egg freezing

As you embark on your egg freezing journey, you'll quickly become familiar with a big aspect of the process: monitoring appointments. These regular check-ins during the 10-14 day egg freezing cycle are essential for ensuring the success and safety of your cycle. While the prospect of frequent medical visits might seem daunting, understanding what to expect can help you approach these appointments with confidence. Let's dive into the details of monitoring appointments during your egg freezing cycle.

The purpose of monitoring appointments during egg freezing

After you begin your fertility medications, your body will start producing multiple eggs. This is where monitoring appointments come into play. These visits serve several critical purposes:

• Tracking your response to medication
• Ensuring multiple eggs are developing properly
• Determining the optimal time for egg retrieval
• Preventing overstimulation and the risk of Ovarian Hyperstimulation Syndrome (OHSS)

Egg freezing medications are not one-size-fits-all. Every woman's body responds differently to fertility drugs, which is why individualized monitoring is so important. Your doctor will use these appointments to fine-tune your treatment plan, adjusting medication dosages if necessary and pinpointing the ideal moment for egg retrieval. These visits also provide an opportunity to address any concerns or questions you may have. 

During these appointments, your care team will work to ensure that you are neither overstimulated nor understimulated. Overstimulation can potentially lead to ovarian hyperstimulation syndrome (OHSS) while understimulation may result in a lower yield of mature eggs. Through monitoring, your healthcare team will optimize your chances for a successful outcome while also prioritizing your health and well-being above anything else. 

Location and frequency of egg freezing monitoring appointments

Typically, these appointments take place at your fertility clinic. However, if you're not located near your primary clinic, arrangements can often be made for monitoring at a local fertility clinic or monitoring center like an OBGYN office.

As for frequency, be prepared for regular visits. Monitoring appointments usually occur every 2-3 days during your stimulation cycle. However, depending on your individual response and your doctor's assessment, you might find yourself at the clinic more or less. On average, you can expect around 5-6 appointments during your cycle.

What to expect during monitoring appointments

Your monitoring appointments will primarily consist of two key components: transvaginal ultrasounds and blood tests. Let's break down what you can expect from each:

1. Transvaginal ultrasounds

The star of the show during monitoring appointments is the transvaginal ultrasound (some folks in the fertility world jokingly call this “dates with Wanda”). This imaging technique uses an ultrasound wand to allow your doctor to visualize your ovaries and uterus, providing crucial information about your progress. 

When you arrive for your appointment, a nurse will escort you to a private room. You'll be asked to undress from the waist down and lie on an exam table with your feet in stirrups. The ultrasound technician or doctor will then insert a thin, wand-like device called a transducer into your vagina.

The word “transvaginal” means the ultrasound transducer goes in the vagina. Now, let's address the elephant in the room: does it hurt? While the sensation can be uncomfortable, most women describe it as pressure rather than pain. The procedure is generally quick, lasting only a few minutes.

During the ultrasound, your doctor will be looking at several key factors:

• Follicle count: Each follicle is a fluid-filled sac that contains an egg. The number of follicles present indicates how well you're responding to the fertility medications.
• Follicle size: Your doctor will measure the size of each follicle. This measurement helps determine the maturity of the eggs within. As you continue your medications, these follicles will grow – typically about three millimeters every two days.
• Uterine lining: Although not directly related to egg freezing, your doctor will also assess the thickness and quality of your uterine lining.

The goal is for most follicles to reach a size between 18 and 20 millimeters before egg retrieval, though this can vary based on individual circumstances.

2. Blood Tests

In addition to the ultrasound, you'll likely have blood drawn at some or all of the monitoring appointments. These blood tests primarily measure your estrogen levels, which rise as your follicles grow and produce more estrogen. Your doctor will use these results, in combination with your ultrasound images, to assess your progress and make any necessary adjustments to your medication protocol.

The blood draw is typically quick and straightforward. If you're someone who gets nervous around needles, don't hesitate to let the staff know. They're experienced in working with patients who have a range of comfort levels with medical procedures.

Interpreting your results

After your ultrasound and blood tests, you might be eager to know what it all means. While your doctor will provide personalized feedback, here are some general guidelines:

• Follicle count: A higher number of follicles generally indicates a good response to the medication. However, quality is just as important as quantity.
• Follicle size: Your doctor is looking for consistent growth. Ideally, most follicles will be growing at a similar rate.
• Estrogen levels: Rising estrogen levels typically indicate that your follicles are developing well. However, if levels rise too quickly, your doctor might adjust your medication to prevent overstimulation.

Remember, these results are just snapshots in time. What matters most is the trend over multiple appointments. Don’t be afraid to ask questions so you can understand how your egg freezing cycle is progressing!

Tips for egg freezing monitoring appointments

To ensure your monitoring appointments go smoothly and provide the most accurate information, consider the following tips:

1. Schedule wisely: Most clinics will try and schedule your appointments first thing in the morning. This allows for the most accurate hormone measurements and can help you avoid disrupting your work day.
2. Stay hydrated: While you'll need an empty bladder for the ultrasound, staying well-hydrated in general can make blood draws easier.
3. Wear comfortable clothing: Opt for easily removable bottoms to make the ultrasound process more convenient.
4. Take notes: Jot down any questions you have between appointments so you don't forget to ask your doctor.
5. Be flexible: Your body's response to the medications might necessitate last-minute changes to your appointment schedule. Try to maintain some flexibility in your calendar during this time.

Monitoring appointments can be a lot. The frequent medical interventions, the uncertainty of each appointment's outcomes, and the general stress of the egg freezing process can take a toll.

Remember, it's entirely normal to feel a range of emotions during this time. Some women find it helpful to bring a friend or family member to appointments for support. 

Leading up to the egg retrieval

As your monitoring appointments progress, your doctor will be looking for signs that your eggs are nearing maturity. When most of your follicles reach the target size, and your hormone levels are appropriate, your doctor will schedule the exact day and time for your egg retrieval.

You'll be given specific instructions for this final stage, including when to administer your trigger shot – a medication that prompts final egg maturation and sets the stage for retrieval.

If you do decide to cycle multiple times, there are some benefits to repeating the process. Each cycle provides valuable insights, helping your care team identify the most effective type of care and medication regimen tailored specifically for you. This personalized approach can enhance the efficiency and success rate of subsequent cycles.

Summing it up

Monitoring appointments are a big part of the egg freezing process. While they require time and commitment, they're important for ensuring the safety and success of your cycle. By understanding what to expect, you can approach these appointments with confidence and use them as opportunities to stay informed about your progress.

Remember, every woman's egg freezing journey is unique. Your experience may differ from others, and that's perfectly normal. Trust in the process, communicate openly with your medical team, and don't hesitate to ask questions. You're taking a proactive step towards your reproductive future, and that's something to be proud of.

Freeze your eggs with Cofertility

We’d love the opportunity to support you on your egg freezing journey.

Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.

Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help promote social justice and strengthen gender equality.

In an era where women are increasingly taking control of their reproductive futures, egg freezing has grown in popularity, with a 30% increase in egg-freezing cycles from 2021 to 2022 alone!  But as with many aspects of modern relationships, this scientific advancement has given rise to new and complex questions. One we hear often: Should your partner contribute financially to your egg freezing journey?

This question, unimaginable just a generation ago, is now a reality for many couples navigating the intersection of love, career, and family planning. It touches on deeply personal issues of autonomy, commitment, fairness, and shared futures, all against the backdrop of what can be a significant financial investment. In this article, we’ll share some of our learnings about paying for egg freezing from our members.

How much does egg freezing cost?

The cost of egg freezing, which can range from $10,000 to $20,000 per cycle (not including storage fees), is substantial. For many egg freezers, it represents a significant portion of their savings or might require taking on debt. In this context, the idea of sharing the cost with a partner can seem appealing, even logical. But it's far from straightforward.

A relationship litmus test

This decision to share the cost of egg freezing is as much about your relationship as it is about fertility. It requires couples to have honest conversations about their future together, their financial situations, and their views on family planning.

Indeed, the question of whether a partner should contribute to egg freezing costs is a litmus test for many aspects of a relationship. It forces couples to confront their level of commitment, their financial compatibility, and their visions for the future.

For Sarah* (names have been changed), a real estate executive in New York, the decision to ask her boyfriend of five years to share the cost of her egg freezing was natural. "We've talked about having kids someday, but we're both focused on our careers right now," she explains. "It felt like an investment in our shared future." Her partner agreed, viewing it as a way to support Sarah's choices while keeping their options open.

But not all couples find the decision so straightforward. Lauren, a startup marketer in San Francisco, grappled with whether to even bring up the topic with her partner. "I worry that asking him to contribute financially might put too much pressure on our relationship," she confides. "Would he expect me to freeze embryos? What if we break up?"

There’s a lot to think through. Should you freeze eggs or embryos? If a relationship ends, what happens to the eggs? Do you need to have a contract? Could contributing to egg freezing create a sense of obligation or expectation that might not otherwise exist? 

The decision to share the cost of egg freezing also intersects with broader questions of gender equality and financial independence. In a world where women still earn less on average than men, is it fair to expect women to shoulder the entire cost of fertility preservation? Or does asking a partner to contribute reinforce outdated notions of male financial responsibility?

Sarah Elizabeth Richards, author of Motherhood, Rescheduled, shared with NPR, "I do think there's a place to say, 'There's a cost to me for staying in this relationship, and it's fair if you help me absorb it.'” 

