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Egg Freezing Q&A: What is Vitrification?
If you're considering egg freezing, you may have come across the term "vitrification." This rapid freezing technique is a game-changer in the world of egg freezing, offering significantly improved success rates compared to older freezing methods. Let's dive into what vitrification is and why it's so important for preserving your fertility.
If you're considering egg freezing, you may have come across the term "vitrification." This rapid freezing technique is a game-changer in the world of egg freezing, offering significantly improved success rates compared to older freezing methods. Let's dive into what vitrification is and why it's so important for preserving your fertility.
Vitrification vs. slow freezing
Eggs (oocytes) are unique cells. They contain a high amount of water, which makes them particularly vulnerable to damage during freezing. But why do we need to freeze them to begin with? The freezing portion of egg freezing is important because freezing cells to sub-zero temperatures stops all biologic activity and preserves them for future use.
Up until recently, fertility clinics used a process called “slow-freezing”. Traditional slow-freezing methods often led to the formation of ice crystals within the egg. These crystals could pierce the cell membrane and cause irreversible damage, lowering the egg's viability after thawing.
Through vitrification, a special solution containing cryoprotectants protects the cells from the damaging effects of freezing. This solution, combined with ultra-rapid cooling, transforms the water molecules in the cells into a glass-like state instantly, preventing the formation of harmful ice crystals.
This has improved the overall survival rate of eggs (when they are later thawed) from 75% to over 95%.
How does vitrification work?
Vitrification is a multi-step process that carefully protects the egg during the freezing process. Here's a simplified breakdown:
- The eggs are placed in solutions with increasing concentrations of cryoprotectants. These substances essentially replace the water within the egg, minimizing the risk of ice crystal formation.
- The eggs are then plunged into liquid nitrogen, which cools them at an incredibly fast rate (thousands of degrees per minute). This speed is crucial to prevent ice crystals from having time to form.
- The vitrified eggs, now in a glass-like state, are safely stored in cryogenic tanks until they are ready to be used.
The length of time that frozen human eggs can be stored depends on several factors, including the quality of the eggs, the storage method used, and the regulations of the country or state where the eggs are being stored.
Scientifically, if you work with a good clinic in the United States using vitrification, you can keep them stored indefinitely. However, some countries, such as the United Kingdom have a cap on the number of years you can store eggs (for the UK, you can store your eggs for up to 55 years). Currently there is no limit in the United States.
Typically, I see patients that store their eggs for two to five years. With vitrification, the chances of damage during storage are usually quite low.
What happens when the vitrified eggs are thawed?
When you're ready to use your frozen eggs and turn them into embryos, you’ll first have them shipped from the storage facility to the clinic you are working with. Then, a careful warming process using a specialized procedure reintroduces water and reverses the vitrification process.
An embryologist will then examine the thawed eggs to determine how many survived the freezing and thawing process. As I shared above, survival rates for vitrified eggs are generally quite high.
Next, the surviving eggs are fertilized with sperm (either from a partner or donor) in a process called intracytoplasmic sperm injection (ICSI). The fertilized eggs, now embryos, are allowed to develop in the lab for several days. Finally, one or more of the healthiest embryos are transferred to your uterus (or the uterus of a gestational carrier) with the hope of implantation and a successful pregnancy. Not every frozen egg will result in a successful pregnancy. Several factors, including egg quality, the fertilization process, and embryo development contribute to the overall success rates.
Summing it up
Vitrification has revolutionized egg freezing, making it a more reliable and successful option for women who want to freeze their eggs for potential future use. By understanding this process, you can feel confident that your eggs are being protected in the best possible way, maximizing your chances of building the family you desire.
If you have further questions about vitrification or egg freezing in general, don't hesitate to consult with a fertility specialist. They can provide personalized guidance and help you make informed decisions about your reproductive future.
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Does Egg Freezing Require Surgery?
Egg freezing (also known as oocyte cryopreservation) is a way to preserve your eggs today for potential use in the future. It offers women more control over their reproductive timeline. While the thought of freezing your eggs might seem intimidating, the actual egg retrieval portion of the process is a minimally invasive procedure. Let's break down what egg freezing involves and whether it requires surgery.
Egg freezing (also known as oocyte cryopreservation) is a way to preserve your eggs today for potential use in the future. It offers women more control over their reproductive timeline. While the thought of freezing your eggs might seem intimidating, the actual egg retrieval portion of the process is a minimally invasive procedure. Let's break down what egg freezing involves and whether it requires surgery.
Egg freezing: a step-by-step overview
The egg freezing journey typically involves several phases. Understanding each step can help ease any anxieties and make you feel more prepared for the process. Let's break it down in more detail:
- Medical screening: Before embarking on the egg freezing process, you'll undergo a comprehensive medical screening with your fertility doctor. This evaluation helps determine if you're a good candidate for egg freezing and ensures the process is right for you. The screening might involve reviewing your medical history to identify any underlying health conditions that could impact egg quality or the success of the procedure. Additionally, you might have a physical exam to assess your overall health. Ovarian reserve testing— which includes blood tests to measure hormone levels (especially AMH) and ultrasounds to assess the number of follicles in your ovaries— is common for evaluating ovarian reserve (your body's supply of eggs).
- Ovarian stimulation: Once you’re ready to get started, you'll take hormonal medications for about 10-12 days. These medications work by stimulating your ovaries to produce multiple eggs in a single cycle, rather than the usual one. The goal is to increase the number of eggs available for retrieval, giving you more options for the future.
- Monitoring: During the ovarian stimulation phase, you'll visit your fertility clinic for regular checkups. These appointments typically include ultrasounds to track how your follicles (where the eggs develop) are growing, and blood tests to monitor your hormone levels. This close monitoring helps your doctor personalize your medication dosage and determine the optimal time for egg retrieval.
- Trigger shot: When your eggs are nearing maturity, you'll receive a final injection of a hormone called hCG (human chorionic gonadotropin). This "trigger shot" essentially gives the eggs the final push to fully mature in preparation for retrieval.
- Egg retrieval: Approximately 36 hours after your trigger shot, you'll undergo the egg retrieval procedure. This is an outpatient procedure done under sedation, meaning you'll be asleep and won't feel any pain. Your doctor will use a thin needle guided by ultrasound to carefully aspirate the eggs from your ovarian follicles.
- Freezing: Immediately after retrieval, the eggs are taken to a specialized lab. Here, they undergo a process called vitrification, which involves flash-freezing them in liquid nitrogen. This ultra-rapid freezing preserves the eggs in a way that maximizes their viability for future use.
Does egg freezing require surgery?
Many women are understandably curious about the egg retrieval process and whether it requires surgery. The reassuring answer is no – egg retrieval is a minimally invasive, outpatient procedure. It doesn't involve any incisions, stitches, or the extended recovery time typically associated with surgery.
The procedure itself takes place at a fertility clinic and usually lasts less than 30 minutes. You'll receive sedation, ensuring you're entirely relaxed and won't experience any discomfort. To retrieve your eggs, your doctor will use a thin needle guided by ultrasound imaging. This needle is carefully inserted through your vaginal wall and into your ovarian follicles to delicately extract the mature eggs.
While egg retrieval isn't surgery, some mild side effects are common afterward. You may experience some cramping, bloating, or tenderness – similar to what you might feel during a menstrual period. Over-the-counter pain relief typically manages these symptoms, and they generally fade within a day or two. Most women can resume their regular activities quickly after the procedure.
Deciding if egg freezing is right for you
Egg freezing empowers you to take charge of your reproductive timeline. It is a proactive approach to family planning, offering the potential to build the family you desire on your own terms. While the decision to freeze your eggs is personal, this option opens up possibilities that might not have existed otherwise.
If you're considering egg freezing, the most important step is to consult with a reputable fertility doctor. They can provide the personalized guidance, realistic expectations, and expert support you need to make an informed decision that aligns with your individual goals and circumstances. By exploring all aspects of egg freezing, you pave the way for a more confident and empowered journey towards future family planning.
Read more:
- What's the Egg Retrieval Process Like?
- I'm Afraid of Needles; Can I Still Freeze My Eggs?
- Questions to Ask Your Doctor at an Egg Freezing Consultation
How Cofertility can help
If you are interested in freezing your eggs, we can connect you with a fertility specialist for a consultation to discuss your specific situation. Our Freeze by Co platform offers two programs for egg freezers:
- Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure — medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge.
- Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.
Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.
I'm Interested in Donating My Eggs: Will I Be Anonymous?
Anonymity is often a primary question for potential donors as they may believe that anonymity to be a way to protect themselves from the emotional complexity that is egg donation. They may believe that by remaining anonymous they can avoid forming any type of relationship with the child or recipients thereby also potentially avoiding feelings of guilt, responsibility, or attachment. Or they may not want it to interfere with future relationships or their own family dynamics. While anonymity is no longer realistic, disclosed and undisclosed egg donation offers benefits and the chance for meaningful future connections.
