egg freezing

Our goal at Cofertility is to match intended parents with Split members who can help them achieve their goal of parenthood.  Because of that, we want to make sure we’re upfront about what might disqualify someone from our Split program. 

Through this program, you can freeze your eggs for free if you donate half to a family who can’t otherwise conceive. But, importantly, several factors may limit your eligibility.  Some of these are official disqualifiers based on regulations by the Food and Drug Administration (FDA). Others are discretionary disqualifications based on recommendations by governing bodies like the American Society for Reproductive Medicine (ASRM). 

While it’s not possible to create an exhaustive list of every reason someone may not qualify for our Split program, this guide outlines some of the most common reasons for disqualification.

Age

To apply to be a part of the Split Program, you must be between the ages of 21-33. This is because you’ll need to complete your retrieval before you turn 35, so because the process can take some time, we don’t accept applicants who are 34 or older. 

The reason for this age limitation is because data shows that, on average, those over 35 tend not to respond to fertility medication as well and therefore may not produce as many eggs. Also, research shows that, unfortunately, egg quality declines with age. Various factors may affect your cycle timing (application paperwork, time to match with a family, and more) and you will need to cycle before you turn 35. We’d hate for someone to apply, get accepted, and then when the time comes for the cycle itself, potentially age out.

If you are 34-39, you are still eligible to participate in our Keep program. With this program, you can freeze your eggs and keep 100% of them for yourself. 

If you are under 21 and you’d like to participate, please reach out and we’ll get back in touch after you turn 21. 

Health-related factors 

As a preliminary step in the process, we’ll review several health-related factors. 

For starters, you’ll need to have two ovaries and you cannot have taken a Depo Provera shot, which can interfere with hormonal medications, within the past 6 months. 

Due to these hormonal medications you’ll need to take during egg freezing, you also cannot be currently pregnant or breastfeeding. However, if you plan to stop breastfeeding within the next six months, you can still go through with your Split application. You’d just need to hold off on your actual freezing cycle until then, and this situation would be communicated to potential match families. 

Additionally, you’ll need to have a BMI of 18-29. Those outside of this range are at increased risk of complications, negative outcomes, and negative side effects from hormonal medications or an egg retrieval. 

You will not qualify if you’ve had a sexually transmitted disease within the past 12 months (but can apply after 12 months of treatment). You also will be disqualified if you’ve been refused as a blood donor due to other infectious disease or medical conditions. Same goes if you’ve ever had a blood transfusion. 

Medical and family history

We will also review your and your family’s medical history. Unfortunately, this means that if you are adopted and cannot confirm your biological family’s medical history, you will not qualify. 

Though not an exhaustive list of every condition that may disqualify a member, when reviewing your personal and family medical history, we look for personal and/or family history of:

• Cancer
• Heart/blood disease
• Neurological diseases
• Mental health disorders
• Thyroid disorders
• Genetic disease
• Fertility issues
• Reproductive disease
• Autoimmune disease
• Respiratory disease
• Metabolic disease
• Gastrointestinal disease
• Kidney disease
• Birth defects

We review your personal and family medical history as a whole with our medical advisors. When reviewing, we consider the severity of the disease/conditions, number of relatives with the disease/condition, age of diagnosis, as well as that relative’s relation to you.

Psychological screening

There are also some psychological questions you’ll have to answer. We don’t expect you to be perfect. But note that certain psychological factors may be more likely to disqualify you than others. 

For example, a history of physical, sexual or substance abuse or having family members with psychiatric disorders that could be passed down may make it more difficult to be approved than, for example, having had some mild depression or anxiety. Per ASRM guidance, we will exclude those with a personal or first-degree (parents, siblings, offspring) family history of: 

• Bipolar disorder
• Schizophrenia
• Schizoaffective disorder
• Severe depression
• History of alcoholism or drug abuse

Genetic screening

As part of the process, you’ll also be required to do genetic testing via blood test or saliva sample. This helps ensure that embryos resulting from your eggs will lead to a viable pregnancy and that a child won't be born with severe disease. 

But even for serious diseases, not all disease-related genes are deal breakers. For example, if we find that you have a copy of a gene that can lead to cystic fibrosis, spinal muscular atrophy, or thalassemia, this may or may not disqualify you; it can depend on the clinic and genes of the intended parents. 

In line with ASRM guidance, in most conditions where carrying one copy of a particular gene won't impact the child themselves, you can still qualify for the Split program. 

Physical screening

In addition to genetic screening, you will have to undergo a physical screening to ensure you are physically healthy and producing a good number of eggs.  

Some disqualifications here are set in stone by the Food and Drug Administration (FDA). If evidence of any of these conditions arises, you will be considered ineligible for the program. These are considered to be non-negotiable.

• HIV
• Hepatitis B
• Hepatitis C
• Human transmissible spongiform encephalopathy
• Treponema pallidum

The following could also be deal breakers: 

• Issues with your ovaries, such as having only one ovary
• Hormone levels outside of recommended limits with concerns about your ability to produce sufficient eggs
• Any issues that would make the egg freezing and donation process risky for your health
• Evidence that you are at high risk of getting a sexually transmitted disease or could already have one. Doctors will look for discharge or ulcerative lesions for this purpose
• Indicators of possible drug use (needle tracks, for example) or exposure to needles in non-sterile conditions—including recent piercings or tattoos within the past 12 months

Anti-Mullerian hormone (ovarian reserve) levels

As you likely know, women have a set egg quantity present at birth. Your eggs mature in ovarian follicles, and each of these follicles produces the anti-Mullerian hormone (AMH). Over time, this hormone level drops; eventually, it drops so low that women naturally develop what's known as a diminished ovarian reserve (DOR).

Your AMH level can help predict how well medication may work to stimulate your ovaries to produce eggs. It also tells doctors what dosage of drugs may be needed to do so. The higher the AMH level, the more eggs generally produced. 

At Cofertility, if your AMH < 2, you are ineligible for our Split program. We only accept Split Members with these higher AMH levels as it helps mitigate the possibility of a second cycle to obtain enough eggs that could result in a live birth down the line (for yourself and for intended parents). Nevertheless, it’s important to note that, even with a high AMH level, there is always a chance that you need to do another cycle to improve the odds of a live birth. In the Split Program, you will receive AMH-reading bloodwork prior to being activated on our platform. 

If it turns out that your AMH levels are below the required minimum threshold, you would unfortunately be ineligible to move forward with egg donation. However, we can still help you freeze your eggs for your own future use through our Keep program.

State-specific qualifications

Some states do maintain their own requirements for women who are donating eggs. These requirements will extend to those in our Split program and would be determined by the location of the clinic at which you would be conducting the retrieval. 

Any state-specific egg donation qualifications will be evaluated at the time of your physical examination. 

Additional disqualifying factors

Lastly, there are a few additional factors that, unfortunately, would disqualify you from our Split program. These include if you:

• Have served jail time for more than two days within the previous 12 months
• Have undergone body piercing and/or tattooing within the past twelve months in which sterile procedures may not have been used
• Have the highest education level of GED
• Have Indigenous American ancestry and are associated with a tribe — this is due to the Indian Welfare Act 
• Currently use any nicotine products regularly, since the ASRM has confirmed an association between smoking and decreased fertility — if you engage in vaping, you will need to quit for 2-3 months before re-applying for Split, but if you only vape occasionally/socially, you will need to quit for one month prior to your retrieval date

If one or more of the above applies to you and you’d still like to participate in our Split program, reach out to us. We’d be happy to chat with you about your fertility options, including your ability to re-apply in the future. 

The net net

We know this sounds like a lot, but these disqualifiers are in place to respect the health and wellbeing of our Split members and intended parents. If you have any questions about Split—including the factors outlined here—don’t hesitate to connect with us. 

You have tons to offer, and whether you qualify for the Split program is in no way reflective of your value. The most important thing is that you feel one hundred percent comfortable in any decision you make. This is a big one, and we’re with you every step of the way.

You’ve likely heard about the process called egg freezing (sometimes called “fertility preservation”), where they stimulate the follicles in the ovaries and retrieve unfertilized eggs to preserve them for future use. 

But what exactly does that process look like? And why would someone want to go through it? Read on—we’ll explain everything you need to know about egg freezing. 

The process for freezing eggs

While it may sound like a very intense process—and for some women, the side effects of the  medications used to stimulate the eggs can certainly feel that way—freezing your eggs is actually a safe and minimally invasive procedure. 

