and what you’re going to do with the results.
“Even if you don’t want to do fertility treatments [right now], there is no harm in coming in to talk to us about it,” says Dr. Knopman. “You can make better decisions when you have that information than when you don’t…[and] the worst thing to do is sit at home and ruminate, trying to interpret your own results or diagnose yourself.”
What’s the takeaway here? After taking an at-home fertility test, you might want to plan to make an appointment with a fertility specialist. It can be a simple introductory or informational appointment, and even a virtual one. But hopefully, it will give you peace of mind and — most importantly — answers.
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AMH 101: Everything You Need to Know
Everything you need to know about the little signal your ovaries send out called Anti-Müllerian Hormone (AMH).
Ever scrolled through that health and wellness side of social media and stumbled upon something called AMH? Maybe your best friend casually mentioned getting her AMH tested, and you were too embarrassed to ask what the heck she was talking about. You're young, you feel great, and having babies isn't even on your radar right now. But here's the thing: understanding this thing called AMH could be a major game-changer for your future.
What is AMH?
AMH stands for Anti-Müllerian Hormone. Think of it as a little signal your ovaries send out. This hormone level tells your doctor about how many eggs you have left – also known as your ovarian reserve. Basically, AMH is one clue into your fertility. And, here's why you should care even if kids aren't on your mind yet.
Why does AMH matter in your 20s and 30s?
AMH can be a helpful biomarker for your health and fertility. Why?
- Knowledge is power: Knowing your AMH levels gives you valuable insights into your reproductive timeline. It helps you make informed decisions about when you might want to start a family and whether fertility preservation options (like freezing your eggs) might be something to consider down the road.
- Fertility isn't forever: You might think of your 20s as your prime fertility years, and while you're not wrong, it's not the full picture. Your fertility peaks in your early 20s and starts a gradual decline in your mid-30s. For some people, this decline is faster, and AMH levels can give you a heads-up.
- Unexpected roadblocks: AMH testing can help detect potential fertility issues early on, like Polycystic Ovarian Syndrome (PCOS) or premature ovarian insufficiency. Getting this info sooner rather than later can help you take steps to manage these conditions and protect your fertility.
What can AMH test results tell you?
So what exactly can AMH tell you about your fertility? Your AMH level is positively correlated with the number of follicles you have in your ovaries. Simply put, the more follicles you have, the higher your AMH level typically is. As a result, AMH levels have been shown to be a good predictor of ovarian reserve and someone’s expected response to fertility treatments.
In fact, several studies have shown that there is a strong correlation between what your AMH level is and the number of mature eggs retrieved during an egg freezing or in vitro fertilization (IVF) cycle. To learn more about those studies, check out AMH and Egg Retrieval Outcomes.
What your AMH level can’t tell you is the exact number of eggs you have left in your ovaries or what your chances of pregnancy are. There are a number of other factors like your age, overall health, and genetics that also affect the number and quality of eggs and your overall fertility. So while AMH can be a useful tool in assessing your fertility, it shouldn’t be the only factor when making decisions about fertility treatments.
So, you got your AMH tested. Now what? Here's a basic breakdown of what those numbers usually mean:
- Normal AMH means you're right on track for your age – good news!
- High AMH might suggest a good number of eggs remaining, and potentially even point towards conditions like PCOS where your egg count is unusually high.
- Low AMH could mean you have fewer eggs remaining than typical for your age group. It might signal a faster decline in fertility, but it doesn't mean you can't get pregnant at all.
Remember, your AMH level is just one piece of the fertility puzzle. Other factors like your overall health, other hormone levels, family history, and lifestyle habits matter too!
What are normal AMH numbers?
What is considered a “normal” AMH level depends on your age, as well as the lab where you take the test. Since there is no international standard, it’s best to use the reference ranges included on the test results (your doctor can share those with you if you did a test through a clinic).
In general, however, an AMH between 1.0 and 3.5 ng/mL suggests a “normal” range that is likely to have a good response to egg freezing.
Common reasons for high AMH
The most common reason for high AMH is that you are very fertile and likely to retrieve more eggs in an egg freezing cycle. But, it does not necessarily mean that the eggs are of good quality. Egg quality is determined by factors such as your age, genetics, and environmental factors, and cannot be measured directly by AMH levels.
But a high AMH level may also indicate PCOS, which is a hormonal disorder that affects 8–13% of females of reproductive age. Those with PCOS typically have high levels of androgens (male hormones) and may have irregular periods, acne, and excess hair growth. Patients with an average AMH level ≥ 4.45 ng/ml have a 9.35 times higher likelihood of developing PCOS, but not all patients with a high AMH have PCOS.
In rare cases, abnormally high AMH could be a sign of an ovarian tumor. Certain types of ovarian tumors, such as granulosa cell tumors, can produce high levels of AMH.
Read more in: What Does a High AMH Result Mean?