Egg donation is a medical procedure where a woman donates her eggs to individuals or couples who are unable to have children using their own eggs. The egg donor undergoes a series of medical and psychological screenings and hormonal treatments to stimulate egg production. Once the eggs are mature, they are retrieved through a short surgical procedure done on an out-patient basis. The eggs are then fertilized with sperm (either from the intended father or sperm donor) and the resulting embryos are either transferred to the recipient's uterus (intended mother or gestational carrier) or frozen for later use.
Many times donors have seen first hand their own friends or family struggling with infertility. Witnessing this creates a desire to help and motivates them to donate their eggs. This act of giving can be deeply fulfilling on a personal level knowing that they are creating family trees or relationships (parents, grandparents, aunts, uncles, etc.) that might otherwise have never existed.
Anonymity is often a primary question for potential donors as they may believe that anonymity to be a way to protect themselves from the emotional complexity that is egg donation. They may believe that by remaining anonymous they can avoid forming any type of relationship with the child or recipients thereby also potentially avoiding feelings of guilt, responsibility, or attachment. Or they may not want it to interfere with future relationships or their own family dynamics. While anonymity is no longer realistic, disclosed and undisclosed egg donation offers benefits and the chance for meaningful future connections.
Donor anonymity
The traditional concept of anonymous donation prioritizes privacy and confidentiality for donors, the intended parents, and any resulting children. In traditional anonymous donation, there is no exchange of identifying information between the egg donor and the intended parents. If there is contact, it is very limited and is facilitated by the fertility clinic or agency.
But in recent years, DNA testing services, like 23andMe, have had a profound impact on egg donor anonymity. The ability to uncover genetic connections through these tests undermines the anonymity promised in traditional egg donation arrangements. Even if donors and recipients agreed to anonymity, individuals who were conceived using donor eggs may take one of these tests and uncover genetic connections to relatives, including their egg donor.
In the past, when anonymity was promised in egg donation arrangements, it was often based on the understanding that the identities of both the donor and the recipient would remain confidential and undisclosed to each other. However, as mentioned above, with the increasing popularity of direct-to-consumer genetic testing services, maintaining complete anonymity in egg donation is basically impossible. If an egg donation agency or egg bank promises anonymity, be very weary. They are not able to guarantee it due to DNA testing.
There is an increasing trend towards greater openness in egg donation arrangements in many countries, with increasing recognition of the importance of providing donors and offspring with the option for contact. For example, the United Kingdom has a regulated system for egg donation overseen by the Human Fertilisation and Embryology Authority (HFEA). Donors are required to provide non-identifying information that may be shared with offspring at the age of 18.
Disclosed and undisclosed donation
At Cofertility, we offer donors and the families they match with two general types of relationships.
In a disclosed relationship, the egg donor and recipient exchange contact information and can communicate directly. So, both the donor and the recipients are aware of each other's identities. The scope and degree of communication (both during and post-match) is what both parties make of it. This can range from occasional updates to ongoing relationships and involvement in each other's lives.
In an undisclosed relationship, identifying information is not exchanged and communication is facilitated through Cofertility. With an undisclosed donation, the donor and the family can choose to allow the donor-conceived child to receive the donor’s contact information when they turn a certain age (usually 18). This is called Open ID, an increasingly popular option.
Benefits of non-anonymous donation
Non-anonymous donation offers a more personalized approach. It provides donors and intended parents the opportunity to establish meaningful relationships and make informed choices based on mutual understanding and respect. This openness can offer opportunities for building positive relationships and can enable donors and intended parents to provide emotional support to one another throughout the donation process. This support network can be valuable in navigating the emotional complexities and challenges associated with egg donation.
Considerations for potential egg donors
The level of desired openness in egg donation is a personal choice and can vary significantly from individual to individual. Some individuals may prioritize transparency and openness in all aspects of their lives, including reproductive choices, while others may prefer privacy and discretion. Some may feel comfortable with potential future contact whereas others do not. Both are completely acceptable.
Summing it up
The concept of egg donor anonymity has evolved over time, with increasing recognition about the benefits of disclosure in egg donation. Initially, anonymity was commonly practiced to protect the privacy of all involved. However, as attitudes towards third party reproduction in general have shifted and advancements in technology have made maintaining anonymity difficult, there has been a growing trend towards disclosure and openness in egg donation. Every donor needs to prioritize their own comfort and values while understanding the positive possibilities of connection. It's essential for individuals considering egg donation to be aware of the potential risks and limitations regarding anonymity and to carefully consider the implications before proceeding with the donation process.
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Egg Freezing: What Happens to Unused Frozen Eggs?
Egg freezing can provide amazing reproductive optionality in the event that you may need to use your frozen eggs to have children down the line — but what happens to unused frozen eggs if you don’t end up needing them? In this article, we’ll discuss what happens after you freeze your eggs and some options for what to do with any unused frozen eggs.
Egg freezing can provide amazing reproductive optionality in the event that you may need to use your frozen eggs to have children down the line — but what happens to unused frozen eggs if you don’t end up needing them? In this article, we’ll discuss what happens after you freeze your eggs and some options for what to do with any unused frozen eggs.
Because it can be beneficial for anyone with ovaries to freeze their eggs — we offer a program to freeze your eggs for free through our Split program, when you donate half of the eggs retrieved to another family who can’t otherwise conceive. Our hope is that whenever you’re ready to start trying for a baby, you’ll be able to get pregnant unassisted. That being said, with 1 in 6 individuals experiencing fertility challenges, egg freezing allows you to be a little bit more prepared, just in case.
Once you freeze your eggs, there are various paths you can decide on in the future, whether or not you choose to use them. Let’s dive in.
What are the chances I’ll need to use my frozen eggs?
As we mentioned, fertility challenges are — unfortunately — not entirely uncommon. Again, our hope is that your experience trying to conceive, whenever you’re ready, is easy-breezy. But that just may not be the case, which is why we’re on a mission to make egg freezing more accessible, empowering, and positive for all.
It's an especially valuable option for those who know they want to build a family, but know they might need to use IVF down the line. This includes single moms by choice and members of the LGBTQ+ community, who often rely on assisted reproductive technologies to achieve their family-building dreams.
If you do end up wanting to use those eggs in the future, that involves:
- Shipping them from storage
- Thawing them
- Fertilizing them into embryos in a lab (otherwise known as IVF, or in vitro fertilization)
- Letting those embryos develop for several days, with the option to have them genetically tested
- Transferring an embryo into your uterus or that of a gestational carrier to hopefully develop into a live birth
The data on frozen egg thawing
It’s a relatively straightforward process, but given that egg freezing was only recently popularized, there’s not a ton of long term data around how many people end up needing to use those eggs in the future. We do have some data around thaw rates, as the success of thawing frozen eggs is not guaranteed. One study from 2009 found that the overall survival rate of eggs from vitrification (the most commonly used method of egg freezing today) was 95%.
A 2023 UK-based study followed a cohort of 167 women that underwent 184 social egg freezing cycles between January 2006 and March 2022, and showed that 16% of the women have returned to use their frozen eggs so far. That statistic, however, should be examined with a grain of salt — the biggest reason being that if someone froze her eggs as late as 2022, the odds of her moving forward with IVF only one year later may be unlikely.
Another 2022 study led by experts at NYU Grossman School of Medicine and the NYU Langone Fertility Center looked at 15 years of frozen egg thaw outcomes. Of 543 women, 61% moved forward with at least one embryo transfer. While this doesn’t tell us exactly how many women thawed their eggs, it was likely greater than 61%, assuming that some of these eggs unfortunately either didn’t survive the thaw or didn’t fertilize into embryos.
Read more in Egg Freezing Thaw Rates
What happens if I *don’t* use my frozen eggs?
Before you move forward with egg freezing, you’ll sign a contract with your clinic (or long-term storage facility), where you state your preferences about what to do with your eggs if, at any point, you decide not to move forward with fertilization and transfer. Don’t worry — you can always change your mind later on.
If you don’t end up needing your frozen eggs, or decide down the line that you don’t want to keep them in storage for any reason, here are your options.
Unused frozen eggs option #1: discard them
If you know you don’t want to keep storing your frozen eggs, and would rather not pursue other options (listed below), you can always request that the clinic or storage facility dispose of them.
Unused frozen eggs option #2: donate them to science
The biggest reason why egg freezing technology has made so much progress over the years is because of individuals volunteering to provide reproductive material for research. The ability to study frozen eggs and embryos, along with the medications, techniques, or devices used among various cycles can help improve success rates for others pursuing fertility treatment in the future.
If you don’t see this listed in your initial contract but want to pursue this as an option, ask your clinic if this is possible.
Unused frozen eggs option #3: keep paying for storage
Frozen egg storage fees will vary depending on the location of the storage facility, the time you’re willing to commit to storage (some facilities offer discounts for bulk pricing — say, paying for 5 years upfront), transportation fees, and more. Typically, this ranges between $500 - $1,500 per year.