1. Take our quiz to find affordable egg freezing options near you, including our Split program (where you can freeze your eggs for free if you give half to another family who can’t conceive) and our Keep program (where you can freeze your eggs more affordably and keep them all for your own future use). If you’d like to participate in Split, you can move forward with that application right away. If you’d like to join our Keep program, we’ll email you your options once you take the quiz.  
2. With Keep, the egg freezing process begins with a consult with your fertility doctor. They will do some initial testing to determine the current health of the eggs your ovaries are producing, both in number and in quality. You’ll undergo bloodwork and  an ultrasound to get a sense of this.
3. Next, you’ll likely undergo some general health screenings to make sure you’re not carrying any viruses that could complicate the process (like HIV or certain forms of hepatitis).
4. Once your health check is through, you’ll likely begin a series of medications, including ones that will stimulate your ovaries and/or prevent early ovulation. You’ll give yourself shots daily. If you freeze with Cofertility, we’ll provide you with step by step videos to ease the transition.
5. Around this time, you can also join the Cofertility Member Portal, where you can connect with (and lean on) other women freezing their eggs at the exact same time! 
6. Your doctor will monitor you during this time to confirm that the medications are working and that your estrogen levels are increasing while keeping your progesterone levels low. You may also undergo a vaginal ultrasound to monitor the condition of the follicles where your eggs will eventually mature.
7. After 10 to 14 days you’ll start a medication to help speed up egg maturity ahead of your egg retrieval. 
8. The retrieval process happens under light sedation and involves using a vaginal ultrasound and a needle with a suction device to retrieve the eggs—this sounds more intense  than it is.his procedure is normally done right in the clinic and takes about 10 minutes.
9. Once the eggs are retrieved, they’re flash frozen and stored in subzero temperatures, normally with a substance like liquid nitrogen to prevent the development of ice crystals. 
10. You can go home after the procedure and rest up!

How your body responds to the process

Everyone’s body will react differently to each step of the egg freezing process. While some women will experience bloating or hormonal responses from the medications that stimulate egg maturation, others may feel much less. You might experience some mild cramping or bloating following the retrieval process as your ovaries continue to remain enlarged from the medications used. 

Additionally, you’ll have an increased risk of pregnancy in the week following your retrieval. Because of this, many doctors suggest avoiding unprotected sex during this time period.

The goals for women who freeze their eggs can differ

Not everyone has the same intentions when they start the process of freezing their eggs. Some women may hope to prolong their reproductive years until they’re ready to have children, while others may be hoping to use their frozen eggs as donor eggs to help someone else who is trying to start a family. 

One thing all of these women have in common is that they’re hoping to improve their chances of those eggs eventually resulting in a healthy baby. To some extent, the more eggs there are, the better the chances of those resulting in a life birth. But we also know that egg quality is important. The number one factor impacting egg quantity and quality? Age. 

A study in the Journal of Assisted Reproduction and Genetics confirmed that the probability of at least one live birth varies with the number of mature eggs available and the age of the woman trying to conceive. For example, a woman under 35 who is trying to conceive will need 9 mature eggs to achieve a 70% chance of having at least one live birth. If you’re trying to conceive in your mid to late 30s, you may need double as many eggs to achieve that same 70% success rate. 

Because women in their 30s tend to produce less eggs, women who are freezing their eggs at this age may end up having to either settle for fewer eggs or undergo multiple rounds to collect enough eggs to have on hand for later implantation. As you can imagine, those costs can creep higher and higher the more rounds you endure, driving up the price tag and the risk of failure. 

Some things to consider about freezing your eggs

There are obviously many factors that go into the freezing process;  but, there are a few points to consider outside of the physical. You’ll also need to account for the cost—you not only need to pay for all of the testing and procedure plus monthly storage fees until you’re ready to fertilize your eggs. To this end, you will likely need to budget an extra $550-$1,000 a year to pay a company to store and monitor your eggs after they’ve been retrieved and frozen.

These procedures can quickly add up to a few thousand dollars—likely anywhere between $8,000 to $20,000. That price can be too high for some, which is why we’ve developed our Split program. With Split, you can freeze your eggs for free, if you qualify and donate half of your retrieved eggs to an intended parent who matches with your profile.

Getting a jump start on your fertility is a wise choice

Deciding to freeze your eggs is a proactive choice and a good idea if you’re not sure exactly when you’ll be ready to start a family (if you even want to). It’s also perfect for anyone who wants to retrieve healthy eggs before undergoing chemotherapy or a surgical procedure that could alter your fertility chances. 

The average age women have become parents has increased over time—with many spending their earlier adult years focused on getting an advanced degree, furthering their careers, or even finding the right partner—however, our biological clocks have remained the same.  

Take a look at your options

At Cofertility, we offer a variety of options for freezing your eggs, including our Split program where we’ll help you through the process of stimulating and retrieving your eggs at no cost as long as you donate half the eggs retrieved from each cycle (if you qualify). If donation is not for you, we also have a Keep Program in which you freeze and keep 100% of the eggs for yourself. Contact us today to learn more - no commitment required, but we’d love to talk through can help you take charge of your future reproductive health.

You may have heard that freezing your eggs in your 20s can help increase your chances of pregnancy down the line, but is there actually any truth to the claim? According to the American College of Obstetrics and Gynecologists (ACOG), there really is, given a woman’s peak fertility years span from the end of her teens to the end of her 20s. 

Read on to learn what you need to know about egg freezing success rates by age.

The best time to think about egg freezing is probably…now 

During these prime fertility years, we’re often focused on other things. In our 20s, we’re finishing school, launching our careers, traveling, having fun…starting a family may not even be a blip on your radar. Unfortunately, that also means that by the time you’re ready to get proactive about your fertility (or starting a family), your prime reproductive years may have already passed. 

This is why we believe that proactively thinking about your fertility is always a good idea for anyone looking to stay in control of their reproductive options. And one major barrier, until now, has been the accessibility and affordability of egg freezing. At Cofertility, we aim to change that, by partnering with local fertility clinics to create opportunities to freeze your eggs more affordably. 

Take our quiz to see what egg freezing options you may qualify for, including our Split program, where you can even freeze your eggs for free(!) if you give half to a family that can’t otherwise conceive and you qualify.

What are the egg freezing success rates by age?

We measure the “success” of an egg retrieval and later vitrification (the process of freezing and storing your eggs) in a couple of ways. Some of the major important milestones in a successful retrieval are: 

• The ability to collect high quality and healthy eggs 
• The ability to collect a large, but safe, number of eggs during a single cycle (between 10-20 is ideal)
• Whether collection takes place at an age where the eggs have a very good chance of surviving both the freezing and the warming process down the line 

Success rates for women in their 20s

Your 20s are by and large the best time to freeze your eggs, with 25 to 27 being the optimal age, according to a 2010 report from the CDC. The report found that eggs frozen during a woman’s 20s will have a 50 percent chance of resulting in a live birth per cycle, regardless of the age of the person carrying the pregnancy once the eggs are used. Women in this age range have fully finished developing (as opposed to someone in their late teens or early 20s who may still be growing and maturing) and are likely to have the healthiest and most robust eggs. 

Not only does it make it easier for eggs collected at this age to go on to become successful pregnancies, but it also makes it the most cost effective period, because you’re likely to get more eggs with fewer rounds of freezing than if your eggs were collected at a later age. 

Success rates for women in their 30s

Success rates in your 30s will depend on if you’re closer to 30 or 40, as well as your AMH levels. One study of 1,241 women found that the average number of eggs retrieved on the first egg freezing round was:

• 21 eggs for women under 35
• 17 eggs for women 35-37
• 14 eggs for women 38-40

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Because women in their 30s tend to produce less eggs, at this age you may end up having to either settle for fewer eggs for freezing or undergo multiple rounds to collect enough eggs to have on hand for later implantation. As you can imagine, those costs can creep higher and higher the more rounds you endure. 

Now, you might be thinking: isn’t 14 eggs a lot?  It’s true that eggs retrieved from women under the age of 36 will have a 95 percent survival rate after being thawed.  

But more importantly, not all thawed eggs will become viable embryos and lead to a live birth. As this chart underscores, the probability of a live birth varies with the age of the woman trying to conceive and the number of mature eggs available. In short, the older the woman, the more eggs required to achieve a high probability of a live birth. 

A study in the Journal of Assisted Reproduction and Genetics further supports this point. For example, a woman under 35 will need 9 eggs to achieve a 70% chance of having at least one live birth. If you’re trying to conceive in your mid to late 30s, you may need double as many eggs to achieve that same 70% success rate. 

Success rates for women in their 40s

Because success rates drop significantly as you near the end of your 30s, it’s actually not recommended that women have their eggs frozen past the age of 38, according to the American Society for Reproductive Medicine (ASRM). 

But don’t let that news worry you. If you haven’t had your own eggs retrieved by this point, and are struggling to conceive, you still have some other options (including the use of donated eggs). 

Ask us anything

If you’d like help figuring out when to freeze your eggs, you can contact Cofertility for more information. While every woman’s fertility path differs, we can connect you with reputable clinics who can offer basic guidance about when the time is right for you to freeze your eggs during a consultation or dig into specifics by going through a preliminary exam in a provider’s office.

We understand that the timing may not be right for you to start a family right now, but that doesn’t mean it’s too early to start thinking about what choices will be available to you when that time comes. As you can see, a lot goes into preparing to freeze your eggs.  The earlier you consider your fertility, the more options you’ll have. 

Whether you decide to freeze or not, we’re here for you to answer any questions or talk through any concerns. 

According to the American College of Obstetrics and Gynecologists (ACOG), a woman’s peak fertility years are from their late teens to their late 20s. While these may be the easiest biological years for starting a family, between travel, work, school, life…at that point in your life, family planning might not be your top priority. 

Fortunately, thanks to modern medicine, you have some options. Egg freezing allows you to preserve your healthy eggs at any point in time, without committing to starting a family. Let's talk about what you need to know about freezing your eggs. 

Here’s what you need to know about the process

While there are some big hurdles to clear—like the expenses of going through the process and how (and where) you’ll store your eggs—freezing your eggs is a way to take more control of your future fertility health. 

