Split

So you’re freezing your eggs - congratulations! This is such an empowering step in your life, and we hope that you can experience the process with positivity and hope for the future. 

We know the process can also be confusing and overwhelming, especially when it comes to understanding what activities are safe and not safe during egg freezing. First and foremost, it's important to understand that egg freezing is a medical procedure and should be treated with the same level of care and attention as any other medical procedure. This means that you should always follow the instructions of your provider and avoid any activities that may put your health at risk.

In this article, we will explore some of the things you can and can't do during egg freezing. Let’s go!

Can I work out while freezing my eggs?

Exercise is generally safe during egg freezing, but high-impact, twisting, bouncing, or intense movements should be avoided to reduce the risk of ovarian torsion, a rare but serious condition where the ovary twists on its supporting tissues.

Workouts to avoid during egg freezing:

🚫 Running – High-impact, bouncing motion increases ovarian torsion risk

🚫 HIIT workouts – Sudden movements and abdominal strain can be risky

🚫 Weightlifting (heavy lifting) – Can place strain on the abdomen

🚫 Pilates & Yoga (certain poses) – Twisting movements may be harmful

Safe exercise alternatives:

✅ Walking – Low-impact and safe for circulation

✅ Light stretching – Avoid deep twists, but gentle movement is fine

✅ Leisure swimming – Avoid high-intensity laps, but gentle swimming can be relaxing

Talk to your fertility doctor about your current workout regimen and if anything needs to be adjusted. Some clinics can also provide a medical note to pause gym memberships if needed. Always listen to your doctors and your body, and prioritize your health during the process.

Can you go to work during egg freezing?

Working during the egg freezing process is generally considered safe, but it's important to be mindful of any physical demands or stressors that may be associated with your job. Your fertility doctor may recommend taking some time off work to rest and recover if you're experiencing any side effects from the medication used in the egg freezing process. And after the egg retrieval, it’s recommended you give yourself time to rest (although I know women who felt fine enough to go back to work!). Most people are able to return to work within a day or two of an egg retrieval.

Read more in Navigating Egg Freezing and Work: A Comprehensive Guide

Can you drink coffee during egg freezing?

Caffeine consumption is generally considered safe during the egg freezing process, but it's important to be mindful of your intake. Some experts recommend limiting your caffeine intake to less than 200 milligrams per day, which is roughly equivalent to one cup of coffee. While most of the research on the impact of caffeine is on pregnancy, we think it’s better to play it safe during egg freezing too. 

Can you drink alcohol during egg freezing?

Alcohol consumption is not recommended during the egg freezing process. Studies have shown that alcohol consumption can negatively impact fertility and may also increase the risk of certain complications associated with egg freezing. The good news is there are loads of EANABs (equally-appealing, non-alcoholic beverages) these days. Try a soda water with lime and no one will bother you!

What about smoking?

Smoking is not recommended during the egg freezing process (or ever!). Studies have shown that smoking can negatively impact fertility and may also increase the risk of certain complications associated with egg freezing. Smoking can decrease the number and quality of eggs retrieved, and increases the risk of ovarian hyperstimulation syndrome (OHSS), a potentially serious complication of the egg freezing process.

Can you have sex during the egg freezing cycle?

If you’re participating in our Split program, where you freeze your eggs for free by donating half of the retrieved eggs to another family, you’ll need to avoid sex entirely, since becoming pregnant or contracting and STD would result in your cycle being canceled.

What can you eat during egg freezing?

Eating a healthy and balanced diet is an important part of overall health and wellness, and it's especially important during the egg freezing process. Eating a diet rich in fruits, vegetables, lean protein, and healthy fats can help support your overall health and may improve the success of the egg freezing process. Once the eggs are retrieved, you can indulge in dessert, a cocktail, and resume your normal diet!

What supplements can I take during egg freezing?

In addition to eating a healthy diet, taking supplements may also be beneficial during the egg freezing process. Folic acid, for example, has been shown to improve reproductive outcomes and is often recommended for women undergoing egg freezing. Other supplements such as CoQ10, DHEA, and omega-3 fatty acids may also be recommended by your fertility doctor. It's important to note that you should always talk to your fertility doctor about what you’re taking – and what you want to be taking – before you start egg freezing, as some may interact with fertility medications.

Can I take painkillers during egg freezing ?

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a class of medications that reduce pain, inflammation, and fever. NSAIDs like ibuprofen and naproxen may need to be avoided during your egg freezing cycle as they can interfere with ovulation. Your doctor may recommend alternative pain relief options, like acetaminophen (Tylenol), if needed.

Read more in What Medications Do I Need To Stop Before Freezing My Eggs?

Can you use a hot tub or steam room during egg freezing?

There’s conflicting info here. Some doctors say hot tubs, steam rooms, and saunas should all be avoided during the egg freezing process, citing that they can cause a spike in body temperature, which can be harmful and may negatively impact the success of the egg freezing process. While others say it’s fine. Knowing that there’s always a small risk that public hot tubs are carrying bacteria or can cause allergic reactions, it’s safest to wait until after the egg retrieval. 

Can you take a hot bath during egg freezing?

This is another controversial one – some fertility clinics say hot baths are fine, while others say you should stick with showers. Some providers even recommend avoiding baths from the day of your retrieval and several days after, in order to allow your body to safely heal. Ask your doctor what they think, or just stick to showers to play it safe!

Can I continue my skincare return while freezing my eggs? Are beauty products safe? 

For the most part, you can continue your regular skincare routine during egg freezing, but some ingredients and treatments may warrant caution. While there is no direct evidence that skincare products impact egg quality, some fertility doctors recommend avoiding retinoids (Vitamin A derivatives), hydroquinone, and high concentrations of salicylic acid, as these are commonly discouraged during pregnancy and fertility treatments. If you use prescription-strength skincare products, check with your doctor to be sure they’re safe.

That said, most skincare staples—including hyaluronic acid, vitamin C, niacinamide, and sunscreen—are considered safe to use during the process. Keeping your skin hydrated, protected, and irritation-free is the best approach. If you’re considering chemical peels, laser treatments, or other invasive procedures, it may be best to wait until after your retrieval to avoid unnecessary irritation or downtime. The good news is that your cycle should last no longer than two weeks.

Can I get Botox during egg freezing?

To date, there haven’t been any studies on the impact of Botox or other facial injections on fertility treatments. However, since fertility treatments involve hormonal changes and potential inflammation, some doctors recommend avoiding Botox during the egg freezing cycle, just to be cautious.

If Botox is part of your routine, consider scheduling your treatment before starting ovarian stimulation so you can go through your cycle without concerns. Once your eggs are retrieved, you can discuss with your doctor when it’s safe to resume injections. While there’s no definitive evidence that Botox affects fertility or egg quality, it’s always best to follow the “better safe than sorry” approach when undergoing fertility treatments.

Can I get the flu or COVID-19 vaccine during egg freezing?

Yes, you can receive a flu or COVID-19 vaccine while undergoing fertility treatment, including egg freezing. Leading reproductive health organizations, including ACOG (American College of Obstetricians and Gynecologists) and ASRM (American Society for Reproductive Medicine) confirm that COVID-19 vaccination is safe for individuals undergoing fertility treatments.

However, you may want to consider the timing of your vaccination to minimize any potential discomfort during key stages of treatment. Some people experience mild side effects after vaccination, such as tenderness at the injection site, fever, headache, muscle aches, or fatigue. To ensure that any symptoms are not mistaken for reactions to fertility medications or procedures, it may be best to schedule your vaccine a few days before or after major milestones like egg retrieval.

Your fertility doctor can provide personalized guidance on the best time to receive the vaccine based on your cycle. 

How soon after egg retrieval can I resume normal activities?

While most individuals can return to light activities within a day or two after egg retrieval, it’s important to listen to your body and follow your doctor’s recommendations. Many people only take off work the day of their retrieval, but if you're experiencing bloating, cramping, or fatigue, giving yourself an extra day to rest can be beneficial.

However, strenuous exercise and heavy lifting should be avoided for at least a week to reduce the risk of ovarian torsion, a rare but serious condition where the ovary twists on its supporting ligaments. Since your ovaries will remain enlarged for some time after the retrieval, intense workouts, high-impact movements, or heavy lifting can increase discomfort and complications.

Here’s a general timeline for resuming activities:
✅ Next day: Light activities like walking or desk work are usually fine.
✅ 2-3 days post-retrieval: Many people feel ready to return to normal daily tasks.
✅ 1 week post-retrieval: Gradually reintroduce moderate exercise, but avoid core-intensive workouts.
✅ 2 weeks post-retrieval: Most people can resume their regular fitness routine if cleared by their doctor.

If you experience severe bloating, pain, nausea, or difficulty urinating, contact your fertility doctor, as these could be signs of ovarian hyperstimulation syndrome (OHSS).

Summing it up

Egg freezing is such an intense (and often expensive) process. In order to get your best outcomes possible, it’s probably better to err on the conservative side. Always follow the instructions of your fertility doctor, and avoid any activities that may put your health at risk. We are wishing you the best!

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Cofertility is in the “family” business, striving to make egg freezing and third-party reproduction more human-centered and accessible for all. Our Freeze by Co program allows you to freeze your eggs for free, when you give half to a family who can't otherwise conceive.

More people than ever are thinking about preserving their fertility for the future. But what’s the difference between freezing eggs and freezing embryos? More importantly, which is the better option for you?

While both procedures have given people more choice around when they have children and how they conceive them, they’re not the same and there’s plenty to think about when trying to choose one over the other.

What’s the difference?

There’s one major difference between freezing eggs and freezing embryos. When you freeze your eggs, they stay unfertilized. We all know that to make a baby, you need an egg and a sperm because each of them provides half of the material needed. On its own, an egg can’t function (and neither can a sperm).

An embryo, on the other hand, is an egg that has already been fertilized by a sperm. Once they combine, the egg and sperm become a single cell. Over the next three to four days, the embryo divides several times, going from one to two to four to eight cells, and so on until it reaches the blastocyst stage and is ready to be frozen. Once an embryo has developed, there’s no going back– that is, there’s no way to turn that embryo back into a separate egg and sperm. 

Things to consider

So how does this information help you figure out whether to freeze eggs or embryos? Well, there are two big factors to consider: your circumstances and the research.