What matters most is that you feel empowered to make an informed choice that's right for you, whether that means paying for it entirely yourself or seeing it as a shared investment in a future family.

Key conversations to have with your partner

If you're considering asking your partner to contribute to your egg freezing, here are some key points to discuss:

• Your individual and shared visions for the future
• Your current financial situations and how this expense fits in
• How you typically handle shared expenses and major financial decisions
• Your feelings about fertility, family planning, and personal autonomy
• If you plan to freeze eggs or embryos
• What would happen if you were to break up
• Your understanding of the medical process and its potential outcomes

Remember, there's no universally right or wrong answer. Only the answer that works best for you. We’ve seen it all. The key is to approach the conversation with honesty, empathy, and a willingness to listen to each other's perspectives.

Read more in How to Talk to Your Partner About Freezing Your Eggs

A new approach to funding egg freezing

Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for potential egg freezers:

Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.

Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.

Egg freezing, also known as oocyte cryopreservation, is a process where a woman's eggs are retrieved, frozen, and stored for later use. This allows women to preserve their eggs at their current age, potentially increasing their chances of having a biological child in the future.

Egg freezing is becoming more and more common, with a 30% increase in egg-freezing cycles from 2021 to 2022 alone! 

I’m Dr. Meera Shah, a double-board certified OBGYN and Reproductive Endocrinologist (REI). I have helped countless women freeze their eggs as a fertility doctor and as a Medical Advisor to Cofertility. This article is a guide to everything you need to know to make a confident, informed decision about egg freezing.

Why people choose to freeze their eggs

There are many reasons why women opt for egg freezing. Here are some of the most common reasons we hear:

• Focusing on other priorities: Women focusing on career or personal goals can freeze their eggs until they're ready to start a family.
• Waiting for the right partner: As the average age of first marriage continues to rise, some women choose to freeze their eggs instead of rushing into a marriage.
• Medical reasons: Women facing medical conditions or treatments that could impact fertility, such as chemotherapy or radiation, can freeze their eggs before undergoing these treatments.
• Genetic predisposition: Women with a family history of early menopause may choose to freeze their eggs to ensure they have viable eggs for future use.
• Peace of mind: Some women simply want the peace of mind knowing they have a backup plan for their fertility.

At what age should you freeze your eggs?

There is no perfect age at which to freeze your eggs. However, the younger you can do it, the better. According to the American Society for Reproductive Medicine (ASRM), an optimal time to freeze your eggs is in your 20s and early 30s, while you have a higher ovarian reserve and eggs are healthier. 

A large 2020 study at a fertility clinic that specializes in this area looked at egg freezing cycles for over 1,200 people. It compared the average number of eggs people of different ages were able to freeze versus the “optimal” or goal number of eggs they should freeze. This goal number was based on how many eggs would give them a 70% live birth rate after doing 1 or 2 egg freezing cycles (this rate is calculated using some other numbers and it typically goes up as we age to make up for the lower number of healthy eggs). 

The study found that younger people, unsurprisingly, have an easier time freezing the goal number of eggs in one cycle. As people aged, they needed multiple egg freezing cycles to reach that goal number.

Read more in What’s the Best Age to Freeze My Eggs?

Is it worth freezing eggs after age 35?

The findings from the study above bring up a common question–is it worth freezing eggs after age 35? Well, it depends. The ASRM does not recommend egg freezing for people older than 38, but this isn’t a strict cutoff. 

Your biological clock is not a cliff. Everyone’s fertility decreases down at a different rate. Having your fertility hormones checked can sometimes help you and your doctor get a general idea of your ovarian reserve and chance of a future pregnancy. This can better help you decide if egg freezing is right for you.

Egg freezing success rates by age

Success rates with egg freezing depend on a lot of factors: your health, your ovarian reserve, your response to egg freezing medication, and the quality of the clinic. That being said, generally, younger women have higher success rates due to better egg quantity and quality. 

A 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, not all thawed eggs will become viable embryos and lead to a live birth. 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 nine 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. 

The right number of eggs to freeze for your age

Different folks have different reasons for freezing their eggs. Some may be thinking about prolonging their fertility into the future. Others may be freezing some eggs but also hoping to donate some eggs to help others grow a family — something that’s done via our Split program, where you freeze for free when donating half of the eggs to a family that can’t otherwise conceive. 

Either way, studies have found that the optimal number of eggs to freeze really comes down to your age. That’s because the number of eggs in the body isn’t the only thing to decrease as you get older — egg quality decreases too, and egg quality is the number one factor in determining whether an egg can eventually result in a live birth. 

Here are the number of eggs you’ll want to freeze based on your age in order to obtain an optimal live birth rate:

Should I do multiple egg retrievals?

What happens if you don’t get as many eggs as you had hoped during your egg retrieval cycle? 

If you’ve undergone one round of egg freezing and the number of eggs your reproductive endocrinologist retrieved from your ovaries wasn’t as high as you’d hoped, you may want to talk to them about trying again. A fertility specialist can help you talk through all of your options.

There is technically no limit to the number of egg freezing rounds a person can undergo, but it’s not recommended that egg donors undergo more than six cycles. If you’re hoping to split your eggs with intended parents (donating half of the eggs retrieved) as part of our Split Program, you may find that additional retrievals help you provide the optimal amount of eggs for a live birth for you and for the intentend parents too. 

The right number of eggs to freeze to have multiple children

If you’re planning to have a big family one day, you may want to look at the number of eggs it’s recommended you freeze to achieve one live birth and talk to your Reproductive Endocrinologist (REI) about freezing more eggs. 

As we shared above, a woman under age 35 will need to freeze about nine eggs to achieve a 70% chance of a successful pregnancy and live birth. If you’re under age 35 now and thinking you might want to use frozen eggs to conceive twice in your future, you will want to freeze closer to 18 eggs.

The number of eggs necessary will increase with your age at time of the retrieval, and the number of children you hope to have via those eggs. 

Can frozen eggs guarantee a successful pregnancy in the future?

When trying to decide if you should freeze your eggs, it’s important to know that egg freezing is not an “insurance policy” for your fertility. While egg freezing can take some of the stress of having a baby right now off your shoulders, it is not a guarantee that you’ll have a baby in the future. 

Why not? Well, for one, not all the eggs that get frozen will actually be viable. It’s expected that some eggs will not survive the warming process when it comes time to use the eggs. In addition, the chances of the eggs that do survive being successfully fertilized depends on a variety of factors, including how old you were when you froze them (more on this later). 

This is not to sway your decision one way or another. Ultimately, only you and your doctor can decide if egg freezing is the right decision for you. But it's important to go in knowing that it’s not meant to be a done deal. As egg freezing has gotten more popular, many companies will gloss over this fact. We don't think that's right and want to be straight with you from the outset.

Freezing your eggs when you’re unsure if you want kids

Perhaps the biggest benefit of egg freezing is that it puts the decision-making power entirely in your hands. Whether you’re freezing your eggs because you want to focus on your career or you’re about to undergo medical treatment that may affect your fertility later on, or you’re waiting to find the right partner, freezing your eggs allows you to preserve some of your fertility independently. 

While you might not be sure about having kids today, if you do decide you want kids down the road, especially if you’re in your mid- to late-thirties, having eggs on ice will increase the chances that you’re able to do so.

Know this: most people do not regret their egg retrieval procedure. We looked at five studies on egg freezing. The rates of regret reported in these studies varied, likely due to the sample size, study design, and the follow-up period. However, taken together, these studies suggest that the vast majority of those who freeze their eggs have zero regrets.

There also appear to be factors that reduce the chances of regret, including feeling fully informed beforehand, and getting adequate support during the egg freezing process. In other words, if you take the time to think things through and feel supported throughout the journey, you’re less likely to regret making this decision for yourself.

The egg freezing process: step-by-step

The egg freezing process is about a two-week journey. You will work closely with a Reproductive Endocrinologist (fertility doctor) and the clinic team throughout the process. 

Here's a detailed breakdown of what you can expect from start to finish, and beyond:

1. Ovarian stimulation: You'll take hormone medications to stimulate your ovaries to produce multiple eggs, and have multiple monitoring appointments and blood tests to see how the eggs are maturing.
2. Egg retrieval: Your eggs will be retrieved through a minor surgical procedure using ultrasound guidance.
3. Vitrification: Your eggs will be rapidly frozen using a technique called vitrification, which helps preserve their quality.
4. Storage: Your frozen eggs will be stored in a secure facility until you're ready to use them.
5. Thawing and fertilization: When you're ready to conceive, your eggs will be thawed, fertilized with sperm (either your partner's or a donor's), and transferred to your uterus.

Will egg freezing hurt my future fertility?

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.

Is egg freezing safe?

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. 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.

Egg freezing vs embryo freezing 

There’s one major difference between freezing eggs and freezing embryos. When you freeze your eggs, they stay unfertilized. We all know that to make a baby, you need an egg and a sperm because each of them provides half of the material needed. On its own, an egg can’t function (and neither can a sperm).

An embryo, on the other hand, is an egg that has already been fertilized by a sperm. Once they combine, the egg and sperm become a single cell. Over the next three to four days, the embryo divides several times, going from one to two to four to eight cells, and so on until it reaches the blastocyst stage and is ready to be frozen. Once an embryo has developed, there’s no going back– that is, there’s no way to turn that embryo back into a separate egg and sperm. 

