Options. You may not be ready to be a mom yet but want to preserve that option. Egg freezing provides the greatest opportunity to have a baby using your own eggs instead of donor eggs in the future. Freezing your eggs is about giving yourself some peace of mind and minimizing stress, so you can pursue your goals. It’s okay, now we can hit snooze on that biological clock.
Yes. Numerous studies investigating the long term consequences of ovarian stimulation show little to no significant risk. Serious complications are rare. Most women report mild bloating and fatigue.
We recommend numbers of eggs based on your age, reproductive history, ovarian reserve and family building goals. Everyone is different and your unique situation will help us arrive at an appropriate number for you, but we generally recommend 20 eggs for women under 35 and more for women over 35. For older women, this may mean multiple cycles, depending on your ovarian reserve.
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When you’re ready, your eggs are thawed, fertilized with sperm, and ultimately transferred back to your uterus as embryos.
Cryopreservation places cells into a “glass-like state” where all biologic processes stop by rapidly changing the temperature to -196°C using liquid nitrogen. The cell can be maintained in this state for years without aging. Your doctor will determine a protocol that’s right for you. Bioidentical hormones are used to help the ovaries produce multiple eggs from multiple follicles. These eggs are then retrieved from your body and cryopreserved a few hours later.
A woman’s age at the time an egg is released is the single most important factor affecting fertility. Beginning in your 20s, there's a gradual decline in the ability to become pregnant. Around age 35, fertility begins to decline more rapidly. Freezing your eggs gives you more options for the future by preserving your eggs (and their current quality) today.
Two factors lead to this decline: fewer and lower quality eggs.
Fewer: eggs, unlike sperm, are only produced before a baby is born. At birth, a female is born with 1-2 million eggs. These eggs are called primordial follicles and are suspended in a state of partial maturity that is not completed until ovulation (often decades later). They are gradually released over the next 50 years. Total eggs remaining in the ovaries:
At birth: ~1-2 million
At puberty: ~400-500,000
At age 35: ~25,000
*Quality: While the total number of eggs available declines daily, egg quality also starts to drop as the long term effects of minor environmental damage add up. The cumulative effects of aging become apparent by your mid 30s, when eggs are more likely to produce chromosomal errors (called “aneuploidy”), leading to miscarriages and infertility.
Egg freezing (or 'oocyte cryopreservation') stops eggs from aging by placing them into a state of 'biologic pause' (vitrification) until a woman is ready to get pregnant. The health of those eggs is safely maintained at the age and time they were frozen.
Your uterus is amazing and is not affected by age the way eggs are. In fact, many women have conceived after menopause with donor eggs and a little estrogen to support the uterus.
Turns out, cryopreservation of eggs takes lots of expertise. Prior to freezing, the embryologist safely replaces all the water from an egg with cryoprotectants. S/he rapidly moves the egg cell through different solutions and then must freeze (vitrify) the eggs in 1 microliter of water (that is 1/1000 of a milliliter). The whole process is still done by hand, and the best protocols are still considered trade secrets. At Spring, we’re proud to work with the best embryologists who have the best equipment to innovate and improve existing protocols.
Everyone has different plans, and when egg freezing fits for one person might not be the right time for another. There's no clear answer and this is a personal choice, but we know that eggs are healthiest when women are in their mid 20's. This is when women have the most follicles and eggs free of chromosomal abnormalities. This is why most egg donor programs only work with women between the ages of 21 to 30.
Everyone has different reproductive horizons: some women go through menopause at 51 while others might have their last menses at 41. Freezing eggs can seem expensive for younger women who are earlier in their careers, but the process is actually less expensive when you are younger. Older women commonly need to do more cycles at a greater expense because they produce fewer eggs and require more medication.
The best way to decide on whether and when to freeze your eggs is to have an initial consult. During this 60 minute appointment, we'll perform a pelvic ultrasound and blood test to assess your ovarian function. Then we can discuss your treatment plan. The plan we choose depends on your unique situation. We want to understand your goals and concerns, and provide the best option for you.
This all depends on your “ovarian reserve” (or the number of eggs present in the ovaries at any given time). Younger women usually have more follicles (immature eggs) and can retrieve and preserve more good quality, mature eggs per stimulation cycle. At your first consult, a pelvic ultrasound with an antral follicle count gives us a good idea of how many to expect.
Again, this all depends on your age and antral follicle count, as well as your family-building goals. Some women retrieve all the eggs they need in one cycle. Others may require several cycles, especially if they think they might like to have multiple children when they’re ready. Your initial consult is the best way to get started. We’ll assess your ovarian reserve, and discuss your options. Together we’ll make a plan.
Since egg freezing is a relatively new procedure, there isn’t a lot of data on the long term storage of frozen eggs. Reports comparing eggs frozen for four years with those frozen for short durations do not show any adverse effects of longer storage. Animal studies and human embryos have shown good outcomes after over 20 years of being cryopreserved. So while we can never say with complete certainty, it seems that storage for up to 20 years can be both safe and effective.
Yes. Studies of over 5,000 children born from thawed/frozen eggs show no increased risk for congenital abnormalities or adverse pregnancy outcomes.
Your eggs are safe at Spring. Our building was constructed to meet or exceed modern seismic standards, including all California and local guidelines, and will easily withstand any anticipated tremors or quakes in the area.