If you don’t know who you want to have children with, then freezing your eggs may be the best approach. This option gives you the freedom to hold off on thinking about having a baby until you’ve met someone or are ready to choose a sperm donor. 

On the other hand, if you are currently with a partner who you know you’d like to have children with but now isn’t the right time, then freezing embryos might be the way to go. The caveat here is to be 100% certain—stars like Sofia Vergara and more recently, Anna Kendrick, have run into trouble after freezing embryos with partners they didn’t end up with. 

Now, let’s look at the research.

Is freezing embryos really better?

The short answer here is not necessarily. The long answer is that each case is unique so whether freezing embryos or eggs is the better option for you will depend on your specific situation and what your labs, imaging, and other health information suggest. 

With that in mind, let’s break down the pros and cons of each method.  

Pros and cons of freezing eggs vs embryos

Freezing/thawing process

Historically, embryos have been “tougher” than eggs and therefore, easier to freeze and thaw. Freezing eggs was much more of a gamble since they’re large cells with a lot of water inside. That water can turn into ice crystals during freezing which, in turn, can damage the chromosomes in the eggs and make them unusable.

But it’s not all gloom and doom for egg freezers! Researchers have continued to study the technology and the statistics have changed as newer and better freezing technologies have emerged. Nowadays, an excellent lab can expect 97% of the eggs that they freeze to survive compared to 95% for embryos. 

But, let’s be clear, these numbers don’t mean that your chances of a successful live birth are 3% higher with frozen eggs, it just means that they are a little more likely to make it to the next phase of IVF. The higher the quality of your frozen eggs (i.e. if you freeze your eggs relatively young and maintain a healthy lifestyle), the more likely they will have thaw rates that are just as good (if not higher) than that of embryos.

Quality

A major weakness of egg freezing is that there is no way to test the quality of eggs on their own–they still have to make it through the thawing process, fertilization, and develop into a healthy embryo that can be implanted into the uterus (not all of them make it this far).

This can lead to a situation where someone uses their eggs years after freezing them and those eggs don’t perform as well as they thought they would. By then, this person is older so their egg quality has declined even more. Not having that quality information upfront can make it hard to judge how many eggs need to be frozen to lead to an actual baby.

In contrast, embryos have to get past several important hurdles that give fertility specialists a much better sense of their quality and the chances of a baby later. That’s because turning eggs into embryos requires that they be successfully fertilized and that those embryos survive up to a point where they can be frozen (usually the blastocyst stage, around day 5 of development). 

In addition, embryos are graded at each point in their development based on an embryologist’s opinion of whether they are high quality or not (embryologists are experts who study the development of embryos). 

Finally, you have the option to run a genetic screening test on embryos, which can help more accurately predict whether they’re likely to become healthy babies. Research has shown that preimplantation genetic screening can result in lower miscarriage rates and higher live birth rates per embryo transfer. There is no such test for frozen eggs. 

Chances of a healthy baby down the line

Recent studies comparing the likelihood of actual babies being born, known as the live birth rate (LBR), have shown that it’s now pretty even whether you’re freezing eggs or embryos. Before this, the LBR with frozen eggs was quoted at about 50% the LBR of frozen embryos. 

A study published in May 2022 provides even more evidence to support this. The study, done at NYU, is the largest U.S. report of elective fertility preservation outcomes to date and is based on 15 years of real-life frozen egg thaw outcomes for people who had delayed having children and had natural, age-related fertility decline.

On average, study participants were 38 years old at the time they froze their first set of eggs. The study found that regardless of age, those who thawed at least 20 mature eggs had a 58% LBR. This was unexpected given that so many of the participants were past the optimal age to freeze eggs (35 years old or younger). People under 38 years old who thawed 20 or more mature eggs had a 70% LBR per patient. The length of frozen egg storage did not change the success rate.

Additionally, the study found that 39% of people between 27 and 44 years old (most were between 35 and 40 when they froze their eggs) had at least one child from their frozen eggs, which is comparable with age-matched in vitro fertilization (IVF) outcomes. Researchers also found that many of the participants studied had more than one child through egg freezing. 

When compared to data collected by the Centers for Disease Control and Prevention (CDC) from the nation’s nearly 500 fertility clinics on people trying to conceive at age 40 using fresh eggs or embryos, only 30% who underwent IVF became pregnant and the LBR was less than 20%.

The final conclusion? For those starting families later, egg freezing and thawing at a later date provides a higher pregnancy success rate than using fresh embryos during assisted reproductive technology.

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*One important point the researchers make about their study is that it was limited by the number of patients. More studies need to be done in the future that include people from a variety of geographic locations and center types. 

Cost

Last, but certainly not least, is the financial side of this. Is embryo freezing more expensive than egg freezing?

Honestly, yes. The upfront cost of egg freezing is definitely less than that of embryo freezing (which requires in vitro fertilization before freezing). While egg freezing costs upward of  $10,000 on average, creating and freezing embryos can add a few more thousand dollars to that bill. If you’re freezing embryos using a sperm donor, the sperm can add a further $300 to $4,000, depending on several factors. In both cases, you will also need to pay an annual fee to store your eggs or embryos until you use them. This can cost anywhere from $500-$1000 per year, depending on the clinic you use. 

Depending on the type of medical coverage you have, your insurance may cover some of these costs, so make sure you reach out and see what support you can receive from them. Many clinics also offer financial plans and other forms of support so always ask!

TL;DR: Freezing eggs comes with a lower upfront price tag which makes it an easier and more accessible choice than embryo freezing, allowing more people to preserve their future options. 

Additional Resources

Both the Centers for Disease Control & Prevention (CDC) and experts at Harvard Brigham and Women’s Hospital have developed calculators for assessing a person’s chances of success with artificial reproductive technology (ART). The CDC IVF Success Estimator helps estimate the chances of a live birth with IVF while the BWH Egg Freezing Counseling Tool helps to estimate the chances of at least 1 live birth based on your age and number of frozen eggs.  

What do I ask my provider?

Use your health care provider as a support and resource. They should be able to answer any of your questions. Not sure what to ask? Here are a few questions to help you get started: 

• How many eggs or embryos do you recommend I freeze, at my current age, to have the highest percentage chance of a live birth later on?
• How many treatment cycles will I need to do to get to this number? It’s totally normal to need more than 1 cycle, but it’s nice to know what to expect ahead of time. 
• What is this lab’s rate of successful freezing and thawing of eggs vs embryos (“oocyte cryosurvival rate” is the medical term)? Are they closer to minimal or maximum competency?
• How much would each cycle cost? 
• Are there any financial support options, plans, or advice? 
• What are the health risks? What about common side effects? 
• Is there an upper age limit for using my eggs or embryos in the future? 
• How long can I store them and how much will it cost per year?

Do You!

At the end of the day, there’s no universal rule around the best approach to preserving fertility. Family planning is going to look different for every person so you need to do what’s right for you. When you’re ready, talking to a fertility specialist can help you make up your mind. 

In the meantime, Freeze by Co is here to help you every step of the way on that journey. Our Split program allows those who qualify to freeze their eggs for free! In a “Split” cycle, you donate half of the eggs retrieved to a family that’s trying to conceive and freeze the remaining half for yourself. Or, if you don’t want to donate, you can still participate in the Keep program, where you’re able to freeze your eggs and keep them all for yourself, on your timeline. In addition, you’ll have access to our online support community. This valuable resource lets you engage with other people freezing their eggs at the same time! 

Whatever you end up choosing for yourself, our team is here to guide you through it and keep your options open.

Egg retrievals, which take about 30 minutes, are considered a minimally invasive procedure. Women undergoing egg freezing often ask me if they are “put to sleep” (under anesthesia) during that time… and the answer is, usually yes. Not only is it important for you to remain still during the procedure, but anesthesia can help you relax and block pain. In this guide, we’ll review some of the most common questions we get about anesthesia and egg retrievals:

• What happens during an egg retrieval? 
• What is anesthesia and is it safe?
• What type of anesthesia is used for an egg retrieval?
• Is propofol used for egg retrievals?
• How is sedation administered during an egg retrieval?
• How long are you under anesthesia for egg retrieval? 
• What happens during anesthesia in an egg retrieval?
• How do you prepare for anesthesia during egg freezing?
• Why do you need anesthesia during egg freezing?
• Can you do an egg retrieval without anesthesia or sedation?
• What can you do if you’re afraid of anesthesia?

First, let’s review what happens during an egg retrieval

The egg retrieval is the final culmination of the egg freezing process. During an egg retrieval, the eggs are removed from the ovaries and frozen for your future use. 

Here is a general overview of what happens during an egg retrieval procedure:

1. You are usually given medication to help relax and reduce anxiety.
2. You are usually given a local anesthetic to numb the area where the eggs will be retrieved.
3. A thin needle is inserted through the vagina and into the ovary, guided by ultrasound imaging.
4. Fluid is gently suctioned through the needle to remove the eggs from the follicles.
5. The retrieved eggs are examined under a microscope to determine their number and quality.
6. The eggs are then frozen and sent to long-term storage.

The entire egg retrieval procedure typically takes about 30 minutes, and you can go home the same day knowing how many eggs were retrieved.

What is anesthesia and is it safe?

Anesthesia is a medical treatment that blocks the sensation of pain and other sensations during surgery or other medical procedures. It is administered by anesthesiologists, doctors who are specially trained to manage pain and other aspects of care during and after surgery.

Anesthesia is generally safe, but like any medical procedure, it does carry some risks. The type and severity of the risks depend on the individual patient and the type of anesthesia being used. Some common risks associated with anesthesia include allergic reactions, breathing problems, and blood pressure changes. However, these risks are rare and the benefits of anesthesia typically outweigh the potential risks.

It's important to discuss any concerns you have with your anesthesiologist and other members of your healthcare team before your surgery or procedure. They can help you understand the potential risks and benefits of different types of anesthesia and help you make an informed decision about your care.

There are several types of anesthesia:

• General anesthesia is used to render a patient unconscious and provide full body muscle relaxation. 
• Regional anesthesia numbs a larger area of the body, typically involving a nerve block.
• Local anesthesia numbs a small area of the body, such as a single tooth.
• Monitored anesthesia care (MAC) is a form of sedation used to keep a patient relaxed and comfortable during a procedure. 
• Sedation is used to help people relax and feel comfortable during a medical procedure. It can range from minimal sedation (also known as "conscious sedation") to deep sedation, in which the person is not conscious but can be aroused.
• Twilight sedation or twilight anesthesia is another term you may hear for sedation, when a patient is sedated but remains conscious in a “twilight state”.