If you don’t know who you want to have children with, then freezing your eggs may be the best approach. This option gives you the freedom to hold off on thinking about having a baby until you’ve met someone or are ready to choose a sperm donor. 

On the other hand, if you are currently with a partner who you know you’d like to have children with but now isn’t the right time, then frozen embryos might be the way to go with the goal of a future embryo transfer. The caveat here is to be 100% certain—stars like Sofia Vergara and more recently, Anna Kendrick, have run into trouble after freezing embryos with partners they didn’t end up with. 

Read more in Should I Freeze Eggs or Embryos?

Cost of egg freezing

The question of how much does it cost to freeze your eggs will come down to a few factors. These include the number of cycles you undergo to retrieve eggs and how long you keep the eggs in storage. Overall, the typical egg freezing can cost anywhere from $10,000 to $20,000 for one cycle plus the cost of storage fees.

Another option? 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 — we think it’s a win-win. 

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 freezers. ‍We partner with lenders, like Sunfish, to offer you fertility financial resources.

Learn more about egg sharing

Egg sharing programs exist worldwide to help make fertility care more accessible. Egg sharing is when a woman undergoes an egg retrieval, and some of the resulting eggs are donated to a family that can’t otherwise conceive.

In Cofertility’s Split program, women can freeze their eggs for free when they donate half of the retrieved eggs to a family who can’t otherwise conceive. 

Ask us anything

If you’d like help figuring out when to freeze your eggs, you can contact us for more information. While every woman’s fertility preservation 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 for an egg retrieval process.  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. 

The demands of medical school can make it seem like there's never a good time to focus on personal goals like proactive family planning. But if egg freezing is on your mind, understanding the best timing can make the process much smoother. Medical school actually offers some unique advantages. You are better positioned to understand everything involved in the medical procedure.

When it comes to egg freezing, your age is the most important factor influencing future success rates with frozen eggs, so acting while you're younger (under 35) gives you the best possible options. Additionally, certain phases of med school might have slightly more flexibility than the intensity of residency.

So, when should you consider freezing your eggs during medical school? Optimal windows include summer breaks (most time available), fall/spring breaks (if you're a meticulous planner), or potentially elective periods (depending on your choices). Let’s dive in to learn more.

A quick overview of egg freezing

The egg freezing process itself typically takes a few weeks. It begins with ovarian reserve and fertility testing along with a consultation with a fertility doctor where you map out the plan. Once you’re ready to go, you'll take hormonal medications for about 10-12 days to encourage the development of multiple mature eggs. During this time, you'll have regular monitoring appointments to track your progress.  Once the eggs are ready, they'll be retrieved in a short, outpatient procedure under sedation.  After retrieval, your eggs are frozen and stored for future use.

A guide to the ideal timing during medical school

Here's the essential timeline to keep in mind:

2-3 months before your egg freezing cycle:

• Initial consult: Discuss your goals, the process, and costs with a fertility doctor.
• Baseline testing: Bloodwork and ultrasound to assess ovarian reserve.
• Stop birth control: Depending on the type of birth control you are taking, you may need to stop taking it ahead of the egg freezing cycle. 

The egg freezing cycle:

• Medications and monitoring: Begin ovarian stimulation with daily hormone injections for 10-12 days. This phase requires several monitoring appointments (ultrasounds and blood tests) at your fertility clinic or a local remote monitoring clinic. If you work with Cofertility in our Split program, we can work with you and your program to find the most convenient place for these appointments, including at your hospital.   
• Egg retrieval: Short, outpatient procedure under sedation where eggs are retrieved and frozen.
• Recovery: Expect a few days of cramping and/or bloating. Most people can return to light activities soon after.

Expect about 3 to 6 monitoring appointments (which last no more than an hour) and one day for the retrieval.  Ideally, you'll want to align the cycle with a break in your medical school schedule– such as spring break, summer break, or otherwise– to ensure you have the flexibility you need for appointments.

The key is being proactive! Don't wait to start the conversation with a fertility clinic. The earlier you plan, the less stressful it will be. Since medical schools publish their calendar in advance, use one of the week-long breaks as a target for the egg retrieval. You can then work backwards from that date to start the cycle. 

Be your own advocate with your school's administration about needing some flexibility for medical appointments. If you work with Cofertility, we can help you map out the egg freezing schedule and find a cycle start date that works with your schedule. 

If you join our Split program, you will be assigned a Member Advocate who will take the extra steps to understand your busy schedule and help schedule appointments in the most convenient way possible. In some cases this means reaching out to the hospital(s) connected to your medical school program for availability to perform labs and ultrasounds.

Freeze your eggs with Cofertility

Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:

1. Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
2. Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

The benefits of working with Cofertility include:

• Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
• Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
• Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
• Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
• Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.

Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.

If you're considering egg freezing, you may have come across the term "vitrification." This rapid freezing technique is a game-changer in the world of egg freezing, offering significantly improved success rates compared to older freezing methods. Let's dive into what vitrification is and why it's so important for preserving your fertility.

Vitrification vs. slow freezing

Eggs (oocytes) are unique cells. They contain a high amount of water, which makes them particularly vulnerable to damage during freezing. But why do we need to freeze them to begin with? The freezing portion of egg freezing is important because freezing cells to sub-zero temperatures stops all biologic activity and preserves them for future use. 

Up until recently, fertility clinics used a process called “slow-freezing”. Traditional slow-freezing methods often led to the formation of ice crystals within the egg. These crystals could pierce the cell membrane and cause irreversible damage, lowering the egg's viability after thawing.

Through vitrification, a special solution containing cryoprotectants protects the cells from the damaging effects of freezing. This solution, combined with ultra-rapid cooling, transforms the water molecules in the cells into a glass-like state instantly, preventing the formation of harmful ice crystals.

This has improved the overall survival rate of eggs (when they are later thawed) from 75% to over 95%. 

How does vitrification work?

Vitrification is a multi-step process that carefully protects the egg during the freezing process. Here's a simplified breakdown:

• The eggs are placed in solutions with increasing concentrations of cryoprotectants. These substances essentially replace the water within the egg, minimizing the risk of ice crystal formation. 
• The eggs are then plunged into liquid nitrogen, which cools them at an incredibly fast rate (thousands of degrees per minute). This speed is crucial to prevent ice crystals from having time to form. 
• The vitrified eggs, now in a glass-like state, are safely stored in cryogenic tanks until they are ready to be used.

The length of time that frozen human eggs can be stored depends on several factors, including the quality of the eggs, the storage method used, and the regulations of the country or state where the eggs are being stored.

Scientifically, if you work with a good clinic in the United States using vitrification, you can keep them stored indefinitely. However, some countries, such as the United Kingdom have a cap on the number of years you can store eggs (for the UK, you can store your eggs for up to 55 years). Currently there is no limit in the United States.

Typically, I see patients that store their eggs for two to five years. With vitrification, the chances of damage during storage are usually quite low.

What happens when the vitrified eggs are thawed?

When you're ready to use your frozen eggs and turn them into embryos, you’ll first have them shipped from the storage facility to the clinic you are working with. Then, a careful warming process using a specialized procedure reintroduces water and reverses the vitrification process. 

An embryologist will then examine the thawed eggs to determine how many survived the freezing and thawing process. As I shared above, survival rates for vitrified eggs are generally quite high. 

Next, the surviving eggs are fertilized with sperm (either from a partner or donor) in a process called intracytoplasmic sperm injection (ICSI). The fertilized eggs, now embryos, are allowed to develop in the lab for several days. Finally, one or more of the healthiest embryos are transferred to your uterus (or the uterus of a gestational carrier) with the hope of implantation and a successful pregnancy. Not every frozen egg will result in a successful pregnancy. Several factors, including egg quality, the fertilization process, and embryo development contribute to the overall success rates.

Summing it up

Vitrification has revolutionized egg freezing, making it a more reliable and successful option for women who want to freeze their eggs for potential future use. By understanding this process, you can feel confident that your eggs are being protected in the best possible way, maximizing your chances of building the family you desire.

If you have further questions about vitrification or egg freezing in general, don't hesitate to consult with a fertility specialist. They can provide personalized guidance and help you make informed decisions about your reproductive future.

Read more:

• What Happens to My Eggs After Egg Freezing?
• Egg Freezing Thaw Rates
• Egg Freezing: How Long Can My Eggs Be Stored?
• What Happens to My Frozen Eggs if I Never Use Them?
• How to Increase Egg Freezing Chances of Success

Egg freezing (also known as oocyte cryopreservation) is a way to preserve your eggs today for potential use in the future. It offers women more control over their reproductive timeline. While the thought of freezing your eggs might seem intimidating, the actual egg retrieval portion of the process is a minimally invasive procedure. Let's break down what egg freezing involves and whether it requires surgery.