In the event of a large and prolonged power outage, all of our critical equipment is connected to a large Uninterruptible Power Supply (UPS) system (with over 16,000 pounds of batteries!) located on site, so we are never subject to a power surge or failure. Our UPS immediately sends us an emergency alert and can maintain power for over 8 hours, allowing plenty of time to fire up our backup generator, which is also regularly maintained and tested. As with everything at Spring, we have backup systems for our backup systems, and we take nothing for granted.
Protocols can vary but egg freezing is typically a two week process involving:
1. 10-14 days of hormone stimulation, culminating in a final “trigger shot” 36 hours before the egg retrieval
2. Usually 5 monitoring appointments
3. The egg retrieval: a 20 minute procedure under sedation (you are asleep with an anesthesiologist present but you are not intubated or paralyzed)
Some patients may additionally benefit from two weeks of hormonal preparation prior to beginning stimulation. The addition of these medications helps follicles grow at the same rate to optimize the number of eggs retrieved.
Our goal is to obtain the greatest numbers of healthy eggs from your ovaries. The eggs begin in a small “antral” follicle in your ovary. Ovarian stimulation gently prompts these follicles to grow or “mature” a cohort of eggs. You will follow this process and can see how we measure your follicles during your monitoring appointments, which are usually 20-30 minute morning visits leading up to your retrieval. Based on the growth of your follicles, assessed via ultrasound, and hormone levels, assessed via blood tests, we adjust your medications and time your final injection, the “trigger shot” which causes the eggs to finally mature in preparation for retrieval.
Some patients report bloating and feel tired from the hormones. These effects are usually well tolerated and do not require treatment.
For the most part, no, though injections can cause minor irritation and discomfort. We'll provide instructions and tips to make it easy. During the retrieval, you'll be under anesthesia for 20 minutes. Most patients wake up with minimal discomfort or cramping that does not require additional medication. For the few patients who experience more severe cramping, rarely do they need more than Tylenol or ibuprofen (Advil).
The idea of giving yourself injections can be intimidating. While many people feel anxious the first or second time, hundreds of thousands of women have safely undergone hormone stimulation and find that they quickly get used to administering their own medications. Some patients have a friend or partner help with the injections. We also work with several nurses who offer home visits to administer nightly injections. Lastly, we can recommend a protocol with fewer shots for those who are still uncomfortable.
People ask this all the time and unfortunately, you’ll hear varying (conflicting) opinions from different people in and outside of our field. At Spring, we recommend a healthy, balanced diet with proper hydration. Avoiding highly processed foods and anything that doesn’t have nutritional value is always smart. Beyond that, be good to you!
Alcohol is fine in moderation (1-2 drinks per day) until 2-3 days before your egg retrieval. Abstinence is fine too. Many people find this a good time to pursue their healthiest habits.
Research suggests mild to moderate caffeine intake is not associated with any adverse outcomes. Up to 2 cups of coffee per day are not associated with any worse outcomes.
In addition to numerous other health risks, cigarette smoking is a reproductive toxin. It accelerates the loss of eggs and can advance menopause. Less is known about marijuana.
Yes, but we recommend using a condom as your follicles grow. You may have many eggs developing and toward the end be at a high risk of pregnancy if any ovulate before retrieval. We recommend abstinence the week before and after your retrieval, as the ovaries may be enlarged and sensitive.
Yes. Moderate exercise is fine until around day 5 of stimulation, then we recommend low impact activities like hiking, yoga, or walking. After your retrieval, we recommend taking it easy from strenuous activities for about a week.
Hot tubs are fine if you are egg freezing. They should be avoided after an embryo transfer.
Egg freezing doesn’t require isolation! For your convenience and peace of mind, you may want to be local for stimulation through retrieval. However, travel is fine, as long as you can make it to your monitoring appointments. If you need to be out of town for a few days, you can if necessary find a fertility center there to do a monitoring appointment or two. When traveling long distances, you can keep refrigerated meds in a cooler pack and the TSA should let you through airport security just fine (though if you’d like a doctor’s note, we are happy to oblige).
Every relationship is unique. We believe that egg freezing is a positive, practical choice, and that families and partners should be supportive. Many patients tell us that going through the experience with their boyfriend or partner actually made them closer, and that sharing with their family members gave them comfort too.
You know your workplace dynamics best. We’ve noticed that as egg freezing becomes more common (and even covered by some employers), more and more patients feel comfortable sharing their experiences at work which we think is great. Most report being pleasantly surprised at how supportive their colleagues are of this choice, and by how many coworkers have done this themselves. Practically speaking, many people like inform their work in case of scheduling commitments or the need to stay local around the time of the actual egg retrieval.
Come visit us at Spring Fertility for a consult. Just contact us to book and we’ll send you a questionnaire, so we can review your file in advance of our first meeting. Your insurance may require pre-approval in order to cover the cost of the consult.
Not ready for a consult? Come for a free info session. You can meet our team, tour our lab, and get more information about egg freezing. We’re here for any and all your questions!
Egg freezing is considered an elective procedure not covered by most commercial insurance plans. However, some policies do cover the initial consult and some of the medications, which our team can help you verify.
Professional fees are covered by most commercial carriers: Blue Cross, Blue Shield PPO, Aetna PPO, Cigna PPO. We also accept HMO with Brown & Toland Medical Group and Hills Physicians Medical Group and United Multiplan. The IVF lab and surgical center are not in network but most patients with IVF coverage have out of network benefits that cover most of these fees.
Many top employers in the Bay Area offer progressive fertility benefits to support their employees. Contact your HR department to see if yours does.