May 26, 2018

How does egg freezing work? | Future Family

Egg freezing is a very personal decision, and two words that often come up in the fertility health discussions are “anxiety” and “empowerment”. There are many reasons why women may feel anxious about freezing their eggs: from considering whether it’s the right step to understanding the process and health impacts.  At Future Family, we believe that the more knowledge you have, the more empowered you can feel about discussing it with friends and family, and the less anxious you will feel about next steps.

In our previous blog, “Is Egg Freezing Right for Me?”,  we discussed the initial questions that inevitably come up at the very early stages of consideration. Once you decide you want to do it,  there are the “unknowns” about the process itself–first steps, hormones, shots, effects on the body, timing, risks.

So, let’s address some of the unknowns.  One of the biggest and pressing ones is, “How many eggs will I need to plan the family I want?” The good news is there is now scientific research that can help you calculate the number of eggs you might need to have one, two and three children based on your age.

Understanding the process and gathering medical information will give you greater confidence to take next steps.

1. What's the Process of Egg Freezing?

The process can be broken down into the following four steps.

· Step 1: Stimulate the growth of eggs.

· Step 2: Trigger the release of eggs

· Step 3: Retrieve eggs.

· Step 4: Freeze eggs.

Step 1:  Stimulate growth of eggs.

Every month your ovaries have a number of follicles that could grow and release an egg. During natural ovulation, your body usually releases only one mature egg a month.  Daily shots of more follicle stimulating hormone (FSH) than you usually produce helps you keep more eggs growing and produce a higher number of mature eggs. Every few days, you go into the doctor’s office to safely monitor the growth of your eggs through ultrasounds. You also get blood tests done to check your estrogen levels.

Step 2: Trigger the release of eggs.

About 35 to 36 hours before your eggs are retrieved, you give yourself  a “trigger shot”. This is usually where many of us will need guidance and assurance! At Future Family, our dedicated Fertility Coaches, who are registered nurses who have helped thousands with fertility healthcare can guide you through this step over the phone. This shot literally triggers the release of your eggs.

Step 3: Retrieve eggs.

Using a small needle guided by a camera, your fertility doctor removes your eggs from their ovarian follicles just before they are released. The procedure takes about 10 to 20 minutes, and you will be under a light anesthesia–something similar to when you have dental surgery. Once your eggs are removed, your doctor puts them into a test tube and hands them off to the embryologist.

Step 4: Freeze eggs

The embryologist counts the number of eggs and identifies the best quality (mature) eggs–those eggs that are most likely to fertilize later. The embryologist then takes those eggs and freezes them to minus 196 degrees in liquid nitrogen, in a process called vitrification. Your eggs are now frozen and stored until you need them.

2.  Should I worry about whether the medications are bad for me?

There are definitely short-term side effects of the hormones. They can be from mild to severe, and somewhere in between.

This is a two-part question.  The first is about the short-term side effects of the medications during the process. The second is about the long-term effects of the hormones and whether they increase your chances of breast or ovarian cancer.

There are definitely short-term side effects of the hormones. They can be from mild to severe, and somewhere in between. They can make you feel moody and emotional in the same way that you might feel during PMS. You might experience breast tenderness, hot flashes or nausea. As your eggs grow, your belly can also become bloated, and the hormones can make you put on a few pounds. One of the biggest risks of the hormone injections is you could have too many follicles grow and your estrogen levels could get too high. This may create a risk of ovarian hyper-stimulation ­syndrome, which can cause more severe symptoms. But this happens in only two percent of cycles, and it’s why your doctor carefully monitors the process with blood tests and ultrasounds.

A number of studies on the long-term the impact of fertility medications found no association between fertility drugs and ovarian cancer. One 2013 study by researchers at the Mayo Clinic followed 1,900 women and concluded that women who used fertility drugs were not at an increased risk of developing ovarian tumors compared to infertile women who did not use fertility drugs.

The question, however, is whether the effects are different if you’ve used fertility drugs for a longer period of time or if you have a higher risk of cancer (for example, if you’ve tested positive for the BRCA 1 or 2 gene mutations).  A study in 2016 showed no increase in ovarian cancer in BRCA carriers who underwent fertility treatment.

A 2016 report by The American Society for Reproductive Medicine says there does not appear to be a meaningful increase of risk of invasive ovarian cancer, breast cancer, or endometrial cancer following the use of fertility drugs. The ASRM also advises that women who have diagnosed infertility tend to have a higher risk for cancer even though there is no found connection between the fertility drugs and this risk.  Image

3. How many eggs do I need to guarantee a baby later?

There are no guarantees, and this holds true even if you’re trying to make a baby naturally. But there is a 2017 study by researchers at The Center for Infertility and Reproductive Surgery at Harvard Medical School that can help you better calculate your chances. The researchers conducted the study to offer reasonable expectations. They concluded that it all depends on your age. Because the DNA in your eggs age and the egg quality decreases, older women tend to require more frozen eggs to have a baby than younger women.

The study predicted the likelihood of having one, two or three children based on your age and the number of eggs retrieved, frozen and successfully thawed.  The predictive model they developed is based on a population of women with a normal amount of eggs for their age group.

For example, a 28-year-old woman who freezes 20 eggs, has a 94 percent chance of having a baby from those eggs. A 34-year-old woman who freezes 20 eggs has a 90 percent chance of having one baby, a 66 percent chance of having two babies, and a 15 percent percent chance of having three babies. The chances of one baby, two and three babies for a 37-year-old woman who freezes the same amount drops to 75 percent, 39 percent, and seven percent, respectively. For a 42-year-old woman, the rate drops to 38 percent, 15 percent and one percent, respectively.

The researchers noted, however, that this prediction depends on a number of factors, including you and your partner’s health, the number of children that you imagine having, and your level of comfort with risk. For example, some women feel comfortable having a 50 percent likelihood of a live birth from frozen eggs while others may not want to freeze eggs unless the chances are much higher.

4. How Do I Store My Eggs and How Much Does it Cost?

Freezing your eggs costs anywhere from $12,000 to $15,000 for the process, and this does not include storage. When creating your egg-freezing budget, you should factor in storage fees per year.  Storing your eggs depends on your clinic and the prices vary. Some clinics offer both short-term and long-term storage. The cost varies depending on where you live and how your clinic is set up for storage. The majority of clinics charge between $500 to $750 per year. There are few clinics that cost less and a few that cost more, so it’s important to research your options.

Understanding the process and gathering medical information will give you greater confidence to take next steps.  The questions above are by no means a comprehensive list–there are other questions that may come up as you speak with doctors and understand more about your own biology.  Get in touch with us–our team is committed to answering any other questions you may have and guiding you through the process.

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