Common reasons AMH would be low
By far, the most common reason for a low AMH is age. People with ovaries are born with all the eggs that they’re going to have in their lifetime. These eggs are then slowly used up over time as you ovulate during each menstrual cycle until menopause is reached. As a result, ovarian reserve naturally decreases over time, meaning the AMH level also decreases.
Research suggests that hormonal birth control may affect AMH levels but it depends on the type of birth control. Specifically, birth control use is associated with a lower average AMH level than for people who are not on birth control, with the exact effect depending on the type of birth control.
The amount of time you’re on birth control may also be a factor. Multiple studies have shown that AMH doesn't change if you use combined oral contraceptive pills for less than six months. However, you may have a lower AMH if you’ve been a long-term user of the pill (or other hormonal methods). Thankfully, this is temporary – AMH levels typically rebound after a person stops using birth control.
There are several other, less common causes for a low AMH level. These include:
- Genetic disorders that affect the X chromosome
- Medical treatments like radiation or chemotherapy
- Having surgery on your ovaries
- Losing one or both of your ovaries
- Autoimmune conditions
Read more in: What Does a Low AMH Result Mean?
Factors that can influence AMH levels
It's important to know that some things can temporarily or even permanently change your AMH:
Birth control
Certain types of birth control can suppress your natural AMH levels. One study looked at data from women on various types of birth control and found:
- Combined oral contraceptive pill led to 23.7% lower AMH
- Progestin-only pill led to 14.8% lower AMH
- Vaginal ring led to 22.1% lower AMH
- IUD led to 6.7% lower AMH
- Implant led to 23.4% lower AMH
- Copper intrauterine device led to 1.6% lower AMH
The authors concluded that birth control use is associated with a lower mean AMH level when compared to those who are not on contraceptives, with variation depending on the type of birth control
Health conditions
Things like PCOS, endometriosis, vitamin D deficiency, or even a recent ovarian surgery can impact your AMH levels.
Chemotherapy
Chemotherapy treatments for conditions like cancer can significantly lower AMH levels. Research indicates that pre-chemotherapy AMH levels may be helpful in predicting ovarian function and potential fertility after treatment. A prospective study of women treated with chemotherapy for early breast cancer showed that long-term ovarian function after treatment was predictable using serum AMH levels before treatment.
Obesity
Studies suggest a connection between obesity and lower AMH levels, though the exact relationship is complex. Obesity is linked to hormonal imbalances and inflammation, which can disrupt ovarian function and potentially affect AMH production. However, it's important to note that not everyone with obesity experiences lowered AMH, and other factors could also be at play. More research is needed.
Smoking
Studies have also shown that tobacco use, usually cigarette smoking, decreases AMH levels. This effect appears to be reversible though–it was only seen in people who were active smokers, not people who had previously smoked.
What is a good AMH level for egg freezing?
Research has found that AMH is a good predictor of the response to ovarian stimulation and the number of eggs retrieved. Because of this, fertility doctors typically use your AMH levels (along with other biomarkers) to determine the drugs and dosages you will need to maximize your response to ovarian stimulation.
Now, what about a correlation between AMH and actual babies born (live birth rate)? Well, while AMH does seem to have some association with live birth rates after IVF, its ability to actually predict a live birth is not that great. This is especially true for younger people. A 2021 study found that AMH is a good predictor of live birth in older (>39 years old), but not younger, people. They found that younger participants (≤38 years old) could get pregnant even with low AMH levels as long as they had frequent egg retrievals.
Does AMH predict the number of eggs you will retrieve during egg freezing?
The overall success of an egg freezing cycle largely depends on the number and quality of eggs retrieved. Studies have shown that AMH levels can be used as a predictor of egg quantity, and can thus help to predict the potential success of egg freezing. Those with higher AMH levels tend to have better outcomes with egg freezing, as they are likely to have more eggs retrieved and a higher chance of success in future fertility treatments.
But by no means does a high AMH level guarantee a lot of eggs during an egg retrieval procedure for fertility treatments. The number of eggs retrieved during an egg freezing cycle depends on several factors, including your age, ovarian response to stimulation medications, any other underlying medication conditions, and the skill of the fertility doctor performing the procedure.
When eggs are retrieved, only a portion of those eggs will be mature. A mature egg is one that’s ready and able to be fertilized. At most clinics, any non-mature eggs are discarded, though you can talk to your clinic about whether they’re open to freezing those too.
Multiple studies have shown a strong correlation between AMH levels and mature eggs retrieved during egg freezing or IVF.
Let’s look at a few of the studies:
The study: Correlation between anti-Müllerian hormone, age, and number of oocytes
Who: 1500 patients in Brazil between July 2012 and April 2019
The findings: “A positive correlation was found between serum AMH levels and total number of retrieved and mature oocytes from stimulated cycles”
Who: 1,112 patients undergoing an egg retrieval as part of ART
The findings: “AMH showed a stronger correlation with egg number compared with age over a wide age range”
Who: 314 infertility patients with an average age of 31.0 ± 4.5 years
The findings: “the AMH level of women of all ages was positively correlated with the number of retrieved oocytes “
Who: 58 women with fluctuating and persistently high serum day 3 (D3) FSH.