The type of anesthesia that is best for you will depend on your medical history and your preferences. Your healthcare team will help you decide which type of anesthesia is best for you.

What type of anesthesia is used for an egg retrieval?

For egg retrieval procedures, a common type of anesthesia used is sedation, a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic). Conscious sedation lets you recover quickly and return to your everyday activities soon after your procedure.

According to board-certified anesthesiologists Dr. Steven Alfond of Extend Fertility, “There’s light sedation, like taking a dose of Valium; during light sedation, patients are awake, and they’ll probably remember what’s going on. Light sedation might be used for simpler procedures. The fertility procedures require something a little deeper; we call it deep sedation. Most patients require just one medication—propofol—and, depending on pain, a pain medication.”

Sedation for egg retrievals is generally a combination of propofol, fentanyl, and midazolam, and designed to keep you still (so the doctor can successfully perform the procedure) as well as relaxed and comfortable. In some cases, such as when a larger procedure is required, general anesthesia may be used. This type of anesthesia is designed to put the patient into a deeper sleep, allowing them to remain unaware of the procedure.

Propofol for egg retrievals

Propofol is a sedative-hypnotic medication that is used to produce sleepiness or drowsiness and to relieve anxiety before and during the egg retrieval. It is often used for intravenous (IV) conscious sedation, which means that you remain awake but relaxed and comfortable during the procedure. Propofol is a popular choice for conscious sedation because it takes effect quickly and wears off rapidly, so you typically feel alert soon after the procedure. 

How is sedation administered during an egg retrieval?

Propofol is administered through an IV line, and the amount of medication can be adjusted to achieve the desired level of sedation. Because it is not general anesthesia, you can breathe on your own and don’t need breathing tubes (phew!).

How long are you under anesthesia for egg retrieval? 

Here’s the good news – the egg retrieval is a relatively quick procedure that typically takes 30 minutes. The length of time you are “under” or “asleep” depends on the type of anesthesia being used and your response to the medication.

If general anesthesia is used, you will be unconscious for the duration of the procedure and will not be aware of the time passing. If conscious sedation is used, you will be awake but relaxed and comfortable, and may not remember much of the procedure.

Regardless of the type of anesthesia used, the anesthesiologist will carefully monitor your vital signs and adjust the medication as needed to ensure your safety and comfort during the procedure. After the procedure, you will need to rest in a recovery area until the effects of the anesthesia have worn off, which can take anywhere from a few minutes to a few hours. (This is why it’s important to bring a buddy to drive you home!)

What happens during anesthesia in an egg retrieval?

If your doctor uses conscious sedation during the retrieval, the medication can take effect quickly (within seconds), so you’ll begin to feel relaxed and drowsy soon after receiving it. You’ll remain conscious and able to respond to commands during the procedure, but may not remember much about it afterwards.

If you choose deep sedation, you will go into a state of unconsciousness or near-unconsciousness rather quickly. You will not be fully aware of your surroundings and may not be able to respond to commands or communicate with the doctor. In other words, you’ll be in a deep sleep. 

If your doctor uses general anesthesia, you will be unconscious and unable to feel pain or sensation. General anesthesia is typically administered through an intravenous (IV) line or with a gas that you inhale. It is used to relax and incapacitate the muscles in your body, so that you do not move during a surgical procedure.

In any of these situations, your vital signs, such as heart rate and blood pressure, are closely monitored by the anesthesiologist to ensure your safety. The anesthesiologist will adjust the dosage of the medication as needed to keep you in a deep state of unconsciousness. After the retrieval is completed, the anesthesiologist will slowly reduce the level of medication, and you will begin to wake up. It is common to feel groggy and disoriented when you first come out of a deep sleep, but you’ll be back to yourself in no time.

How do you prepare for anesthesia during egg freezing?

Here are some ways to prepare for your egg retrieval:

• Inform your doctor about all the medications you are currently taking, including prescription and over-the-counter drugs, supplements, and herbs.
• Follow any instructions given by your doctor or anesthesiologist regarding eating and drinking before your egg retrieval.
• Arrange for someone to drive you home after the egg retrieval.
• Remove all jewelry and leave it at home.
• Wear comfortable, loose-fitting clothing to the clinic.

Your doctor will give you instructions for preparing for the egg retrieval, and it is important to follow their instructions to reduce the risk of complications during and after the procedure. 

Why do they use anesthesia and sedation during egg freezing?

Sedation and anesthesia are often used for egg retrievals to keep you still (so the doctor can successfully perform the procedure) as well as relaxed and comfortable.

You can work with your doctor to determine which method to use, based on your preferences and medical history. It is important to discuss the options and any concerns you have before the procedure. Your doctor can help you understand the potential risks and benefits of different types of sedation and help you make an informed decision about your care.

Can I do an egg retrieval without anesthesia or sedation?

While sedation is standard of care for an egg retrieval procedure, it is usually not required. Some women have had medical reasons for not wanting sedation, while others are concerned with the drugs used during sedation and are looking for a more natural course of treatment. If you don’t want to use anesthesia for your egg retrieval, it’s important to talk to your doctor in advance of the procedure. 

Most women prefer egg retrievals under sedation/anesthesia. But doing an egg retrieval without anesthesia is cheaper and faster, and does not require the presence or assistance of an anesthesiologist. Research has shown that it results in good satisfaction among the patient and the physician. 

A study of 100 women undergoing egg retrievals found that women who chose to skip sedation were significantly more likely to express fear of anesthesia. Those women experienced more pain during egg retrieval, but all but one said they would do the same in future cycles. 

What to do if you’re afraid of anesthesia

If you are afraid of anesthesia, it is important to communicate your concerns with your healthcare team in advance of the procedure. They can help you understand the process of anesthesia, your options, and what to expect. It may also be helpful to speak with an anesthesiologist, who can explain the specific medications and techniques that will be used during your egg retrieval.

You may also choose to bring a trusted family member or friend with you to your appointments, so that you have someone to support you and ask questions (you should also have someone with you at the retrieval as well).

Lastly, you may benefit from practicing relaxation techniques, such as deep breathing or progressive muscle relaxation, in the days leading up to your retrieval. I also found it helpful to listen to music through my headphones as the IV was put in and I went under sedation. Remember that your doctors are trained to keep you safe and comfortable throughout the procedure. You’ve got this!

Cofertility is in the “family” business, striving to make egg freezing and third-party reproduction more human-centered and accessible for all. Our Freeze by Co program allows you to freeze your eggs for free, when you give half to a family who can't otherwise conceive

People come into the doctor’s office often with concerns that they may never be able to have children, either because of their age or because of their lab results. The result they are usually referring to is their anti-Müllerian hormone (AMH) test. When an AMH comes back less than promising, people get anxious real quick.

But a single hormone level can never tell you that you can or cannot get pregnant. There is more to fertility than a person’s hormone level or their age, though the two are important. Let’s dig deeper into AMH and age and what they can really tell us about fertility. 

What is AMH?

An AMH test is a simple blood test commonly used to assess ovarian reserve. Ovarian reserve is defined by the National Cancer Institute as “the total number of healthy, immature eggs in the ovaries” but I find this to be a bit misleading. Let me explain why.

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. 

The actual number on an AMH report is typically a single digit number that, again, corresponds to the number of healthy follicles you have but it isn’t the actual total number in your ovaries if we were to count them. For example, an AMH of 3.5 does not mean you have 3.5 follicles. It does mean that you likely have the expected number of healthy follicles in your ovaries and we expect that each of those follicles contains an egg that has the potential to lead to pregnancy. And since AMH is thought to be stable throughout the menstrual cycle, it’s considered to be the best lab indicator we have for a person’s reproductive potential (in combination with age). 

What AMH is actually very good at is predicting the timing of menopause. Research shows that AMH becomes very low or undetectable about five years before menopause. Other research has shown that the time of menopause may be predicted with a mathematical model using only one AMH value and the age of the patient. 

TL;DR? Your actual AMH number is not the total number of healthy follicles (with eggs in them) that you have, but it does correspond to your overall ovarian reserve, or your reproductive potential based on the number and quality of eggs you have. AMH is actually a better predictor of the timing of menopause, since it becomes very low or undetectable about five years beforehand.

AMH and age

So how does AMH relate to your age? ​​In younger people, a gradual increase in AMH levels is seen from the first day of life. Maximum levels are reached in the teenage years and they stay pretty steady until around the age of 25. After that, AMH and age are inversely correlated, meaning that as a person gets older, their AMH goes down. Additionally, the rate at which someone’s AMH goes down varies from person to person so it’s impossible to guess where someone’s AMH will be in the future.

What is a normal AMH for my age?

Unfortunately, there is no international standard for AMH levels. However, some studies have tried to assess AMH levels and create models for what is considered normal for specific ages. One study looked at the median AMH levels (in ng/mL) in 2,741 participants. Their results are listed below:

• Under 25 = 5.13
• 25 = 5.42
• 26 = 4.91
• 27 = 4.12
• 28 = 4.96
• 29 = 3.87
• 30 = 3.53
• 31 = 3.59
• 32 = 3.44
• 33 = 2.70
• 34 = 2.49
• 35 = 2.58
• 36 = 2.28
• 37 - 1.85
• 38 = 1.66
• 39 = 1.72
• 40 = 1.27
• 41 = 1.26
• 42 = 1.20
• 43 = 0.81
• >43 = 0.72

If you have a lower or higher AMH than the numbers above going into your 30s or 40s, I encourage you not to freak out! Remember that these are medians, which means many people have AMH levels above or below them. Multiple studies have shown that AMH doesn’t correlate with how likely you are to get pregnant. In fact, one study looked at AMH, FSH, and inhibin B levels and tracked people for a year. They found that there was no correlation between someone’s ovarian reserve and their ability to conceive and that a low ovarian reserve was not associated with lower fertility. As a result, they did not recommend the use of FSH or AMH levels to “assess natural fertility.”

Lastly, It’s also important to keep in mind that the interpretation of AMH levels is laboratory assay-dependent. This means it can be different from lab to lab and test to test. Your provider should give you the reference range for their specific lab. If you get your AMH tested in one lab and then get it tested at another lab later, let your provider know before comparing those numbers. 

