What is Egg and Embryo Freezing?
Egg freezing (human oocyte cryopreservation) is a straightforward process in which a woman’s eggs are extracted, frozen, and stored for later use. If a woman chooses to store embryos rather than eggs, the eggs are fertilized in a process called in vitro fertilization (IVF) before they are frozen.
Later, when the woman is ready to try becoming pregnant, she will go through a CET cycle and the eggs are thawed, fertilized, and then becomes an embryo(s) that are transferred to the uterus. If embryos were stored rather than eggs, they are thawed and transferred to the woman’s uterus in a process called Cryo-Embryo Transfer (CET).
Our IVF team uses the latest cryopreservation technique which takes advantage of ultra-rapid cooling. This technique has allowed our doctors to achieve pregnancy rates with frozen eggs and embryos that are the equivalent to those obtained in a fresh IVF cycle.
There are Two Parts to the Process
- Cycle for Retrieval and storage of Eggs or Embryos
- Thawing and embryo transfer
Women and couples today delay having children for various reasons. Whatever the reason, there are now some excellent fertility preservation options available to women and couples. Here are some reasons why you may choose to freeze your eggs. When you freeze your eggs they “Stop” the clock. They remain the age of the age the eggs are frozen.
1. To Receive Cancer Treatment
If you are diagnosed with cancer, you may choose to preserve your eggs. Certain cancer medications, as well as radiation and chemotherapy can have negative effects on your fertility. You may experience temporary or permanent infertility. If you know you want to have children in the future (or you’d like it as an option), you can freeze your healthy eggs before you begin treating the cancer. Some doctors and patients hesitate to do this because they fear it will be a long process or it will delay treatment. However, the freezing process only takes about two weeks.
2. Stop Your Biological Clock
If you haven’t yet found the person you want to have children with, you may want to freeze your eggs. This way, you won’t need to feel the pressure of any “ticking clock.” You’ll be able to find the right person on your own schedule, secure in the knowledge that you eggs are preserved and ready whenever you are.
3. Focus On Your Career
Many women feel pressured to give up their careers in order to raise a family. If you want to build your career, but you don’t want to miss out on the chance for a family, freezing your eggs can offer you a lot of freedom.
4. Ovarian Tissue Preservation
An ovarian tissue transplant (when ovarian tissue is implanted back into the woman’s uterus) offers a way for women to conceive naturally or with the aid of fertility treatments after cancer treatment has ended. Ovarian tissue transplants also allow patients to resume their menstrual cycles and restore the normal hormone levels associated with the menstrual cycle. The life of the transplant is often 2-3 years. If patients are unable to conceive on their own with the transplant, they may undergo fertility treatments including IVF to conceive.
AFCT is collaborating with one of the top experts in fertility preservation and ovarian tissue preservation, Dr. Sherman Silber of St Louis, MO.
Should I Freeze My Embryos?
If you want to have kids someday, but you’re just not ready yet, freezing your eggs is a safe and healthy way to preserve your fertility in case you choose to have children in the future. The best time to freeze your eggs is considered to be in your early to mid-30s, and preferably before 38 years of age. Younger eggs have better chances of developing into a healthy baby. In 2012, the American Society of Reproductive Medicine (ASRM) declared that the procedure was no longer experimental, implying that eggs can be frozen and stored safely and effectively using a new method of verification (an ultra-rapid freezing process). It is important to know that freezing eggs does not guarantee a baby regardless of the woman’s age at the time of the procedure. However, it offers a reliable “insurance plan.” For more information, please visit www.ASRM.org
If you already have a partner, or would like to use a sperm donor, embryo freezing may be a good option for you. Pregnancy rates from embryo freezing can be even higher than those from egg freezing, further ensuring that you will be able to have a family when the time is right for you. If you are not comfortable with freezing and storing embryos for religious or moral reasons, then freezing your eggs is a better choice for you.