Egg freezing: a step-by-step overview

The egg freezing journey typically involves several phases. Understanding each step can help ease any anxieties and make you feel more prepared for the process. Let's break it down in more detail:

1. Medical screening: Before embarking on the egg freezing process, you'll undergo a comprehensive medical screening with your fertility doctor. This evaluation helps determine if you're a good candidate for egg freezing and ensures the process is right for you. The screening might involve reviewing your medical history to identify any underlying health conditions that could impact egg quality or the success of the procedure. Additionally, you might have a physical exam to assess your overall health. Ovarian reserve testing— which includes blood tests to measure hormone levels (especially AMH) and ultrasounds to assess the number of follicles in your ovaries— is common for evaluating ovarian reserve (your body's supply of eggs).
2. Ovarian stimulation: Once you’re ready to get started, you'll take hormonal medications for about 10-12 days.  These medications work by stimulating your ovaries to produce multiple eggs in a single cycle, rather than the usual one.  The goal is to increase the number of eggs available for retrieval, giving you more options for the future.
3. Monitoring:  During the ovarian stimulation phase, you'll visit your fertility clinic for regular checkups.  These appointments typically include ultrasounds to track how your follicles (where the eggs develop) are growing, and blood tests to monitor your hormone levels. This close monitoring helps your doctor personalize your medication dosage and determine the optimal time for egg retrieval.
4. Trigger shot:  When your eggs are nearing maturity, you'll receive a final injection of a hormone called hCG (human chorionic gonadotropin).  This "trigger shot" essentially gives the eggs the final push to fully mature in preparation for retrieval.
5. Egg retrieval:  Approximately 36 hours after your trigger shot, you'll undergo the egg retrieval procedure.  This is an outpatient procedure done under sedation, meaning you'll be asleep and won't feel any pain.  Your doctor will use a thin needle guided by ultrasound to carefully aspirate the eggs from your ovarian follicles.
6. Freezing:  Immediately after retrieval, the eggs are taken to a specialized lab. Here, they undergo a process called vitrification, which involves flash-freezing them in liquid nitrogen. This ultra-rapid freezing preserves the eggs in a way that maximizes their viability for future use.

Does egg freezing require surgery?

Many women are understandably curious about the egg retrieval process and whether it requires surgery. The reassuring answer is no – egg retrieval is a minimally invasive, outpatient procedure. It doesn't involve any incisions, stitches, or the extended recovery time typically associated with surgery.

The procedure itself takes place at a fertility clinic and usually lasts less than 30 minutes. You'll receive sedation, ensuring you're entirely relaxed and won't experience any discomfort. To retrieve your eggs, your doctor will use a thin needle guided by ultrasound imaging.  This needle is carefully inserted through your vaginal wall and into your ovarian follicles to delicately extract the mature eggs.

While egg retrieval isn't surgery, some mild side effects are common afterward.  You may experience some cramping, bloating, or tenderness – similar to what you might feel during a menstrual period. Over-the-counter pain relief typically manages these symptoms, and they generally fade within a day or two.  Most women can resume their regular activities quickly after the procedure.

Deciding if egg freezing is right for you

Egg freezing empowers you to take charge of your reproductive timeline. It is a proactive approach to family planning, offering the potential to build the family you desire on your own terms. While the decision to freeze your eggs is personal,  this option opens up possibilities that might not have existed otherwise.

If you're considering egg freezing, the most important step is to consult with a reputable fertility doctor. They can provide the personalized guidance, realistic expectations, and expert support you need to make an informed decision that aligns with your individual goals and circumstances.  By exploring all aspects of egg freezing, you pave the way for a more confident and empowered journey towards future family planning.

Read more:

• What's the Egg Retrieval Process Like?
• I'm Afraid of Needles; Can I Still Freeze My Eggs?
• Questions to Ask Your Doctor at an Egg Freezing Consultation

How Cofertility can help

If you are interested in freezing your eggs, we can connect you with a fertility specialist for a consultation to discuss your specific situation. Our Freeze by Co platform offers two programs for egg freezers:

1. Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. 
2. Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.

Egg freezing can provide amazing reproductive optionality in the event that you may need to use your frozen eggs to have children down the line — but what happens to unused frozen eggs if you don’t end up needing them? In this article, we’ll discuss what happens after you freeze your eggs and some options for what to do with any unused frozen eggs. 

Because it can be beneficial for anyone with ovaries to freeze their eggs — we offer a program to freeze your eggs for free through our Split program, when you donate half of the eggs retrieved to another family who can’t otherwise conceive. Our hope is that whenever you’re ready to start trying for a baby, you’ll be able to get pregnant unassisted. That being said, with 1 in 6 individuals experiencing fertility challenges, egg freezing allows you to be a little bit more prepared, just in case. 

Once you freeze your eggs, there are various paths you can decide on in the future, whether or not you choose to use them. Let’s dive in. 

What are the chances I’ll need to use my frozen eggs? 

As we mentioned, fertility challenges are — unfortunately — not entirely uncommon. Again, our hope is that your experience trying to conceive, whenever you’re ready, is easy-breezy. But that just may not be the case, which is why we’re on a mission to make egg freezing more accessible, empowering, and positive for all. 

It's an especially valuable option for those who know they want to build a family, but know they might need to use IVF down the line. This includes single moms by choice and members of the LGBTQ+ community, who often rely on assisted reproductive technologies to achieve their family-building dreams.

If you do end up wanting to use those eggs in the future, that involves: 

• Shipping them from storage
• Thawing them
• Fertilizing them into embryos in a lab (otherwise known as IVF, or in vitro fertilization)
• Letting those embryos develop for several days, with the option to have them genetically tested
• Transferring an embryo into your uterus or that of a gestational carrier to hopefully develop into a live birth 

The data on frozen egg thawing

It’s a relatively straightforward process, but given that egg freezing was only recently popularized, there’s not a ton of long term data around how many people end up needing to use those eggs in the future. We do have some data around thaw rates, as the success of thawing frozen eggs is not guaranteed. One study from 2009 found that the overall survival rate of eggs from vitrification (the most commonly used method of egg freezing today) was 95%. 

A 2023 UK-based study followed a cohort of 167 women that underwent 184 social egg freezing cycles between January 2006 and March 2022, and showed that 16% of the women have returned to use their frozen eggs so far. That statistic, however, should be examined with a grain of salt — the biggest reason being that if someone froze her eggs as late as 2022, the odds of her moving forward with IVF only one year later may be unlikely. 

Another 2022 study led by experts at NYU Grossman School of Medicine and the NYU Langone Fertility Center looked at 15 years of frozen egg thaw outcomes. Of 543 women, 61% moved forward with at least one embryo transfer. While this doesn’t tell us exactly how many women thawed their eggs, it was likely greater than 61%, assuming that some of these eggs unfortunately either didn’t survive the thaw or didn’t fertilize into embryos. 

Read more in Egg Freezing Thaw Rates

What happens if I *don’t* use my frozen eggs? 

Before you move forward with egg freezing, you’ll sign a contract with your clinic (or long-term storage facility), where you state your preferences about what to do with your eggs if, at any point, you decide not to move forward with fertilization and transfer. Don’t worry — you can always change your mind later on. 

If you don’t end up needing your frozen eggs, or decide down the line that you don’t want to keep them in storage for any reason, here are your options.

Unused frozen eggs option #1: discard them 

If you know you don’t want to keep storing your frozen eggs, and would rather not pursue other options (listed below), you can always request that the clinic or storage facility dispose of them. 

Unused frozen eggs option #2: donate them to science 

The biggest reason why egg freezing technology has made so much progress over the years is because of individuals volunteering to provide reproductive material for research. The ability to study frozen eggs and embryos, along with the medications, techniques, or devices used among various cycles can help improve success rates for others pursuing fertility treatment in the future. 

If you don’t see this listed in your initial contract but want to pursue this as an option, ask your clinic if this is possible.

Unused frozen eggs option #3: keep paying for storage

Frozen egg storage fees will vary depending on the location of the storage facility, the time you’re willing to commit to storage (some facilities offer discounts for bulk pricing — say, paying for 5 years upfront), transportation fees, and more. Typically, this ranges between $500 - $1,500 per year. 

As part of the free egg freezing provided through Cofertility’s Split program outlined above, you’ll receive 10 years of frozen egg storage. And of course, you can always remove, thaw, or ship them somewhere else before those 10 years are up if you’d like. After all, they’re your eggs! And if you’re working with a good clinic in the US using vitrification methods (and don’t mind paying storage fees), you can even store your frozen eggs indefinitely. 

Unused frozen eggs option #4: donate them to another family

Many individuals or couples — including LGBTQ+ families, those with infertility, or cancer survivors — may rely on egg donation in order to grow their families. If you’re interested in pursuing egg donation, talk to your clinic. You’ll need to undergo some screening to see if you qualify, but this could be an incredible option. 

Conclusion 

If you’re not 100% certain you won’t be using your frozen eggs and you are comfortable with the storage expense, our recommendation is to continue storing your eggs until you’re sure you no longer need or want them. You never know. 

If you have not yet begun the egg freezing process and you are interested in more affordable (even free) egg freezing, take our quiz to see if you qualify for Cofertility’s Split program. It only takes a minute! 

Read More:

• Egg Freezing: How Long Can My Eggs Be Stored?
• Does Donating Eggs Affect Your Fertility?
• What to Look For in an Egg Freezing Clinic

Thanks to advancement in reproductive technology, egg freezing can offer women the opportunity to preserve their fertility while they focus on other aspects of their lives. But what if they have pursued their education, advanced in their careers, and are happily settled with their forever person, when life takes a left turn? Significant life changes such as divorce may also prompt women to consider egg freezing as a way to preserve their fertility for future family-building purposes. This option may allow them the time needed to heal without feeling pressured to rush into finding a new partner and give them the space to make informed decisions about their future.

