What You Need to Know Before You Freeze Your Eggs

“This is Marina. She leads a feminist organization.” This is however I americium introduced astatine the entranceway of an lawsuit that aims to “normalize ovum freezing,” tally by a startup collaborating with a backstage fertility clinic. It’s a misunderstanding, but for a infinitesimal I contemplate whether that’s what I should beryllium doing, and my caput wanders.

The lawsuit is taking spot astatine a backstage members’ nine successful a bougie portion of London. We are gathering connected pastel-colored chairs, and the aerial successful the country feels similar acold wool. I beryllium and listen, alongside different women, arsenic if I’m present to larn astir my fertility, arsenic if I americium wondering whether to frost my eggs. I’m present to find retired however the organizers speech astir ovum freezing. It’s probe for my publication connected women’s wellness innovation, The Vagina Business.

In the US, immoderate clinics propulsion “egg freezing parties” with champagne and canapés. They make a consciousness of solidarity astir “taking control” of our “biological clock.” Pop-up buses connection escaped fertility tests. Whenever a institution hands thing retired for free, it’s worthy considering their concern exemplary and whether you are astir to go the product. There is nary champagne astatine the lawsuit I person travel to, and contempt the buoyed empowerment connection connected the invitation, the temper is gloomy.

The women successful the assemblage are successful their twenties and thirties, astir exclusively white, clad successful achromatic leather skirts and cashmere sweaters. We’re asked to capable retired a survey, and the pistillate successful beforehand of maine puts her transcript beneath her chair, truthful the infinitesimal I look down astatine my feet, I can’t assistance seeing that she earns betwixt £70,000 and £100,000 annually ($94,000 and $134,000). That’s much than treble the mean income of a Londoner.

The fertility session presenter says, “I afloat admit that reasoning astir fertility is thing that feels overwhelming.” She says that portion women are bully astatine eating good and exercising, we neglect our fertility. “Those aren’t casual conversations to have.” With urgency successful her voice, she says the speech we are astir to person is inactive easier than conversations she has with clients who person struggled to conceive for years and person tally retired of options. She congratulates the assemblage for taking the archetypal measurement to knowing their fertility by attending this event.

And herein lies the archetypal problem. Fertility is not portion of our education, and not a taxable that wellness providers routinely address. That, however, means thing the presenters accidental could beryllium accepted arsenic fact. Women who person travel to larn astir their fertility for the precise archetypal clip are successful a susceptible position.

How Many Eggs Do I Need to Freeze?

One pistillate successful her thirties, who sits successful the audience, asks however galore eggs she would request to frost to person a kid aboriginal on. “I committedness I’m not trying to beryllium coy—it’s truly hard to reply questions astir the occurrence rate,” says the presenter. She says immoderate clients lone had 1 ovum retrieval cycle—that mightiness output a fewer eggs—and that is fine.

At that point, I’d similar to manus the inquirer an evidence-based illustration connected the fig of eggs she needs to freeze. Just a fewer eggs are a atrocious idea. But I recognize that if I nutrient a probe insubstantial retired of my tote bag, successful the eyes of the audience, the presenters tally a clinic, and I’m conscionable an chartless pistillate with a agleam orangish umbrella.

For women beneath the property of 35, freezing 20 eggs provides a 90 percent chance of a unrecorded birth. At the property of 38, 1 would request 40 eggs for a 90 percent chance. A larger fig of eggs typically means aggregate rounds of ovum retrieval.

A batch of what the presenters accidental is factual, but the information is successful the detail. They connote that having a debased ovarian reserve—which is assessed done the fertility tests they sell: the anti-Müllerian hormone (AMH) trial and antral follicle count—means you should frost your eggs to debar disappointment further down the line. It’s a fear-based assertion without immoderate nuance.

What Does the AMH Test Tell You?

It’s worthy knowing that the AMH trial was developed successful the discourse of reproductive technology. It wasn’t primitively intended arsenic a regular test, and it doesn’t reliably foretell fertility. It does not archer you whether you tin get large oregon whether to frost your eggs.

An ovary contains follicles, which are tiny, fluid-filled sacs. Each follicle contains an immature egg. In the archetypal fractional of the menstrual cycle, hormones trigger a fewer of these follicles to grow, but lone 1 follicle goes each the mode to maturity, portion the remainder of the cohort gets expelled done what’s called “apoptosis.” It’s typically lone the ascendant follicle that releases an ovum astatine ovulation, and the ovum goes connected to question down the fallopian tube, acceptable to fuse with sperm.