Is AMH or age better at predicting egg quality?

Based on the research, AMH levels alone probably do not accurately reflect egg quality. Though, when AMH is combined with age, it can be a better indicator than when it’s used alone. There is unfortunately no single test or number that can tell you with certainty how likely you are to get pregnant.

Age, on the other hand, 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 difficulties with both getting and staying pregnant (i.e, higher risk of miscarriages). Once a person reaches their mid to late thirties, research shows that the quality and quantity of eggs declines rapidly. 

Unfortunately, there’s not a lot we can do about aging or about the decline in AMH that goes with it. However, it does no good to stress about either of these numbers. As stated earlier, AMH and age are each just one value your provider looks at to assess your overall reproductive potential. Neither value alone can completely predict your chances of conceiving naturally and neither defines your fertility.

Is AMH or age better at predicting how many eggs will be retrieved during egg freezing?

A lower ovarian reserve can mean fewer eggs are retrieved during egg freezing. This means both age and AMH factor into the success of an egg freezing or IVF cycle. 

Research has found that AMH is a good predictor of the response to ovarian stimulation and the number of eggs retrieved, regardless of a person’s age. 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. This is a great example of how age and AMH can both impact fertility.

At what AMH level should I freeze eggs? 

So when should you consider freezing your eggs? Honestly, the sooner the better. There is no specific AMH level at which you have to freeze your eggs. However, we know AMH only goes down as a person gets older, so the earlier you’re able to freeze your eggs, the better your response to the medications will be and, hopefully, the more eggs you’re able to have retrieved to keep your options open later.

When thinking about your AMH, these general guidelines for AMH values (ng/mL) and egg retrieval can be helpful:

• AMH <0.5 = predicts difficulty getting more than three follicles to grow in one egg retrieval cycle (this in turn reduces the chance for pregnancy with IVF)
• AMH <1.0 = suggests a limited egg supply and a short window of opportunity to conceive
• AMH 1.0 - 3.5 = suggests a good response to ovarian stimulation
• AMH >3.5 = suggests an ample egg supply (also indicates that your doctor may need to be cautious in order to avoid ovarian hyperstimulation syndrome (OHSS), a possible complication of ovarian stimulation)

So can you still freeze your eggs if your AMH is low? The simple answer is yes, you can. But you will be more likely to need more than one cycle to reach the ideal number of eggs.

You are not a number

With all the nuances involved here, it’s important not to get lost in the weeds. Fertility is impacted by so many factors that you can drive yourself crazy trying to manage all of them. Remember, you are more than any number. This process can be overwhelming, but focusing on the things that you can control can help you feel more grounded during your fertility journey, whatever it may look like. 

Freeze by Co is here to help you every step of the way on that journey. Our Split program allows people between 21 to 34 years old to have the chance to freeze their eggs for free! In 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, you can still participate in the Keep program up to age 40. In the Keep program, you’re able to freeze your eggs and keep them all for yourself, on your timeline. In addition, you’ll have access to our online support community, the Nest. This valuable resource lets you engage with other people freezing their eggs at the same time! 

Whatever your journey looks like, our team is here to guide you through it and keep your family-building options open.

Intro 

If you're thinking about freezing your eggs and you've started to gather information about it, you're probably coming across a lot of information. This can definitely be overwhelming but there’s no need to panic! We're here to help you figure out if egg freezing is the right choice for you, no matter what age you are.

What is egg freezing?

Before we dive further into this topic, what is egg freezing? Egg freezing, known as oocyte cryopreservation in the medical world, is a technique used to preserve someone’s fertility.  Eggs are collected from the ovaries and frozen so they can be used in the future. If the person is unable to get pregnant naturally, the eggs are unfrozen and used in an assisted reproductive technology (ART) procedure, like in-vitro fertilization (IVF). Whether you know you want to have kids or you aren’t sure and want to give yourself more time to figure it out, think of egg freezing as a way to keep your options open for the future.

Should I freeze my eggs?

There are many, many reasons why someone might choose to freeze their eggs but the decision is a deeply personal one that requires some careful consideration. When making that decision though, it’s important to know that egg freezing is not an “insurance policy” for your fertility. While egg freezing can take some of the stress of having a baby right now off your shoulders, it is not a guarantee that you’ll have a baby in the future. 

Why not? Well, not all the eggs that get frozen will actually be viable. It’s expected that some eggs will not survive the warming process. In addition, the chances of the eggs that do survive being successfully fertilized depends partially on how old you were when you froze them (more on this later). Beyond that, fertility and pregnancy risks change with age. If you freeze your eggs at 30 and use them when you're 40, you'll have to deal with the realities of pregnancy at 40.

This is not to sway your decision one way or another. Ultimately, only you and your doctor can decide if egg freezing is the right decision for you. But it's important to go in knowing that it’s not meant to be a done deal.

Pros of egg freezing

Ok, now that we’ve gone through the basics, let’s discuss the pros and cons.

Perhaps the biggest advantage of freezing your eggs is the fact that it lowers the risk of having children with genetic abnormalities associated with ovarian aneuploidy. Ovarian aneuploidy refers to when an egg has an abnormal number of chromosomes which leads to an abnormal pregnancy. Most people are born with 46 total chromosomes (23 pairs). The most common aneuploidy risk seen by far is Down syndrome. Babies with Down syndrome have an extra copy of one of these chromosomes, chromosome 21. The medical term for having an extra copy of a chromosome is “trisomy” so Down syndrome is also known as Trisomy 21. Freezing your eggs at a younger age decreases (but does not totally eliminate) the risk of an abnormal number of chromosomes.

Another benefit of egg freezing is that it puts the decision-making power entirely in your hands. Whether you’re freezing your eggs because you want to focus on your career or you’re getting a medical treatment that may affect your fertility later on or you’re waiting to find the right partner, freezing your eggs allows you to preserve some of your fertility independently. 

Egg freezing also gives you options in terms of having your own biological children. Of course, there is the obvious option of having the eggs fertilized and the embryos implanted into your uterus. But you also have the option of having those embryos implanted into a gestational carrier or into your partner if they have uterus. 

Finally, freezing your eggs does not affect your ability to get pregnant naturally. The egg freezing process and retrieval procedure simply rescue eggs that would have died with your next menstrual cycle. This means it does not affect your ovarian reserve (the number of eggs in your ovaries). Once you’ve completed the full process, your body will continue to ovulate and release an egg each month like normal.  

Cons of egg freezing

Now, let’s talk about the disadvantages of egg freezing. 

The most obvious downside is the cost. While some insurance plans may cover egg freezing, this isn’t the case most of the time. The out-of-pocket cost of egg freezing varies but it can be up to $20,000 depending on where you are and which clinic you use. This typically includes bloodwork, medications, ultrasounds, and the egg retrieval procedure. This does not include the annual storage fee (which can be up to $800 per year) and any follow-up procedures if you end up using those eggs. Learn how you can freeze for free with Freeze by Co. 

The next thing to consider is the hormone medications and egg retrieval process themselves. These medicines not only require injecting yourself (or having a partner or friend do it) but they can have some not-so-fun side effects. These can include fatigue, nausea, bloating, headaches, abdominal pain, breast tenderness, and irritability. A severe risk of hormone medications is ovarian hyperstimulation syndrome (OHSS). This condition can lead to blood clots, shortness of breath, abdominal pain, dehydration and vomiting. It may even require admission to the hospital to manage. Thankfully, OHSS is rare nowadays, affecting only up to 2% of patients.

The egg retrieval process is quick and the most common symptoms afterwards are pelvic or abdominal pain, constipation, bloating, and spotting. The main concern here is the time you need. One typical egg-freezing cycle can range from 10 to 14 days and during that time you'll be attending doctor appointments almost daily to make sure your eggs are maturing correctly.

If you’re taking any gender-affirming hormones like testosterone, you may need to take a break in order to freeze your eggs. One study showed that transgender men who used gender-affirming hormones and stopped a few months before fertility treatments ended up with the same number of eggs as cis women. But getting off hormones can be hard and could trigger gender dysphoria so the best option is to freeze eggs before transitioning if at all possible.

No one likes to be the bearer of bad news but this is an important one. Egg freezing may mean your eggs stay the same age forever but unfortunately, your body does not. As you age, the risks of pregnancy increase for both you and your potential child. These risks include gestational diabetes, preeclampsia, c-section delivery, preterm delivery of a baby with low birth weight and other risks related to the pregnancy being IVF. However, these risks vary widely depending on many other factors. 

One final caveat to remember is that egg freezing does not guarantee a live birth. It’s likely that not all eggs will survive the thawing process. Some will not fertilize. Others fertilize abnormally, and still others don’t implant successfully in the uterus. A large study at NYU in July 2022 showed a 39% live birth rate for people who used their frozen eggs. The two factors that affected the success rates the most were age at the time of egg freezing and the number of eggs thawed. Specifically, the live birth rate was over 50% for people who thawed at least 20 eggs or who were under 38 when they froze their eggs. Which brings us to our next question: what age is best for egg freezing? 

When should I freeze my eggs? 

Let me start by saying that there is no perfect age at which to freeze your eggs. However, the TL;DR is that the younger you can do it, the better. According to the American Society for Reproductive Medicine (ASRM), an optimal time to freeze your eggs is in your 20s and early 30s, while you have a higher ovarian reserve and eggs are healthier. So whether you’re 25 or 35, you can absolutely freeze your eggs!

A large 2020 study at a fertility clinic that specializes in this area looked at egg freezing cycles for over 1,200 people. It compared the average number of eggs people of different ages were able to freeze versus the “optimal” or goal number of eggs they should freeze. This goal number was based on how many eggs would give them a 70% live birth rate after doing 1 or 2 egg freezing cycles (this rate is calculated using some other numbers and it typically goes up as we age to make up for the lower number of healthy eggs). 

The study found that younger people, unsurprisingly, have an easier time freezing the goal number of eggs in one cycle. As people aged, they needed multiple egg freezing cycles to reach that goal number.

These findings bring up a common question–is it worth freezing eggs after age 35? Well, it depends. The ASRM does not recommend egg freezing for people older than 38, but this isn’t a strict cutoff. Everyone’s fertility goes down at a different rate. Having your fertility hormones checked can sometimes help you and your doctor get a general idea of what your ovarian reserve is. This can better help you decide if egg freezing is right for you.