As part of the free egg freezing provided through Cofertility’s Split program outlined above, you’ll receive 10 years of frozen egg storage. And of course, you can always remove, thaw, or ship them somewhere else before those 10 years are up if you’d like. After all, they’re your eggs! And if you’re working with a good clinic in the US using vitrification methods (and don’t mind paying storage fees), you can even store your frozen eggs indefinitely.
Unused frozen eggs option #4: donate them to another family
Many individuals or couples — including LGBTQ+ families, those with infertility, or cancer survivors — may rely on egg donation in order to grow their families. If you’re interested in pursuing egg donation, talk to your clinic. You’ll need to undergo some screening to see if you qualify, but this could be an incredible option.
Conclusion
If you’re not 100% certain you won’t be using your frozen eggs and you are comfortable with the storage expense, our recommendation is to continue storing your eggs until you’re sure you no longer need or want them. You never know.
If you have not yet begun the egg freezing process and you are interested in more affordable (even free) egg freezing, take our quiz to see if you qualify for Cofertility’s Split program. It only takes a minute!
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Egg Freezing After Divorce or a Breakup
Divorce or a breakup can be an incredibly challenging and emotionally taxing life event. The end of a relationship can bring about feelings of loss, grief, loneliness, and uncertainty. Divorce can impact various aspects of one's life, including future plans— plans that may have included children. Significant life changes such as divorce may also prompt women to consider egg freezing as a way to preserve their fertility for future family-building purposes.
Thanks to advancement in reproductive technology, egg freezing can offer women the opportunity to preserve their fertility while they focus on other aspects of their lives. But what if they have pursued their education, advanced in their careers, and are happily settled with their forever person, when life takes a left turn? Significant life changes such as divorce may also prompt women to consider egg freezing as a way to preserve their fertility for future family-building purposes. This option may allow them the time needed to heal without feeling pressured to rush into finding a new partner and give them the space to make informed decisions about their future.
The emotional impact of divorce
Divorce or a breakup can be an incredibly challenging and emotionally taxing life event. The end of a relationship can bring about feelings of loss, grief, loneliness, and uncertainty. Divorce can impact various aspects of one's life, including future plans— plans that may have included children. A divorce or breakup can raise concerns about future fertility issues, especially for women over the age of 35.
How egg freezing works, and how much it costs
The process of egg freezing typically begins with ovarian stimulation where the woman undergoes hormonal treatments to stimulate the ovaries. The goal is to produce multiple eggs in one cycle as typically only one egg is produced in a cycle. Once the eggs have reached maturity, they are retrieved via an out-patient procedure where a thin needle is inserted into each follicle, and the eggs are retrieved. Once retrieved, the eggs are cryopreserved using vitrification, a rapid cooling technique. The frozen eggs are then stored in cryogenic tanks until they are ready to be used.
There are a few factors that determine success rates. By success rates we are referring to a live birth outcome using the frozen eggs. Generally, women under 35 have better outcomes and the more eggs retrieved, the higher the likelihood of success. A recent study found that irrespective of age at freezing, a significantly high live birth rate was achieved when the number of eggs frozen per patient was 15 or more.
The process of freezing eggs can cost anywhere from $10,000 to $20,000 and above. Costs include things like the initial consultation and testing, ovarian stimulation and egg retrieval, the egg freezing procedure, medication, and storage fees. Once the eggs are ready to be used, there are costs involved for thawing and then fertilizing to create embryos. After that there are fees for embryo testing and the transfer. If a sperm donor is used, there are various costs involved with that as well.
Learn more about our Split program, where qualified women can freeze their eggs for free when donating half to a family that couldn’t otherwise conceive.
Navigating the decision-making process
Egg freezing allows women to take control of their fertility and help them make informed decisions about their reproductive future, with or without a partner. However, there is still some concern about whether those who choose this option will regret their decision, especially given the costs involved. This article looks at several studies that explore this idea of regret. Overall, it was surmised that the only regret most had was they wished they had done it sooner.
Deciding to freeze eggs after a breakup or divorce can be a complex and personal decision. So it is important to feel and process emotions, seek support when needed, and make decisions that feel right for you and your future goals. It is understandable that following a breakup or divorce, there may be uncertainty about future relationships. So the decision to freeze eggs may involve deciding how to move forward with one's fertility independent of a partner.
It’s also normal to have mixed feelings about the decision to freeze eggs, including relief at having a plan in place for the future but also sadness about the circumstances that led to the decision, and anxiety about the unknowns ahead. So it is very important to find healthy ways to manage stress and anxiety during this time. Which includes self-care, self-compassion, and leaning on support systems.
As important as it is to plan for the future, it is also important to keep in mind that plans always evolve over time. So I encourage you to remain flexible. Be prepared to adjust plans as circumstances change. For example, at what point will you consider a sperm donor? If you find a new partner will you use frozen eggs or will you try to get pregnant on your own? If you do get pregnant without using the frozen eggs, what happens to the frozen eggs? Do they remain stored for a certain period of time? Are they donated? Or are they disposed?
Summing it up
Divorce or a break up brings about significant life changes, including changes in family planning. Freezing eggs provides a way to preserve fertility options for the future, allowing individuals to take time to decide on family planning when they're ready, whether it's with a future partner or as a single parent. It also allows individuals to focus on their emotional healing without feeling rushed into making decisions. By offering a way to preserve fertility and extend the window for family planning, egg freezing has become a valuable option for women navigating life changes.
Read more
- Amanda Goetz on Egg Freezing After Divorce
- We Asked Four Women: Did You Freeze Eggs or Embryos?
- A Breakdown of Egg Freezing Success Rates by Age
Freeze your eggs with Cofertility
Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:
- Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure — medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
- Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.
The benefits of working with Cofertility include:
- Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
- Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
- Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
- Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
- Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.
Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.
Can I Donate My Eggs if I Have a Mental Health Condition?
If you are thinking about donating your eggs, there are a few considerations you should take into account before starting the process. Read on for everything you need to know about egg donation if you have a mental health condition.
At Cofertility, we’re big believers in destigmatizing mental health conditions — whether it’s depression, anxiety, ADHD, substance abuse, or anything else. If you’re treating or working through a mental health condition, we support you and your strength, and we know that recognizing a mental health condition can actually be pretty empowering. But if you are thinking about donating your eggs, there are a few considerations you should take into account before starting the process. Read on for everything you need to know about egg donation if you have a mental health condition.
Do antidepressants or anti-anxiety medications impact cycle outcomes?
If you’re currently on medication for depression or anxiety, the short answer is — most likely — no. Most commonly used SSRI antidepressants and anti-anxiety medications (benzodiazepines) have not been shown to have clear long-term effects upon egg freezing cycles. That includes both egg quantity and quality, as well as hormone levels and the ability to ovulate. There is concern that the use of SSRIs and other antidepressants during fertility treatments could interfere with the effectiveness of hormonal medications used in treatments, potentially by altering the body's response to these hormones or affecting hormone levels directly. This interaction could theoretically exacerbate symptoms of depression due to the added stress of fertility treatments and the hormonal fluctuations they cause
If you’re planning on freezing your eggs — regardless of whether you’re also donating any — you’ll need to provide your doctor’s office with your current medications. As for official guidance, the CDC and the American Society for Reproductive Medicine (ASRM) consider antidepressant usage safe during fertility treatments. That said, you can never be too proactive, so we definitely recommend bringing this question up with your doctor and discussing your medication, specifically.
When it comes to egg donation, however, things get a little bit more complicated. The ASRM (yes, the same organization that stated antidepressants are safe to take during fertility treatments) considers the current use of SSRIs or other antidepressants a “relative exclusion criteria”' for egg donation. So, not an automatic disqualification, but something that should be reviewed by the doctor on a case-by-case basis. All clinics may view this guidance differently, and different intended parents may feel differently about the issue. Again, we recommend discussing your usage of these medications with your fertility clinic and your psychiatrist. Two people may take the same medication for very different reasons, and context is important here.
Cofertility’s eligibility decisions are rooted in adherence to ASRM guidelines, which fertility clinics follow within comprehensive screenings. Many clinics may have their own eligibility policies on top of the guidelines dictated by ASRM – we ultimately defer to the discretion of the clinic and overseeing physician.
Risks of inheritability — and what they mean for your cycle
Even though the usage of SSRIs or antidepressants may not impact your egg freezing cycle outcome or automatically disqualify you from egg donation, it’s still important to understand the inheritability risk of your mental health condition to potential future offspring. When you are undergoing medical screening for egg donation in a specific match, it involves more than just meeting the general requirements for egg donation. This process also includes eligibility to donate for a particular family. Since sperm contributes the other half of the genetic material in an embryo, it is essential to evaluate the genetic carrier status of both you, the egg donor, and the sperm provider collectively.