The process of freezing your eggs is broken into two steps. The first step is when you initially freeze your eggs or embryos, and the second step is thawing and implanting the eggs or embryos. Here’s what you can expect:
Part 1: Egg/Embryo Freezing and Storage
- Initial consultation
The first step is to set up a consultation where the doctor will assess your fertility potential and discuss your options. This is a good time to decide whether egg freezing or embryo freezing is a good option for you. This initial workup will typically include some blood tests and an ultrasound screening to determine your ovarian reserve.
We check your hormones like TSH, T4, Prolactin, Free Testosterone, DHEAS and HIV 1, 2, Hepatitis B, C, RPR, Blood type, Rubella and a genetic screen. We also include a blood test called AMH. This blood test will help asses your ovarian reserve and will give us some guidance for the amount of stimulation you will require and a preliminary information about the number of eggs we may obtain.
- Ovarian stimulation
During the ovarian stimulation process, you will receive daily injections of follicle-stimulating hormone (FSH), and Menapur (FSH, LH) which facilitate the development of multiple eggs in the ovaries, so more than one egg will be available for freezing. Patients typically come to the office 3-5 times for ultrasounds, blood work, and monitoring during this 10-14 day period.
- Egg Retrieval: Prior to and during the retrieval the patient is given intravenous sedation (with an IV needle) by an anesthesiologist. The egg retrieval is performed using a transvaginal ultrasound for visualization of the follicles and a long needle to aspirate the eggs out of the follicles through the wall of the vagina. The eggs are then passed to the embryologist in tubes containing culture media. The procedure requires approximately 15-30 minutes and patients are monitored for approximately 1 hour to ensure safety.
- Egg/Embryo Freezing and Storage: If you choose to freeze embryos, then your eggs will be fertilized with your partner’s sperm soon after retrieval and allowed to grow in a petri dish for a few days before they are frozen. If you decide to freeze your eggs, then they are frozen immediately after the retrieval.
The entire freezing process takes about two months. Depending on the number of eggs or embryos that you and your doctor decide to freeze, you may need to undergo more than one egg freezing cycle.
- Fertilization of the Eggs to Embryos
For women who have frozen eggs, the eggs will go through a special process for thawing the eggs and preparing them for fertilization to embryos. For women who elect to freeze embryos they will immediately go through the fertilization process. The Fertilization process happens when the embryologist receives the eggs, the eggs are removed from the follicular fluid and placed in the appropriate media where they complete their maturation. After about four hours, the eggs are placed with the sperm; fertilization occurs and the eggs are placed in an incubator. If injection of the sperm into the egg (ICSI) is indicated, it will be performed at this stage.
- Day 1 after Eggs have been Fertilized
Approximately 24 hours after the retrieval, the eggs are checked to see if they fertilized properly and if development of the embryo (fertilized eggs) has begun. The embryos are allowed to develop inside of the incubator for 3-5 days after the retrieval. Incubators control environmental conditions such as temperature, air quality, acidity, and several other factors that may influence the embryos’ development.
- Embryo Development
Embryos between day 1 and 3 after retrieval are called cleavage-stage embryos. On day 5, the embryos are called blastocysts. In some cases, embryos are cultured until day 6. The extended culture of embryos assists in selecting the best embryos for a transfer and limiting the number of embryos placed into the uterus to decrease the chance of multiple pregnancy. If an embryo biopsy is desired that will occur on day 5 or 6.
Thawing and Preparing for Pregnancy
- Preparation for Pregnancy: Once you are ready to try to become pregnant, you’ll begin a cycle of medication to prepare your uterus. Your doctor may choose to prescribe Lupron or Cetrotide to reduce the chances of ovulation occurring unexpectedly. You’ll also receive estrogen and progesterone medications.
You work closely with your doctor to make sure this process goes as smoothly as possible. At this time, you and your doctor will decide whether to have genetic testing performed on the embryos, as well as how many embryos to transfer.
- Embryo Transfer: This is a brief procedure using an abdominal ultrasound to place the embryos about 1.5 cm from the top of the uterus. You’ll need to keep taking hormones to help support the uterus in the early stages of your pregnancy, and your doctor will determine when it is safe for you to stop taking those medications. You will come in for a pregnancy test about 12 days after the embryo transfer, and your doctor will determine if you are pregnant.
Egg Freezing – Frequently Asked Questions
Why should I freeze my eggs?