The emotional impact of divorce

Divorce or a breakup can be an incredibly challenging and emotionally taxing life event. The end of a relationship can bring about feelings of loss, grief, loneliness, and uncertainty. Divorce can impact various aspects of one's life, including future plans— plans that may have included children. A divorce or breakup can raise concerns about future fertility issues, especially for women over the age of 35. 

How egg freezing works, and how much it costs

The process of egg freezing typically begins with ovarian stimulation where the woman undergoes hormonal treatments to stimulate the ovaries. The goal is to produce multiple eggs in one cycle as typically only one egg is produced in a cycle. Once the eggs have reached maturity, they are retrieved via an out-patient procedure where a thin needle is inserted into each follicle, and the eggs are retrieved. Once retrieved, the eggs are cryopreserved using vitrification, a rapid cooling technique. The frozen eggs are then stored in cryogenic tanks until they are ready to be used.

There are a few factors that determine success rates. By success rates we are referring to a live birth outcome using the frozen eggs. Generally, women under 35 have better outcomes and the more eggs retrieved, the higher the likelihood of success. A recent study found that irrespective of age at freezing, a significantly high live birth rate was achieved when the number of eggs frozen per patient was 15 or more. 

The process of freezing eggs can cost anywhere from $10,000 to $20,000 and above. Costs include things like the initial consultation and testing, ovarian stimulation and egg retrieval, the egg freezing procedure, medication, and storage fees. Once the eggs are ready to be used, there are costs involved for thawing and then fertilizing to create embryos. After that there are fees for embryo testing and the transfer. If a sperm donor is used, there are various costs involved with that as well.

Learn more about our Split program, where qualified women can freeze their eggs for free when donating half to a family that couldn’t otherwise conceive. 

Navigating the decision-making process

Egg freezing allows women to take control of their fertility and help them make informed decisions about their reproductive future, with or without a partner.  However, there is still some concern about whether those who choose this option will regret their decision, especially given the costs involved. This article looks at several studies that explore this idea of regret. Overall, it was surmised that the only regret most had was they wished they had done it sooner.

Deciding to freeze eggs after a breakup or divorce can be a complex and personal decision. So it is important to feel and process emotions, seek support when needed, and make decisions that feel right for you and your future goals. It is understandable that following a breakup or divorce, there may be uncertainty about future relationships. So the decision to freeze eggs may involve deciding how to move forward with one's fertility independent of a partner. 

It’s also normal to have mixed feelings about the decision to freeze eggs, including relief at having a plan in place for the future but also sadness about the circumstances that led to the decision, and anxiety about the unknowns ahead. So it is very important to find healthy ways to manage stress and anxiety during this time. Which includes self-care, self-compassion, and leaning on support systems.

As important as it is to plan for the future, it is also important to keep in mind that plans always evolve over time. So I encourage you to remain flexible. Be prepared to adjust plans as  circumstances change. For example, at what point will you consider a sperm donor? If you find a new partner will you use frozen eggs or will you try to get pregnant on your own? If you do  get pregnant without using the frozen eggs,  what happens to the frozen eggs? Do they remain stored for a certain period of time? Are they donated? Or are they disposed?

Summing it up

Divorce or a break up brings about significant life changes, including changes in family planning. Freezing eggs provides a way to preserve fertility options for the future, allowing individuals to take time to decide on family planning when they're ready, whether it's with a future partner or as a single parent. It also allows individuals to focus on their emotional healing without feeling rushed into making decisions. By offering a way to preserve fertility and extend the window for family planning, egg freezing has become a valuable option for women navigating life changes.

Read more

• Amanda Goetz on Egg Freezing After Divorce
• We Asked Four Women: Did You Freeze Eggs or Embryos?
• A Breakdown of Egg Freezing Success Rates by Age

Freeze your eggs with Cofertility

Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:

1. Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
2. Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

The benefits of working with Cofertility include:

• Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
• Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
• Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
• Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
• Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.

Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.

Thinking about delaying having kids for a while? Maybe you’re focused on your career, haven't found the right partner, or just aren't ready yet. Egg freezing (oocyte cryopreservation) is a way to take some pressure off that biological clock and increase your fertility options. But is it right for you?

Let’s dive into some of the factors doctors use to help people determine if they are a good candidate for egg freezing.

Who is a good candidate for egg freezing?

There's no one-size-fits-all answer to who should consider egg freezing (planned fertility preservation). It depends on several factors, including your age, your ovarian reserve (how many eggs you have left), your family-building goals, and when you realistically see yourself wanting children.  Anyone thinking about egg freezing should be aware of the chances of getting pregnant using those eggs later, and understand that there's no guarantee of a baby.

One of the most important factors is your age.  The younger you are at the time of freezing, the better the quality of your eggs, and the higher your chances of a successful pregnancy later.  Those under 35 generally have the highest success rates with egg freezing.

Read more in At What Age Should I Freeze My Eggs?

In addition to age, your doctor will look at your ovarian reserve.  Tests like AMH (Anti-Müllerian hormone), FSH (follicle-stimulating hormone), E2 (estradiol), and an ultrasound to see your antral follicle count will give them a picture of how many eggs you have left.  This information helps them provide guidance on how many eggs you could expect to retrieve during the freezing process and your overall chances of success.

Egg freezing might also be the right choice for those with certain medical conditions, or those with a family history of early menopause.

Because the answer is different for everyone, you’ll want to have an egg-freezing consultation with a fertility doctor. They'll help you assess the pros, cons, costs, and your individual success rates.

Who is not a good candidate for egg freezing?

Ultimately, the decision will be up to you and your fertility doctor. But there are a few factors that could lead your doctor to dissuade you from freezing your eggs. This includes:

• Over 45: The success rates of egg freezing drop significantly beyond age 45 due to decreased ovarian reserve and lower egg quality. While some clinics might offer the procedure, it's important to have realistic expectations about the low chances of pregnancy.
• Severely diminished ovarian reserve: Hormone tests and an antral follicle count provide an estimate of how many eggs are remaining. If these numbers indicate very low ovarian reserve, egg freezing is unlikely to yield enough eggs to make it worthwhile.
• Planning to conceive soon: If you plan to try for a baby within a year or two, egg freezing usually isn't necessary. The odds of conceiving naturally within that time frame are often good, especially if you are younger. Unless there are underlying medical reasons for concern, it makes more sense to try conceiving naturally first.
• No ovaries: Since egg freezing (oocyte cryopreservation) involves retrieving eggs from the ovaries, this procedure is not an option for those without ovaries.

Even if you fall into one of these categories, it's worth a consultation with a fertility specialist.  They can provide personalized guidance based on your specific situation and help you explore all your options.

Why would someone need to freeze their eggs?

There are many reasons why someone might consider freezing their eggs.  One major factor is age-related fertility decline. As people age, both the quality and quantity of their eggs naturally decrease. Freezing eggs at a younger age allows for the preservation of higher-quality eggs, potentially increasing the chances of a successful pregnancy later in life.

Medical reasons also play a significant role. Conditions like cancer, endometriosis, or surgeries with the potential to affect the ovaries can lead to premature infertility. Egg freezing allows individuals to preserve their fertility before undergoing treatments that might compromise it. Egg freezing is also an option for transgender men considering gender-affirming surgery or hormone therapy. It allows them to retain the possibility of having biological children in the future.

Those with a family history of early menopause might also consider egg freezing. If you have female relatives who experienced early menopause, you could be at higher risk. Egg freezing gives you greater control over your fertility timeline.

Sometimes, egg freezing simply centers around flexibility in life planning. Some people choose to delay childbearing to pursue education, establish their careers, or find the right partner.  Egg freezing can provide peace of mind and increased options when it comes to building a family.

At what age should you freeze your eggs?

According to the American Society for Reproductive Medicine (ASRM), an optimal time to freeze your eggs is in your 20s and early 30s, while you have a higher ovarian reserve and eggs are healthier. So whether you’re 25 or 35, you can absolutely freeze your eggs!

A large 2020 study at a fertility clinic that specializes in this area looked at egg-freezing cycles for over 1,200 people. It compared the average number of eggs people of different ages were able to freeze versus the “optimal” or goal number of eggs they should freeze. This goal number was based on how many eggs would give them a 70% live birth rate after doing 1 or 2 egg freezing cycles (this rate is calculated using some other numbers and it typically goes up as we age to make up for the lower number of healthy eggs). 

The study found that younger people, unsurprisingly, have an easier time freezing the goal number of eggs in one cycle. As people aged, they needed multiple egg freezing cycles to reach that goal number. These findings bring up a common question– is it worth freezing eggs after age 35? 

Is it worth freezing your eggs after 35?

Well, it depends. The ASRM does not recommend egg freezing for people older than 38, but this isn’t a strict cutoff. Everyone’s fertility goes down at a different rate. Having your fertility hormones checked can sometimes help you and your doctor get a general idea of what your ovarian reserve is. This can better help you decide if egg freezing is right for you.

To freeze or not to freeze, that is the question

When trying to decide if you should freeze your eggs, it’s important to know that egg freezing is not an “insurance policy” for your fertility. While egg freezing can take some of the stress of having a baby right now off your shoulders, it is not a guarantee that you’ll have a baby in the future.

Why not? Well, not all the eggs that get frozen will actually be viable. It’s expected that some eggs will not survive the warming process. In addition, the chances of the eggs that do survive being successfully fertilized depends partially on how old you were when you froze them (more on this later).