Egg freezing can be a tricky process to navigate and you are not alone when it comes to questions and concerns around it. Freeze by Co is here to help you every step of the way. With our Split program, people between 21 to 34 years old have the chance to freeze their eggs for free! In 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, you can still participate in the Keep program up to age 40. You would be able to freeze your eggs and keep them all for yourself, on your timeline while having access to an additional valuable resource in our support community, The Nest. This community allows you to engage with other people freezing their eggs at the exact same time! 

Regardless of which path you choose, our team will be there to guide you through the process as we work to keep your family-building options on the table.

You might have heard at some point that freezing your eggs can help you preserve your fertility options for your long term future. But just how many eggs should you freeze? Is there an optimal number for egg freezing?

Let’s take a look at how many eggs you can expect to get during the retrieval process and how many eggs you should be freezing for fertility preservation. 

How many eggs do I have?

Before we talk about the number of eggs you should freeze during oocyte cryopreservation — more commonly known as freezing your eggs — we should probably talk about how many eggs are in your ovaries right now. 

Your fertility doctor may have mentioned the term ovarian reserve a few times. When they do that, they’re talking about the number of eggs in your body. But how many eggs are in that reserve?

There is no exact answer here. On average, women are born with anywhere from one to two million eggs. Some women are born with more. Some women are born with less. 

It may sound like a lot either way, but most of the eggs we’re born with don’t stick around. By the time most of us hit adolescence,we have about 300,000 eggs left. From there, the number of eggs in the body naturally decreases by about 1,000 every year, and the decline becomes more rapid after age 35.  

That’s where egg freezing comes into play. The doctors of the Association of Reproductive Medicine (ASRM) states that planned oocyte preservation is “ethically permissible” because it provides women with more autonomy over their reproductive choices. 

Doctors can get a sense of how large your ovarian reserve is before egg freezing by testing the level of the anti-Müllerian hormone (AMH) in your body. This test looks at both your ovarian reserve and how well your body may or may not respond to medications that will stimulate the ovaries. What it can’t determine, however, is the quality of those eggs. And ultimately, you need both quantity and quality.

How many eggs do I need to freeze?

OK, so you may have a lot of eggs in your ovarian reserve — or maybe not. But how many do you actually need to freeze?

This answer varies from person to person and depends on a few individual factors:

• How old are you right now?
• Do you plan to freeze all of your eggs or do you hope to also donate some to help intended parents grow their family? 
• If you think you may want to have children one day, how many do you have in mind?

This list presents a lot to think about, so let’s dive a little deeper to help you make informed decisions about the number of eggs you freeze. 

The right number of eggs to freeze for your age

Different folks have different reasons for freezing their eggs. Some may be thinking about prolonging their fertility into the future. Others may be freezing some eggs but also hoping to donate some eggs to help others grow a family — something that’s done via our Split program, where you freeze for free when donating half of the eggs to a family that can’t otherwise conceive. 

Either way, studies have found that the optimal number of eggs to freeze really comes down to your age. That’s because the number of eggs in the body isn’t the only thing to decrease as you get older — egg quality decreases too, and egg quality is the number one factor in determining whether an egg can eventually result in a live birth. 

Here are the number of eggs you’ll want to freeze based on your age in order to obtain an optimal live birth rate:

How many eggs are retrieved?

For  egg donors aged 25-29, the average number of eggs retrieved is 18, and that number drops to 16 for people age 30-35 — although it varies from person to person.

Your reproductive endocrinologist will be able to tell you the day of your retrieval how many eggs were retrieved. This number will include both mature and immature eggs, so it’s not necessarily the total number of eggs that can be frozen. 

Immature Eggs

• May be partially or completely damaged or have its quality compromised in some way
• Lower chance of fertilization

Mature Eggs

• Have good egg quality
• Are more likely to be fertilized
• Can be frozen

After your retrieval, all of your eggs will be sent to an incubator to check maturity. The lab technicians will look for eggs to achieve meiosis, a kind of cell division that occurs in egg cells. 

The eggs that achieve meiosis will be frozen, and you will be notified of the total number. 

Should I do multiple egg retrievals?

What happens if you don’t get as many eggs as you had hoped during your egg retrieval cycle? 

If you’ve undergone one round of egg freezing and the number of eggs your reproductive endocrinologist retrieved from your ovaries wasn’t as high as you’d hoped, you may want to talk to them about trying again. 

There is technically no limit to the number of egg freezing rounds a person can undergo, but it’s not recommended that egg donors undergo more than six cycles. If you’re hoping to split your eggs with intended parents (donating half of the eggs retrieved) as part of our Split Program, you may find that additional retrievals help you provide the optimal amount of eggs for a live birth for you and for the intentend parents too. 

Of course, you should talk to your doctor about any risks or benefits that come with additional rounds. 

The right number of eggs to freeze to have multiple children

If you’re planning to have a big family one day, you may want to look at the number of eggs it’s recommended you freeze to achieve one live birth and talk to your doctor about freezing more eggs. 

For example, the studies show that a woman under age 35 will need to freeze about nine eggs to achieve a 70% chance of a live birth. If you’re under age 35 now and thinking you might want to use frozen eggs to conceive twice in your future, you will want to freeze closer to 18 eggs to achieve that 70% chance each time. 

That number will increase with each number of children you foresee — provided your expectation is that each child will be conceived with the use of the eggs you are currently freezing. 

Bottom line

There is no “magic number” when it comes to freezing your eggs. Your age, your future plans, and more all come into play. 

We’re here to answer any questions you might have, and the Cofertility community is also here to lend support as you consider all the important factors to make the choice that is right for you.

It may not come as a surprise to learn that the prime time for freezing your eggs is actually a lot earlier than you think. According to the American College of Obstetrics and Gynecologists (ACOG), freezing your eggs while you’re still in your 20s can help boost your chances of a successful pregnancy—and a 2010 report from the Center for Disease Control and Prevention (CDC) says that those eggs have a higher chance at resulting in a live birth no matter your age when you decide to start your family. 

For many women, that means the best time to freeze their eggs is likely the moment they start wondering when they should start. Read on to see what you need to know about why freezing your eggs before you’re even sure what you want to do with them is the best way to ensure you’ll be able to make the decision for yourself when the time is right. 

Your body produces a different number of eggs at different times

Your late 20s and early to mid-30s are considered the peak time to retrieve eggs—with a 2015 study from the American Society for Reproductive Medicine saying you’ll see the best results prior to the age of 34 — because your body has reached complete development and your eggs are at their most healthy and plentiful point.

That doesn’t mean that the quality of your eggs takes a major dip when you celebrate your 38th birthday. Instead, it means that as you add more and more candles to your birthday cake each year your body begins to produce fewer eggs. This becomes important when you realize how many eggs you’ll need to retrieve when you begin the process of freezing your eggs.  

Take the 2020 study from Assisted Reproduction Technologies (ART) that showed women under the age of 35 were retrieving an average of 21 eggs during their first round of egg freezing while women between the ages of 35-37 were retrieving an average of 17. Four eggs may not seem like that big of a difference at first, but once you take into account how many eggs experts say you should have on hand when it comes time to start fertilization you’ll begin to realize just how quickly those numbers add up. 

Producing fewer eggs may increase costs

The saying less is more doesn’t apply too much in the world of fertility, where your chances of going on to have a live birth increase based on the number of eggs you have on hand when it comes time to fertilize and implant them. 

That 2020 ART study that showed the average number of eggs retrieved each cycle also showed that if you're under the age of 35 you will need 9 eggs for a 70% chance at having a baby. However, if you’re looking to hit that same 70% mark in your later years (think 38-40), you’ll need closer to 18 eggs to have the same chances at a live birth. With women in that age range only averaging 17 eggs per retrieval, that may mean multiple cycles, and with a $10,000-20,000 price tag that can quickly add up.

The best time to freeze your eggs is, unfortunately, usually before you can afford it

Not many people have that much money readily available in their 20s, which is why egg freezing is often financially out of reach for those who would benefit most from it. With programs like Freeze by Co you can take advantage of those peak fertility years even if you can’t exactly swing the costs. 

One program offered by Freeze by Co is Split. Split Members benefit by offsetting the cost of freezing their eggs by donating half of them to a family that cannot otherwise conceive. Split Members match with intended parents, and undergo an egg freezing cycle where half of their eggs are donated to the perfect intended parents (after testing and meeting qualifications, of course). The other half are then stored (for free) for the split member for up to 10 years. 

If you’d rather hold onto all your eggs until you’ve decided what your fertility future holds, you can use Freeze by Co’s Keep Member plan. These members can still benefit from lower costs, thanks to things like reduced medication fees, consultation discounts, and more. 

This is the most cost-effective age to freeze your eggs

With all these numbers flying around you may be wondering where the health benefits and the financial benefits meet. According to a 2015 study published in the journal Fertility and Sterility, the two numbers seem to cross paths at the age of 35.

Women who freeze their eggs at 35 for use by the age of 40 spend an estimated $15,000 less than those who are trying to have a baby at 40. And that’s not the only good news, that math seems to hold up all the way until the age of 38. 

Freezing your eggs should be a positive experience

With the accessibility Cofertility gives women to take control of their fertility process, you can feel empowered to make decisions based on what’s in the best interest for you and your body without having to worry about your bank account. 

Getting an earlier start at freezing your eggs through Freeze by Co (even if you don’t have a partner or aren’t even sure that your dream future includes children yet) will: 

• Give you a higher chance at eventually achieving a live birth even if you wait until your late 30s or early 40s.
• Allow you to wait on making major decisions about your education, career, and future until you’re ready.
• Offer you the freedom to make medical decisions based on what’s right for you instead of what type of coverage your employer offers at the time. 
• Provide peace of mind because no matter what your future family may look like you’ve already taken the first step to making your dreams a reality. 

Even if you’ve missed that peak window into your fertility there are still plenty of benefits to freezing your eggs. With all of the new plans offered by Freeze by Co you’re likely to find one that will fit your current needs while giving you a chance to plan for your future.

If you’re a female physician in the United States, you may have heard that you’re at a higher risk of infertility than your female friends who took a different career path. It certainly sounds like the kind of “fact’ that gets posted on social media one day and suddenly becomes gospel, whether it’s true or not. 

