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.

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.