That being said, it’s important that you think of freezing your eggs not as a guarantee, but rather, a proactive step you can take towards fulfilling potential long-term family planning goals. It is not an insurance policy, but it can help give you more options in the future. 

Research has found that freezing nine eggs while under age 35 leads to a 70% chance of a live birth (studies found that the average number of eggs retrieved for the same women is 18-21). And the more eggs you freeze, the better those odds get. There are always chances that your retrieval could fail, or that implantation down the line may not take. Still, egg freezing in your 20s does offer higher chances of success than having them retrieved at a later age.

Getting ready for retrieval 

Before you can freeze your eggs, you’ll want to ensure your body is producing as many eggs as possible. This means taking hormones that can help stimulate the follicles on your ovaries to produce a larger than normal quantity of eggs.

According to the Mayo Clinic, this may include taking multiple medications or injectables like: 

• Ollitropin alfa or beta (Follistim AQ, Gonal-f) 
• Menotropins (Menopur)
• Leuprolide acetate (Lupron Depot) 
• Cetrorelix (Cetrotide)
• hCG

Your doctor will monitor your progress with blood tests across the 10-14 day period. He or she will tweak any ovarian-stimulating medications you’re given to make sure your estrogen and progesterone levels are where they need to be for a successful retrieval. 

During these visits, you’ll likely also have vaginal ultrasounds. The doctor will use this to check on the development of the follicles where your eggs mature. It might sound overwhelming, but vaginal ultrasounds are usually painless. 

Then, when the time is right—typically 10 to 14 days after you’ve started your medications—you’ll check back in with your doctor and receive a final  injection of something called a human chorionic gonadotropin. This is the final kick to help your eggs mature and prepare them for retrieval. 

Retrieving your eggs

Retrieval is typically done while you’re under a light sedation at a fertility clinic. Your doctor will retrieve your eggs via vaginal ultrasound with suction to remove eggs from follicles. You’ll likely wake up feeling well rested while your medical team has done all of the heavy lifting for you!

While you won’t feel any pain during the procedure, a little soreness afterwards isn’t uncommon.  

Freezing and monitoring

After your procedure your eggs undergo a process called vitrification (AKA: freezing). This process relies on subzero temperatures to cool the eggs for storage. They’re normally stored along with a substance (like liquid nitrogen) that  keeps ice crystals from forming within the frozen eggs. They’re then placed in cold storage for 24/7 temperature monitoring.  

Storage timelines

You may be surprised to learn that your frozen eggs have no expiration date. In fact, in 2021 a child was born from an embryo frozen 25 years prior! Once your eggs have been successfully frozen they cease all biological activity, including aging and deterioration. 

While some countries may have limits on the length of time your eggs can remain frozen, this has not taken hold in the United States. This comes as good news for women who are hoping to freeze their eggs earlier in life and may need more years of frozen storage. 

Our Split program includes 10 years of free storage at a reputable long-term facility, where you'll have access to them whenever you choose to use them. Our Keep program also allows you to store your eggs for 10+ years, though note that the payment will be out of pocket each year. 

How much does it cost?

A lot of women worry about the price tag for freezing their eggs. One piece of good news is that as technology (and availability) of these solutions advances, costs are starting to come down.

Still, you can be looking at a bill for a few thousand dollars for the procedure alone—anywhere between $6,000 to $11,000—plus an annual bill between $300-$1,200 for storage, and up to $5,000 for medications. 

With Cofertility, however, we’ve worked with clinic partners to get you discounts on freezing (think: 75% off initial consults at certain clinics), storage (up to 80% off compared to reputable clinic freezing), and medications (about a 20% savings). 

For those who qualify, our Split program also offers the opportunity to freeze your eggs for free if you donate half of them to a family who can’t otherwise conceive. Yep, zero dollars. 

Split allows you to take control of your reproductive future (while offsetting the costs), and enables you to give someone else the greatest gift of all: a shot at parenthood. But at the end of the day, our mission is to empower women with reproductive choice. If you decide that freezing isn’t for you, we respect that. And most of all, we applaud you for taking this step towards exploring your options and learning more about your own fertility. 

The egg freezing process can feel like a black box. How do you find a clinic to freeze your eggs? How long will the whole process take? And what is this all going to cost? 

With thousands of women freezing their eggs every year, there are plenty of options out there for you. Here’s a look at how to make sense of the egg freezing process and how to make sure this is the right path for you.  

Breaking down the egg freezing process

Choosing a clinic

The first step in the egg freezing process is choosing a clinic. If you decide to move forward with egg freezing, you will need to visit the clinic for monitoring every few days, so it’s best to choose a facility that’s within driving distance. With Cofertility’s Keep program — where you can freeze your eggs more affordably and keep them all for future use — we’ll help you find a clinic based on your location, their pricing structure, and their success rates. 

Our Split program, on the other hand, allows you to freeze your eggs for free if you give half to a family who can’t otherwise conceive and you qualify.

Consultation 

Once you’ve settled on a clinic, it’s time to meet with a reproductive endocrinologist (REI, or fertility specialist) to talk about the egg freezing process. You’ll get a chance to find out more about how egg freezing works at your chosen facility, discuss any risks of the procedure, and talk through any family-building goals. If kids are still a TBD, no problem!

Note that some clinics will only work with women under 40 when it comes to egg freezing. Research indicates egg quality begins to decrease in a woman’s early 30s and declines more rapidly past age 35. Because of this, you must be under 40 to participate in our Keep program.

Age is only one factor, however. During your egg freezing consultation, the REI will ask questions about your menstruation history, any past pregnancies, and your overall health. 

Evaluation and bloodwork

After (or during) your consultation with an REI, the next part of the egg freezing process is bloodwork and other testing to determine if you are a good candidate for egg freezing. 

This testing may include:

• Ovarian reserve testing: Your doctor will order bloodwork to evaluate your egg supply. These blood tests may screen for anti-mullerian hormones (AMH), follicle-stimulating hormones (FSH) and estradiol. Importantly, these labs can predict how your body will respond to the injectable fertility medications used in an egg freezing cycle. You’ll also do a (painless) transvaginal ultrasound, which will show how many egg-containing follicles your ovaries contain as a baseline.
• Disease testing: Bloodwork will help your doctor assess whether you have any infectious diseases such as HIV, syphilis, hepatitis, gonorrhea or chlamydia.

Connecting with your community

If you’re freezing your eggs through Cofertility’s programs, you’ll be able to utilize our Member portal to connect with other women freezing their eggs at the exact same time. Support one another, ask each other questions, and gain confidence as you begin your fertility journey. 

Medications

Most women’s bodies release just one egg a month during the menstrual cycle. In order to freeze more than one egg, injectable medications will be taken over a period of a couple weeks. These meds will stimulate your ovaries to produce more eggs in a single cycle.

Most women can give themselves the injections, which are needed 1-2 times per day for about two weeks. The medications do carry some side effects, including bloating, headaches and moodiness. About 0.5 - 5% of women develop a condition called ovarian hyperstimulation syndrome (OHSS), in which fluid accumulates around the ovaries and causes discomfort and bloating. While the condition can occasionally be severe, it is  typically temporary with symptoms subsiding about a week after your egg retrieval. 

Medications commonly prescribed in the egg freezing process include:

• Follitropin alfa or beta (Follistim, Gonal-f)— Used to stimulate the ovaries
• Menotropins (Menopur) — Used to stimulate the ovaries
• Ganirelix or Cetrorelix (Cetrotide) — Used to prevent premature ovulation
• Leuprolide acetate (Lupron) — Used to prevent premature ovulation or as a trigger shot to help eggs mature
• Human chorionic gonadotropin (Pregnyl, Ovidrel) — Used as a trigger shot to help the eggs mature

If you choose to freeze your eggs through Cofertility’s Keep program, you’ll be able to take advantage of partnerships and discounts on medication costs to help lighten the load. 

More blood tests and monitoring

Once you’ve started hormone injections, your REI will keep a close eye on you to make sure things are moving along smoothly. You’ll visit the clinic every few days to undergo bloodwork and ultrasound so the doctors can determine how your ovaries are responding to the medication and if it’s time to retrieve your eggs. 

This process usually lasts around two weeks until the fertility specialist determines egg development has reached a point where it’s time for all your eggs to be retrieved. 

During this time, it’s recommended that you abstain from sex or use barrier methods of contraception as the medications can make your body more fertile, increasing your chances of getting pregnant. You’ll also want to decrease exercise during the stimulation phase to prevent ovarian torsion, or twisting. 

Egg retrieval 

Also called aspiration, the egg retrieval process is done right at your fertility clinic where your REI will use a mild sedative or anesthesia. With the help of a guiding ultrasound, your doctor will use a special needle that’s inserted into the ovarian follicles to remove multiple eggs.  

Although you may feel some cramping and general discomfort after the procedure, the egg retrieval is not usually painful. You should plan to have someone with you that day to drive you home from the doctor’s office, but many women are able to return to work within a day or two after the procedure.

Because your ovaries are enlarged, you may continue to feel cramping and a feeling of fullness for a couple weeks. You will also be advised to avoid unprotected sex in the weeks directly after the egg freezing process as your chances of getting pregnant may be higher during this time. 

Cryopreservation

Once the eggs are removed from the ovary, you’ve reached the final step of the egg freezing process. The eggs undergo a process called vitrification.  