There are many reasons you may choose to freeze your eggs. If you plan to delay childbearing, it is essential that you take charge of your fertility ahead of time, since fertility begins to decline in the late 30s. You may also choose to freeze your eggs if you are waiting until you find the right partner, or if you have certain cancers that require chemotherapy or radiation, which can cause permanent damage to your eggs. Egg freezing is also essential to any women who has had any autoimmune disease, Endometriosis or any ovarian surgery as all may contribute to a decline in ovarian reserve.
At what age should I consider freezing my eggs?
While there is no right or wrong time to freeze your eggs, your late 20s to mid-30s are the best ages to consider freezing your eggs because that is when your body is the most fertile. At AFCT we have done egg freezing for several women around the age of 40.
I have irregular periods or other fertility issues; can I still freeze my eggs?
Yes, most women with irregular cycles have plenty of eggs, even if they do not ovulate regularly. Also, many fertility issues can be overcome with in vitro fertilization (IFV), which you will have to undergo anyway if you want to become pregnant using frozen eggs or embryos.
What is IVF?
IVF (in vitro fertilization) is a process of manual fertilization by combining an egg and sperm in a laboratory dish, and then transferring the embryo to the uterus.
What are the benefits of freezing embryos rather than eggs?
There is evidence that frozen embryos may have slightly higher pregnancy rates than frozen eggs.
What is a frozen embryo transfer (FET)?
FET is a procedure in which previously frozen embryos are thawed and transferred back into the woman’s uterus.
What are my chances of getting pregnant with frozen eggs or embryos?
The rate varies greatly depending on the woman’s age at the time of egg or embryo freezing and by the fertility center. At AFCT, we have some of the highest pregnancy rates in the country with age playing the largest role in success rates.
What is Preimplantation Genetic Diagnosis (PGD/PGS/CCS)?
PGD is a test used to determine if genetic or chromosomal disorders are present in embryos prior to transferring them into the uterus.
How are my eggs or embryos stored?
Eggs and embryos are stored in tubes and placed into tanks of liquid nitrogen.
How long can the frozen eggs and embryos be stored?
Eggs and embryos have resulted in healthy pregnancies up to ten years after freezing.
How soon after the transfer will I know if I am pregnant?
You will come to our office for a pregnancy test 12 days after the embryo transfer.
How can I maximize my chances of becoming pregnant after an embryo?
The best way to maximize your chances of getting pregnant are to stay as healthy and stress-free as possible. Our Lisanne Wellness Center specializes in stress-reduction and weight-loss programs, as well as acupuncture treatments that will maximize your chances of having a healthy pregnancy. Learn more about Lisanne Wellness Center today.
Is there an age limit for getting pregnant with frozen eggs or embryos?
This varies greatly based on the individual and your overall health. However, there is some evidence that women are able to carry a pregnancy to term well into their 50s.
Will egg freezing reduce the likelihood that I’ll be able to become pregnant on my own later?
No. In puberty, you have about 300,000 eggs and you will only ovulate about 300 of these eggs so there are many eggs which will never be utilized.
How many eggs I need to have extracted to become pregnant?
This depends on the age of the women, however the average number of 10 eggs is a comfortable number to produce enough embryos that will result in live birth.
What happens to my eggs if I decide not to become pregnant?
This is entirely up to you. If you’d like, you can donate them to research or to another individual (we can assist you with either of these options), or you can ‘discard’ them.
What will this cost?
Costs vary depending on how many cycles you would like to freeze and whether you would like to freeze just your eggs or complete embryos. There is a separate cost for each year of storage. Please contact our Billing Manager, who will be will be happy to answer your questions regarding costs, payments, insurance coverage, and reimbursements.
Will my insurance cover egg or embryo freezing?
Typically, insurance will not cover egg or embryo freezing. However, now there may be some exceptions for women who have experienced fertility issues or have other health conditions. Call your health insurance provider for more information.
The Advanced Fertility Center of Texas (AFCT) has several fertility treatment centers located throughout the Houston metropolitan area. We offer the most comprehensive, state-of-the-art fertility services.