This is not to sway your decision one way or another. Ultimately, only you and your doctor can decide if egg freezing is the right decision for you. But it's important to go in knowing that it’s not meant to be a done deal.

Freeze your eggs with Cofertility

We’d love the opportunity to support you on your egg-freezing journey.

Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.

Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg-freezing process (or gearing up for it) to connect and lean on each other.

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help promote social justice and strengthen gender equality.

Summing it up

Here are the factors to consider if you are debating if egg freezing is right for you:

• Age matters a lot. The younger you are at the time of freezing, the better the quality of your eggs, and the higher your chances of a successful pregnancy later.  Those under the age of 35 generally have the highest success rates with egg freezing. Egg freezing isn't recommended for people older than 45 due to low chances of success.
• Think about your timeline. How long do you plan to wait to have children? Egg freezing is great for a longer delay, but likely not worthwhile if you’re only thinking a year or two ahead.
• Check your eggs. Tests like AMH, FSH, and ultrasounds with follicle count can give you a picture of your ovarian reserve (aka, how many eggs you have left).
• It's not a guarantee. Even with frozen eggs, there's no promise of having a baby in the future.
• The $ factor. Egg freezing is expensive! Most insurance plans don't cover it, so be prepared for an out-of-pocket cost. Or consider our Split program where you can freeze your eggs for free when donating half to a family that can’t otherwise conceive. 

Freezing your eggs is a big decision, and it's different for everyone. The best thing to do? Talk to a fertility specialist!  They'll help you understand the pros, cons, chances of success, and whether it makes sense for your particular situation.

So, you want to freeze your eggs, but you also want to travel — potentially to an area reportedly affected by the Zika virus. You’ve heard a lot here and there about the serious risks of Zika, but does living your globetrotting dreams mean you need to put your egg freezing plans on hold? 

In this article, we will delve into what the Zika virus is, where you could contract it, and how it could impact the outcome of egg freezing cycles. Additionally, we will discuss the regulations and guidelines set forth by fertility clinics, as well as specific considerations for egg donation. The TLDR: we recommend proper planning, timing, and precautions, (especially if you’re freezing your eggs for free when you donate half to another family who can’t conceive), when it comes to traveling to an area affected by Zika.

What is Zika and where is it found? 

Zika virus is a mosquito-borne flavivirus primarily transmitted by Aedes mosquitoes. While Zika virus infection often presents with mild symptoms, such as fever, rash, joint pain, and conjunctivitis, it poses a significant risk to pregnant individuals due to its association with congenital Zika syndrome, which can result in severe birth defects such as microcephaly. 

The virus has been found to persist in bodily fluids, including semen and vaginal secretions, for an extended period, raising concerns about the potential transmission of Zika through reproductive tissues. So, even if you yourself did not travel to a Zika-affected area, if you had sex with someone who did, there still poses a risk. Unfortunately, there are currently no vaccines available to prevent contracting Zika. 

Zika virus has been reported in various regions globally, with particular prevalence in tropical and subtropical areas. Countries with ongoing transmission of Zika virus include but are not limited to parts of Central and South America, the Caribbean, Africa, Southeast Asia, and the Pacific Islands. It's important for individuals considering egg freezing to stay informed about current Zika-affected regions, as travel to these areas may impact their fertility treatment plans. The good news is that according to the CDC, since 2019, there have been no confirmed Zika virus cases from US territories. 

How Zika could impact your egg freezing cycle?

Research about Zika and egg freezing is scarce and ongoing. But if you’re considering undergoing egg freezing, exposure to Zika could have implications on the success of the procedure. Zika virus infection could potentially impact the quality and viability of eggs, leading to compromised outcomes in your egg-freezing cycle. And because Zika is a virus that may be able to be transmitted sexually, there is a concern that the risk of Zika can be transmitted through the fertilization process. 

Fertility clinic regulations and guidelines

In response to the Zika virus outbreak, many fertility clinics have implemented strict regulations and guidelines to mitigate the risk of transmission and ensure the safety of patients undergoing assisted reproductive procedures. These regulations often include restrictions on travel to Zika-affected areas for individuals undergoing fertility treatments, including egg freezing. 

We recommend notifying your fertility clinic as soon as possible of any upcoming travel to a Zika-affected area, and you can discuss with your doctor how this should (or shouldn’t) impact your cycle timeline.

Zika guidelines for egg donation 

When it comes to egg donation in particular, the American Society for Reproductive Medicine (ASRM) and the Food and Drug Administration (FDA) have provided guidance to fertility clinics regarding the handling of reproductive tissues in the context of Zika virus transmission. According to the latest guidance published in 2018, the use of sperm, eggs, and embryos from a donor is not recommended if he/she/they: 

• Have had a diagnosis of Zika virus infection in the past 6 months
• Reside in or traveled to an area with active Zika virus transmission within the past 6 months
• Have had sex with a person if within the past six months that person was diagnosed with Zika, experienced an illness consistent with Zika, or traveled to an area with active Zika transmission

This guidance applies to both disclosed and undisclosed donations. However, in the case of a disclosed donation, many fertility clinics are willing to waive the six-month quarantine if both the donor and intended parents agree. 

So, what should you do?

We get it — when there’s still so much to learn about Zika, understanding its potential impact upon your egg freezing cycle can feel confusing. If you’re planning an egg freezing or donation cycle, it’s crucial to stay informed about Zika-affected areas and adhere to the regulations and guidelines set forth by fertility clinics and regulatory bodies. 

Again, when in doubt, consult with your reproductive endocrinologist for the latest guidance and recommendations. They’ll help you navigate how this may affect your egg freezing timeline and decision-making. By prioritizing safety and asking the right questions, you can make informed choices to protect your reproductive health and achieve your fertility goals.

In 2012, when the American Society for Reproductive Medicine (ASRM) and Society for Assisted Reproductive Technology (SART) removed the “experimental” label off of egg freezing, it began a new era of empowering women with taking control of their reproductive choices. 

According to SART data, egg freezing in the United States increased by 880% between 2010 and 2016. In a recent 2021 study, a total of 231 patients with 280 cycles were reviewed. 74.2% of oocytes survived thaw/warming, and 68.8% of surviving oocytes were successfully fertilized with a live birth rate of 33.8% 

Although egg freezing has high success rates it is not a guarantee or an insurance policy as some do experience loss during the thawing process. The emotional and psychological impact of potential loss during this stage can be very painful. Before embarking on egg freezing, it is important to be well informed and have realistic expectations regarding the likelihood of future use and outcomes. 

Emotional responses to loss in fertility treatments

Reasons behind wanting or needing to use cryopreservation vary from a young woman who is not yet ready to start a family to someone undergoing medical treatment. The idea of being able to stop the biological clock is not only exciting but can be a relief and bring some peace of mind. But, what happens for those who return to use their cryopreserved oocytes only to come out empty-handed? This unique loss creates intense disappointment, grief, guilt, and stress. 

Grieving and processing the loss

It can be incredibly painful to come to terms with this type of loss. You may feel that options have run out and that the door to parenthood has been closed. Processing this loss is difficult because it can feel invisible. This loss represents the demise of something that never was - this ‘thing’ was only something that was seen with your mind’s eye, your heart, and your soul. Because of the invisibility of this loss, you may feel that your feelings are not being recognized or acknowledged, or that you are not being validated or supported during this time.  

Give yourself some breathing room. Let all the emotions come up and let them be for a bit - it is okay to feel angry, bitter, sad, hurt. These are normal reactions to this type of loss.  We work so hard to avoid or push our emotions away. But how to process loss and how to grieve means to notice our emotions, name them, and allow them to come and go on their own time. 

Seeking support and building a support network

Healthy ways to process emotions can include talking to loved ones and telling them what it is that you need from them. If that does not feel right then start building a support network consisting of online or local support groups composed of people going through the same things. Never underestimate the role of professional support especially by counselors specializing in fertility issues. They can help you manage emotions and give you a safe space to talk. 

Self-care and coping strategies

Explore different methods of self-care that feel right for you such as engaging in hobbies or participating in creative or social activities. These can be anything from journaling, exercising, being in nature etc. 

Summing it up

Egg freezing has afforded women the ability to start a family on their own terms. Science has found a hack to nature’s biological clock. But before embarking on egg freezing and thawing, set realistic expectations. Understand that there can be many different outcomes. And not all have a happy ending. Do your research, ask a lot of questions. And most importantly, be kind to yourself. 

Egg freezing is, undoubtedly, one of the most empowering journeys anyone with a uterus can embark on. One of the biggest reasons you’ll feel like you can conquer the world after an egg freezing cycle is also one of the least fun parts about it: the injections.

If you’ve already begun to explore freezing your eggs, you know that the process requires administering injectable medication shots. So a thorough understanding of how they work — and how to get through them all (mentally, emotionally, and physically) — is essential. This article aims to provide clinically-sourced tips to guide you through this crucial aspect of egg freezing.

Types of egg freezing shots and medications

At its core, egg freezing involves the use of injectable medications to stimulate the ovaries, promote egg development through maturity, and enhance the chances of a successful egg retrieval. What doctors — and you — are looking for is strong egg volume and quality, and certain medications are used to help you on the road to get there.

These medications fall into a few categories:

Follicle-Stimulating Hormone (FSH)

FSH medications stimulate the ovaries to produce multiple eggs.

