WHAT IS EGG FREEZING?

HOW EGG FREEZING WORKS

Egg freezing is the process of stimulating your ovaries to release eggs and retrieving them for storage (OOCYTE CRYOPRESERVATION). Eggs can be stored for unlimited time without compromising their quality. However, the woman’s age when starting egg freezing. Generally the best age to start egg freezing is 35 years old or younger. After 42 years old, your egg quality & quantity decline significantly, and your chance of success is very slim.

Each cycle, you will be able to retrieve 10-20 eggs. Even with this number, the chance of having 1 baby is only 80-90% (Many of the eggs don’t have good quality; or implantation may not be successful, etc.) So if you plan to have multiple children, you’ll have to do multiple egg retrieval cycles accordingly.

WHEN TO FREEZE YOUR EGGS?
Between the age of 30 and 34, the quality of eggs doesn’t vary much. You don’t have to start storing your eggs super early, keeping in mind that the cost of storage per year is about $1000. After 35 years old, the quality & quantity of eggs drop precipitously every year. It is advisable to start the process before 42 years old.

All egg freezing facilities in my city (Los Angeles) had a 3 month waitlist (wow!). I booked my appointment at UCLA, and then they had a cancellation & spot opening up, so I was able to see the doctor after 1 month. Apparently this is a highly demanded procedure nowadays.

HOW TO PREPARE FOR EGG FREEZING PROCESS

Here’s the sheet that my doctor at UCLA gave me:

Basically no alcohol, caffeine, no vigorous exercise while doing the stimulation! I’ve added the following to my daily routine:
– Actif Prenatal Vitamin: this is very good all-around daily multivitamin for women who are going through IVF or planning to get pregnant. My doctor told me to take it from the very beginning.
– Actif Fertilmax : this helps improve egg quality and ovulation.

– Gatorade (zero sugar): to provide electrolytes like Ca++, Na+.

COST OF EGG FREEZING

The cost of egg freezing process in 2022 in Los Angeles is $14,800. This includes all office visits, medications, egg retrieval at UCLA hospital. This does not include egg storage fee of $550/year. Most insurance do not cover any part of the cost. Some companies may pay for egg freezing and IVF as part of your benefits package. This is about $2,000 cheaper than private clinics.

This is the breakdown of what I paid at UCLA hospital as of late 2022:

– First consultation with OB doctor: $700
– Blood work before starting cycle: $302.5
– Ultrasound before starting cycle: $979.3

– All consultations & tests during cycle: $4,000
– Medications: $4489.06
(Including: First pickup with all meds for 5 days: $2,097.5. First Refill 4 Menopur: $367.96. Second Refill all meds: $2023.6 )

– Blood tests: $294.5

– Egg retrieval: $4,071

– Storage fee: $750 for the first year. If you pay for 10 years instead, it’s $550/year.

HOW LONG DOES IT TAKE?

The whole process may take 15-21 days, from the start of your cycle to egg collection day. You can still work as normal, but you’ll have to see your OB doctor every other day for ultrasound and blood tests.

HOWEVER, what I didn’t know is that I need to be off birth control before starting the process! So during my first consultation, my OB doctor basically told me to get off birth control for 2-3 months, and come back later to start.

WILL I HAVE TO TAKE MEDICATIONS?

Yes! Below are my meds for 1 cycle. Total bill was $2,097.5.
– Menopur
– Ganirelix
– Follistim Pen for self-injection

– Actif Prenatal Vitamin
– Actif Fertilmax

Starting stimulation – with Menopur and Follistim

SUCCESS RATE OF EGG FREEZING

This paper (published in 2022) shows that the final live birth rate per patient is 39%. It means that 61% of people who go through egg freezing process don’t achieve any live birth, due to various reason, including unsuccessful thaw, irregular embryo development etc. This study was done at New York University Fertility Center from 2005 to 2020.

The age at which women freeze their eggs is a factor in success: Women who are younger than 35 have a 18% chance of having a baby when five eggs are frozen, but this falls to 7% if the woman is over 35 at the time of freezing.

The earlier you start egg freezing process, the higher the chance of having any live birth. To me, this shows the necessity of doing multiple cycles of egg freezing. Many women do only 1 cycle, with 10-15 eggs retrieved and achieve 0 baby.

HOW MANY WOMEN DO EGG FREEZING?
In 2022, the number of healthy women freezing eggs in the US was 15,000. This number continues to rise sharply at an estimated rate of 20% per year.

Here are some FAQ from UCLA Fertility Center:

WHO NEEDS EGG (OOCYTE) FREEZING?

Women with cancer requiring chemotherapy and/or pelvic radiation therapy that may affect fertility.

Surgery that may cause damage to the ovaries.

Risk of premature ovarian failure because of chromosomal abnormalities (e.g. Turner syndrome, fragile X syndrome), or family history of early menopause.

Ovarian disease with risk of damage to the ovaries.

Genetic mutations requiring removing the ovaries (e.g. BRCA mutation).

Fertility preservation for social or personal reasons to delay childbearing.

HOW IS EGG FREEZING DONE?

First, your UCLA fertility specialist may perform an assessment of the ovarian reserve to estimate the potential yield of oocytes prior to ovarian stimulation cycle. The assessment would include blood tests and pelvic ultrasound. This will also help to determine the necessary dose of medications. Ovarian stimulation is carried out in the same manner that is used with in vitro fertilization (IVF), using injectable hormonal medications. Following the stimulation, the oocytes and the surrounding fluid in the ovarian follicles are aspirated vaginally while under sedation.

The maturity of the eggs is assessed under the microscope, and those that are mature are cryopreserved. Currently, vitrification is the method of choice for cryopreserving oocytes, and this is achieved by ultra-rapid cooling into liquid nitrogen where they can be stored.

HOW WILL THE EGGS BE USED IN THE FUTURE?

When the woman is ready to use the frozen eggs to achieve pregnancy, these cryopreserved eggs are placed in warming solution and assessed. Those eggs that survived the freezing process are fertilized with intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into the egg, and the fertilized eggs will grow in culture until the embryo(s) are ready to be transferred into the uterus to achieve pregnancy, typically 3-5 days after fertilization.

WHAT ARE THE CHANCES OF A SUCCESSFUL PREGNANCY USING FROZEN-THAWED OOCYTES?

Clinical pregnancy rates have been estimated between 4-12% per oocyte. But since egg freezing is relatively new, more data will be needed to have a better idea on these success rates. In general, the two most important factors in determining the probability of a live birth are the woman’s age at the time of egg freezing and the number of available eggs.

ARE THERE EFFECTS ON THE OFFSPRING CONCEIVED FROM FROZEN-THAWED OOCYTES?

Available data comparing births resulting from previously frozen oocytes with those from fresh oocytes have not shown an increased risk of congenital anomalies. More long-term data, however, will be needed to further assess these risks.

WHAT ARE THE RISKS ASSOCIATED WITH THE OOCYTE CRYOPRESERVATION PROCEDURE?
Risks are similar to those associated with ovarian stimulation for IVF, which include small risks of ovarian hyperstimulation syndrome (enlargement of the ovaries and fluid accumulation in the pelvis and abdomen), infection, and bleeding related to the egg retrieval procedure.

HOW SUCCESSFUL IS IVF WITH FROZEN EGGS?