The findings: “These data demonstrate for the first time that serum AMH is a prognostic indicator independent of age and FSH of the number of eggs retrieved”
Who: 73 women undergoing ART with elevated early follicular FSH levels
The findings: “Random AMH levels were strongly correlated with the number of oocytes retrieved during an ART cycle among women with elevated FSH”
Read more in AMH and Egg Retrieval Outcomes
What AMH do I need to donate my eggs?
Through Cofertility’s 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. In the context of donating through our Split program, having an appropriate level of AMH is important. Fertility doctors typically consider an AMH level above 2.0 ng/ml as a good indicator for egg donation, and this is the benchmark used at Cofertility. Note that some clinics have a higher requirement.
This level suggests that you are likely to respond well to fertility treatments and produce a sufficient number of eggs for both donation and personal use. This allows us to proceed with the egg retrieval process in a manner that is both safe and effective.
However, if your AMH level is lower than this, it does not necessarily mean you cannot freeze your eggs. You can still qualify for 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.
Everyone is unique, and AMH is just one factor of many that we consider during the evaluation process. You can learn more about qualifications for our Split program here.
When should I test my fertility?
So, when is the “right” age for testing your fertility, anyway?
It depends.
And ultimately, it’s up to you! It’s your body, and your data, and there is no one-size-fits-all answer. We’re firm believers that knowledge is power and you deserve this information. Studies do show that our ovarian reserve declines with age — in other words, it’s a good idea to assess your fertility potential sooner rather than later. That way, if you do want to preventatively freeze your eggs, you can do so while your ovarian reserve is still higher.
According to the American Society for Reproductive Medicine (ASRM), the optimal time to freeze your eggs is in your 20s and early 30s. This study also indicated that, as we get older, our chances of needing to do multiple egg freezing cycles increase in order to achieve a 70% live birth rate. We know we’re a bit of a broken record here, but: the younger you are, the healthier and more plentiful your eggs are.
Should I test my fertility at home or in a clinic?
At-home fertility tests have gained popularity in recent years due to their convenience and privacy. These tests typically involve collecting blood or urine samples and mailing them to a laboratory for analysis. On the other hand, in-clinic fertility tests are conducted at a medical facility, where specialized equipment and healthcare professionals are available.
The pros of at-home fertility tests include:
- Convenience and privacy: Samples can be collected in the comfort of your home.
- Cost-effective: At-home tests are often more affordable than in-clinic procedures.
- Early assessment: At-home tests allow you to gain insights into your fertility potential before actively trying to conceive. Plus, you won’t have to wait to get squeezed in for an appointment at the clinic!
The pros of testing your fertility at a clinic:
- A broader scope: At-home tests may not provide a comprehensive evaluation of fertility health, while testing your fertility at a clinic provides a more comprehensive picture of your fertility. An important note is, when testing your fertility at a clinic, you’ll also undergo a transvaginal ultrasound, where the technician or doctor will be able to get a view of what’s going on in those ovaries and the number of follicles available this cycle.
- Better accuracy: Some at-home tests may have varying levels of accuracy when compared to in-clinic tests.
- Facetime: At a clinic, you’ll have the ability to chat directly with a doctor, before and after your results.
If you do end up going with an at-home test, we have an exclusive discount with the LetsGetChecked Ovarian Reserve Test. It’s $139, and you can get 25% off with code COFERTILITY25. But there are many other options as well.
Although at-home fertility tests are a great way to get a peek behind the curtain of your fertility, they aren’t without limitations. For starters, according to recent studies, measuring AMH alone may not predict your time to pregnancy. As mentioned above, testing your fertility with a doctor at a clinic will likely provide a more comprehensive picture of your fertility outlook, especially as they consider your medical history, and conduct a physical exam and transvaginal ultrasound. Of course, you’ll also get professional interpretation of the results that you may not receive with an at-home fertility test.
All of that being said, any fertility testing (whether at home or in a clinic) only measures your fertility at that given point in time. It should not be taken as a guarantee for future outcomes. It also can’t tell you anything about your egg quality, which cannot be truly observed until it comes time to actually fertilize those eggs.
You are not a number
Repeat after me: you are more than one number! Your AMH level provides valuable insights into your ovarian reserve, but it’s just one piece of the puzzle when it comes to your fertility. AMH is always used as part of a full fertility evaluation, which often includes information about your medical history and age, a partner semen analysis, an ultrasound of the pelvis, an x-ray of the uterus and fallopian tubes, and/or additional lab work.
If that sounds like a lot, it is. This process can be overwhelming but focusing on the things that you can control can help you feel more grounded during your fertility journey, whatever that may look like.
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