Depending on your condition, your reproductive endocrinologist (REI, otherwise known as your fertility doctor) may ask your psychiatrist if you are able to safely go off of your medication if needed. And during your psychological evaluation, the psychiatrist will want to verify that you aren’t under excessive stress or experiencing any instability when providing consent.
If, based on your condition and psychiatric history, you are still cleared for egg donation, it’s likely that you will be matched with intended parents who don’t maintain a shared history of your condition or related ones. This will be discussed with a genetic counselor as part of the process to mitigate risk of inheritability to future offspring as a result of your egg donation.
What criteria is required for egg donation?
In order to mitigate the risk of inheritability of mental health issues to offspring, the ASRM has the following criteria in place that would deem someone ineligible to donate:
- Presence of significant psychopathology
- Positive family history of psychiatric disorders
- Current use of psychoactive medication
- Substance use disorders
- Two or more first-degree relatives with substance use disorders
- History of emotional, sexual, or physical abuse without professional treatment
- Excessive stress
- Relationship instability
- Inadequate cognitive functioning to support informed consent
- High-risk sexual practices
- Risks/concerns for the donor for future contact with donor-conceived offspring
Each of these factors would be evaluated as part of your initial egg donation application and/or your psychological screening later in the process.
What’s the rationale for psychological screening for egg donation?
As part of the egg donation application process, mental health screening checkpoints exist at two key points:
- The initial (written) application, including a detailed medical history screening, as some conditions are more heritable than others
- The psychological evaluation that takes place once you’ve already passed bloodwork and physical evaluation portions of the process
These screenings take place for several reasons, but the two primary ones are egg donation preparedness and reducing inheritable risks of the mental health conditions to any resulting offspring.
Preparedness for egg donation
Egg donation isn’t *not* a big deal. You’re helping grow another family who otherwise can’t conceive — and, if you’re donating your eggs through Cofertility’s Split program, you’re also freezing half of the eggs retrieved for your own fertility future. This process is definitely manageable (and actually, empowering?), but someone should only go through with it if they are truly one-hundred-and-fifty-percent ready.
There are many emotional implications involved with egg donation, both for you and the intended parents. Implications like, what degree of communication with intended parents or any future offspring are you comfortable with, if any? We review every single Split program application to ensure that every member feels not only prepared, but excited, about the prospect of matching with another family and donating half of their retrieved eggs.
Reducing inheritable risks to offspring
The second, more clinical reason for psychological screening is ultimately to reduce the risk of any potential future offspring inheriting any serious mental health issues. We (and maybe you, if you’re reading this) know first-hand the struggles mental health conditions can bring, not only to the affected individual but also their loved ones. Depending on the severity of the conditions, it’s important to get ahead of any potential risks to families that may be created as a result of egg donation.
The net-net
Ultimately, if you have a mental health condition, your likelihood of getting approved for egg donation is totally case-by-case. It depends on the specific condition, the severity, medication (if applicable), possible input from your psychologist/psychiatrist, and the evaluation of your readiness for donation. Checks and balances and standardizations within the process exist to ensure you (a) feel great about consenting to the procedure, and (b) that there is not a high risk of passing along a severe condition to potential offspring.
Egg donation with Cofertility
If you’re curious to learn more about egg donation through Cofertility, take our quiz here to see if you may qualify for our Split program. Through Split, donors are supported throughout the process and get to keep half of the eggs retrieved for their own future use.
With our innovative approach, you’ll also get:
- Free storage of your own eggs in cryopreservation for up to 10 years
- Coverage of all medical costs throughout the egg freezing and donation processes
- Connection to the Cofertility community for support all along the way (and after, too!)
- The ability to work with intended parents to decide together what your relationship will look like
We hope to support you on your egg freezing and donation journey!
Who Should and Shouldn't Freeze Their Eggs
Thinking about delaying having kids for a while? Maybe you’re focused on your career, haven't found the right partner, or just aren't ready yet. Egg freezing (oocyte cryopreservation) is a way to take some pressure off that biological clock and increase your fertility options. But is it right for you? Let’s dive into some of the factors doctors use to help people determine if they are a good candidate for egg freezing.
Thinking about delaying having kids for a while? Maybe you’re focused on your career, haven't found the right partner, or just aren't ready yet. Egg freezing (oocyte cryopreservation) is a way to take some pressure off that biological clock and increase your fertility options. But is it right for you?
Let’s dive into some of the factors doctors use to help people determine if they are a good candidate for egg freezing.
Who is a good candidate for egg freezing?
There's no one-size-fits-all answer to who should consider egg freezing (planned fertility preservation). It depends on several factors, including your age, your ovarian reserve (how many eggs you have left), your family-building goals, and when you realistically see yourself wanting children. Anyone thinking about egg freezing should be aware of the chances of getting pregnant using those eggs later, and understand that there's no guarantee of a baby.
One of the most important factors is your age. The younger you are at the time of freezing, the better the quality of your eggs, and the higher your chances of a successful pregnancy later. Those under 35 generally have the highest success rates with egg freezing.
Read more in At What Age Should I Freeze My Eggs?
In addition to age, your doctor will look at your ovarian reserve. Tests like AMH (Anti-Müllerian hormone), FSH (follicle-stimulating hormone), E2 (estradiol), and an ultrasound to see your antral follicle count will give them a picture of how many eggs you have left. This information helps them provide guidance on how many eggs you could expect to retrieve during the freezing process and your overall chances of success.
Egg freezing might also be the right choice for those with certain medical conditions, or those with a family history of early menopause.
Because the answer is different for everyone, you’ll want to have an egg-freezing consultation with a fertility doctor. They'll help you assess the pros, cons, costs, and your individual success rates.
Who is not a good candidate for egg freezing?
Ultimately, the decision will be up to you and your fertility doctor. But there are a few factors that could lead your doctor to dissuade you from freezing your eggs. This includes:
- Over 45: The success rates of egg freezing drop significantly beyond age 45 due to decreased ovarian reserve and lower egg quality. While some clinics might offer the procedure, it's important to have realistic expectations about the low chances of pregnancy.
- Severely diminished ovarian reserve: Hormone tests and an antral follicle count provide an estimate of how many eggs are remaining. If these numbers indicate very low ovarian reserve, egg freezing is unlikely to yield enough eggs to make it worthwhile.
- Planning to conceive soon: If you plan to try for a baby within a year or two, egg freezing usually isn't necessary. The odds of conceiving naturally within that time frame are often good, especially if you are younger. Unless there are underlying medical reasons for concern, it makes more sense to try conceiving naturally first.
- No ovaries: Since egg freezing (oocyte cryopreservation) involves retrieving eggs from the ovaries, this procedure is not an option for those without ovaries.
Even if you fall into one of these categories, it's worth a consultation with a fertility specialist. They can provide personalized guidance based on your specific situation and help you explore all your options.
Why would someone need to freeze their eggs?
There are many reasons why someone might consider freezing their eggs. One major factor is age-related fertility decline. As people age, both the quality and quantity of their eggs naturally decrease. Freezing eggs at a younger age allows for the preservation of higher-quality eggs, potentially increasing the chances of a successful pregnancy later in life.
Medical reasons also play a significant role. Conditions like cancer, endometriosis, or surgeries with the potential to affect the ovaries can lead to premature infertility. Egg freezing allows individuals to preserve their fertility before undergoing treatments that might compromise it. Egg freezing is also an option for transgender men considering gender-affirming surgery or hormone therapy. It allows them to retain the possibility of having biological children in the future.
Those with a family history of early menopause might also consider egg freezing. If you have female relatives who experienced early menopause, you could be at higher risk. Egg freezing gives you greater control over your fertility timeline.
Sometimes, egg freezing simply centers around flexibility in life planning. Some people choose to delay childbearing to pursue education, establish their careers, or find the right partner. Egg freezing can provide peace of mind and increased options when it comes to building a family.
At what age should you freeze your eggs?
According to the American Society for Reproductive Medicine (ASRM), an optimal time to freeze your eggs is in your 20s and early 30s, while you have a higher ovarian reserve and eggs are healthier. So whether you’re 25 or 35, you can absolutely freeze your eggs!
A large 2020 study at a fertility clinic that specializes in this area looked at egg-freezing cycles for over 1,200 people. It compared the average number of eggs people of different ages were able to freeze versus the “optimal” or goal number of eggs they should freeze. This goal number was based on how many eggs would give them a 70% live birth rate after doing 1 or 2 egg freezing cycles (this rate is calculated using some other numbers and it typically goes up as we age to make up for the lower number of healthy eggs).
The study found that younger people, unsurprisingly, have an easier time freezing the goal number of eggs in one cycle. As people aged, they needed multiple egg freezing cycles to reach that goal number. These findings bring up a common question– is it worth freezing eggs after age 35?
Is it worth freezing your eggs after 35?