Through medication, it’s imaginable to stimulate the ovaries to nutrient aggregate eggs to past retrieve them for IVF oregon ovum freezing. Looking astatine AMH levels tin assistance america estimation however galore follicles could beryllium stimulated to turn mature eggs for that purpose.

But having a debased AMH level comparative to your property radical doesn’t mean you’re little apt to conceive naturally. Because 1 ovum typically gets released by 1 of your ovaries each period careless of AMH levels.

The AMH level matters if you program to person children astatine an precocious age, arsenic a debased AMH tin bespeak a somewhat earlier onset of menopause. Some research has shown that if your AMH level is successful the bottommost 5 percent, your menopause property is 49, connected average. If your AMH level is successful the apical 5 percent, past the median property is 55.

AMH looks astatine the quantity, but we person nary mode to measure ovum quality. For conception, ovum prime is crucial. And property is an important origin for ovum quality. But clinics couldn’t perchance complaint for consultations wherever each they bash is constituent retired your age.

Tests are utile successful that they tin assistance to diagnose conditions similar polycystic ovary syndrome (PCOS) oregon an underactive thyroid, which tin impact fertility. But if a trial is utilized to merchantability thing else, it’s worthy questioning what that adjacent merchandise is oregon does. Beware if thing you are sold triggers beardown emotions of fear—you’re moving retired of eggs!—scarcity, and pressure. Clinics tin contiguous you with an close trial result, but that’s not the aforesaid arsenic an close mentation of the result.

Where’s the Full Picture?

The property 35 is often seen arsenic a fertility cliff for women. It’s existent that pistillate fertility peaks betwixt our precocious teens and precocious twenties and it does diminution much steeply aft 35. But statistically it declines successful a slope—it does not autumn disconnected a cliff—and determination are idiosyncratic variations.

Egg freezing tin sphere eggs that are statistically apt to beryllium of a higher prime astatine a younger property for a gestation astatine a aboriginal stage—though it’s physically much demanding to transportation a gestation astatine a aboriginal age, and the hazard of gestational diabetes, for instance, increases.

What’s more, erstwhile frozen eggs are thawed, their endurance rates alteration by clinic. The presenters stress that 95 percent of eggs they person frozen astatine their session past the thawing process. But that fig is conscionable 1 of galore factors that request to beryllium considered.

The ovum has to past freezing, storage, and thawing; it has to beryllium genetically viable; it has to fertilize; and the gestation has to enactment out—there are galore steps connected the way. According to the American Society for Reproductive Medicine, the accidental for a azygous ovum resulting successful a commencement is between 2 percent and 12 percent.

The presenters ne'er usage the connection “IVF” oregon “ICSI” (Intracytoplasmic Sperm Injection) adjacent though a fertility attraction is the logical decision of freezing your eggs. They truthful omit that specified a attraction carries an further terms tag and that resulting pregnancies thin to beryllium higher risk.

Success rates vary. Out of 2.5 cardinal IVF cycles performed astir the satellite per year, astir 500,000 effect successful a birth. That means 80 percent of IVF cycles don’t succeed.

They besides don’t notation imaginable broadside effects of the medicine that’s utilized to stimulate the ovaries for ovum retrieval, specified arsenic headaches, fatigue, cramping, and nausea, and they don’t notation uncommon but perchance superior complications specified arsenic ovarian hyper-stimulation syndrome. At 1 point, they accidental they don’t privation to get “too technical.” But if I were readying to frost my eggs, I would similar to cognize the evidence, risks, and outgo up front.

Egg freezing is an costly procedure, though prices alteration by geography. One rhythm of ovum freezing tin outgo $10,000 successful the US and £7,500 successful the UK. The outgo tin beryllium arsenic debased arsenic €2,750 successful Spain, not dissimilar from a afloat acceptable of Invisalign braces. It’s not astonishing Spain has already go an egg-freezing tourism hub.

There are aggregate components that marque up the outgo of the procedure. There’s the consultation, medication, humor tests and screening, arsenic good arsenic the existent ovum retrieval and freezing rhythm or, much likely, respective cycles. The 2nd portion is the ovum retention fee, which is typically annual, and the 3rd portion is the transportation of the eggs to effort a gestation erstwhile they’re thawed. It’s often the lawsuit that fertility clinics don’t uncover each the costs progressive up front.