Eggs are then frozen to subzero temperatures and can be stored for years to come, ready to be thawed if you decide you want to use them for in vitro fertilization (IVF). With Cofertility’s Keep program, we offer our Members discounts and promotions on various parts of the egg freezing process to help make it more affordable.

A second egg freezing process

Depending on how many eggs were able to be retrieved, your doctor may recommend a second round of medication and another retrieval. 

The number of eggs you should freeze will depend largely on your age — researchers at Brigham & Women’s Hospital in Massachusetts have created a calculator that estimates the likelihood of live birth for elective egg freezing in women. Although it’s not exact, it does supply some probabilities to help you make a decision on whether you should do a second cycle of egg freezing. 

For example, they estimate if a 30-year-old woman has frozen 15 eggs, she has an 83% chance of giving birth to one child from those eggs. She has a 50% chance of giving birth twice and a 22% chance of having a third child with the use of her frozen eggs. 

Costs of the egg freezing process

Another factor to consider when deciding if you want to proceed with the egg freezing process — or undergo a second cycle — is cost. Around the country, the process of freezing your eggs can cost anywhere from $10,000 to $20,000 or even more, and there are yearly costs for storage of eggs after the retrieval process. 

At Cofertility, we’ve made it our mission to make egg freezing more accessible. With discounts, partnerships and promotions, we’re hoping to remove lack of affordability as a barrier to fertility preservation. To get a sense of pricing (and savings!) for our Keep program with clinics in your area, take our quiz to tell us more about yourself. 

Unfortunately, most insurance companies do not pay for many egg freezing costs unless it has been deemed medically necessary for a woman. Cofertility’s offerings, similarly, are self-pay. 

Bottom Line

There’s a lot going on during the egg freezing process and a whole lot to consider. The homework you’re doing now will make all the difference as you move along through the process and can ask all the right questions!

Your uterus creates extra tissue each month to create a cushy home for your potential baby. But if you have endometriosis, your uterine tissue grows wild, and can end up in places you don’t want it to be—including places where it could cause some serious fertility issues. In fact, a recent Journal of Assisted Reproduction and Genetics study estimated endometriosis is to blame for between 25% to 50% of all infertility cases. 

What is endometriosis?

Endometriosis develops when your body grows uterine lining (a tissue called endometrium) in places where it doesn’t belong. Most often, it shows up in areas near your uterus—your fallopian tubes and ovaries, on the outside of the uterus, in the vagina or cervix. In a few rare cases, it can even end up in other places, like your bladder. 

It may feel like you’re the only person in the world dealing with these symptoms, but the truth is, it’s just that people don’t talk about their symptoms. Endometriosis is extremely common. According to the Office on Women’s Health, more than 11% of women between the ages of 15 and 44 have developed it. Of those women, 30% to 50% experience some form of endometriosis infertility challenges. This is most common in women who: 

• Are in their 30s and 40s, especially those with family members who have had it 
• Started their period at a younger age
• Have never had children
• Have extremely long or short menstrual cycles

Signs of endometriosis

The most common red flag that you might have endo is severe cramping and pain, especially during your period. Here are some of the other telltale signs that you’re growing uterine tissue in odd places:

• Pelvic pain: Women with endometriosis often develop chronic severe back and pelvic pain. They may also experience severe menstrual cramps, pain when they pee, and even painful sex (which will definitely be a fertility hurdle). 
• Digestive upset: Stomach cramping, diarrhea, constipation and bloating occasionally accompany endometriosis, especially if you have your period. 
• Heavy periods—and spotting in between them: Women with endometriosis may bleed outside their typical menstrual cycle, or develop heavy bleeding when they have their period. Fun times! 
• Infertility: Scarring and excess tissue can literally cause a roadblock that can keep eggs and sperm from meeting, or even prevent a fertilized egg from implanting in the uterus.

How endometriosis can affect fertility

In case its other symptoms didn’t suck enough, endometriosis can also cause infertility, thanks to the scarring and excess tissue buildup. Ironically, all that uterine tissue that your body is producing for a baby could actually block the pathways to conception. 

“Endometriosis is thought to cause infertility because of the scarring and adhesions that result when endometrium grows on pelvic organs,” says Dr. Nataki Douglas, M.D., Ph.D, director of translational research for the Department of Obstetrics, Gynecology and Women’s Health at Rutgers University in New Jersey. The more extensive the disease and scarring, the greater the negative impact on fertility. “For instance, the adhesions can make it more difficult for an egg to be swept up by a fallopian tube and become fertilized.”

Can and should I freeze my eggs if I have endometriosis?

Absolutely. Some doctors will recommend egg freezing for women with endometriosis, while they're young and the condition is still in the early stages. Because some surgeries for endometriosis can actually worsen fertility by inadvertently removing healthy ovarian tissue or compromising vascular supply to the ovary, egg freezing should be done before any such surgeries.

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 is making egg freezing more empowering, positive, and accessible — even free — when you give half of the eggs retrieved to a family who can’t otherwise conceive. 

What your doctor might recommend

The good news is, endometriosis can often be treatable. Depending on your situation, treatment might include:

• Hormone therapy: Often in the form of birth control pills, this prevents additional tissue growth and damage. 
• Pain relievers: Over-the-counter pain relievers can help manage the pain that comes with endometriosis at certain points in your cycle.
• A diagnostic workup: Thankfully, some women with endometriosis are still able to conceive, but talk to a reproductive endocrinologist if you don’t get a positive pregnancy test on your own within 6 to 12 months. A full diagnostic workup might be a good idea. Dr. Marra Francis, MD, FACOG, an OB/GYN in The Woodlands, TX, notes that this workup would likely include both diagnostic procedures for endometriosis and a hysterosalpingogram (HSG), which will show if your tubes are blocked. This may prevent pregnancy or increase the risk of an ectopic pregnancy, so you’ll want to work with your doctor on figuring out the best course of action.  
• Surgery: This is one of the most effective methods for treating endometriosis and preserving fertility, according to Dr. Douglas, but also the most invasive. These surgeries can remove adhesions and ovarian cysts, clearing tissue out of the fallopian tubes and making pregnancy a real possibility. 

Still, you might need a little boost to make that baby happen. While there are tons of treatments out there, depending on a host of factors—age, number of years trying, status of fallopian tubes, status of sperm—women can proceed with standard fertility treatments, like oral medication and IUI. However, while it is the most invasive, “IVF has the best results in the majority of women with endometriosis,” says Daniel Kort, associate medical director and practice director at Neway Fertility in New York City. 

Bottom line

Endometriosis can be a real pain—literally and figuratively—and infertility is one of the most common complications associated with it. Fortunately, with a little help from a reproductive endocrinologist, it’s still possible to conceive if you’ve developed endometriosis infertility.

Polycystic ovarian syndrome isn’t just a single issue, but a constellation of symptoms that many women have. And if you have a messed-up menstrual cycle, significant weight gain, or infertility, there’s a chance you may have it. You can thank an imbalance in your male and female hormones (androgen and progesterone) for getting you on this crazy train.

Even if you don’t have PCOS, it’s likely you know plenty of people who do—one in 10 women of childbearing age have the syndrome. And while any woman can develop PCOS, you’re more likely to have it if your mother or sisters had it, or if you’re overweight or obese. For some women, the symptoms start as soon as they get their first period, while others develop the syndrome later on—after significant weight gain, for instance.

Your body on PCOS

PCOS is one of those issues that may require some detective work (and some testing) before you get a diagnosis. Some of the most common PCOS symptoms include:

• Irregular periods: Your period may not follow a set schedule, may not occur often, or it may extend long beyond the typical five to seven days (lucky you). Women may also experience painful periods or pain during ovulation, says Dr. Janelle Luk, medical director and founder of Generation Next Fertility in New York City. 
• Hormonal imbalances: The increased levels of androgen can cause male-like hair patterns—including male pattern baldness, facial hair, and excess body hair—along with severe acne. You may also have a lower than normal level of progesterone, a key female hormone associated with fertility.
• Blood sugar fluctuations: We all get hangry from time to time, but if you have PCOS, this goes one step further. “Sometimes, women may also experience sugar cravings and blood sugar fluctuations that physically manifest themselves in a lack of energy or feeling light-headed,” Dr. Luk says. These blood sugar issues can sometimes lead to weight gain that’s hard to lose. PCOS can also boost your chances of developing prediabetes or type 2 diabetes. 
• Polycystic ovaries: Normally, ovary follicles release eggs during ovulation. But if you have PCOS, the excessive androgen could be working against ovulation. Your ovaries may appear swollen, and may contain several follicles that are holding on to eggs and not releasing them. That said, this isn’t a dead giveaway that you have PCOS. Having cysts alone isn’t enough for a PCOS diagnosis, and your doctor should assess your menstrual cycle (or lack thereof), hormone levels, and weight fluctuation. 

And just because you don’t check the box for every symptom, doesn’t mean you don’t have PCOS or PCOS infertility. You don’t have to have all the symptoms to be diagnosed with PCOS, and sometimes PCOS actually flies a bit under the radar. Your best bet is to head to a doctor who can specifically check for PCOS. 

How PCOS could impact your fertility

If the PCOS symptoms—like that insane menstrual cycle—don’t suck enough, they can also do a number on your ability to become pregnant. According to Dr. Luk, PCOS often creates infertility issues due to its impact on periods and ovulation; if you aren’t ovulating, you aren’t releasing an egg.