Well, it depends. The ASRM does not recommend egg freezing for people older than 38, but this isn’t a strict cutoff. Everyone’s fertility goes down at a different rate. Having your fertility hormones checked can sometimes help you and your doctor get a general idea of what your ovarian reserve is. This can better help you decide if egg freezing is right for you.
To freeze or not to freeze, that is the question
When trying to decide if you should freeze your eggs, it’s important to know that egg freezing is not an “insurance policy” for your fertility. While egg freezing can take some of the stress of having a baby right now off your shoulders, it is not a guarantee that you’ll have a baby in the future.
Why not? Well, not all the eggs that get frozen will actually be viable. It’s expected that some eggs will not survive the warming process. In addition, the chances of the eggs that do survive being successfully fertilized depends partially on how old you were when you froze them (more on this later).
This is not to sway your decision one way or another. Ultimately, only you and your doctor can decide if egg freezing is the right decision for you. But it's important to go in knowing that it’s not meant to be a done deal.
Freeze your eggs with Cofertility
We’d love the opportunity to support you on your egg-freezing journey.
Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.
Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg-freezing process (or gearing up for it) to connect and lean on each other.
By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help promote social justice and strengthen gender equality.
Summing it up
Here are the factors to consider if you are debating if egg freezing is right for you:
- Age matters a lot. The younger you are at the time of freezing, the better the quality of your eggs, and the higher your chances of a successful pregnancy later. Those under the age of 35 generally have the highest success rates with egg freezing. Egg freezing isn't recommended for people older than 45 due to low chances of success.
- Think about your timeline. How long do you plan to wait to have children? Egg freezing is great for a longer delay, but likely not worthwhile if you’re only thinking a year or two ahead.
- Check your eggs. Tests like AMH, FSH, and ultrasounds with follicle count can give you a picture of your ovarian reserve (aka, how many eggs you have left).
- It's not a guarantee. Even with frozen eggs, there's no promise of having a baby in the future.
- The $ factor. Egg freezing is expensive! Most insurance plans don't cover it, so be prepared for an out-of-pocket cost. Or consider our Split program where you can freeze your eggs for free when donating half to a family that can’t otherwise conceive.
Freezing your eggs is a big decision, and it's different for everyone. The best thing to do? Talk to a fertility specialist! They'll help you understand the pros, cons, chances of success, and whether it makes sense for your particular situation.
AMH 101: Everything You Need to Know
Everything you need to know about the little signal your ovaries send out called Anti-Müllerian Hormone (AMH).
Ever scrolled through that health and wellness side of social media and stumbled upon something called AMH? Maybe your best friend casually mentioned getting her AMH tested, and you were too embarrassed to ask what the heck she was talking about. You're young, you feel great, and having babies isn't even on your radar right now. But here's the thing: understanding this thing called AMH could be a major game-changer for your future.
What is AMH?
AMH stands for Anti-Müllerian Hormone. Think of it as a little signal your ovaries send out. This hormone level tells your doctor about how many eggs you have left – also known as your ovarian reserve. Basically, AMH is one clue into your fertility. And, here's why you should care even if kids aren't on your mind yet.
Why does AMH matter in your 20s and 30s?
AMH can be a helpful biomarker for your health and fertility. Why?
- Knowledge is power: Knowing your AMH levels gives you valuable insights into your reproductive timeline. It helps you make informed decisions about when you might want to start a family and whether fertility preservation options (like freezing your eggs) might be something to consider down the road.
- Fertility isn't forever: You might think of your 20s as your prime fertility years, and while you're not wrong, it's not the full picture. Your fertility peaks in your early 20s and starts a gradual decline in your mid-30s. For some people, this decline is faster, and AMH levels can give you a heads-up.
- Unexpected roadblocks: AMH testing can help detect potential fertility issues early on, like Polycystic Ovarian Syndrome (PCOS) or premature ovarian insufficiency. Getting this info sooner rather than later can help you take steps to manage these conditions and protect your fertility.
What can AMH test results tell you?
So what exactly can AMH tell you about your fertility? Your AMH level is positively correlated with the number of follicles you have in your ovaries. Simply put, the more follicles you have, the higher your AMH level typically is. As a result, AMH levels have been shown to be a good predictor of ovarian reserve and someone’s expected response to fertility treatments.
In fact, several studies have shown that there is a strong correlation between what your AMH level is and the number of mature eggs retrieved during an egg freezing or in vitro fertilization (IVF) cycle. To learn more about those studies, check out AMH and Egg Retrieval Outcomes.
What your AMH level can’t tell you is the exact number of eggs you have left in your ovaries or what your chances of pregnancy are. There are a number of other factors like your age, overall health, and genetics that also affect the number and quality of eggs and your overall fertility. So while AMH can be a useful tool in assessing your fertility, it shouldn’t be the only factor when making decisions about fertility treatments.
So, you got your AMH tested. Now what? Here's a basic breakdown of what those numbers usually mean:
- Normal AMH means you're right on track for your age – good news!
- High AMH might suggest a good number of eggs remaining, and potentially even point towards conditions like PCOS where your egg count is unusually high.
- Low AMH could mean you have fewer eggs remaining than typical for your age group. It might signal a faster decline in fertility, but it doesn't mean you can't get pregnant at all.
Remember, your AMH level is just one piece of the fertility puzzle. Other factors like your overall health, other hormone levels, family history, and lifestyle habits matter too!
What are normal AMH numbers?
What is considered a “normal” AMH level depends on your age, as well as the lab where you take the test. Since there is no international standard, it’s best to use the reference ranges included on the test results (your doctor can share those with you if you did a test through a clinic).
In general, however, an AMH between 1.0 and 3.5 ng/mL suggests a “normal” range that is likely to have a good response to egg freezing.
Common reasons for high AMH
The most common reason for high AMH is that you are very fertile and likely to retrieve more eggs in an egg freezing cycle. But, it does not necessarily mean that the eggs are of good quality. Egg quality is determined by factors such as your age, genetics, and environmental factors, and cannot be measured directly by AMH levels.
But a high AMH level may also indicate PCOS, which is a hormonal disorder that affects 8–13% of females of reproductive age. Those with PCOS typically have high levels of androgens (male hormones) and may have irregular periods, acne, and excess hair growth. Patients with an average AMH level ≥ 4.45 ng/ml have a 9.35 times higher likelihood of developing PCOS, but not all patients with a high AMH have PCOS.
In rare cases, abnormally high AMH could be a sign of an ovarian tumor. Certain types of ovarian tumors, such as granulosa cell tumors, can produce high levels of AMH.
Read more in: What Does a High AMH Result Mean?
Common reasons AMH would be low
By far, the most common reason for a low AMH is age. People with ovaries are born with all the eggs that they’re going to have in their lifetime. These eggs are then slowly used up over time as you ovulate during each menstrual cycle until menopause is reached. As a result, ovarian reserve naturally decreases over time, meaning the AMH level also decreases.
Research suggests that hormonal birth control may affect AMH levels but it depends on the type of birth control. Specifically, birth control use is associated with a lower average AMH level than for people who are not on birth control, with the exact effect depending on the type of birth control.
The amount of time you’re on birth control may also be a factor. Multiple studies have shown that AMH doesn't change if you use combined oral contraceptive pills for less than six months. However, you may have a lower AMH if you’ve been a long-term user of the pill (or other hormonal methods). Thankfully, this is temporary – AMH levels typically rebound after a person stops using birth control.
There are several other, less common causes for a low AMH level. These include:
- Genetic disorders that affect the X chromosome
- Medical treatments like radiation or chemotherapy
- Having surgery on your ovaries
- Losing one or both of your ovaries
- Autoimmune conditions
Read more in: What Does a Low AMH Result Mean?
Factors that can influence AMH levels
It's important to know that some things can temporarily or even permanently change your AMH:
Birth control
Certain types of birth control can suppress your natural AMH levels. One study looked at data from women on various types of birth control and found:
- Combined oral contraceptive pill led to 23.7% lower AMH
- Progestin-only pill led to 14.8% lower AMH
- Vaginal ring led to 22.1% lower AMH
- IUD led to 6.7% lower AMH
- Implant led to 23.4% lower AMH
- Copper intrauterine device led to 1.6% lower AMH
The authors concluded that birth control use is associated with a lower mean AMH level when compared to those who are not on contraceptives, with variation depending on the type of birth control
Health conditions
Things like PCOS, endometriosis, vitamin D deficiency, or even a recent ovarian surgery can impact your AMH levels.
Chemotherapy
Chemotherapy treatments for conditions like cancer can significantly lower AMH levels. Research indicates that pre-chemotherapy AMH levels may be helpful in predicting ovarian function and potential fertility after treatment. A prospective study of women treated with chemotherapy for early breast cancer showed that long-term ovarian function after treatment was predictable using serum AMH levels before treatment.