Luteinizing Hormone (LH)

LH medications support the final maturation of eggs within the ovaries.

Gonadotropin-Releasing Hormone Agonists/Antagonists

These medications prevent premature ovulation, ensuring that eggs are retrieved at the optimal time.

Human Chorionic Gonadotropin (hCG)

hCG triggers the final maturation of the eggs, preparing them for retrieval. Otherwise known as a “trigger shot,” this shot is timed right before your retrieval so they are at peak maturity (without ovulating, of course!).

The number of shots required varies among individuals, but it typically ranges from 10 to 20 injections over a period of 8 to 14 days. While the idea of injections may seem daunting, many individuals find the process totally manageable with proper guidance.

At Cofertility, all Freeze by Co members gain access to our free member community portal, where we share tons of egg freezing tutorial videos that walk you through the whole thing, step-by-step. You can also ask a partner, friend, or family member to help!

Do egg-freezing shots hurt?

The pain associated with egg freezing shots is subjective and varies among individuals. Most commonly, individuals report feeling a mild discomfort or a slight pinch during the injection. Here are some tips on managing egg freezing injections and making the process more comfortable, but you can dive into more here.

Tips for making injections painless

Utilize the right technique

Proper injection technique is crucial for minimizing pain. The angle and speed at which the needle is inserted, as well as the depth of injection, can impact the level of discomfort. Our videos in our community member portal provide a good, close look at the right technique and method of injection. If you have extra syringes, you can also practice injecting water on a peach or another fruit!

Ice the injection site

Applying an ice pack to the injection site for a few minutes before the injection can numb the area, making the process more comfortable.

Let medications reach room temperature

Allowing the medications to reach room temperature before injection can reduce the sensation of cold, making the process more comfortable. (Of course, you’ll want to read the packaging or talk to your doctor to make sure this is okay for your specific medication).

Take deep breaths

Practicing deep breathing exercises before and during the injection can help relax the muscles, making the process less painful.

Troubleshooting egg-freezing shots

Despite careful planning and execution, you may encounter some issues with egg freezing injections. It’s essential to be aware of potential challenges and know when to call your clinic.

Missed or incorrect dosages

Missing or administering an incorrect dosage can impact the efficacy of the egg freezing process. In case of a missed or potentially incorrect or missed dosage, it is crucial to contact your doctor immediately for guidance on the appropriate course of action. Most fertility clinics have on-call support that you can contact after hours if needed.

Injection site reactions

Some individuals may experience redness, swelling, or bruising at the injection site. These reactions are generally mild and temporary. However, persistent or severe reactions should be reported to your doctor for evaluation.

Ovarian Hyperstimulation Syndrome (OHSS) risks

OHSS is a potential (though low) risk of egg freezing, during which your ovaries can become overstimulated as a reaction to the fertility medication. If you experience symptoms such as severe abdominal pain, nausea, or shortness of breath, it is crucial to seek immediate medical attention.

If you’re afraid of needles

We get it. Sometimes, even with the most support and the best resources, you just might not be able to get yourself there when it comes to needles — even if you really want to freeze your eggs. If this is the case, talk to your doctor about a protocol known as “mini IVF”.

Mini IVF is a newer, needle-free alternative to fertility injections, where fertility medication is given via capsule form instead. Often, mini IVF candidates include those who are at higher risk of developing OHSS or those who actually have lower ovarian reserves that may not be able to be helped much with injectable medications anyway.

If this is you, chat with your doctor to see if you’re a candidate for mini IVF and what kinds of results to expect.

Summing it up

Mastering the art of egg freezing involves meticulous attention to ordering, organizing, and administering injectable medication shots. We’ve got your back with tons more educational content and egg-freezing tips.

If this article’s got you feeling like you can conquer the world (10-14 days of egg-freezing injections? No sweat!), check out our Split program, where you can freeze your eggs for *free* when you donate half to another family who can’t conceive. By donating half of their frozen eggs to LGBTQ+ parents, those with infertility, or cancer survivors, participants in our Split program can make a meaningful impact for themselves and others. Apply for our Split program today.

Maybe you already know the ins and outs of egg freezing, or maybe not — but (especially if you’re a med student), the question remains: how can you afford it? Or, better yet, could your school possibly even offer egg freezing as an insurance benefit? 

The answer? It depends, and it may differ whether you’re a student or faculty member. In this article, we’ll share an overview of egg freezing and the costs involved, why egg freezing is especially important to consider as a female in medicine, and what kind of egg freezing benefits universities may offer medical students and faculty. 

Why you should care about egg freezing

First things first: what even is egg freezing, and why should we talk about it? Egg freezing is a procedure where your eggs are extracted, frozen, and stored for later use. While you may not end up needing them, if you do end up facing fertility challenges or decide to pursue donor sperm to grow your family, you can thaw your previously frozen eggs and fertilize them with sperm. This will, hopefully, lead to those eggs becoming embryos that can then be transferred to your uterus and ideally, result in a pregnancy. 

Data tells us that the younger eggs are, the healthier and higher quality they are. Our egg quantity also declines with age, so if you’re going to freeze your eggs, freezing at an earlier age is ideal and increases the likelihood of conceiving a biological child in the future. 

Female physicians face infertility at a higher rate

We hate to report this, but a recent study indicated that roughly 25% of female doctors trying to conceive face fertility challenges — just about double the rate of the general public. The rate of pregnancy loss among female surgeons is equally concerning; at 42%, this compares to the rate among the general public of 1 in 4 pregnancies ending in some sort of loss.

“Roughly 25% of female doctors trying to conceive face fertility challenges — just about double the rate of the general public.”

There are many factors that contribute to these statistics. For starters, female physicians are more likely to delay family building due to pursuing their medical education and residency. Depending on the specialty, many doctors will be well into their 30s before beginning to try for their first child. And, as previously explained, age can impact egg quality and quantity down the line. Combine this with the strain caused by the grueling lifestyle of residency, and the impact of a medical track upon a female physician’s fertility becomes even clearer.

Egg freezing coverage for med students and faculty

Before jumping into specifics around egg freezing coverage, it’s important to understand the concept of university healthcare insurance, especially for students.  

How university healthcare coverage works

Many higher education institutions offer health insurance plans to their students, either through the university itself or by facilitating access to external plans. These plans typically cover essential medical services, preventive care, and, in some cases, mental health services.

University health insurance plans usually operate on an annual basis. Students are required to enroll in or waive coverage at the beginning of each academic year. The cost of coverage is often included in tuition and fees, and coverage extends throughout the academic year, including breaks. Some plans also cover services rendered off-campus, providing flexibility for students studying abroad or residing off-campus.

However, the extent and details of coverage vary widely among university health insurance plans, and there are even various state-by-state regulations that govern what’s allowed. 

Egg freezing coverage for med students

So, if we know that medical professionals are more likely to experience fertility challenges, surely there must be sweeping, extensive egg freezing coverage to help them get ahead of it, right? These individuals are sacrificing their time, their livelihoods, their sleep, and their bank accounts to take care of us — so of course they’re being taken care of too, yes? 

For students, unfortunately, the answer is no. 

Typically, as part of university healthcare plans, elective procedures (chosen by the patient vs. being deemed “medically necessary”) such as proactive egg freezing are not covered. And, while many university healthcare institutions do have their own in-house fertility clinics with reproductive endocrinologists on staff conducting assisted reproductive technology (ART) procedures daily, these services are not subsidized for students. 

Non-elective procedures that may be covered, on the other hand, might include things like egg freezing as a result of a cancer diagnosis. Some schools may even include infertility treatment as part of their student healthcare coverage. It’s essential for students to review their specific plan details to understand the scope of coverage and any potential gaps in benefits. 

One 2022 study found that only one medical school provides coverage for elective fertility preservation. Unfortunately, however, at the time of writing, we were not able to confirm which school is referenced (if this is your school — we want to hear about it!).

It is worth noting that some private fertility clinics will subsidize costs for med students, residents, or fellows, in recognition of the unique additional hardships that they face when it comes to family building. At the time of writing this, Massachusetts-based Boston IVF, for example, currently offers 25% off one egg freezing cycle plus 15% off medication through VFP Pharmacy Group for those individuals. With many locations nationwide, Shady Grove also offers a discount on egg freezing cycles (including monitoring, retrieval, and freezing) for surgical residents across various specialties. Their site is not clear on the exact discount, but you may contact ResidentEggFreezing@USFertility.com for the most up-to-date information. 

Egg freezing coverage for med school faculty

Like many employers, to entice the best and brightest minds, medical universities often tout the benefits that come along with working on staff. This includes healthcare coverage, and those plans may include some degree of fertility and family-building coverage. Johns Hopkins, the University of Maryland, and the University of Michigan (to name a few) all provide faculty with the option of enrolling in their insurance plans that include fertility treatment coverage.

That being said, for egg freezing in particular, even for med school faculty it still has to be deemed “medically necessary” vs. “elective” in order to be covered within these plans. Instead, the healthcare coverage that’s usually provided tends to focus primarily on services for those trying to conceive — hormonal, IUI, or IVF treatment and medication. 

How to freeze your eggs more affordably

Given that elective egg freezing coverage — even for med students and faculty — tends to remain an out of pocket expense, you’re probably wondering how to afford the costs. Depending on where you’re located, your clinic, and your medication protocol, average egg freezing cycle costs can range anywhere from $10,000 - $20,000, plus annual storage fees. 