PCOS can make getting pregnant challenging, but it’s hardly impossible. While it’s super common, it’s actually one of the most treatable causes of infertility in women. If you know you have PCOS, Dr. Douglas suggests talking to your doctor about proactive steps you can take to balance your hormones and create a plan if and when you decide to try to get pregnant. 

So can I freeze my eggs if I have PCOS?

Absolutely. Like others, women with PCOS may want to freeze their eggs to proactively increase their chances of having children down the road. It’s best to freeze when you are younger, in order to get the most high quality eggs possible. 

You’ll want to make sure you work with the best doctors, because women with PCOS are more susceptible to developing ovarian hyperstimulation syndrome (OHSS) during egg freezing. This is because they are likely to have more follicles, and the more follicles an ovary has the more likely it is to be overstimulated by HCG, one of the drugs used during egg freezing. One study of 2,699 women with PCOS undergoing IVF found that 75.2% had a normal response to controlled ovarian hyperstimulation (COH), while 24.8% developed OHSS.

Interested in freezing your eggs? We can help! Freeze by Co is a better approach to egg freezing, where you can freeze for free when you give half to a family who can't otherwise conceive.

What your doctor might recommend for managing PCOS

Medication is generally the first step to try to get everything moving. If you’re trying to conceive soon, progestin therapy might be used to level out your hormones. Metformin, a medication that is used to treat type 2 diabetes, can also help treat PCOS. Although metformin isn’t FDA approved for the treatment of PCOS, decreasing insulin resistance in women with PCOS has been shown to give spontaneous ovulation rates a boost, says Dr. Marra Francis, MD, FACOG, an OB/GYN in The Woodlands, Texas. 

Some women may need to move on to ovulation-inducing medications, like Clomid, but women with PCOS need to be carefully monitored if they do. If you have PCOS and take Clomid, you may be at increased risk of releasing more eggs than the one or two typically released with each Clomid cycle, which could result in twins. 

If these treatments still can’t help you conceive, your doctor may move onto other protocols. Get ready—here come the injections, like Follitism or Menopur. If the injections alone still don’t get you pregnant, IVF may be your best bet, according to Daniel Kort, associate medical director and practice director at Neway Fertility in New York City.

Summing it up

PCOS can lead to some really crappy symptoms. But fortunately, there are plenty of tools and treatments you can use to combat your PCOS and boost your chances of getting pregnant.

If your doctor told you that you have uterine fibroids—or even if you just think you might have them—you’re probably wondering if they’re going to mess with your chances of getting pregnant down the line, or if they’ll impact your ability to freeze your eggs. 

The good news is that fibroids are pretty common. The better news is that in most cases, they’re no problem at all. Here’s the 411 on fibroids and egg freezing.

What causes fibroids?

Fibroids are technically tumors, but they aren’t cancerous and shouldn’t increase your risk of uterine cancer, according to the Office on Women’s Health. Yay, right? Slightly less yay: there’s no clear answer about why these growths appear, but doctors do think there’s a genetic component. 

“Fibroids develop when one cell starts to divide and grow,” explains Dr. Anthony Propst, reproductive endocrinologist at Texas Fertility Center. According to Dr. Propst, they can be as small as a marble or as big as a volleyball. (Yup, you read that right. A volleyball—yikes.)

Dr. Propst says that 50% (!!!) of reproductive-age women have one or more fibroids, and that they’re more common among African American women. A 2013 study in the Journal of Women’s Health showed that African American women were more likely to experience severe fibroid symptoms (like heavy periods) and more likely to report that fibroids affect their physical activities.

What symptoms will I have?

Infertility is one symptom of fibroids, says Dr. Propst, but if you haven’t been trying to conceive yet then you may be totally in the dark about these little suckers. If that’s the case, here are some other symptoms to look out for:

• Heavy bleeding during menstruation
• Prolonged and/or painful periods
• Pelvic pain or pressure 
• Lower back pain
• Painful sex

UCLA Health reports that about one-third of fibroids are large enough to be detected by your OB/GYN during a physical, so don’t blow off those annual exams, ladies. 

How do I know if I have fibroids?

An ultrasound is the best way to tell if you have uterine fibroids. It will also reveal their location and size. Depending on your doctor, this may be an abdominal ultrasound or a transvaginal one. If you haven’t had one of those yet, we know it might sound intimidating, but trust us, it’ll be super helpful in getting a really good look around. 

So, can and should I freeze my eggs if I have fibroids?

Yes, you can freeze your eggs if you have fibroids. In fact, some people opt to freeze their eggs before certain fibroid treatments. 

However, some fibroids can make it difficult to access the ovaries during the egg retrieval. If you are interested in freezing with Freeze by Co, we will set you up with a fertility doctor for a consultation where they can give you more personalized advice.

Will fibroids affect my fertility?

Fibroids can affect fertility now or in the future. Approximately 5% – 10% of infertile women have fibroids, but most women with fibroids will not be infertile. According to Dr. Mark Trolice, infertility specialist at Fertility CARE: The IVF Center in Florida, it’s not the size of fibroids but the location that determines their overall effect on fertility.

“Unless the uterine cavity is affected by fibroids, we leave them alone,” he says. “But if there’s a distortion of the cavity—like if the fibroid is growing there, or is pushing into the cavity—then surgery is recommended,” since that might affect fertility.

Dr. Propst adds that fibroids growing within the muscle of the uterus (also called intramural fibroids) can impact your pregnancy chances, because fibroids within the womb can prevent implantation of an embryo. 

Can fibroids affect egg quality?

Fibroids can affect whether sperm and egg meet (by blocking the pathway) and if the embryo has room to implant in the uterus. Fibroids can also affect the growth and positioning of the baby if you do get pregnant. But there’s not much known about if fibroids can impact egg quality, and it’s likely that there’s no correlation. 

Do I need to do something about my fibroids?

Once more, for the people in the back: it depends on where they’re located. 

“With those intramural fibroids, the bigger they get, the more likely they are to affect fertility,” says Dr. Propst, who recommends surgery in those cases. So if your fibroid is large and located in the uterine muscle, you’re gonna have to problem-solve.

According to the Mayo Clinic, surgery for fibroids could include: 

• A noninvasive ultrasound procedure (done inside an MRI scanner)
• A minimally invasive procedure, like a laparoscopy or myomectomy (you’ll go home the same day)
• A traditional abdominal surgery (you’ll have to stay overnight...but get to eat lots of Jell-O)
• A hysterectomy (not good, but don’t panic...this is a worst-case scenario)

Whether or not to undergo fibroid surgery is a decision you’ll have to make with your doctor, but there are pluses and minuses, so make sure you’re well-informed. 

You may not be thrilled about surgery (especially if your fibroids aren’t causing symptoms), but Dr. Trolice says that there are risks of pregnancy complications with fibroids, especially larger ones, and a 2014 study published in the American Journal of Obstetrics and Gynecology backs this up: it suggests that the size, number, location, and type of fibroid can contribute to higher rates of preterm birth, cesarean delivery, and postpartum blood loss and hemorrhage.

What’s the bottom line with fibroids and fertility? Location, location, location. You might never know you have them, and even if you do, you might never need to do anything about them—unless they’re in a spot where they could interfere with a future pregnancy, in which case you’ll have a few mostly-not-terrible surgery options to choose from. 

So can you freeze your eggs if you have fibroids? Yes, you can still pursue egg freezing. And we’re here to help you freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive. Plus, our inclusive online spaces allow you to connect with others going through the process. Learn more!

If you think you probably want kids someday—just maybe not, like, today—you might be considering freezing your eggs. Women who choose to do it can find it really empowering, but it can also be a huge personal and financial investment. We’ve gathered the basic info you’ll need to decide whether egg freezing is right for you. 

What’s the process like?

The whole point of egg freezing is to trick your ovaries into sending a whole crop of eggs out into the world in one go. This starts with nearly two weeks of intense, at-home prep work on your part. Here’s how it all plays out:‍

Shots/Sonograms/More Shots

Starting on day 2-3 of your period, you’ll give yourself daily injections of follicle stimulating hormones (FSH) and luteinizing hormones (LH). In a natural cycle, your brain makes smaller doses of these hormones on its own to signal to the ovaries that it’s time to make a single egg ready for ovulation. With this treatment, the brain’s natural process is overridden by the injections in order to encourage the ovaries to release as many eggs as possible.

But not so fast, ovaries! You’ll also be given a third drug in combination with these that will keep your eggs from releasing before the doctor is ready to catch them. Depending on which one you’re prescribed, you’ll start taking this at the same time as the stimulants, or about halfway through the stimulant cycle. Don’t worry, you’ll receive specific instructions on all of these and before you know it, you’ll be an expert at giving yourself a shot. Look at you go!

You’ll take these daily injections for 10-12 days, during which time you’ll also be carefully monitored by the clinic with trans-vaginal ultrasounds that examine your follicles (the ovarian sacs that release the eggs), and blood tests to track your hormone levels. Your medications will be adjusted based on the info from these tests.

When follicles are nice and plump, you do a trigger shot and then go into the center for your egg retrieval. This actually triggers ovulation and it’s what’s needed for the DNA to become mature, but your eggs will be retrieved right before they’re released from the follicles.