Obesity
Studies suggest a connection between obesity and lower AMH levels, though the exact relationship is complex. Obesity is linked to hormonal imbalances and inflammation, which can disrupt ovarian function and potentially affect AMH production. However, it's important to note that not everyone with obesity experiences lowered AMH, and other factors could also be at play. More research is needed.
Smoking
Studies have also shown that tobacco use, usually cigarette smoking, decreases AMH levels. This effect appears to be reversible though–it was only seen in people who were active smokers, not people who had previously smoked.
What is a good AMH level for egg freezing?
Research has found that AMH is a good predictor of the response to ovarian stimulation and the number of eggs retrieved. Because of this, fertility doctors typically use your AMH levels (along with other biomarkers) to determine the drugs and dosages you will need to maximize your response to ovarian stimulation.
Now, what about a correlation between AMH and actual babies born (live birth rate)? Well, while AMH does seem to have some association with live birth rates after IVF, its ability to actually predict a live birth is not that great. This is especially true for younger people. A 2021 study found that AMH is a good predictor of live birth in older (>39 years old), but not younger, people. They found that younger participants (≤38 years old) could get pregnant even with low AMH levels as long as they had frequent egg retrievals.
Does AMH predict the number of eggs you will retrieve during egg freezing?
The overall success of an egg freezing cycle largely depends on the number and quality of eggs retrieved. Studies have shown that AMH levels can be used as a predictor of egg quantity, and can thus help to predict the potential success of egg freezing. Those with higher AMH levels tend to have better outcomes with egg freezing, as they are likely to have more eggs retrieved and a higher chance of success in future fertility treatments.
But by no means does a high AMH level guarantee a lot of eggs during an egg retrieval procedure for fertility treatments. The number of eggs retrieved during an egg freezing cycle depends on several factors, including your age, ovarian response to stimulation medications, any other underlying medication conditions, and the skill of the fertility doctor performing the procedure.
When eggs are retrieved, only a portion of those eggs will be mature. A mature egg is one that’s ready and able to be fertilized. At most clinics, any non-mature eggs are discarded, though you can talk to your clinic about whether they’re open to freezing those too.
Multiple studies have shown a strong correlation between AMH levels and mature eggs retrieved during egg freezing or IVF.
Let’s look at a few of the studies:
The study: Correlation between anti-Müllerian hormone, age, and number of oocytes
Who: 1500 patients in Brazil between July 2012 and April 2019
The findings: “A positive correlation was found between serum AMH levels and total number of retrieved and mature oocytes from stimulated cycles”
Who: 1,112 patients undergoing an egg retrieval as part of ART
The findings: “AMH showed a stronger correlation with egg number compared with age over a wide age range”
Who: 314 infertility patients with an average age of 31.0 ± 4.5 years
The findings: “the AMH level of women of all ages was positively correlated with the number of retrieved oocytes “
Who: 58 women with fluctuating and persistently high serum day 3 (D3) FSH.
The findings: “These data demonstrate for the first time that serum AMH is a prognostic indicator independent of age and FSH of the number of eggs retrieved”
Who: 73 women undergoing ART with elevated early follicular FSH levels
The findings: “Random AMH levels were strongly correlated with the number of oocytes retrieved during an ART cycle among women with elevated FSH”
Read more in AMH and Egg Retrieval Outcomes
What AMH do I need to donate my eggs?
Through Cofertility’s Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive. In the context of donating through our Split program, having an appropriate level of AMH is important. Fertility doctors typically consider an AMH level above 2.0 ng/ml as a good indicator for egg donation, and this is the benchmark used at Cofertility. Note that some clinics have a higher requirement.
This level suggests that you are likely to respond well to fertility treatments and produce a sufficient number of eggs for both donation and personal use. This allows us to proceed with the egg retrieval process in a manner that is both safe and effective.
However, if your AMH level is lower than this, it does not necessarily mean you cannot freeze your eggs. You can still qualify for our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.
Everyone is unique, and AMH is just one factor of many that we consider during the evaluation process. You can learn more about qualifications for our Split program here.
When should I test my fertility?
So, when is the “right” age for testing your fertility, anyway?
It depends.
And ultimately, it’s up to you! It’s your body, and your data, and there is no one-size-fits-all answer. We’re firm believers that knowledge is power and you deserve this information. Studies do show that our ovarian reserve declines with age — in other words, it’s a good idea to assess your fertility potential sooner rather than later. That way, if you do want to preventatively freeze your eggs, you can do so while your ovarian reserve is still higher.
According to the American Society for Reproductive Medicine (ASRM), the optimal time to freeze your eggs is in your 20s and early 30s. This study also indicated that, as we get older, our chances of needing to do multiple egg freezing cycles increase in order to achieve a 70% live birth rate. We know we’re a bit of a broken record here, but: the younger you are, the healthier and more plentiful your eggs are.
Should I test my fertility at home or in a clinic?
At-home fertility tests have gained popularity in recent years due to their convenience and privacy. These tests typically involve collecting blood or urine samples and mailing them to a laboratory for analysis. On the other hand, in-clinic fertility tests are conducted at a medical facility, where specialized equipment and healthcare professionals are available.
The pros of at-home fertility tests include:
- Convenience and privacy: Samples can be collected in the comfort of your home.
- Cost-effective: At-home tests are often more affordable than in-clinic procedures.
- Early assessment: At-home tests allow you to gain insights into your fertility potential before actively trying to conceive. Plus, you won’t have to wait to get squeezed in for an appointment at the clinic!
The pros of testing your fertility at a clinic:
- A broader scope: At-home tests may not provide a comprehensive evaluation of fertility health, while testing your fertility at a clinic provides a more comprehensive picture of your fertility. An important note is, when testing your fertility at a clinic, you’ll also undergo a transvaginal ultrasound, where the technician or doctor will be able to get a view of what’s going on in those ovaries and the number of follicles available this cycle.
- Better accuracy: Some at-home tests may have varying levels of accuracy when compared to in-clinic tests.
- Facetime: At a clinic, you’ll have the ability to chat directly with a doctor, before and after your results.
If you do end up going with an at-home test, we have an exclusive discount with the LetsGetChecked Ovarian Reserve Test. It’s $139, and you can get 25% off with code COFERTILITY25. But there are many other options as well.
Although at-home fertility tests are a great way to get a peek behind the curtain of your fertility, they aren’t without limitations. For starters, according to recent studies, measuring AMH alone may not predict your time to pregnancy. As mentioned above, testing your fertility with a doctor at a clinic will likely provide a more comprehensive picture of your fertility outlook, especially as they consider your medical history, and conduct a physical exam and transvaginal ultrasound. Of course, you’ll also get professional interpretation of the results that you may not receive with an at-home fertility test.
All of that being said, any fertility testing (whether at home or in a clinic) only measures your fertility at that given point in time. It should not be taken as a guarantee for future outcomes. It also can’t tell you anything about your egg quality, which cannot be truly observed until it comes time to actually fertilize those eggs.
You are not a number
Repeat after me: you are more than one number! Your AMH level provides valuable insights into your ovarian reserve, but it’s just one piece of the puzzle when it comes to your fertility. AMH is always used as part of a full fertility evaluation, which often includes information about your medical history and age, a partner semen analysis, an ultrasound of the pelvis, an x-ray of the uterus and fallopian tubes, and/or additional lab work.
If that sounds like a lot, it is. This process can be overwhelming but focusing on the things that you can control can help you feel more grounded during your fertility journey, whatever that may look like.
Read more:
Understanding the Risks of Zika in Egg Freezing and Donation
In this article, we will delve into what the Zika virus is, where you could contract it, and how it could impact the outcome of egg freezing cycles. Additionally, we will discuss the regulations and guidelines set forth by fertility clinics, as well as specific considerations for egg donation. The TLDR: we recommend proper planning, timing, and precautions when it comes to traveling to an area affected by Zika.
So, you want to freeze your eggs, but you also want to travel — potentially to an area reportedly affected by the Zika virus. You’ve heard a lot here and there about the serious risks of Zika, but does living your globetrotting dreams mean you need to put your egg freezing plans on hold?
In this article, we will delve into what the Zika virus is, where you could contract it, and how it could impact the outcome of egg freezing cycles. Additionally, we will discuss the regulations and guidelines set forth by fertility clinics, as well as specific considerations for egg donation. The TLDR: we recommend proper planning, timing, and precautions, (especially if you’re freezing your eggs for free when you donate half to another family who can’t conceive), when it comes to traveling to an area affected by Zika.
What is Zika and where is it found?
Zika virus is a mosquito-borne flavivirus primarily transmitted by Aedes mosquitoes. While Zika virus infection often presents with mild symptoms, such as fever, rash, joint pain, and conjunctivitis, it poses a significant risk to pregnant individuals due to its association with congenital Zika syndrome, which can result in severe birth defects such as microcephaly.