Modern reproductive technologies similar IVF and ovum freezing are worthy celebrating, arsenic they assistance millions of radical commencement a household successful a mode that was intolerable successful erstwhile decades. They tin beryllium a lifeline. The crushed I absorption connected the nuances and risks present is that the abstraction urgently needs much regularisation and transparency: We merit the afloat picture.

No Longer Experimental

Egg freezing—or its method name, “oocyte cryopreservation”—was developed successful the 1980s, to beryllium utilized for aesculapian reasons. The thought down “medical ovum freezing” is to sphere the eggs of idiosyncratic who is astir to person a fertility-threatening procedure. It tin beryllium a protective measurement against chemotherapy, which diminishes fertility, arsenic good arsenic conditions including autoimmune disorders and terrible endometriosis. It is besides utilized by trans men who would similar to sphere their fertility.

With the improvement of “vitrification”—a much reliable freezing technique—egg freezing was commercialized for nonmedical reasons. In 2012, some the American Society of Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology decided to assistance the “experimental” statement of ovum freezing.

Since then, “social ovum freezing” has been connected the rise. Kim Kardashian froze her eggs. Jennifer Aniston has said she regrets not freezing her eggs. On TikTok, influencers upload videos of their regular injections and reels astir their trips overseas to person their eggs frozen.

Every pistillate is antithetic erstwhile it comes to however property affects her fertility. Some women bash not endure infertility successful their aboriginal forties. Egg freezing typically works champion for those successful their twenties and thirties and is not usually recommended for women implicit 38 years, according to ASRM. And yet, research shows that the mean property of ovum freezing successful the UK and United States is 38. The main information is to “buy time” to find a partner, according to research done astatine Yale University.

The process involves regular injections for astir 8 to 14 days to stimulate a radical of eggs to mature and develop. During this time, ultrasounds and humor tests find whether the medicine is working. Retrieving the eggs is usually done nether wide anesthetic oregon sedation. Once the eggs are inspected by an embryologist and deemed usable, they tin beryllium frozen.

“I often perceive the operation ‘this is insurance,’” Timothy Hickman, the erstwhile president of the Society for Assisted Reproductive Technology (SART), told me. But that’s misleading. “Life security is simply a policy: If you request it, it pays off; this whitethorn not wage off.”

Whether venture-backed startups are a affirmative summation to the fertility space, depends connected whether they amusement radical the afloat picture. Or whether they maximize their profits by making fear-based claims.

What would beryllium genuinely revolutionary is to find ways to bring down the prices of fertility treatments and marque them transparent and accessible to all, ideally covered by healthcare, arsenic is already the lawsuit successful immoderate countries.

The Future of Egg Freezing

For now, our information connected ovum freezing is limited, portion the uptake continues to increase. Most studies showing palmy pregnancies with frozen eggs absorption connected donor eggs. We bash not person large-scale information connected women freezing and utilizing their ain eggs, due to the fact that astir eggs frozen precocious haven’t been thawed yet.

In a fewer decades’ time, ovum freezing mightiness look radically different. The process mightiness go truthful safe, accessible, and effectual that women successful their twenties confidently frost a tiny fig of eggs to sphere their prime conscionable successful case.

Clinics alteration successful however bully they are astatine fertilization. The aerial prime wrong the laboratory matters. Shining a reddish airy connected sperm cells improves their performance—they look to similar the spotlight—and a petri crockery covered successful a bladed furniture of diamond tin help. All of this could amended the process.

Egg freezing could besides autumn retired of favour for taste reasons, if governments introduced amended childcare policies and addressed wealthiness inequalities and if workplaces acknowledged the value of families, truthful that radical nary longer delayed having children and being a azygous genitor would go easier. It’s precise bittersweet that this script seems little apt than the technology-focused ones.

Alternatively, the process whitethorn nary longer exist, due to the fact that it’s been replaced by different technological advance. In 2023, researchers astatine Osaka University successful Japan led by Professor Katsuhiko Hayashi managed to crook the stem cells of antheral mice into ovum cells. These ovum cells were implanted successful pistillate mice who gave commencement to 7 babies. Perhaps, this could yet construe into quality research. Or perhaps, scientists find a mode to shield our ovum prime from declining with age.

Excerpt adapted from The Vagina Business: The Innovative Breakthroughs that Could Change Everything successful Women’s Health by Marina Gerner. Copyright 2024. Published with support of Icon Books.