Retrieval

An egg retrieval is a minor surgical procedure. Most centers use twilight anesthesia, so you’ll be under sedation through an IV, but breathing on your own. The doctor performing the egg retrieval will insert a trans-vaginal sonogram. Now, here’s the kinda weird part: on the tip of that sonogram wand is a small needle, which pierces the vaginal wall, and then enters the ovary on the other side (the doctor is watching all of this happen on the sonogram screen). The needle drains the fluid (containing the microscopic egg) from each of the mature follicles. The entire thing takes about 20 minutes, and you can go home soon after. 

In the lab, each egg is isolated from the fluid by an embryologist, then stripped of its surrounding cells, and checked under a microscope for maturity. Mature eggs are frozen, post-mature eggs are discarded, and immature eggs may be observed overnight, to see if they are ready to be frozen the next day. 

Recovery

Depending on how many eggs are retrieved, getting over the procedure might be no big deal, or you could have post-retrieval symptoms. Some women experience bloating, cramping, nausea, and potentially some weight gain for a few days after the procedure. Time to stock up on coconut water and get cozy with some Netflix. 

How many eggs will I get?

“People always ask, ‘why can’t you just give every woman enough drugs so that everyone makes 20 eggs?’ But that’s not how it works. Our ovaries have a set number of follicles every menstrual cycle,” explains Dr. Talebian. And of course, each woman is different, so the expectation for egg retrieval has to be set on an individual basis. 

“You can have a 30-year-old who has 30 follicles and produces 30 eggs; and you can have a 30-year-old with 4 follicles and produces 4 eggs.” Once you begin the process, your doctor will monitor your follicle count as well as a blood test of your anti-Müllarian hormone (AMH), which are both good predictors of how many eggs you can expect. It’s super personal and varies case-by-case.

Once your eggs are frozen, the next important number to seek when interviewing a clinic is their thaw rate. This number indicates the percentage of frozen eggs actually survive the warming process in order to be used for IVF. Beyond that, there isn’t really enough data to provide success rates for pregnancy using a woman’s own frozen eggs (versus frozen embryos, for example.

“Anyone who says they can give success rates based on egg freezing is probably not giving an accurate answer,” says Dr. Talebian. “We can give you success rates for healthy donor eggs, but most women who come in to freeze eggs at ages 30-35 have not come back to use those eggs. So there isn’t enough data to give a success rate.”

At what age should I freeze my eggs? 

As we’ve said before, everyone is different, but Dr. Talebian provided some basic guidelines.

• If you have no fertility risk factors: between ages 30-34
• If you have some fertility red flags: consider testing at an earlier age, if, for example, if you have a history of endometriosis, family history of early menopause, or any history of radiation or chemotherapy exposure

“Unfortunately, there’s no magic blood test or ultrasound or MRI that says ‘oh you could wait until you’re 38, or you need to do it at 28,’” says Dr. Talebian. What the centers do have are the stats for the average women at each age and then your personal history and the follicle counts they can take when you come in for your first appointment. Based on all this information, you can have a straightforward convo with the doctor about your likelihood of success, so you can make the best call for your future. 

Read more: A Breakdown of Egg Freezing Success Rates by Age

How much will it cost?

It can totally vary, depending on where you live and from center to center. We can help with this. In our Freeze by Co program, we get special pricing from clinics and on medications. Plus, you get access to an amazing community of women freezing at the same time.

We also offer free egg freezing through our Split program, where you freeze your eggs for free when you donate half to a family that can’t otherwise conceive.

Want to learn more? Take our quiz to see if you’re eligible. 

The AMH (anti-mullerian hormone) test is just one of many tests you may get when seeking answers about your fertility. But we know you’re not about to head to the doctor’s office for a blood draw without understanding what you’re getting yourself into. So here’s the full scoop on what to expect.

The lowdown on the AMH test

Think of the AMH blood test as a peek into a woman’s ovarian reserve. Here’s how it works: The AMH hormone is secreted by follicles in the ovaries. As you may know, follicles are the beginnings of human eggs, and a woman only has a finite number of eggs—the number of eggs decreases with age. This test measures the level of AMH in your blood.

“A higher level of AMH correlates to a higher ovarian reserve, or as we say, ‘the more gas left in the tank,’ says Dr. Joshua Hurwitz, MD, senior physician and partner at Reproductive Medicine Associates of Connecticut (RMACT).

About those eggs...

Unfortunately, women with a lower ovarian reserve may retrieve fewer eggs during egg freezing, so understanding your ovarian reserves is an important step in informing yourself and your doctors about what’s going on in your body. That way, you can make the right plans for you, depending on your goals.

Probably the most common reason to have an AMH blood test is as part of a fertility evaluation for any female patient interested in egg freezing or IVF, says Dr. Hurwitz. Any woman who’s trying to understand her future fertility potential could decide to have her AMH levels tested as well. In other words, you also might want to get the AMH blood test if you fall into any of these categories:

• You’re considering becoming an egg donor
• You might be freezing your eggs
• You’re thinking about getting pregnant and want to know if there’s a reason to act quickly

This isn’t like looking into a crystal ball. While having a normal ovarian reserve gives you a snapshot of what your fertility looks like now, it’s not a guarantee for what will happen in the future. Still, the results could help a woman more confidently decide to wait to try to become pregnant, or to freeze her eggs for potential use in the future, says Dr. Hurwitz.

What AMH do I need to freeze my eggs?

Research has found that AMH is a good predictor of the number of eggs retrieved during egg freezing, independent of age. Because of this, a fertility doctor will use your AMH levels (amongst other biomarkers) to determine the drugs and dosages during the procedure. 

In general, says Hurtwitz, patients can interpret their AMH level this way:

• Above 1.0 ng/ml (nanograms per deciliter): Normal
• Below 1.0 ng/ml: Showing weakness in the ovarian reserve
• Below 0.5 ng/ml: Showing severe weakness in the ovarian reserve

But know that a very high level of AMH could be a sign of polycystic ovary syndrome (PCOS), which may require specific fertility treatment and/or medications. When AMH is over 5.0 nanograms per deciliter, for example, Dr. Hurwitz says it’s worth addressing if there are other potential signs of PCOS. Also, FYI: younger women tend to have higher AMH levels, and older women tend to have lower AMH levels.

What AMH do I need to donate my eggs?

If you are looking to donate your eggs, minimum AMH requirements may be slightly higher. For example, with Cofertility’s Split program, we require a minimum AMH of 2.0, though clinics may have their own unique requirements. This is to increase the chances of retrieving enough eggs to actually split, to ensure positive outcomes for both parties involved.

AMH as part of a full work-up

It’s important to know that the AMH really isn’t a one-and-done test. It’s often done as part a full fertility evaluation, which may also include:

• Hysterogram (a.k.a. Sonohystogram or SHG), an ultrasound in which saline is added to the uterus (sort of a weird sensation but not so bad), so doctors can see inside and identify any problems with the uterus or fallopian tubes.
• Semen analysis, a test of a male partner’s sperm that gauges sperm count, as well as motility (the way they move) and morphology (size, shape and structure). Guys are so lucky this is their only major test.
• Hysterosalpingogram (HSG), an X-ray of the uterus and fallopian tubes (with a liquid dye in your bod!), which also can help identify or rule out certain problems.

In fact, the AMH probably isn’t the only ovarian reserve test you’ll get. It’s often done alongside:

• FSH blood test, another blood test. This is used to measure a different hormone called the Follicle Stimulating Hormone. FSH is released at the beginning of the menstrual cycle, so you’ve got to have your blood drawn at day 2, 3, or 4 of your period. A high level of FSH is associated with low ovarian reserve, and a low level of FSH is associated with a normal ovarian reserve.
• Basal Antral Follicle Count, an ultrasound in which the doctors will count the number of follicles they can see. The more follicles, the greater the ovarian reserve.

A woman’s age is also a huge factor in ovarian reserve and is really the most accurate way of gauging the quality of the remaining eggs, says Dr. Hurwitz.

It’s painless (mostly)

Since this is just a low-key blood test, there’s really not much to worry about. It can be done at any time during your menstrual cycle, and you don’t need to prep for it by fasting or in any other way. Think of it like getting a blood draw at your annual physical. You’ll have blood taken as usual through a needle into a syringe, and a Band-Aid will be placed on the site. Then, you’ll be able to go about your day as normal.

Dr. Hurwitz says his patients usually receive their AMH test results within a few days up to about a week, and they’re given over the phone by a nurse who can answer any questions they may have about their AMH levels. Then, after all their initial testing is done, the doctor sits down with his patients and discusses the results of all their tests to give a 360-degree picture of their fertility status. 

Plotting your next steps

AMH level alone won’t tell you what your next steps will be. If you’ve had all the ovarian reserve testing done, there isn’t anything further that needs to be measured in that regard.

Remember, AMH level should never be the sole measure of a woman’s fertility. In fact, one recent Journal of the American Medical Association study found that AMH levels didn’t predict which women would get pregnant over the course of a year. This is a reassuring sign for women who have low AMH levels, but Dr. Hurwitz notes that it doesn’t mean that the AMH test results aren’t important. They can help your doctor understand what’s going on in your body.

