Everything You Need to Know About Egg Freezing

Celebs such as Chrishelle Stause, Kaitlyn Bristowe, Mindy Kaling, and Kourtney Kardashian have all been outspoken about freezing their eggs in recent years — and it turns out they're onto something.

Egg freezing has become an increasingly popular option for many people as they decide to delay having kids for a variety of reasons, including lack of a partner, wanting to focus on their career, or not being ready to take on the financial burden of raising children right now. In fact, the number of total egg-freezing cycles in the U.S. has gone up by more than 104 percent since 2009, according to a report from the Society for Assisted Reproductive Technology.

If you've ever looked into freezing your own eggs, you know that it can be quite a confusing process. (It takes how long — and costs that much?!) Here's a useful primer guide that breaks things down for you.

Why You Might Freeze Your Eggs

"Multiple reasons exist for egg freezing," says Kecia Gaither, M.D., double board-certified doctor in ob-gyn and maternal fetal medicine and director of perinatal services and maternal fetal medicine at NYC Health Hospitals/Lincoln in the Bronx, New York. "The ultimate reason is to delay childbearing but allow women to preserve their fertility in lieu of an anticipated [fertility] decline."

Egg freezing allows anyone born with ovaries to preserve their eggs at a time when those eggs are likely to be at their healthiest, explains Cindy Duke, M.D., Ph.D., dual-certified ob-gyn/virologist and fertility specialist.

FYI: Studies show people who freeze their eggs before age 35 have a better chance of having a successful pregnancy in the future than people who freeze their eggs after age 35. (That's because as you age, not only does the number of your eggs decline but so does their quality, says Dr. Duke.)

"This provides younger women, or women with health conditions, the ability to preserve their unfertilized eggs until they are ready to pursue parenthood," she says.

Some of the common reasons why you'd want to delay childbearing and freeze your eggs, says Dr. Gaither, include:

• You have education or career goals you'd like to achieve.
• You haven't found the right partner.
• You've been diagnosed with cancer or a condition such as endometriosis, where the disease and/or treatment could impact your ovarian function.
• You don't feel psychologically or financially equipped to raise a child right now.
• You're unsure if you want to have a child, but would like to safeguard the option

"Ultimately, the benefits confer protection of healthy eggs until such a time as the woman deems 'right' to conceive," says Dr. Gaither.

The Egg Freezing Process

Most of the confusion around egg freezing has to do with the process. Here's what it really involves.

Phase 1: Diagnostic Testing and Planning with Your Doctor

During this first phase of the egg-freezing process, your doctor may run ovarian reserve testing, which can include a combination of tests, says Dr. Duke. One common test is a blood test that measures the levels of specific hormones related to fertility, such as follicle-stimulating hormone (FSH), estradiol, and Antimüllerian hormone (AMH), according to the American Society for Reproductive Medicine (ASRM). As part of ovarian reserve testing, your doctor may also have you take a medication called clomiphene citrate, which is used to help stimulate ovulation, for five to seven days. The results of this test can help your doctor evaluate how well your body might respond to fertility drugs.

Another type of ovarian reserve test is a transvaginal ultrasound that counts the number of small follicles (2–10 mm in size) in your ovaries. (ICYDK: Follicles are small sacs of fluid on your ovaries that contain developing eggs.) This can tell you how many eggs you have and what your response will be to gonadotropin medicines, which contain FSH, the main hormone responsible for producing mature eggs.

"The first step can take an uncertain amount of time as your doctor has to do testing on specific days of your menstrual cycle," adds Monte Swarup, M.D., board-certified ob-gyn and founder of HPD Rx. "The goal of this phase is to determine how many eggs you will produce that can be frozen."

Note that no ovarian reserve test can predict your ability to get pregnant or how many fertile years you might have left, according to the ASRM — but these tests can give your doctor insight into how likely you might be to get pregnant compared to other people the same age as you. Plus, keep in mind that you might show falsely low levels of AHM if you take the birth control pill or other forms of hormonal birth control.

