What is the difference between egg freezing and in vitro fertilization (IVF)?
Egg freezing is basically the first part of IVF. Both procedures require women to take ovary stimulating hormones for approximately 10 days to produce multiple eggs. Upon retrieval, an egg freezer banks her eggs for future use, while a woman undergoing IVF immediately moves onto phase two – fertilization and embryo transfer.
I’ve been on the birth control pill for a long time, does that mean I will have more eggs saved up?
No, the birth control pill neither preserves nor decreases your egg quantity. A woman is born with a finite number of eggs and these eggs die out naturally whether you are ovulating or not.
What is the optimal age to freeze eggs?
Dr. Jamie Grifo of NYU Fertility explains: “if a woman freezes her eggs too early there is always the possibility that she may get pregnant without needing to use her frozen eggs. However, if we look at IVF data there is an inflection point in pregnancy rates after the age of 35. Between the ages of 38 to 39 there is an even larger inflection point. Certainly over age 42 there is not much benefit to freezing your eggs. Typically, 41 and under is the limit.”
Is there an age cut off limit for egg freezing?
Most clinics recommend freezing earlier for better quality embryos. Although the specific age cut off limit varies from clinic to clinic, typically fertility clinics recommend freezing eggs prior to age 38. In addition to age, however, clinics also take into account other factors including hormone levels and antral follicle (resting follicle) count.
What is an ovarian reserve?
Women are born with approximately 1-2 million eggs and each menstrual cycle one single egg is released by ovulation. As a woman ages both the quantity and quality of her eggs diminishes directly impacting her likelihood of pregnancy. Ovarian reserve, or fertility potential, is measured by the quantity of follicles and the health of the eggs within those follicles.
Can I test my ovarian reserve?
Yes, there are several ways to test ovarian reserve. Most clinics conduct AMH and FSH (Day 3) blood tests, as well as an antral follicle count test via a transvaginal ultrasound. These three tests combined can provide a good assessment of your ovarian reserve.
How long does the egg freezing process take?
Soup to nuts, freezing your eggs takes approximately 12 days. First, you will undergo 8–10 days of hormone injections. Over this period, you will visit your clinic about every other day for a blood test and ultrasound to gauge your follicle development and monitor your medication protocol. Approximately 35 hours prior to retrieval, a trigger shot is administered to spark the ovulation. Egg retrieval is typically a 10-15 minute procedure under sedation. Most women return to work the day after retrieval.
How are the eggs retrieved?
The retrieval process is fast and according to most women (and we have talked to a lot) one of the easy parts of the egg freezing process. Once you are under anesthesia, your doctor uses an ultrasound guided needle attached to a catheter to remove the eggs from each of your ovaries. The procedure is short, approximately 10–15 minutes, and leaves no scars or stitches.
How many retrieved eggs are considered a good amount?
Dr. Licciardi of NYU Fertility Center answers succinctly answers this question:“The too obvious answer is the more the better. However 10-15 is a good yield. More than that is a bonus. It is true 30 may be better than 15, but most women do not make 30 so that should not be your goal. Estimates in the 10-15 range usually do not prompt much patient/doctor discussion, however when the estimate is lower, the talks become more frequent and important.”
How are the eggs frozen?
The de facto egg freeing method today is vitrification or fast freezing. Eggs are vitrified or transformed into a glass-like state protecting the delicate egg from destructive ice crystal formations.
Should I freeze eggs or embryos?
Dr. Marc Kalan responded to this question in interview with Eggsurance: “The decision between freezing eggs or embryos hinges on several factors. First, if a patient has a sperm source to which they are committed, then they should freeze embryos. Embryo freezing has been performed for close to 3 decades and therefore there are long term data to support its use. While it appears that egg freezing may be as efficacious as embryo freezing, there are just not enough data, at this point, to know for sure. For women who do not have a sperm source and are not interested in donor sperm, egg freezing is really the only option for them. Fortunately, it is a good option and can provide a reasonable chance for pregnancy in the future. For the women in the middle, who are considering a sperm donor, but would like to keep their options open, I often recommend freezing some eggs and some embryos. So long as there are enough eggs, this option gives the best of both worlds.”
What percentage of eggs survive the thawing process?
Due to advances in egg vitrification, most clinics report a 90%+ thawing success rate. This is much higher than the older, slow-freezing method.
How long can cryopreserved eggs be stored?