Taking your AMH results into consideration with all your other test results and health history,  you and your doctor will come up with a course of action. There’s no one answer for what this will be based on AMH level, but a low ovarian reserve might prompt a woman to begin egg freezing sooner. 

Interested in freezing your eggs? We can help! Our Freeze by Co is a better approach to egg freezing, and free when you give half to a family who can't otherwise conceive

So, you’ve already taken the first step and decided you want to pursue egg freezing, but now you’re asking yourself, “how do I tell people I’m freezing my eggs?” 

We get it, deciding to freeze your eggs is a huge decision, and talking about it with the people in your life can feel even more overwhelming, especially your romantic partner. However, having an open and honest conversation is a great way to ensure that both of you are on the same page. Here are some tips on how to approach the conversation.

Educate yourself first

Before you try to explain the egg freezing process to your partner, it’s important to have a clear understanding of it all yourself. Your partner is definitely going to have a lot of questions about the process, so make sure to spend some time researching the process, success rates, and cost involved so that you’re prepared to answer their questions. This will also help you approach the conversation with confidence and show that you’re not taking this decision lightly.

Talk about what this means for your future

We know, talking about family-building with your partner can sometimes feel a little uncomfortable, especially if the relationship is still new. However, it’s important to make sure your partner understands what freezing your eggs means for your future family planning (and why you’re choosing to freeze eggs instead of embryos). Whether you know you want to have kids someday or you’re still not sure, freezing your eggs is a great way to give yourself and your partner options down the line. And with Cofertility’s Split program, you can do so without the financial strain, by freezing your eggs entirely for free when you give half to another family. 

Freezing eggs vs. embryos

If you’re in a relationship with a biologically male partner, you may be wondering if you should freeze embryos instead of eggs. While it’s true that thawing success rates can be slightly higher for embryos than eggs (at a 95% survival rate vs 90% for eggs), the downside is that once an egg is fertilized with sperm, there’s no going back, so freezing eggs instead of embryos will give you more options down the line. We know, this might be a little bit of an awkward one to bring up with your partner, but it might come up at some point, so the best you can do is be prepared with the facts.

Prepare for their questions

If you think through the possible questions they could ask, you’ll feel more prepared and confident in answering them. This could include:

• Why are you freezing your eggs?
• What are the potential risks and side effects of egg freezing?
• What if you don’t need the eggs down the line?
• How long can you keep frozen eggs?
• How many eggs should you freeze to maximize your chances of a successful pregnancy?
• How many eggs do you think you’ll get? How many do you want?
• Are there any potential emotional or psychological effects of egg freezing?

Obviously you can’t predict every question that may be thrown your way. And if they ask a question that throws you off, you can just say “Great question, let me think about how to best answer that and get back to you”. 

Revisit the conversation often

Something as important as your fertility and reproductive future should never be a one-and-done conversation, so keep this conversation an ongoing one. It’s likely that your perspectives will evolve over time, so it’s important to keep the conversation fresh so you can address any concerns as they come up. If at any time you or your partner have questions, our team at Cofertility is always here to help.

Summing it up

The decision to freeze your eggs is extremely personal and life-changing in a lot of ways, so it’s crucial that you feel supported in this decision. We know approaching the conversation can be scary at first, but by following the tips we just mentioned, you’ll be able to have an honest, empathetic, open conversation with your partner about your egg freezing journey and your future.

Egg freezing, formally known as oocyte cryopreservation, is a medical procedure that allows you to preserve your fertility by retrieving, freezing, and storing your eggs for future use. 

Egg freezing is an exciting and empowering option for those who want to take control of their fertility and pursue their life goals on their own timeline. But where should you start? In this article, we’ll share some factors to consider when selecting an egg freezing clinic that will give you the confidence and support you need throughout the process.

Reputation

When it comes to choosing an egg freezing clinic, reputation is key. It’s not just about the clinic, it’s also about the doctor you will work with. There are a few ways to find out the reputation of a clinic and specific doctor. You can research online, read reviews, and ask for recommendations from your doctor or friends who have undergone the procedure.

If you work with Cofertility to freeze your eggs, we have a list of vetted fertility clinic partners we will share to help you make a confident choice.

Experience and outcomes

Now that you’ve narrowed down the list, you can use the Society for Assisted Reproductive Technology (SART) website to look up data on specific fertility clinics. SART data provides detailed information on the number of cycles performed, age of patients, and success rates for various fertility treatments, including egg freezing. By reviewing the SART data, you can gain insight into a clinic's expertise and quality of care for egg freezing. Here’s how:

1. Go to SART's website at www.sart.org.
2. Click on "Clinic Data" in the top menu and select "National Summary Report."
3. Choose the year for which you want to view the data.
4. Use the search bar to find the clinic you are interested in.
5. Click on the clinic's name to view their data.
6. Look for the section titled "Egg Freezing Cycles" to see the clinic's success rates for egg freezing.
7. Review the clinic's success rates for egg freezing and compare them to the national average.

Keep in mind that success rates alone may not give a complete picture of a clinic's quality. SART may also not be helpful when looking up newer clinics, as the data takes about two years to post. If you’re working with a newer clinic, you can look up the doctor’s previous clinic to learn more about their past track record.

Accreditation and certification

To ensure that you receive the highest quality care, look for clinics that are accredited and certified by respected organizations. These certifications demonstrate that the clinic has met rigorous standards for safety, quality, and performance. Specifically, look for:

• The Joint Commission (JCAHO) is an independent, non-profit organization that accredits and certifies healthcare organizations in the United States. A fertility clinic that is accredited by the Joint Commission has met rigorous standards for quality and safety.
• College of American Pathologists (CAP) is a professional organization that accredits laboratories and pathology services. A fertility clinic that is accredited by the CAP has demonstrated proficiency in laboratory techniques and quality control.
• Society for Assisted Reproductive Technology (SART) reporting, as described in the section above. 

At Cofertility, we only partner with clinics that report outcomes to SART and have a CAP certified lab.

Technology and facilities

Egg freezing technology has come a long way in recent years, so it's important to choose a clinic that uses the latest equipment and facilities. By finding a clinic with state-of-the-art technology, you can be more confident that your eggs will be frozen and stored in the best possible conditions. Plus, a modern and comfortable clinic environment will help you feel relaxed and at ease during the process.

Here are some questions you can ask the clinic to get a better idea of their capabilities:

• What type of equipment do you use for egg freezing?
• How long have you been using this equipment, and how often do you update it?
• What is the success rate of your egg freezing procedure?
• Do you use vitrification or slow freezing? (You want a clinic that uses vitrification)
• What measures do you take to ensure the quality and safety of the eggs during the freezing process?
• Can you provide details about your laboratory and facilities for egg freezing, including any recent upgrades or renovations?
• Do you participate in research or clinical trials related to egg freezing?

By asking these questions, you can get a better sense of the clinic's commitment to using the latest technology and techniques for egg freezing, as well as their focus on quality and safety. A reputable and modern clinic will be happy to answer your questions and provide you with information to help you make an informed decision about your egg freezing journey.

The team

The staff at an egg freezing clinic can make all the difference in your experience. Look for clinics that have a team of knowledgeable, caring professionals who will guide you through every step of the process. The best clinics offer ongoing support and counseling to ensure that you feel confident and empowered throughout your egg freezing journey. During a consult, you’ll get to meet with the doctor and see if you click before moving forward.

Plus, if you work with us, you’ll get access to our team to help you every step of the way. 

Cost 

And last, but definitely not least, cost is an important consideration when choosing an egg freezing clinic. There’s no way around it, egg freezing is expensive. The typical egg freezing cycle can cost anywhere from $10,000 to $20,000 plus the cost of storage. A few clinics list their pricing on the website, but for most clinics, you will need to ask. Keep in mind that the price from the clinic does not usually include medications or long-term storage.  

Read more in How to Pay for Egg Freezing.

Cofertility can help

Freeze by Co offers women a chance to freeze their eggs for free when they donate half of the retrieved eggs to a family that can’t otherwise conceive. The cost of the entire process, including 10 years of cryopreservation, is fully covered. 

Or, if you want to freeze and store your eggs for your own future use without donating, Freeze by Co offers lower prices on things like consultations and storage, along with access to our community of women going through the process at the same time. ‍

Donating eggs can be a generous and life-changing decision for both the donor and the intended parent. If you have been interested in donating your eggs, you may be wondering if there’s an age cut-off. The short answer is, yes, there are age restrictions when it comes to donating eggs. In this article, we will discuss how old you have to be to donate your eggs and what factors may affect your eligibility.

What is the minimum age for egg donation?

American Society for Reproductive Medicine (ASRM) suggests that egg donors be at least 21 years of age at the time of donation. Most clinics and agencies follow this suggestion to ensure the donor is mature enough to understand the procedure and follow through on the commitment. 

To be part of our Split Program, where you freeze your eggs for free when donating half to a family that can’t otherwise conceive, you must be at least 21 years old. And while we do not accept Split members who are under 21, please reach out and we’ll get back in touch after you turn 21. 

What is the maximum age for egg donation?

While there is no legal maximum age to become an egg donor, ASRM recommends that donors be under the age of 34 and most clinics follow this guideline. 

At Cofertility, we require our Split program members to be 33 or under, as it can take some time to match with intended parents and complete your cycle. If you are 34-39, you are still eligible to participate in our Keep program. With this program, you can freeze your eggs and keep 100% of them for yourself. 

