When is the best time to freeze your eggs? This is a very common question, but the answer is different for everyone. In general, the short answer is that we’d like you to freeze your eggs before 35, if you’re not planning on having a baby before you reach this age. In general, if you’re healthy, your cycles are regular, and you have no risk factors, we’d like you to freeze before age 35. The longer answer is more individualized. If you’re asking this question, give yourself a pat on the back, because you’re reading this blog now and getting more informed. One of the most important things to remember is that egg freezing is simply not for everyone. Freezing eggs can be great for some people and not the right choice for others, but it is a trending topic that many people of reproductive age are wondering about.
Egg Freezing: Making an Informed Decision
I feel that you (and all of my patients) deserve to have a lot of information about egg freezing if you’re asking this question. Detailed information, like exactly how it’s going to feel, how much it’s going to cost, what does it mean for you, is essential to the decision-making process. The only way you can really, truly make an informed decision is to talk to someone who actually freezes eggs. Now some people might say, “I don’t want to go in and talk to a doctor. That feels like too much pressure.” You can do a lot of research online, but ultimately, if you’re really interested and you think you might want to freeze your eggs, you should talk to a doctor directly.
Having said that, before you go in, you should make sure you tell yourself that you shouldn’t feel pressured to freeze your eggs. Even if the doctor you see is great at freezing eggs and thinks you’re a great candidate for egg freezing doesn’t necessarily mean that it’s right for you. So again, I think doing some research online or talking to somebody who has been through it are good places to start. Ultimately, you should go in and see a specialist- someone who has a great reputation, who’s done a lot of egg freezing, and someone you’re comfortable with. It’s always nice to get a recommendation from a friend! Resolve.org is a great resource for getting a referral for a wonderful board-certified reproductive endocrinologist in your area.
Egg Freezing and Our Medical System
If you are coming to see me, I would say I’d love for you to freeze your eggs before you’re 35. I do see a lot of young women coming to see me way before then, but I don’t think that’s too early. Our medical system is traditionally a disease-based system. A lot of people feel funny going in to see the doctor if they don’t have a problem or if it’s not time to get their procedure done. I think being proactive and learning about egg freezing ahead of time is a great thing. In fact, studies have shown that if we built this into the healthcare system, that if little girls and little boys knew about their reproductive health and their bodies way ahead of time, then they could make informed, reasonable decisions for themselves earlier in life. This helps them to avoid hearing a news article, having a panic attack, and saying, “oh my gosh, am I running out of time to have a baby? Should I run out and freeze my eggs? Is it an egg freezing emergency?” I don’t think that’s a great feeling.
It’s really nice seeing that a lot more young women are informed about their health, thinking about this, and coming in to see me way ahead of time. A lot of them come in to see me, we talk, we do an exam, we do testing, and then they leave and feel comfortable not freezing their eggs yet, but rather thinking, “well, I’m in a pretty good spot right now, but if things change or if a couple of years go by and I’m not where I want to be, and I don’t have a baby, I don’t have a family, maybe I should think about freezing my eggs then.”
When Do People Freeze Their Eggs?
Egg Freezing Before Cancer Treatment
What are some common scenarios where people should freeze their eggs? Number one- it’s standard of care for all women who have not finished their family (or are not sure they’ve finished their family) that are of reproductive age to think about freezing their eggs before any type of cancer treatment. Cancer treatment can often damage your eggs, and this is true for men too- it can damage your sperm. Radiation and chemotherapy, while potentially lifesaving, can knock out your eggs and sperm. The American Society for Reproductive Medicine and the American Society for Clinical Oncology want everyone to be informed about the option to consider freezing your eggs if you have a cancer diagnosis. It doesn’t make sense for everybody to do it, but it makes sense for everybody to at least get some information about it. Even if you’re not getting chemotherapy or radiation, the fact that most cancer patients need to get treated for the cancer and then wait until they’re cancer free for a few years to start a family means that you’re automatically much older at that point in your life. Age alone can dramatically impact your fertility. It makes sense for anyone with that kind of diagnosis to think about whether or not they want to freeze their eggs.
Egg Freezing for Those with Medical Issues
Anyone with systematic medical issues that would cause a delay in you having your family, or might possibly directly impact your eggs or your general health, should think about freezing their eggs. Again, there’s not a one-size-fits-all solution for everyone. However, I feel that if you’re thinking about it, this might mean you should take the next step and talk with a doctor about your options.
Egg Freezing and Delayed Childbearing
Everyone’s delaying childbearing these days, and there’s some controversy about why people are doing that. We feel, in general as a society, that people should get an education. They should graduate high school, go to college, and maybe even consider Grad school. We know that the more education you have, the better your income. Also, interestingly, the longer you delay childbearing, the higher your average lifetime income is. I’ve heard studies saying it can be a $7,000 to $10,000 a year difference in your annual income for every year you delay childbearing. That data makes me think that a lot of the gender wage gap is about childbearing, about the fact that women carry the babies and men don’t carry the babies. Delayed childbearing is really, really common in society these days, and I think egg freezing makes sense if you’re delaying childbearing. Not all of delayed childbearing is due to career reasons, though! Interestingly, a lot of people are delaying childbearing because they say they haven’t been able to find the right person to settle down with or the right person to have a family with. Whatever the reason, delayed childbearing is very common, and as you get older it becomes harder and harder to get pregnant and harder and harder to stay pregnant.
How Does Age Impact Fertility and Pregnancy?