Phase 2: Preparing for Egg Extraction

This stage is when you'll begin to get daily hormone injections to help your body produce more eggs, a phase that will last around two months.

"The goal is to increase the odds that the follicle on your ovaries produce eggs and that they mature properly," says Dr. Swarup. "Your individual body and your cycles determine the schedule for achieving this phase."

For a week or two, you'll inject yourself once or twice a day with follicle-stimulating hormones or hormones that prevent premature ovulation — or you can also have a friend or health-care provider do the injections, says Dr. Swarup.

"You will be visiting your doctor frequently to do pelvic ultrasounds and blood testing to check your hormone levels," he says. "The tests help determine proper dosing and your [egg extraction] surgery's eventual timing."

When your follicles are large enough, you'll get what is known as a "trigger" shot. This shot has to be done at a very specific time and helps the eggs to maturity so they can be retrieved, says Dr. Swarup. A trigger shot contains human chorionic gonadotropin, a hormone produced by the placenta and typically found in early embryos, as Shape previously reported.

Phase 3: Retrieving Eggs Surgically

Next, your doctor will surgically retrieve the eggs 36 hours after your trigger shot. This is an outpatient procedure done at your doctor's office — usually with sedation so you're conscious during it, says Dr. Swarup. It typically takes 15–45 minutes, he adds.

"Your doctor will use a needle, which is guided by an ultrasound that suctions the fluid from your follicles," says Dr. Swarup. "The goal is that the follicles each contain an egg that is mature."

Dr. Swarup says recovery is minimal and that you'll probably be able to work the next day. "Most women feel pain-free and normal within a few days," he says.

Phase 4: Freezing and Storing the Eggs

Immediately after your doctor surgically retrieves the eggs, they'll pass the fluid from the follicles to an embryologist to see if there are any mature eggs, explains Dr. Swarup.

"The mature eggs will be frozen or cryopreserved," he says. "The labs use a process of fast freezing called vitrification. The eggs will be frozen in your fertility clinic until you want to use them."

Phase 5: Returning to the Clinic to Thaw and Use the Eggs

Decided it's time to use your frozen eggs? They'll need to survive being thawed; the overall survival rate of thawed eggs is 79 percent, according to a review spanning 15 years of patient data (although this can vary based on age, genetics, medical conditions, and other variables). Next, eggs must be fertilized successfully with sperm from a partner or a donor to become an embryo.

At this point, embryos will undergo genetic testing to make sure they have a normal chromosome complement and thus are most likely to result in a healthy pregnancy and baby, which is necessary for a viable pregnancy, says Dr. Swarup. Doctors will scan for abnormalities caused by too many or too few chromosomes in the embryo's DNA.

Once the embryos are deemed viable, "the final step includes the embryos being transferred and implanted back into the uterus for a healthy pregnancy and a live birth," he concludes. An embryo transfer, BTW, is usually done at your doctor's office in an outpatient procedure within two to five days of your egg retrieval.

How Much Does It Cost to Freeze Eggs?

How much freezing your eggs costs will depend on where you live. But the typical cost is anywhere from $30,000–$40,000 for treatment and storage, says Dr. Gaither. This amounts to about $15,000 per cycle, with most people needing an average of two cycles to get enough eggs, she says.

"The majority of insurance companies do not cover the cost of the procedure, but there are more insurance companies now that will cover some portions," adds Dr. Duke. "So you just need to check with your insurance."

The Bottom Line

As you can see, there are real benefits to freezing your eggs — but it's a lengthy process that will cost you a pretty penny. And the older you are when you do it, the lower your odds it'll result in a successful pregnancy in the future. So ask your doctor how many eggs you need to freeze to give yourself a good chance at a baby, should you need to thaw them in the future, suggests Dr. Duke.

Choosing the right clinic is also key to upping your chances of having a baby down the line if you decide that's what you want. "Find out what their rate of 'oocyte cryosurvival' is," says Dr. Swarup. "This is the number of eggs surviving when they are warmed."

He recommends making sure this data is for the eggs the clinic has both frozen and warmed. "Look for a rate of at least 80 percent — a score of 90 percent is excellent," he says.