The virus has been found to persist in bodily fluids, including semen and vaginal secretions, for an extended period, raising concerns about the potential transmission of Zika through reproductive tissues. So, even if you yourself did not travel to a Zika-affected area, if you had sex with someone who did, there still poses a risk. Unfortunately, there are currently no vaccines available to prevent contracting Zika.
Zika virus has been reported in various regions globally, with particular prevalence in tropical and subtropical areas. Countries with ongoing transmission of Zika virus include but are not limited to parts of Central and South America, the Caribbean, Africa, Southeast Asia, and the Pacific Islands. It's important for individuals considering egg freezing to stay informed about current Zika-affected regions, as travel to these areas may impact their fertility treatment plans. The good news is that according to the CDC, since 2019, there have been no confirmed Zika virus cases from US territories.
How Zika could impact your egg freezing cycle?
Research about Zika and egg freezing is scarce and ongoing. But if you’re considering undergoing egg freezing, exposure to Zika could have implications on the success of the procedure. Zika virus infection could potentially impact the quality and viability of eggs, leading to compromised outcomes in your egg-freezing cycle. And because Zika is a virus that may be able to be transmitted sexually, there is a concern that the risk of Zika can be transmitted through the fertilization process.
Fertility clinic regulations and guidelines
In response to the Zika virus outbreak, many fertility clinics have implemented strict regulations and guidelines to mitigate the risk of transmission and ensure the safety of patients undergoing assisted reproductive procedures. These regulations often include restrictions on travel to Zika-affected areas for individuals undergoing fertility treatments, including egg freezing.
We recommend notifying your fertility clinic as soon as possible of any upcoming travel to a Zika-affected area, and you can discuss with your doctor how this should (or shouldn’t) impact your cycle timeline.
Zika guidelines for egg donation
When it comes to egg donation in particular, the American Society for Reproductive Medicine (ASRM) and the Food and Drug Administration (FDA) have provided guidance to fertility clinics regarding the handling of reproductive tissues in the context of Zika virus transmission. According to the latest guidance published in 2018, the use of sperm, eggs, and embryos from a donor is not recommended if he/she/they:
- Have had a diagnosis of Zika virus infection in the past 6 months
- Reside in or traveled to an area with active Zika virus transmission within the past 6 months
- Have had sex with a person if within the past six months that person was diagnosed with Zika, experienced an illness consistent with Zika, or traveled to an area with active Zika transmission
This guidance applies to both disclosed and undisclosed donations. However, in the case of a disclosed donation, many fertility clinics are willing to waive the six-month quarantine if both the donor and intended parents agree.
So, what should you do?
We get it — when there’s still so much to learn about Zika, understanding its potential impact upon your egg freezing cycle can feel confusing. If you’re planning an egg freezing or donation cycle, it’s crucial to stay informed about Zika-affected areas and adhere to the regulations and guidelines set forth by fertility clinics and regulatory bodies.
Again, when in doubt, consult with your reproductive endocrinologist for the latest guidance and recommendations. They’ll help you navigate how this may affect your egg freezing timeline and decision-making. By prioritizing safety and asking the right questions, you can make informed choices to protect your reproductive health and achieve your fertility goals.
How to Cope with Loss During the Egg Thawing Process
Before embarking on egg freezing, it is important to be well informed and have realistic expectations regarding the likelihood of future use and outcomes. Although egg freezing has high success rates it is not a guarantee or an insurance policy as some do experience loss during the thawing process.
In 2012, when the American Society for Reproductive Medicine (ASRM) and Society for Assisted Reproductive Technology (SART) removed the “experimental” label off of egg freezing, it began a new era of empowering women with taking control of their reproductive choices.
According to SART data, egg freezing in the United States increased by 880% between 2010 and 2016. In a recent 2021 study, a total of 231 patients with 280 cycles were reviewed. 74.2% of oocytes survived thaw/warming, and 68.8% of surviving oocytes were successfully fertilized with a live birth rate of 33.8%
Although egg freezing has high success rates it is not a guarantee or an insurance policy as some do experience loss during the thawing process. The emotional and psychological impact of potential loss during this stage can be very painful. Before embarking on egg freezing, it is important to be well informed and have realistic expectations regarding the likelihood of future use and outcomes.
Emotional responses to loss in fertility treatments
Reasons behind wanting or needing to use cryopreservation vary from a young woman who is not yet ready to start a family to someone undergoing medical treatment. The idea of being able to stop the biological clock is not only exciting but can be a relief and bring some peace of mind. But, what happens for those who return to use their cryopreserved oocytes only to come out empty-handed? This unique loss creates intense disappointment, grief, guilt, and stress.
Grieving and processing the loss
It can be incredibly painful to come to terms with this type of loss. You may feel that options have run out and that the door to parenthood has been closed. Processing this loss is difficult because it can feel invisible. This loss represents the demise of something that never was - this ‘thing’ was only something that was seen with your mind’s eye, your heart, and your soul. Because of the invisibility of this loss, you may feel that your feelings are not being recognized or acknowledged, or that you are not being validated or supported during this time.
Give yourself some breathing room. Let all the emotions come up and let them be for a bit - it is okay to feel angry, bitter, sad, hurt. These are normal reactions to this type of loss. We work so hard to avoid or push our emotions away. But how to process loss and how to grieve means to notice our emotions, name them, and allow them to come and go on their own time.
Seeking support and building a support network
Healthy ways to process emotions can include talking to loved ones and telling them what it is that you need from them. If that does not feel right then start building a support network consisting of online or local support groups composed of people going through the same things. Never underestimate the role of professional support especially by counselors specializing in fertility issues. They can help you manage emotions and give you a safe space to talk.
Self-care and coping strategies
Explore different methods of self-care that feel right for you such as engaging in hobbies or participating in creative or social activities. These can be anything from journaling, exercising, being in nature etc.
Summing it up
Egg freezing has afforded women the ability to start a family on their own terms. Science has found a hack to nature’s biological clock. But before embarking on egg freezing and thawing, set realistic expectations. Understand that there can be many different outcomes. And not all have a happy ending. Do your research, ask a lot of questions. And most importantly, be kind to yourself.
Mastering the Art of Egg Freezing Injections: Your Guide to Fertility Injections and How to Administer Them
Injectable medication shots can be daunting - mentally, emotionally, and physically - but an essential aspect of egg freezing. This article aims to provide clinically-sourced tips to guide you through it.
Egg freezing is, undoubtedly, one of the most empowering journeys anyone with a uterus can embark on. One of the biggest reasons you’ll feel like you can conquer the world after an egg freezing cycle is also one of the least fun parts about it: the injections.
If you’ve already begun to explore freezing your eggs, you know that the process requires administering injectable medication shots. So a thorough understanding of how they work — and how to get through them all (mentally, emotionally, and physically) — is essential. This article aims to provide clinically-sourced tips to guide you through this crucial aspect of egg freezing.
Types of egg freezing shots and medications
At its core, egg freezing involves the use of injectable medications to stimulate the ovaries, promote egg development through maturity, and enhance the chances of a successful egg retrieval. What doctors — and you — are looking for is strong egg volume and quality, and certain medications are used to help you on the road to get there.
These medications fall into a few categories:
Follicle-Stimulating Hormone (FSH)
FSH medications stimulate the ovaries to produce multiple eggs.
Luteinizing Hormone (LH)
LH medications support the final maturation of eggs within the ovaries.
Gonadotropin-Releasing Hormone Agonists/Antagonists
These medications prevent premature ovulation, ensuring that eggs are retrieved at the optimal time.
Human Chorionic Gonadotropin (hCG)
hCG triggers the final maturation of the eggs, preparing them for retrieval. Otherwise known as a “trigger shot,” this shot is timed right before your retrieval so they are at peak maturity (without ovulating, of course!).
The number of shots required varies among individuals, but it typically ranges from 10 to 20 injections over a period of 8 to 14 days. While the idea of injections may seem daunting, many individuals find the process totally manageable with proper guidance.
At Cofertility, all Freeze by Co members gain access to our free member community portal, where we share tons of egg freezing tutorial videos that walk you through the whole thing, step-by-step. You can also ask a partner, friend, or family member to help!
Do egg-freezing shots hurt?
The pain associated with egg freezing shots is subjective and varies among individuals. Most commonly, individuals report feeling a mild discomfort or a slight pinch during the injection. Here are some tips on managing egg freezing injections and making the process more comfortable, but you can dive into more here.
Tips for making injections painless
Utilize the right technique
Proper injection technique is crucial for minimizing pain. The angle and speed at which the needle is inserted, as well as the depth of injection, can impact the level of discomfort. Our videos in our community member portal provide a good, close look at the right technique and method of injection. If you have extra syringes, you can also practice injecting water on a peach or another fruit!
Ice the injection site
Applying an ice pack to the injection site for a few minutes before the injection can numb the area, making the process more comfortable.
Let medications reach room temperature
Allowing the medications to reach room temperature before injection can reduce the sensation of cold, making the process more comfortable. (Of course, you’ll want to read the packaging or talk to your doctor to make sure this is okay for your specific medication).