Unfortunately, we can’t just write this one off as a social media hoax. Researchers have run the numbers, and it turns out almost 25% of female doctors who are trying to conceive are faced with fertility challenges. This is about double the rate of the general public.

“It turns out almost 25% of female doctors who are trying to conceive are faced with fertility challenges. This is about double the rate of the general public. “

So what’s going on? Should you be freezing your eggs now just in case? Is there anything else you can do? Read on for the research into this fertility concern and what American doctors are doing about it. 

Female doctors and fertility

General fertility rates have been trending downward in the US in recent decades with the CDC reporting record low birth rates in 2018 and only minimal increases since. In 2021, the American birth rate was 1,663 births per 1,000 women — not enough to maintain stable population figures in the US. 

And while some of that could be due to personal choice, scientists have found increasing rates of reproductive problems are cropping up in women and men. Miscarriage rates are up about one % every year and so are the rates of gestational surrogacy — an option growing in popularity for intended parents seeking the help of an additional party for conception. 

But the plight of female doctors stands out among all these figures: 

• 1 in 4 — The approximate number of female physicians who were diagnosed with infertility after trying to have a baby, according to a survey published in the Journal of Women’s Health in 2016 
• 11 % — The percentage of American women in the general population have had the same diagnosis. 
• 42 % —The amount of female surgeons who have experienced a pregnancy loss, according to a survey published in JAMA Surgery in July 2021 which reported that 42 % had experienced a pregnancy loss. 

What’s going on?

What makes female doctors so different from the rest of the population? In part, their education. 

There’s no real way to put this nicely: Age matters when it comes to fertility. Extensive medical research on fertility shows that getting older has a major effect on our reproduction system and our ability to conceive.

But many female doctors — surgeons included — delay pregnancy until after the completion of their residency. How long that will take depends on the doctor’s specialty, but this can be another three to eight years after medical school. For surgeons, a residency is a minimum of five years. 

That puts many female doctors into their 30s before they even begin trying to have their first child. In fact, in the 2016 survey, doctors reported they were 31.6 year old on average at completion of medical school and residency and 30.4 years on average at first pregnancy. By comparison, the average age of an American woman giving birth for the first time in the US is 26 years old, according to data compiled for the New York Times in 2018. 

Almost a third — 28% — of the female doctors surveyed in 2016 who experienced fertility challenges said they would have begun trying to conceive earlier if they could have seen what lay ahead. Close to the same number — 29% — said they experienced diminished ovarian reserve, a condition in which their fertility challenge was linked to having fewer eggs in the body. This condition is largely associated with age. 

But delaying reproduction is only part of the puzzle.

Even after adjusting for age, female physicians have higher rates of infertility. Perhaps this is due to female doctors facing high rates of stress at work that put a strain on the body and can affect reproduction as a whole. Those who opt to start a family before residency is complete may face irregular work schedules and long, grueling shifts that can put intense strain on anyone’s body, but prove especially hard for someone who is pregnant.

Together, all of these factors can have a significant impact on the fertility of a female doctor. 

How can female doctors preserve their fertility?

The numbers may seem a little daunting, especially if you’re in medical school or the midst of your residency. So what can women do about it? 

An infertility task force now exists as part of the American Medical Women’s Association to find answers to this problem plaguing women in medicine, and individual doctors around the country have been working to advocate for improved fertility education and fertility insurance coverage for their peers. 

One of the chief criticisms of the current system comes from Dr. Areila Marshall, one of the founders of the AMWA task force, who wrote about the issue in the journal Academic Medicine in 2020 calling for better awareness of egg, embryo, and sperm cryopreservation. 

Marshall echoed a wish expressed by a number of the physicians who took part in the original 2016 survey: 7% of those doctors said they wished they had known to use cryopreservation to extend their fertility. 

For female doctors who don’t know when — or even if — they want to conceive, egg freezing can be a viable option. 

Freezing is not a guarantee that you will have a baby down the line. It simply means that eggs will be there, waiting, if you decide at some point in the future that you wish to explore conception. 

At Freeze by Co, we are committed to giving women the opportunity to have more control over their reproductive choices. Here women have a variety of paths they can choose from when it comes to egg freezing – whether they’re looking to freeze eggs now or have already frozen some of their eggs.  

Members of our Split program even freeze for free when they give half  of their eggs to intended parents who cannot otherwise conceive.

Bottom line

Women should not have to choose between a dream of pursuing a career in medicine and making reproductive decisions on their own timeline. Egg freezing gives women the power to make more choices about her own body.

While in theory, the idea of egg freezing would have many raising their hands to give this a try, practically speaking it may be more complicated. There are real-world factors to consider: Do I need to freeze my eggs? Will I actually need them down the line? Am I a good candidate? And if so, would it actually fit into my budget, and are the logistics really feasible?

No need to wonder. Here’s what you need to know to make egg freezing possible in reality and the sort of programs where you can bring this to fruition.

Affordable egg freezing programs

We at Cofertility are dedicated to the idea that egg freezing should be more accessible. To make it possible for more of those who are interested, we have designed two different programs that prioritize different aspects of egg freezing. Take our quiz to see if you qualify for these programs.

Paying for keeps

With our “Keep” program, it’s about maximizing the number of eggs that you freeze, geared to enabling many people to be able to answer the question, “Can I freeze my eggs?” with a big, “Yes.”

As a member in this program, you get access to discounted prices we’ve negotiated with clinics and pharmacies, as well as a community of women also freezing their eggs at the same time. With this Keep program we give more leeway on exactly who can participate. While we are aware that research shows that fertility starts to decrease considerably after age 35, you can still take part in the program as long as you are under age 40.

This is egg freezing with real world families in mind, with steps taken to make fees more affordable. The idea is to lighten the load and to make budgeting for egg freezing that much easier, while bringing a little more joy and positivity to the process

The Split cycle

With our Split program, it’s all about taking budgeting out of the equation altogether, while helping another family. 

As a Split program member, if you qualify, you don’t have to set money aside for these burdensome costs at all – they are free as part of the program, including up to ten-years of storage. In return, you give half of your retrieved eggs from a cycle to someone who would be otherwise unable to conceive. The family receiving the donated eggs pays for all the costs to freeze and store your eggs, for their use to build a family now, and your use in the future. 

But, because we are splitting the number of eggs here, every single one counts that much more. So, we need to be more stringent in determining who can become a Split member. 

Important X factors

One of the factors that we weigh heavily for the Split program is age. In order to participate, you cannot be over age 34. That’s because data shows that, on average, those over 35 may not respond to fertility medication as well and therefore may not produce as many eggs. Also, research shows that, unfortunately, egg quality declines with age. 

Given the amount of time it may take to do initial testing and to match you with an intended parent, we have aligned our policy with ASRM (American Society for Reproductive Medicine) guidance on this and limit membership here to those who have not yet turned 34. This way if there’s a hiccup along the way, you won’t have to miss out — there should still be sufficient time to participate in the program.

Another factor to consider is what’s known as your anti-Mullerian hormone (AMH) levels. These levels signal how responsive your ovaries are likely to be to medication given to stimulate them to produce multiple eggs. If this number is pretty high, it usually means that your ovaries will respond well to stimulation. 

If at the time of initial screening, your ovarian reserve appears low based on your ultrasound and bloodwork, you, unfortunately, will not be eligible for the Split program, although you can still become a Keep member and achieve your goals that way. The ASRM guidance underscores the importance of considering biomarkers that indicate a donor’s potential ovarian reserve as part of the selection process. Scientists have found the AMH serum range of 2.20 to 6.8 ng/ml to be the one that research predicts will show if someone has enough ovarian reserve. This indicates how you will likely respond during an egg freezing cycle. 

No matter your ovarian reserve, you can still freeze your eggs. You just may not qualify for our Split program. That’s because we want to ensure that enough eggs are produced in the cycle to make it worthwhile for everyone after the eggs are divided, without your feeling that you’ve come up short and won’t be happy unless you do another cycle.

If you’re among those who qualify though, as many in their fertility prime may be able, this can be a golden opportunity. Feel free to read more about qualifications for joining our Split program.

Logistics

There is, of course, also the question of where you’ll need to go to make all this happen. 

If you’re a Split member, your initial physical screening takes place after you are matched with an intended parent. This includes some blood work and a vaginal ultrasound, which helps determine if this program will work for you, and will likely take place somewhere between where you and the intended parent’s locale. If any travel is needed though, our team will help you to make this happen, doing the necessary organizing. But monitoring for the cycle itself can be done at a local clinic right in your own area.

Meanwhile, Keep members have the flexibility to do the testing as well as the cycle locally, where it’s most convenient. 

Can you freeze your eggs? 

So, is this something that could practically work for you? Both of our programs are designed to make this feasible for a wide-variety of women. We try to keep costs down for Keep members while offering added flexibility to pursue their egg freezing goals. Meanwhile, for Split members the financial barriers are removed altogether.

Hopefully, this helps you to see how, practically speaking, you too can raise your hand up high and answer the question, “Can you freeze your eggs?” with a giant, yes, to make egg freezing in reality.

Cofertility's Split program offers a unique opportunity: freeze your eggs for free when you donate half to a family who needs them. If you’re eligible for the program, your egg freezing procedure, medications, any travel, and ten years of storage will be completely free of charge. 

This guide explains how the program works, who qualifies, what the process involves, and important considerations around egg donation. Whether you're exploring egg freezing options or specifically interested in Split, you'll find clear answers to your questions about eligibility requirements, the matching process, medical screenings, and what happens after donation.

Where do my donated eggs go?

Many different families need donor eggs to have children. These include:

• Couples experiencing infertility
• LGBTQ+ couples
• Cancer survivors
• Women with age-related fertility decline
• Single intended parents

Cofertility welcomes all intended parents to our platform to find their match. The families who receive your donated eggs have often tried multiple approaches to building their family before turning to egg donation.

Who qualifies for the Split program?

While we aim to make Split widely available, we maintain guidelines to protect everyone involved.

To qualify for the program, you must:

• Have both ovaries
• Be between ages 21-33
• Have a BMI less than 29 (for medication safety and procedure effectiveness)
• Be physically and emotionally healthy with no genetic or reproductive disorders
• Be a non-smoker and abstain from recreational drugs and Depo Provera birth control

If you're currently pregnant or breastfeeding, you may still qualify but will need to wait until you've stopped breastfeeding and had at least one menstrual cycle. You'll also need to provide a complete medical history about yourself and your biological family members.