The jury is still out on this one. Most doctors believe that eggs can be safely frozen for up to ten years, however others believe that since frozen eggs are stored in liquid nitrogen (which stops all biological activities in the cell) eggs can be kept in storage indefinitely. Most clinics believe, however, that frozen eggs can last indefinitely – as long as they are frozen correctly and maintained at the correct temperature. The process keeps them at their peak.
I am fertile now, why do I need to take hormones to harvest my eggs?
During monthly ovulation, the body usually chooses ONE egg to ovulate. The rest of the eggs get reabsorbed in the body. As egg freezing’s purpose is to produce and freeze as many eggs as possible, stimulation drugs are required to a) yield a larger volume of eggs b) inhibit ovulation. Some of the drugs (i.e.: Menopur, Follistim) stimulate egg production, while other drugs (i.e.: Cetrotide, Ganirelix) keep the body from reabsorbing them.
Do the stimulation shots hurt?
FSH (Follicle Stimulating Hormone) injections stimulate follicle growth, while LH injections cause eggs to mature. Both of these injections are administered subcutaneously – that means below the skin via a needle – either in the belly or upper thigh. The insertion of the needle is not painful, however there can be slight discomfort when the liquid goes under the skin.
What are the most common side effects of a hormone stimulation medication cycle?
Common side effects that women experience include: weight gain, abdominal discomfort, bloating and irritability. These symptoms will, most likely, increase in intensity a few days before your retrieval as the medication causes the stimulation of multiple eggs as opposed to the single egg produced in a normal ovulation cycle.
Is there anything I can do to lessen the bloating during hormone stimulation cycle?
The hormone stimulation medications hyper-activate the development of multiple follicles, which enlarge the ovaries. Somewhat counter-intuitively, be sure to drink a lot of water or other clear fluids to help reduce the bloating. Also, taking whey protein powder helps relieve some women’s bloating; whey powder can be found in most health food stores.
What is OHSS?
OHSS (ovarian hyper stimulation syndrome) is an excessive response to ovary stimulating medication and is classified as mild, moderate to severe. Mild OHSS, exhibited in bloating, abdominal swelling and/or nausea, can affect one out of every three women. Severe cases, less than 1% of cases, may require hospitalization and potential surgery. While the chances of OHSS are very small, make sure that you proactively communicate potential OHSS symptoms to your Doctor immediately.
Why do I need so many ultrasounds and blood work prior to the egg retrieval procedure?
To ensure that as many healthy and mature eggs are retrieved as possible it is important to frequently check both follicle growth and hormone levels. The ultrasounds measure the maturation of your follicles (the fluid sacs containing your eggs) while the blood work confirms that your medication dosage is correct and that your eggs are maturing. Ultrasounds and blood work may be a real chore, but they are essential to the egg freezing process.
Should I alter my diet prior to freezing my eggs?
Although there is no a specific “egg freezing diet,” patients are recommended to follow a healthy lifestyle. The “don’t” list includes: caffeine, alcohol, and cigarettes. While the “do” list includes: organic produce, whole grain foods and concentrated nutrient sources (i.e.: cold pressed nut oils, oily fish, live yogurt.
Why do I need to stop consuming caffeine and alcohol prior to my procedure?
Numerous studies show that consumption of both caffeine (in any form including coffee, tea, cola, etc.) and alcohol decreases fertility. Be sure to slowly wean yourself off of both substances in the months prior to your egg retrieval.
Why am I still bloated post procedure?
Most women are still bloated right after their procedure. This is due to the fact that the ovulation cycle has been hyper-stimulated and the follicles are still enlarged because of the increased egg production. This bloating should not last more than one week.
Why am I not permitted to do any high impact exercise prior to and two weeks after my procedure?
Due to the stimulation hormones you are taking, your ovaries will become extremely enlarged and these activities could harm your egg development. It is recommended that you stick with low impact exercises that keep your heart rate under 140. Most importantly, however, exercise should be limited to avoid ovarian torsion that could cut off blood supply to the ovaries. If this were to occur (most likely from high impact activities), the ovary would have to be surgically repaired and in the worst-case scenario be removed.
I’m ready to use my frozen eggs, now what?
First you will meet with your doctor and undergo some preliminary test. Once given the green light, you will begin a 2-3 week course of oral medication to prepare your body for embryo transfer. Next your eggs with be thawed, fertilized with sperm using ICSI (intracytoplasmic sperm injection) or injecting a single sperm into a single egg, and transferred to your uterus. At day 10, a pregnancy test will determine your results.