What are the Side Effects and Risks of Egg Freezing?

Egg freezing, also known as oocyte cryopreservation, has grown in popularity, with a 46% increase in egg freezing cycles from 2020 to 2021 alone! While egg freezing is generally considered safe and effective, there are potential side effects that you should be aware of before making the decision to undergo the procedure. In this article, we will discuss some of the most common side effects of egg freezing and what you can expect during and after egg freezing.

How does egg freezing work?

Egg freezing is a process by which your eggs are removed from the ovaries, frozen, and stored for your future use. A typical egg freezing cycle is 10-14 days and involves a process called ovarian stimulation, where hormonal medication is used to stimulate the ovaries to produce multiple eggs. Once the eggs have matured, they are retrieved through a minor surgical procedure.

During this time, you’ll have 4-6 appointments at your clinic. For the first, you’ll do some initial testing. Then, throughout the process, you’ll go in for some bloodwork and transvaginal ultrasounds so the doctor can see how your eggs are developing. The last time you go in will be for the actual egg retrieval.

Egg freezing is a low-risk (but not no risk) procedure 

Egg freezing is considered a safe procedure. In a single egg freezing cycle, the risk of a serious adverse event is under 2.5%. Severe OHSS accounts for the majority of complications, occuring in 0.1-2% of cycles. The risk of other acute complications, including pelvic infection, intraperitoneal hemorrhage, or ovarian torsion, is small (<0.5%).

That being said, many women do experience minor side effects – like bloating, constipation, nausea – from the medications and egg retrieval. 

Side effects of egg freezing medication

While fertility drugs for egg freezing are considered safe, they do occasionally cause side effects including:

• Mild bruising and soreness at the injection site
• Nausea and, occasionally, vomiting
• Temporary allergic reactions, such as skin reddening and/or itching at the injection site
• Breast tenderness and increased vaginal discharge
• Mood swings and fatigue
• Ovarian hyperstimulation syndrome (OHSS)

The biggest risk to ovulation induction medication is ovarian hyperstimulation syndrome (OHSS) – a serious complication that can occur with the use of these medications. OHSS occurs when the ovaries become swollen and painful due to the overproduction of eggs. 

Fortunately, severe OHSS is rare (0.1%–2% of cycles) and can usually be prevented by carefully monitoring hormone levels and adjusting the dose of medication as needed. Women who experience symptoms of OHSS should contact their healthcare provider right away.

If you are at high risk of OHSS, your doctor may prescribe a trigger medicine called leuprolide instead of hCG, which can prevent OHSS. Another medicine called cabergoline also can help reduce the fluid accumulation. Or they may give you extra IV fluids at the time of egg retrieval. 

Side effects and risks of the egg retrieval

The egg retrieval is the final culmination of the egg freezing process. During an egg retrieval, you will be under twilight anesthesia as the eggs are removed from the ovaries. This is done with a thin needle that is inserted through the vagina and into the ovary, guided by ultrasound imaging. Fluid is gently suctioned through the needle to remove the eggs from the follicles. 

Anesthesia is generally safe, but like any medical procedure, it does carry some risks. The type and severity of the risks depend on the individual patient and the type of anesthesia being used. Some common risks associated with anesthesia include allergic reactions, breathing problems, and blood pressure changes. However, these risks are rare and the benefits of anesthesia typically outweigh the potential risks.

The procedure itself can cause common side effects such as constipation, bloating, cramping, spotting, and pain. These symptoms can typically be managed with rest, over-the-counter medications like Tylenol and stool softeners, and staying hydrated. For those experiencing cramping or pain, heating pads can be beneficial. In the case of bleeding, it's important to use pads instead of tampons for easier monitoring of the amount.

Most people can resume normal activities by the next day. However, it is advisable to take it easy and rest at home for the remainder of the day with the presence of another adult just in case. 

There are some post-retrieval red flags to look out for:

• If you notice any of the symptoms below, report them to your healthcare provider asap:
• Temperature above 101 F
• Severe abdominal pain or swelling which does not improve with over the counter pain medications
• Severe nausea or vomiting that doesn’t go away
• Heavy vaginal bleeding (soaking through a pad in an hour; some light bleeding is normal)
• Difficulty urinating, or painful urination
• Fainting or dizziness

If you experience any of the above symptoms, reach out to your doctor immediately. 

Emotional side effects

Egg freezing can be an emotionally challenging experience for some people. Especially for those freezing their eggs because they are concerned about their ability to have children in the future, the procedure can be a source of anxiety and stress. Not to mention the hormone medication used in egg freezing can cause mood swings and emotional instability.

It is important to have a strong support system in place during the egg freezing process. This can include friends, family, and healthcare providers who can provide emotional support and guidance. If you freeze your eggs through Cofertility, you’ll be connected with a cohort of others freezing their eggs at the same time. We offer an online support group, and our entire team of experts will be behind you the entire time. 

Will I gain weight during egg freezing?

Weight gain can also be a potential side effect of egg freezing. The hormonal medication used in the egg freezing process can cause fluid retention and increased appetite, which can lead to weight gain in some patients. However, in just two weeks, it’s unlikely you’ll gain noticeable weight. 

Not all those who undergo egg freezing will experience weight gain (some end up losing weight due to nausea or anxiety). Strategies such as regular exercise and a healthy diet may be recommended to help you feel good during this time.

Rare side effects and complications of egg freezing

While rare, there are some potential complications of egg freezing that can be more serious. These acute complications occur in under 0.5% of egg freezing cycles:

• Ovarian torsion is when a stimulated ovary twists on itself since the ovary is heavier from more follicles, cutting off the blood supply. Surgery is required to untwist the ovary, or in severe cases, to remove the ovary. 
• Intraperitoneal hemorrhage happens when the egg retrieval needle accidentally punctures a blood vessel, causing bleeding within the abdominal cavity.
• Infection can occur if bacteria enter the uterus or ovaries during the egg retrieval procedure.

Your fertility doctor can tell you more about your individual risks based on your health history, and we encourage you to talk to them and ask lots of questions!

Long-term side effects

There is currently no scientific evidence to suggest that egg freezing or donation increases the risk of cancer, including invasive ovarian and breast cancers. The hormones used to stimulate the ovaries to produce multiple eggs for freezing are similar to those used in fertility treatments and are generally considered safe. 

If you have concerns about the potential risks of egg freezing, it's important to discuss these with your fertility doctor who can provide you with personalized advice based on your individual health history and circumstances.

Summing it up

Egg freezing is generally considered safe and effective, with mild and temporary physical side effects being the most common. The most common side effects include bloating, cramping, and breast tenderness. These symptoms are typically caused by the hormonal medication in the lead-up to egg retrieval. These hormones stimulate the ovaries to produce multiple eggs, which can cause swelling and discomfort in the abdomen. Emotional side effects can also occur, but with proper support and self-care, can be managed. 

Some patients may also experience bleeding or spotting after the egg retrieval procedure. This is normal and should not be a cause for concern. However, if bleeding persists or is heavy, let your fertility doctor know right away.

Serious complications such as severe OHSS, infection, intraperitoneal hemorrhage, and ovarian torsion occur in under 2.5% of cycles, and it’s important to understand the symptoms and red flags.