How does the process work?

The Split program involves several steps from application through egg retrieval:

Take the initial quiz

Start with our quick one-minute quiz to see if you might qualify for Split. This gives us basic information about your health and background.

Submit your program application

If your quiz responses indicate potential eligibility, you'll complete a full application. This determines your qualification and helps create your profile that intended parents will see.

Consultation with our team

After passing the initial screening, you'll speak with a Member Advocate who can answer your questions and make sure you understand the process before your profile goes live.

Sign the Split program agreement

We'll send you an agreement outlining the program details. This agreement remains non-binding until you begin your egg retrieval cycle, and it's written in clear language. Our team is available to explain anything you don't understand.

Complete initial testing

You'll take a free AMH (Anti-Mullerian Hormone) test to assess your ovarian reserve. Fertility doctors typically look for an AMH level above 2.0 ng/ml for egg donation, as this suggests you'll likely respond well to fertility treatments and produce enough eggs for both donation and personal use. You’ll also take a free genetic test to tell you whether you carry a gene for certain genetic disorders.

Match with intended parents (optional)

Your profile will be listed on our platform for intended parents to view. Once matched, you'll have a dedicated Member Advocate to guide you through every single step. You can choose to meet the intended parents before proceeding. 

Complete medical screening

After matching, you'll undergo physical screening based on FDA, ASRM, and industry guidelines. This includes bloodwork and a vaginal ultrasound to evaluate your ovarian reserve. Depending on your location, testing may happen at a clinic near you or require some travel (which we organize and pay for).

Start your egg freezing cycle

If approved, you'll begin the stimulation phase. You'll take injectable medications to encourage your ovaries to mature multiple eggs simultaneously. While this might sound intimidating, we provide detailed tutorials and support. A fertility doctor will monitor your progress throughout the 10-14 day stimulation period.

Egg retrieval

When your eggs reach peak maturity, you'll undergo the egg retrieval procedure. This outpatient procedure takes about 30 minutes under sedation. The doctor uses ultrasound guidance to remove the eggs vaginally.

Immediately after retrieval, half the eggs are frozen and stored for you (free for 10 years). You can access them anytime and have them shipped to your chosen fertility clinic. The other half go to the intended parents for fertilization. If an odd number of eggs is retrieved, the additional egg goes to the intended parents.

Next steps

Depending on your family planning goals and how many eggs are retrieved in your first cycle, you might decide to complete a second cycle. 

For women under 35, studies show an average of 18-21 eggs retrieved per cycle, closely correlated with AMH levels. Research indicates that freezing nine eggs gives women under 35 approximately a 70% chance at a live birth.

What will I know about potential genetic offspring and what will they know about me? 

When you join Cofertility, you'll choose between two contact options:

• Disclosed donation: You meet the family (virtually or by phone) before finalizing the match. The relationship afterwards develops according to both parties' preferences.
• Undisclosed donation: You match without meeting the family and communicate only through Cofertility, with no contact information exchanged. If both parties agree, we can facilitate a phone or video meeting in which you can speak without sharing names.

In the case a donor-conceived child experiences a serious medical condition, you may need to provide medical information to us, the fertility clinic, or the intended parents. Also, if new information comes up about your medical history, we’ll need you to let us know. The intended parents are required to do the same. This is in everyone’s best interest so everyone can be made aware of unknown medical conditions that occur.     

Based on psychological research, we encourage families to be open with children about their conception story. As donor-conceived children grow up, they may become curious about their genetics and wish to connect. This is something to carefully consider before joining the Split program.

What Split members say about their experience

We recently surveyed Split members about their experiences. Here’s what they said:

• Strong preference for egg sharing: 88% of respondents said they were more motivated to donate eggs through egg sharing than through traditional cash compensation. Many expressed feeling more comfortable helping a family while preserving their own fertility options.
• High satisfaction rates: 97.4% of members agreed or strongly agreed that regardless of their own family-building journey, they were glad to have participated in the Split program. This exceeds industry standards compared to similar programs in other countries.
• Evolving motivation: Many members noted that while they initially joined for the free egg freezing benefit, meeting the intended parents shifted their perspective. As one member shared: "I initially started this process mostly thinking about the free egg freezing benefits for myself, but after virtually meeting the IPs I am donating to, it made me so much more excited for that part of the process, and that I'm able to help such a great couple start a family of their own."
• Practical value: Members frequently mentioned appreciating the financial accessibility of fertility preservation. As one participant noted: "It really is problematic that your eggs are most viable when you have the least in your bank. This Cofertility split program has given me the chance to secure my eggs while they are still viable without worrying about cost, and the bonus is that I get to help a family in need as well."

Summing it up

Freezing your eggs—especially when donating half—is a huge decision. We hope this overview provides a solid foundation to help you determine whether the Split program aligns with your values and goals. Our team remains available to address any additional questions as you consider this option.

Read more:

• Should I Freeze Eggs or Embryos?
• Does Donating Eggs Affect Your Fertility?
• Will I Regret Donating My Eggs?

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. 

Freezing your eggs is a big decision — one that we know, first-hand, can take time to think through — and freezing and sharing your eggs with another family is an even more weighted one. With our Split program, you can freeze your eggs for free when you give half to a family who can’t conceive. But beyond that, there’s even more that will come out of your Split program journey. 

By freezing your eggs with Freeze by Co’s Split program, you’ll get to:

1. Invest in your reproductive future

Having kids may be way off your radar today. But if you might want children one day, freezing your eggs may help keep that possibility on the table. We believe in making that possibility as accessible as possible. 

2. Do something life-changing for another family

By giving half of your eggs to another family who can’t conceive — whether it’s a couple with infertility, LGBTQ+ parents, or parents with other medical challenges — you’re making their family-building dreams possible. And that’s something truly incredible. 

3. Empower yourself with knowledge about your body

By freezing your eggs, you’ll get an insight into the hormones and ovarian reserve levels that make up your fertility health. 

4. Gain access to your own genetic family history

Once you match with a family, all Split members undergo genetic testing. This knowledge about your genetics could be super important down the line if you start to think about having kids. 

5. Receive concierge-level support throughout the process

If you’re part of our Split program, we’ll hold your hand every step of the way. With direct access to our founders and our community of other women going through the process at the same time,  you’re never alone. 

We’re so excited for you. And remember, we’re always here to help. 

Perhaps the idea of egg freezing is something that you’ve thought about before. For many of us, though, the cost can be a big barrier. You might be hoping to find an affordable egg freezing program that can allow you to freeze your eggs now and store them without breaking the bank, as you pursue your own agenda.

Is this just a pipe dream? With Cofertility, it’s actually…not. Read about how our platform can enable you to give the idea of egg freezing another look, with — wait for it — free egg freezing. And you get to help a family along the way.

A win-win innovation

Egg freezing can cost upwards of $15,000-$20,000, and that doesn’t even count years of storage. We started Cofertility with the dream of giving women more options. That led us to develop what we call our Split program.

With the Split program, if you are eligible, the premise is simple: for each cycle you undergo, you keep half of the eggs for yourself at absolutely no charge, plus ten years of storage and any travel. The other half of the retrieved eggs go to another family who can’t otherwise conceive. The families we help include couples facing infertility, cancer survivors, and gay dads. 

What you get as a Split member

In addition to giving a life-changing gift to another family, as a Split member, you are entitled to the following for free with your egg freezing cycle:

• Care from a board-certified fertility doctor
• Support from one of our Member Advocates
• Access to our community 
• Fertility testing
• Genetic testing
• Any necessary medication
• The egg retrieval
• Egg freezing and storage for 10 years
• Procedure insurance
• Travel

In addition to lightening your own financial load, the good you’ll be doing will be immeasurable.

Am I eligible for the Split program?

To participate in Split, you must meet certain industry- and government-based criteria, including: 

• Age: Between 21 and 33 years old (consistent with ASRM guidelines). Age is a factor that contributes to waning fertility, which, while not true for everyone, tends to decline at age 35. Since the process leading up to egg donation can take time, we cap the program at age 33, as consistent with guidelines set by the American Society for Reproductive Medicine (ASRM). 
• Ovarian health: Possess two ovaries and have no reproductive issues or genetic abnormalities.
• BMI: Between 18 and 29 for optimal medication and retrieval outcomes. Read more about BMI here.
• Lifestyle: Non-smoker and no recreational drug use.
• Health: Good physical and emotional health.

If you meet these requirements, you could be a great candidate for the program. 

Read more in What are the Qualifications for Joining Our Split Program?

Getting started

To find out if our Split program is a way that we can help you reach your egg freezing goals, here’s how the process works:

1. Take our quiz to see if you qualify

First, take our brief quiz to learn more about our Split program and see if you’re a potential fit. It just takes a few minutes. 

2. Apply for join

Then, if you’ve pre-qualified, you move on to the application process. This is your chance to tell us more about your background and create a profile for intended parents to see and hopefully connect with. It will also help finalize your acceptance into the program.

3. Meet with our team

Next, we chat. You get to ask us any questions about the process and get to know us, as we get to know you as well. We’ll walk you through all program logistics and frequently asked questions so you feel completely comfortable with it all. 

4. Screening

During the screening phase, we’ll get a sense of your ovarian reserve and overall physical health to get a sense of whether you’ll have enough eggs available to fairly split for yourself and the intended parents. If your ovarian reserve appears strong enough that splitting the retrieved egg yield has the chance to result in a live birth for both parties involved, and you continue to qualify based on the other physical and psychological screening factors, you’ll be given the final green light.  

5. Find a match

Once you’ve been fully accepted into the program, the matching process begins. When your profile has been selected by intended parents, you’ll have the opportunity to accept the match. If you agree it’s a good fit, then the screening and freezing process can begin.

6. The cycle

Now it’s all about your cycle. This means you’ll start taking injectable medications needed to enable your ovaries to produce multiple eggs. We have loads of materials that can help you successfully manage this.

After close monitoring, when the time is right, you’ll be scheduled for the egg retrieval. During this 30-minute process, the doctor will remove the eggs with the aid of vaginal ultrasound while you’re under light anesthesia.