Why are their age requirements for egg donation? 

Because donor egg IVF is already so expensive and time consuming, families and clinics want to do everything they can to increase chances of success.

One factor that can predict success is age. Women in their 20s typically have a higher quantity and quality of eggs, making them ideal candidates for egg donation. Data shows that, on average, those over 35 tend not to respond to fertility medication as well and therefore may not produce as many eggs. Research also shows that, unfortunately, egg quality declines with age. 

Are there exceptions?

There are cases where a clinician may accept a known donor outside the recommended age range. For example, if someone wanted their 35-year-old sister to donate and she had recently undergone a successful egg retrieval, the doctor may approve her donation. 

Conclusion

Egg donation is a serious commitment and involves a significant time and energy commitment from the donor. The process typically involves several weeks of hormone injections, frequent doctor's appointments, and a minor surgical procedure to retrieve the eggs. 

While 21-34 is the recommended age for egg donation, keep in mind there are additional eligibility criteria. It is important for potential donors to carefully consider the risks and benefits and to ensure that they meet all of the eligibility criteria before making a decision.

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Has anyone ever told you that freezing your eggs will affect your ability to conceive naturally in the future? If you’ve heard this before, it’s understandable that it would make you think twice about pursuing egg freezing or donation. While this is a common question, it’s actually a misconception. Read on to learn more about why this is a myth and what egg freezing actually does for your fertility. 

The truth about egg freezing (or donation) and fertility

Let's get right to it—does freezing or donating eggs impact your ability to get pregnant on your own in the future? The short answer is no, egg freezing won’t lower your egg reserve and it won’t affect your chances of getting pregnant naturally when you’re ready to do so. To understand why this is, let’s talk about the ovulation process. 

What happens when you ovulate?

At the start of each menstrual cycle, when someone is on their period, their pituitary gland (in the brain) will release follicle stimulating hormone (FSH). FSH triggers fluid-filled sacs in both ovaries to grow. These sacs are called follicles and they each contain an egg. The follicles grow until a second signal from the brain forces only one follicle (the “dominant” follicle) to continue to mature and eventually release its egg. That egg being released is what we call ovulation. 

Now that that single egg has been ovulated, what happens to all the other eggs in those other follicles? Well, since those follicles weren’t chosen as the dominant follicle, they stop growing and the eggs inside of them die. This is known as atresia. So, it’s basically survival of the fittest in each ovary every month — yikes!

So what does all that have to do with egg freezing?

Let’s briefly review what the egg retrieval process is for egg freezing, donation, and in vitro fertilization (IVF). The hormone medications used during all three processes prompts your ovaries to allow all of the eggs in a single cycle to mature (instead of the usual one) so you can freeze them for if and when you might need them later on. 

Once the follicles have reached an appropriate size, the eggs are collected during a quick procedure in the office. This retrieval process happens under light sedation and involves using a vaginal ultrasound and a long needle with a suction device to retrieve the eggs. I promise this sounds much more intense than it actually is! An embryologist (an expert in the science of egg freezing) looks at each egg and grades their maturity before freezing them. If you’re doing IVF, they’ll go through fertilization instead of being frozen.  

Can I get pregnant unassisted after egg freezing?

What you may have noticed from what was just explained is that egg freezing actually rescues all the other eggs that your body would otherwise allow to die during a normal menstrual cycle. So the process of egg freezing doesn’t take anything away from your egg reserve, it actually helps you save some extra eggs! And since during each cycle, your body goes through the ovulation process again with a new set of competing eggs, your chances of getting pregnant unassisted in the future also aren’t affected by egg freezing. 

What egg freezing does do is give you additional options for if and when you’re ready to start growing your family.

Egg freezing actually rescues all the other eggs that your body would otherwise allow to die during a normal menstrual cycle. So egg freezing doesn’t take anything away from your egg reserve, it actually helps you save some extra eggs!

Can egg freezing damage my ovaries?

Like any other procedure, there are risks and side effects when freezing eggs, including risks of anesthesia, bleeding, pain, and infection. Thankfully, the majority of people who go through with it deal with side effects for a few days at most. When it comes to the ovaries themselves, they generally recover quickly. While there isn’t a lot of data specific to egg donors (as opposed to people freezing their eggs for themselves), the overall data indicate that the potential risks of surgical complications from egg retrieval are generally very small. However, in people with a history of endometriosis, pelvic inflammatory disease, pelvic adhesions or previous pelvic surgery, the risks are slightly increased so make sure to speak to your doctor about your medical history if you fall into any of these categories.

In terms of complications down the road, there are really two main ways by which egg retrieval might conceivably affect future fertility. The first way is by bleeding and infection from the procedure leading to adhesions (scar tissue) and the need for further surgeries. The second way is through trauma to the ovaries causing the creation of antibodies that may make fertilization of an egg more difficult.

Fortunately, there is no data that supports either possibility. According to one large study of over 7,000 IVF cycles, the rates of both infection and need for surgery to treat a pelvic abscess was 0.03% (about 1 in 3,000 IVF cycles). As for the scar tissue and antibodies, researchers have not found a higher rate of adhesions among people who have had an egg retrieval compared to those who haven’t nor have they found evidence that antibodies interfere with sperm’s ability to fertilize an egg. 

It’s up to you!

If you decide to go through with egg freezing, Freeze by Co is here to help. Our Split program allows those who qualify to freeze their eggs for free! In a Split cycle, you donate half of the eggs retrieved to a family that can’t otherwise conceive and freeze the remaining half for yourself. 

If you don’t want to donate, you can still participate in the Keep program, where you’ll be able to freeze your eggs and keep them all for yourself, on your timeline. In addition, you’ll have access to our online support community. This valuable resource lets you engage with other people freezing their eggs at the same time! 

Whatever you choose, our team is here to support you as you determine which family-building options are right for you!

Vaping has become a popular alternative to traditional smoking in recent years. But while it’s been marketed as a healthier option, the long-term effects of vaping are still not fully understood. One area of concern is the impact of vaping on fertility, especially for those who are considering freezing their eggs for future use. In this article, we’ll dive into the research on if vaping is okay for egg freezing and donation.

Impact of vaping on fertility

Several studies have found that vaping can have negative effects on reproductive health, including decreased fertility and increased risk of miscarriage. According to the American Society of Reproductive Medicine (ASRM), infertility rates in male and female smokers are twice as high as infertility rates among nonsmokers, with infertility rates rising with the number of cigarettes smoked daily. The main ingredients in e-cigarette liquids, such as nicotine and propylene glycol, have been shown to have toxic effects on the ovaries and the eggs they contain.

Nicotine has been shown to reduce the quality and quantity of eggs in the ovaries. It can also lead to decreased blood flow to the ovaries, which can negatively impact the development of the follicles, the structures in the ovaries that contain the eggs. Despite needing more medication during the egg freezing process, smokers often have fewer eggs available for retrieval during an egg freezing cycle, as well as 30% lower pregnancy rates compared with nonsmokers.

Propylene glycol, another common ingredient in e-cigarette liquids, has been shown to have a toxic effect on the ovaries and eggs. The same study has linked propylene glycol to oxidative stress, which can lead to damage to the eggs and decreased fertility. In addition, propylene glycol has been shown to cause DNA damage, which can affect the quality of the eggs.

How vaping may affect egg freezing outcomes

Egg freezing is a process where a woman's eggs are retrieved, frozen, and stored for later use once she is ready to fertilize them and start or grow her family. The more eggs that are retrieved, the better the chances of a live birth down the line. 

While the effects of vaping on fertility are still largely unknown, many fertility clinics advise their patients to quit vaping in an effort to improve egg freezing outcomes related to quality and quantity based on the above research on smoking. Lower quality eggs with a higher DNA damage rate could impact the success of a future pregnancy using these frozen eggs, as these eggs may be less likely to fertilize into embryos (or result in a successful implantation). In addition, fewer eggs retrieved from those who vaped may result in fewer options for future use, which can increase the likelihood of needing additional egg freezing cycles.

Our programs offer the opportunity to freeze your eggs in a way that’s more empowering, positive, and affordable — even free. Take our quiz today to see if you qualify for Split, our free egg freezing program. 

Can I donate my eggs if I vape? 

If you are considering applying for our Split program, where you can freeze your eggs for free when you donate half of the eggs retrieved to another family, please note that you will not be considered eligible if you currently use any nicotine products, including vaping. If you engage in vaping regularly, you will need to quit for two to three months before re-applying for the program. If you only vape occasionally/socially, you will need to quit for one month prior to your retrieval date.

Summing it up

In conclusion, while data is somewhat limited, it appears that the effects of vaping on fertility can have an impact on women who are considering egg freezing. The ingredients in e-cigarette liquids, such as nicotine and propylene glycol, have been shown to have negative effects on reproductive health, including decreased fertilization rates and increased risk of miscarriage. In addition, it is possible that vaping can lead to a lower number of eggs retrieved during an egg freezing cycle and a higher rate of DNA damage in the retrieved eggs. 

Our recommendation? Safe is better than sorry — in the interest of the best cycle outcome, it’s probably a good idea to hold off on the e-cigarettes leading up to and during your egg retrieval. 

If you’re considering egg freezing, consult with a fertility specialist or take our quiz to learn more about how you can preserve your fertility.