Take deep breaths
Practicing deep breathing exercises before and during the injection can help relax the muscles, making the process less painful.
Troubleshooting egg-freezing shots
Despite careful planning and execution, you may encounter some issues with egg freezing injections. It’s essential to be aware of potential challenges and know when to call your clinic.
Missed or incorrect dosages
Missing or administering an incorrect dosage can impact the efficacy of the egg freezing process. In case of a missed or potentially incorrect or missed dosage, it is crucial to contact your doctor immediately for guidance on the appropriate course of action. Most fertility clinics have on-call support that you can contact after hours if needed.
Injection site reactions
Some individuals may experience redness, swelling, or bruising at the injection site. These reactions are generally mild and temporary. However, persistent or severe reactions should be reported to your doctor for evaluation.
Ovarian Hyperstimulation Syndrome (OHSS) risks
OHSS is a potential (though low) risk of egg freezing, during which your ovaries can become overstimulated as a reaction to the fertility medication. If you experience symptoms such as severe abdominal pain, nausea, or shortness of breath, it is crucial to seek immediate medical attention.
If you’re afraid of needles
We get it. Sometimes, even with the most support and the best resources, you just might not be able to get yourself there when it comes to needles — even if you really want to freeze your eggs. If this is the case, talk to your doctor about a protocol known as “mini IVF”.
Mini IVF is a newer, needle-free alternative to fertility injections, where fertility medication is given via capsule form instead. Often, mini IVF candidates include those who are at higher risk of developing OHSS or those who actually have lower ovarian reserves that may not be able to be helped much with injectable medications anyway.
If this is you, chat with your doctor to see if you’re a candidate for mini IVF and what kinds of results to expect.
Summing it up
Mastering the art of egg freezing involves meticulous attention to ordering, organizing, and administering injectable medication shots. We’ve got your back with tons more educational content and egg-freezing tips.
If this article’s got you feeling like you can conquer the world (10-14 days of egg-freezing injections? No sweat!), check out our Split program, where you can freeze your eggs for *free* when you donate half to another family who can’t conceive. By donating half of their frozen eggs to LGBTQ+ parents, those with infertility, or cancer survivors, participants in our Split program can make a meaningful impact for themselves and others. Apply for our Split program today.
Can You Actually Test Your Fertility At Home?
Whatever your reason for wanting to take an at-home fertility test, here’s what you need to know about what your options are, how they work, and what you can expect to learn.
Can you test your fertility from the comfort of your own home? The answer is a bit complicated. Isn’t it always when it comes to fertility? Yes, there are some tests that both men and women can take at home to get a better idea about some aspects of their fertility. But are they an acceptable substitute for an individualized appointment with a fertility specialist?
Unfortunately, no—while these tests are often fairly accurate, that’s not really the issue here, says Dr. Jaime Knopman, a board-certified reproductive endocrinologist. It’s all the medical expertise you’re missing out on when you test your fertility at home.
“The tests we run in our clinic are much more accurate because our job can’t be done completely by machine,” she explains. “It’s not just the tests, it’s the person interpreting them.”
But you still might not live close to a fertility clinic, have insurance that covers fertility appointments or testing, or even feel like you’re really at the point yet in your fertility journey where you need a formal eval from a specialist. We get that.
So whatever your reason for wanting to take an at-home fertility test, here’s what you need to know about what your options are, how they work, and what you can expect to learn.
How can I test my fertility at home: for women
When it comes to the ladies, there are two main varieties of tests you can do at home: you can check your ovarian reserve and you can do a broad panel screening for several different hormones that play a part in fertility health. Here’s the scoop.
Ovarian reserve tests measure the amount of follicle-stimulating hormone (FSH) in your blood with a pinprick. Typically, you collect a sample yourself and mail it back to the company so they can read and deliver your results. Very high levels of FSH can be a sign that you don’t have a lot of eggs, that they’re poor quality, or both, because your body is working overtime to produce enough FSH to release a healthy egg.
- Taking this test feels like a typical finger prick. It hurts for a sec and then you’re over it. You will have to squeeze out some blood into designated spots on a testing card, though, so if you’re blood-averse be prepared.
- The tests themselves can accurately check your FSH level, but there’s more than one way to figure out what your ovarian reserve looks like. Only measuring FSH will give you a piece of the puzzle...but could also cause you to unnecessarily panic about your fertility. Try not to do that! Remember, these tests are useful, but not foolproof.
- FSH levels alone may not be a great way to assess your fertility in the first place. A 2017 JAMA study found that biomarkers like FSH aren’t the best predictors of future fertility in women with reduced versus normal ovarian reserves.
Fertility health screenings capture your FSH level but also a bunch of other hormones that impact your fertility in one way or another. The exact hormones measured in an OTC fertility test differ between companies, but you can usually find out your FSH level and any or all of the following:
- thyroid-stimulating hormone, or TSH a marker of thyroid health)
- estradiol (helps with ovulation)
- anti-mullerian hormone, or AMH (an indicator of egg reserve)
- prolactin (makes breast milk after birth)
- luteinizing hormone, or LH (regulates your cycle, especially ovulation)
- testosterone (helps make follicles, but too much may mess up your fertility)
These tests all work like the ovarian reserve test: you prick your finger, collect some blood samples, send the samples back to the company, and then wait for your results to come in. Usually, you’ll get factual data (like, “your TSH is off”) but also an explanation of what that might mean for your fertility.
Most companies allow you to see your results online and consult with an on-staff medical professional if you have questions or don’t understand your results. They’re pretty easy to order online, but many aren’t cheap—they’re usually about $150—and you’ll have to pay out of pocket.
How can I test my fertility: for men
The only kind of male fertility test that can be done at home is a sperm analysis. About half of all couples’ infertility problems can be caused by male infertility, so knowing if your swimmers are strong or not is a good place to start if you’ve been trying to conceive for a while.
There are actually several different kinds of sperm analysis kits; sometimes you collect a sample and send it through the mail for testing, sometimes you put some sperm on a slide and insert it into a testing device, and sometimes you can even use your smartphone (yes, for real!).
- Testing at home is private and confidential. You don’t have to worry about being unable to provide a sample at an unfamiliar clinic or doctor’s office.
- The kits you send off to labs via mail can be more accurate, but at the same time, there’s a lot that can go wrong here—like failure to keep the sperm stored at just the right temp, which can cause damage to the sample. At-home tests, while giving quicker results with no middle-man, have a lot of potential for both user and technology errors.
- Male fertility is about more than just the amount of sperm: there’s motility, shape, concentration...the list goes on. If your at-home kit is only looking at the number of sperm, your results may not be that helpful. Try to choose a test that looks at more than one type of factor—this will give you the most bang for your buck.
Don’t forget about ovulation!
While ovulation predictor kits only tell you if and when you’re ovulating, this can be very helpful if you’re actively TTC.
These kits work by detecting the presence of LH in the urine, says David Diaz, MD, reproductive endocrinologist and fertility expert. When your LH rises above a certain level, the test strip you’ve peed on will let you know that an ovary is just about to release an egg. This is a good time to get it on, since there’s a good chance that egg could become fertilized.
According to Dr. Diaz, these tests are about 85 percent accurate and available as digital and non-digital tests. If you have fairly regular menstrual cycles, an ovulation predictor kit can be a useful tool in identifying exactly when your fertile window is, but if your cycles are irregular (because of PCOS, pre-menopause, or even just your personal biology), it can be harder to rely on them unless you’re taking a test every day.
Next steps
Okay, you took an at-home test and got your results back...now what? Well, you might not like our answer, but here it is: you should probably still go see a fertility doctor. Yes, even if your results are “normal.” Why?
Because, like we told you upfront, a test you do at home gives you important data — but not the expertise and counsel of a doctor who has met you in person and knows your medical history. You’ll have the info, just not necessarily the context...and the context is super important when it comes to your fertility. At-home tests simply can’t paint the same kind of comprehensive picture that doctor-interpreted lab tests can.
But you’re here because you want to take an at-home fertility test...and TBH, we kinda don’t blame you! We’re curious, too! Just make sure you know what you’re buying, (Dr. Knopman says that you should make sure any OTC test you buy comes from a legit manufacturer with a fertility doctor on their medical review board), what the tests can tell you, and what you’re going to do with the results.
“Even if you don’t want to do fertility treatments [right now], there is no harm in coming in to talk to us about it,” says Dr. Knopman. “You can make better decisions when you have that information than when you don’t…[and] the worst thing to do is sit at home and ruminate, trying to interpret your own results or diagnose yourself.”
What’s the takeaway here? After taking an at-home fertility test, you might want to plan to make an appointment with a fertility specialist. It can be a simple introductory or informational appointment, and even a virtual one. But hopefully, it will give you peace of mind and — most importantly — answers.
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