7. Free storage begins

Then, right away, your half of the eggs will be frozen. As a Split member, this whole process will be entirely free, including up to ten years of storage. In the case of an odd number of eggs, the extra one will be slated for use by the intended parents. However, we ask our clinic partners to save any non-mature eggs retrieved for you, since we don’t know what kind of medical advancements might take place over the next ten years. 

As a Split member, if you feel that it would be beneficial for you down the line, you can always consider doing another cycle. This will allow you to add to what you already have in storage and reap the benefits of additional free egg freezing, making the most of the program.

Why choose split?

• Affordable egg freezing: Eliminate the financial barriers to preserving your fertility.
• Help another family: Give the gift of parenthood to a family in need.
• Comprehensive support: From testing to storage, every step is covered.
• Flexibility: You can undergo multiple cycles to increase your egg reserve.

Adding it up

Our Split program puts egg freezing in reach for all members. It removes what are often the biggest obstacle to taking charge of your fertility timeline — cost — while allowing an opportunity to help another family. 

Once you’ve completed the Split program, you can walk away knowing that not only have you figured out a way to make your goal of storing eggs a reality without the need for scrimping in other areas, but you’ve also succeeded in giving another family a golden opportunity they wouldn’t have had otherwise.

Read more:

• Is Egg Freezing Safe?
• Researchers Followed 921 Egg Freezers; Here’s What They Found
• How to Increase Egg Freezing Chances of Success
• Does Donating Eggs Affect Your Fertility?
• What’s the Best Age to Freeze My Eggs?

Freeze by Co’s Split program allows you to freeze your eggs for free when you donate half of your eggs retrieved to a family that otherwise can’t conceive. It’s a true win-win. But in order to start your freezing process, you first have to match with a family. The sooner you complete your application (and the more robust it is!), the sooner you’ll match and the sooner your own journey can begin. To jump start your process, we wanted to share a few tips on how to fill out your Split application and let your personality shine.

Tip #1: Be yourself! 

We’re frequently asked what kinds of Split members our intended parents (IPs), or Family by Co members, are looking for. The truth is that our IPs are as diverse as our Split members. Each is coming to us looking for a unique match. 

While some IPs are hoping to match with a Split member of a particular ethnicity, others are most interested in matching with someone with shared interests. Ultimately, IPs want to match with someone who they feel connected to as a person. That’s why our application tries to get at the heart of who you are from a variety of dimensions. 

Tip #2: Share your motivation for joining Split

While your interest in egg freezing and egg donation may seem obvious to you, we want to be able to showcase that to our intended parents. They’re drawn to our unique model and love that all of our Split members are incredible, ambitious women who are motivated to preserve a portion of their reproductive future. And IPs are excited about empowering the next generation to own their family-building timelines. 

As such, we encourage you to elaborate as much as possible on why you’re interested in the program. This includes why you want to freeze your eggs (Are you in grad school? Are you gunning for a promotion? Are you just not sure that you want to have kids?) and why you’re interested in donating. No detail is too small. Trust us when we say that it all comes together to paint a picture of why you make an incredible donor. 

Tip #3: Play up your achievements

We get that it can feel uncomfortable to brag about yourself. But your Split application is one instance in which we want you to lay it all out. We — and our IPs  — are continually in awe of how impressive our Split members are. From active community service volunteers to professional award winners, we want you to underscore your achievements. While you might be wondering why winning an award for your undergraduate thesis is relevant to an IP, remember that there may be a family on the other side of our matching platform searching for a Split member with a knack for writing. 

Tip #4: Share photos (or videos!)

The photos you share also help IPs gain a better understanding of you throughout your lifetime. While you’ll want to submit some photos with a clear, head-on view, don’t be afraid to include pictures that showcase your hobbies or passions. Avid hiker? Let’s see you on your favorite trail! Proud dog mom? We want to see your little furball. If you’re waiting on your family to send you childhood photos, note that you can always submit your application without those and add them at a later date. In general, we recommend including at least one baby photo, one childhood photo, one pre-teen photo, and 5 recent photos.

You also have the option of filming a video that will be visible to intended parents. This can showcase your personality, your interest in the program, and your hopes and wishes for the family who you ultimately match with. If you’re interested in submitting a video, let us know.  

If you go this route, consider the following dos and don’ts:

Do’s:

• Explain why you’re interested in the Split program - why are you excited about freezing and donating eggs?
• Share a message with intended parents - what do you want them to know? 
• Shoot the video horizontally
• Keep your video less than 4 minutes and in mp4 format
• Ensure your video is clear with good lighting. Natural light is best so if you can shoot near a window or in the shade outside, that’s ideal! 
• If you have a phone tripod, consider using it for stability. Otherwise, propping your phone up on something else is okay! 

Don’ts:

• Use your last name or other identifying information 
• Avoid filming in any loud or public places

Questions? Reach out

As you’re working through your application, don’t hesitate to reach out to our team with any questions. Our number one priority is ensuring you feel comfortable with the process. That, and helping you shine! 

Our goal at Cofertility is to match intended parents with Split members who can help them achieve their goal of parenthood.  Because of that, we want to make sure we’re upfront about what might disqualify someone from our Split program. 

Through this program, you can freeze your eggs for free if you donate half to a family who can’t otherwise conceive. But, importantly, several factors may limit your eligibility.  Some of these are official disqualifiers based on regulations by the Food and Drug Administration (FDA). Others are discretionary disqualifications based on recommendations by governing bodies like the American Society for Reproductive Medicine (ASRM). 

While it’s not possible to create an exhaustive list of every reason someone may not qualify for our Split program, this guide outlines some of the most common reasons for disqualification.

Age

To apply to be a part of the Split Program, you must be between the ages of 21-33. This is because you’ll need to complete your retrieval before you turn 35, so because the process can take some time, we don’t accept applicants who are 34 or older. 

The reason for this age limitation is because data shows that, on average, those over 35 tend not to respond to fertility medication as well and therefore may not produce as many eggs. Also, research shows that, unfortunately, egg quality declines with age. Various factors may affect your cycle timing (application paperwork, time to match with a family, and more) and you will need to cycle before you turn 35. We’d hate for someone to apply, get accepted, and then when the time comes for the cycle itself, potentially age out.

If you are 34-39, you are still eligible to participate in our Keep program. With this program, you can freeze your eggs and keep 100% of them for yourself. 

If you are under 21 and you’d like to participate, please reach out and we’ll get back in touch after you turn 21. 

Health-related factors 

As a preliminary step in the process, we’ll review several health-related factors. 

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, and this situation would be communicated to potential match families. 

Additionally, you’ll need to have a BMI of 18-29. Those outside of this range are at increased risk of complications, negative outcomes, and negative side effects from hormonal medications or an egg retrieval. 

You will not qualify if you’ve had a sexually transmitted disease within the past 12 months (but 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 disease or medical conditions. Same goes if you’ve ever had a blood transfusion. 

Medical and family history

We will also review your and your family’s medical history. Unfortunately, this means that if you are adopted and cannot confirm your biological family’s medical history, you will not qualify. 

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

• Cancer
• Heart/blood disease
• Neurological diseases
• Mental health disorders
• Thyroid disorders
• Genetic disease
• Fertility issues
• Reproductive disease
• Autoimmune disease
• Respiratory disease
• Metabolic disease
• Gastrointestinal disease
• Kidney disease
• Birth defects

We review your personal and family medical history as a whole with our medical advisors. 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

There are also some psychological questions you’ll have to answer. We don’t expect you to be perfect. But note that certain psychological factors may be more likely to disqualify you than others. 

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, we will exclude those with a personal or first-degree (parents, siblings, offspring) family history of: 

• Bipolar disorder
• Borderline personality disorder
• History of alcoholism or drug abuse
• History of suicide attempts
• Mood disorder
• PMDD
• Schizophrenia
• Schizoaffective disorder
• Severe depression

Genetic screening

As part of the process, you’ll also be required to do genetic testing via blood test or saliva sample. This helps ensure that embryos resulting from your eggs will 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 we find that you have a copy of a gene that can lead to cystic fibrosis, spinal muscular atrophy, or thalassemia, this may or may not disqualify you; it can depend on the clinic and genes of the intended parents. 

In line with ASRM guidance, in most conditions where carrying one copy of a particular gene won't impact the child themselves, you can still qualify for the Split program. 

Physical screening

In addition to genetic screening, you will have to undergo a physical screening to ensure you are physically healthy and producing a good number of eggs.  

Some disqualifications here are set in stone by the Food and Drug Administration (FDA). If evidence of any of these conditions arises, you will be considered ineligible for the program. These are considered to be non-negotiable.

• HIV
• Hepatitis B
• Hepatitis C
• Human transmissible spongiform encephalopathy
• Treponema pallidum

The following could also be deal breakers: 

• Issues with your ovaries, such as having only one ovary
• Hormone levels outside of recommended limits with concerns about your ability to produce sufficient eggs
• Any issues that would make the egg freezing and donation process risky for your health
• Evidence that you are at high risk of getting a sexually transmitted disease or could already have one. Doctors will look for discharge or ulcerative lesions for this purpose
• Indicators of possible drug use (needle tracks, for example) or exposure to needles in non-sterile conditions—including recent piercings or tattoos within the past 12 months

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; eventually, it drops so low that 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 your AMH < 2, you are ineligible for our Split program. We only accept Split Members with these higher AMH levels 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’s important to note that, even with a high AMH level, there is always a chance that you need to do another cycle to improve the odds of a live birth. In the Split Program, you will receive AMH-reading bloodwork prior to being activated on our platform. 

If it turns out that your AMH levels are below the required minimum threshold, you would unfortunately be ineligible to move forward with egg donation. However, we can still help you freeze your eggs for your own future use through our Keep program.

State-specific qualifications

Some states do maintain their own 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

Lastly, there are a few additional factors that, unfortunately, would disqualify you from our Split program. These include if you:

• Have served jail time for more than two days within the previous 12 months
• Have undergone body piercing and/or tattooing within the past twelve months in which sterile procedures may not have been used
• Have the highest education level of GED
• Have Indigenous American ancestry and are associated with a tribe — this is due to the Indian Welfare Act 
• Currently use any nicotine products regularly, since the ASRM has confirmed an association between smoking and decreased fertility — if you engage in vaping, you will need to quit for 2-3 months before re-applying for Split, but if you only vape occasionally/socially, you will need to quit for one month prior to your retrieval date

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.