With increased age, miscarriage rates go up, and issues like Down Syndrome (which is due to an extra chromosome) become more common. That is, we think, the mechanism for why it becomes harder to get pregnant and harder to stay pregnant as we age. There are higher rates of chromosomal abnormalities, like Down Syndrome, seen in older people’s pregnancies. It’s all related to the age of the egg- the longer they are in your body, the more likely you are (when you fertilize the egg) to see an extra or missing chromosome in the embryo. This is why freezing your eggs at a younger age seems to make a lot of sense, and seems to be a sort of insurance policy. It’s not a guarantee- we don’t have a 100% pregnancy rate for egg freezing. But if you freeze eggs when you’re younger than 35 and you use them when you’re older than 35, it does mean that your chances of having a healthy pregnancy seem to be improved and your chances of having infertility seem to be decreased. It’s not a guarantee of having a baby, but it does seem to allow you to maximize your chances of having a healthy pregnancy.
Financial Considerations for Egg Freezing
Some people will freeze their eggs and never end up using them. Freezing eggs does cost a lot of money, and is often not covered by insurance in the United States. It can cost thousands of dollars to freeze your eggs. To freeze one batch of eggs can cost $5,000 to $10,000, and patients often do better if they freeze two or three batches of eggs. At IRMS at Saint Barnabas, in our program, we find that freezing 18 to 21 eggs brings about a 90% (or a little bit more) chance of having one healthy baby.
Egg Freezing Success Rates
It’s possible that you could have more than one healthy baby from 18 to 20 eggs. However, given the current pregnancy rates, we find that every six to eight eggs gives us one to two really nice looking embryos or blastocyst, and each blastocyst is about a 40 to 50% live birth rate. Obviously, that changes depending upon your age. That number is going to be very different if you’re over 40 versus if you’re under 35. On average though, that’s what we’re seeing. If you do the math, that yields about a 90-something percent pregnancy rate for about 18 to 21 eggs in the freezer. On average, we see that during each egg retrieval procedure, we’re getting about 4 to 8 eggs, or half a dozen eggs. That means that a lot of people will need two to three retrievals to get 18 to 21 eggs.
When Should I Freeze My Eggs?
When should you freeze your eggs? In general, we’d like you to freeze your eggs before you’re 35. If you’re a smoker, we want you to quit smoking, and you probably have less eggs than someone who’s a nonsmoker. If you’ve had surgery on your ovaries, you probably have less eggs than somebody who hasn’t had surgery on their ovaries. If you’ve had abdominal or pelvic surgery, you might have less eggs than somebody who hasn’t had those surgeries. If you have shorter cycles (your cycles are closer together) and you’re getting your period every 25 days or less than that, then you might have less eggs. If you have your period less often, like every 30 to 35 days, you might have more eggs than average. That brings us to people who just don’t really get their period. Whether you’re thinking about freezing your eggs or not, you should see a reproductive endocrinologist and figure out why you’re not getting your period on a regular basis. Are there any health implications for that, and should you be doing something about that to keep yourself healthy?
Fertility and a Healthy Lifestyle, What’s the Connection?
Speaking of staying healthy, you can’t turn back the clock by being healthy. However, being healthy definitely still makes a difference. The biological clock still keeps ticking in the eggs and a healthy 40-year-old still has an increased risk for infertility and miscarriages. But a healthy 40-year-old is definitely much better off in terms of carrying a healthy pregnancy. So we do feel like being a healthy weight, getting regular exercise, getting good sleep, eating plenty of vegetables, avoiding sugar (all the things you know you’re supposed to be doing to stay healthy) are good for your eggs as well. Not just good for your general health, but also good for your eggs.
What Can I Expect When I See a Doctor About Egg Freezing?
What do we do when we see you? We talk with you. We find out about all these things, like are you a smoker? Do you have any health conditions that could lead to higher risks of having reproductive issues? Do you have a family history of endometriosis? If you have a family history of endometriosis, your risk for having endometriosis is much higher than the general population, and endometriosis can definitely impact your fertility. Do you have a family history of Polycystic Ovarian Syndrome? Polycystic Ovarian Syndrome is the most common hormonal or endocrinologic cause for irregular periods. You don’t necessarily have to have irregular periods in order to have PCOS, but if you have a family history of PCOS, you have higher rates of infertility. You also have extra eggs, because PCOS patients often have more eggs than average. If you have other fertility issues, you should probably come in and be seen by a reproductive endocrinologist. Do you have a family history of premature ovarian failure or premature menopause? That makes your risk for premature menopause higher. When you come in to talk to me, we’ll talk about all those things. Do you have those risk factors? Are there things in your life or in your family history, or in your personal medical history, that are going on that can affect your eggs? Then we talk about the process of egg freezing and we’ll tell you about the pricing for egg freezing.
We’ll do a full exam- heart, lungs, breast exam, and vaginal ultrasound. We’ll take a look at the ovaries, because looking at the ovaries in person gives me some idea of how you’ll respond to medications. We’ll do something called an AMH level, or Anti-Mullerian Hormone level. That will help me figure out how many eggs you have. A lot of people think that because IVF and egg freezing technology is so advanced, I can tell you a lot about your eggs. In reality, the testing that we do can really only say a couple of things. It can say, “you’re average for your age, you’re above average for your age, or you’re below average for your age.” The most predictive factor for egg freezing is age. So we can, without even meeting you or talking with you or anything like that, predict how good your eggs are just from your age. That’s why we say think about freezing your eggs before age 35.
I hope this has been helpful to you in terms of your thinking about egg freezing! Good for you for being proactive about your health. If you have any more questions about this topic or others related to reproductive health and fertility, please reach out to me and ask whatever is on your mind. I’m dedicated to keeping people informed about these important topics- you included!