That being said, there are various ways to lighten the load of egg freezing costs, including financing, using money from your flexible spending account (FSA) or health savings account (HSA), crowdfunding, and more. 

With Cofertility, though, you may be able to freeze your eggs completely for free if you donate half of the eggs retrieved to another family who can’t conceive through our Split program. This may include LGBTQ+ intended parents, those with infertility, or cancer survivors who want to grow their family. 

If you’re interested in learning more about our Split program, take our one-minute quiz to see if you’re eligible and get started. 

Read more:

• Why Do Female Physicians Face Higher Rates of Infertility?
• Everything You Need To Know About Egg Freezing Medication
• Do’s and Don’ts for Egg Freezing: Alcohol, Baths, Exercise, and More

As a fertility psychologist with training and education in third-party reproduction and 10+ years of experience screening egg donors, I wanted to share a little more about the rigorous psychological evaluation that takes place for potential egg donors.

Whether you are someone who is thinking about donating your eggs or someone pursuing donor egg IVF, this article is for you. Understanding the process and its importance can ensure a smooth and ethical egg donation process. 

What is screening like for a potential egg donor?

Psychological screening of a potential egg donor starts with the initial application. This application digs deep into the donor’s physical, medical, and emotional history. It also digs deep into her first and second degree. The reason we need to look into family history is because certain disorders are heritable and the receiving parties need to know and fully understand a donor's complete medical picture before deciding to move forward with her. 

Once a donor matches with a family, she then undergoes a psychological evaluation with a fertility psychologist. The American Society for Reproductive Medicine has set forth guidelines for Psychologists to follow when assessing potential egg donors. These guidelines are a way to ensure informed consent, to ascertain that she does not have any psychological contraindications to donating, and that she will be able to be committed and fulfill her responsibilities for the cycle.  

The evaluation is an interview which will review many of the things found in the application but will delve deeper. For example, the interview will include, but is not limited to, conversations about family, work, education, medical, and psychological history. Potential emotional and social risks, understanding disclosed vs. undisclosed relationships will also be discussed. The evaluation will also include a standardized, empirically-validated test designed for the assessment and/or screening of mental and behavioral disorders. Typically, these are conducted on the same day and can be done in-persons or through a telehealth consultation.

Why would someone fail a psychological screening?

Unfortunately, not everyone is suitable for egg donation, and a psychological evaluation can make this apparent. When someone does not clear psychological screening, it can lead to disappointment for the family and woman alike. 

But, psychological screening of an egg donor comes down to ethical responsibility. We need to ensure the donor’s psychological stability, informed consent, and emotional readiness which includes her understanding of the short and long term consequences of the donation process. 

Further, as a clinician my job does not only include the potential donor and her well-being. It also includes the recipient family, which also includes the future human(s) that will result from the donation. This donation isn’t just a one and done type of deal. So psychological screening is not just a formality, it is a necessity. 

What if I’ve donated my eggs before? Do I have to go through psychological screening again?

Things change. Life happens. Who you were and what you were doing during a previous donation cycle may no longer be the same. So just because you have successfully donated before does not always mean that you will be eligible to donate again. If you are wanting to donate again, I want to know why you want to do this again? I want to know what has changed since your last donation. You will once again complete a full clinical interview along with the standardized assessment. For donors who undergo additional cycles, ASRM recommends that a new full evaluation be conducted if more than 24 months have elapsed since the previous evaluation. 

Summing it up

The American Society for Reproductive Medicine (ASRM) has clear guidelines for who is and is not eligible to donate. These guidelines are there to protect everyone involved. Remember, you are creating an entire new branch of a family tree using your DNA. So it is important that no stone is left unturned. As a therapist, our job is to ensure informed consent (meaning, prospective donors fully understand the process); that the assessment is fair regardless of race, gender, or socio-economic status; and to protect personal and sensitive information as we will be asking for a lot of personal information. 

A psychologically prepared donor is essential for successful egg donation. So it is important to do your research. Understand the process and ask a lot of questions.

Egg donation with Cofertility

At Cofertility, we are striving to be the best place to be an egg donor (or what we call, a Split Member). We offer a supportive and transparent process that empowers donors to make informed decisions about their egg donation journey.

With our innovative approach, donors get to keep half of the eggs retrieved, plus:

• Free storage of their own eggs in cryopreservation for up to 10 years
• Coverage of all medical costs for the egg donation process
• Connection to the Cofertility community for support all along the way and after too
• The ability to work with the intended parents to decide together what your relationship will look like

If giving your eggs to intended parents sounds like something you would like to do, you may be able to qualify for the free egg freezing process and have your donation process covered too.

Find out more about Cofertility, and take our quiz to see if you qualify for Split!

We believe that every donor deserves to have a positive and empowering experience, and we are committed to making that a reality. That’s why Cofertility was named one of the Best Egg Donor Programs by Egg Donor Connect.

If you’re considering freezing your eggs, you’re probably open to trying just about anything to make your cycle as successful as possible. You’re doing all the things: taking supplements, eating a healthy diet, and being mindful of your lifestyle choices. When it comes to acupuncture, though, you may have heard mixed advice. Can acupuncture really help improve egg freezing outcomes? Let’s find out. 

What exactly is acupuncture, anyway?

Acupuncture is a medical treatment based on the disciplines of traditional Chinese medicine (TCM). It’s built on the theory that there are channels that flow through the body, kind of like the circulatory system. 

When someone goes in for an acupuncture treatment, the practitioner inserts teeny-tiny, stainless steel, disposable needles into the patient’s body at specific points along those channels (typically between eight and twelve points, but sometimes up to twenty). Different points are used depending on any symptoms you might be experiencing — back aches, anxiety, acid reflux...you name it! — and practitioners view the body as totally interconnected. It is considered to be generally painless.

What does acupuncture (supposedly) do?

The goal of acupuncture is to regulate each of your systems to get them to work optimally and in harmony with each other. For example, a 2002 Fertility and Sterility study published by the American Society for Reproductive Medicine (ASRM) indicated that receiving regular acupuncture treatments can regulate patients’ endocrine systems (where sex, mood, and sleep hormones are manufactured). 

Regulating your endocrine system via acupuncture can dial down your stress response, which may be heightened during an egg freezing cycle. But the question remains, will decreased stress translate to improvement in actual egg freezing cycle outcomes, in terms of quantity and quality of eggs?

Egg freezing and acupuncture: what the data says

Remember: beta endorphin levels regulate and balance a woman’s Follicle Stimulating Hormone (FSH) levels, which do impact the ability of her ovaries to grow and mature eggs. So when we see a 1998 Journal of Traditional Chinese Medicine study demonstrate dramatically increased beta endorphins among those who received acupuncture vs. those who hadn’t, that’s worth noting.  

But by and large, when it comes to acupuncture and egg freezing, there’s a lot of misinformation out there. The vast majority of available studies focus primarily on IVF success measures: embryo fertilization, positive pregnancy results, and live births. While embryo fertilization is the primary indicator of egg quality, (though many other factors also contribute to fertilization), only looking at acupuncture’s relationship with IVF outcomes can be problematic, because we are viewing a limited population who already may have fertility challenges. 

Some studies have explored the potential influence of acupuncture on the number of eggs retrieved during ovarian stimulation, the egg freezing phase during which a patient takes injectable hormone medications to stimulate her ovaries to mature more eggs for retrieval and freezing. This is helpful for us to explore, but it’s important to note if those studies are only looking at a population who needs to undergo IVF to conceive, as this is different from the population of those looking to electively freeze their eggs.

All of this being said, there is some data out there that’s worth investigating. 

Stress and fertility

In some cases, we may be able to triangulate studies about acupuncture’s impact upon stress and anxiety with studies about the impact of stress upon egg retrieval outcomes. But we need to acknowledge that these are assumptions and hypotheses, taking a transitive property into account rather than studying the direct impact of acupuncture upon egg retrieval outcomes. 

Even then, when only looking at the impact of stress upon fertility and egg retrieval outcomes (largely related to egg quantity), the data is mixed:

• A 2011 British Medical Journal study noted that “pretreatment emotional distress was NOT associated with treatment outcome” (in this case, it’s important to consider that “outcome” = successful pregnancy and live birth using eggs from that treatment cycle).
• A 2009 Psychological Reports article showed a significant correlation between depression and number of eggs retrieved, with fewer eggs retrieved associated with higher instances of depression.
• A 2001 Fertility and Sterility article stated that “baseline (acute and chronic) stress affected biologic endpoints (i.e., number of oocytes retrieved and fertilized).”
• A 2015 General and Comparative Endocrinology study concluded that increased cortisol levels may cause anovulation in stressed mice.
• A 2016 Journal of Biomedical Science study showed that increased cortisol and oxidative stress levels affect our granulosa cell functions, possibly by inducing apoptosis — which results in changes to our estradiol hormones and egg growth, development, and quality.

Some more direct evidence

While there is lots of (mixed) data out there about the relationship between stress and fertility, and some data about how acupuncture reduces stress, there are a handful of studies that actually look directly at the correlation between acupuncture treatments, number of eggs retrieved, and potential egg quality conclusions based on fertilization and live birth outcomes. It’s important to remember that quantity does not necessarily translate directly to quality. Meaning, there is a chance you could have many eggs and very few (or even zero) could result in a fertilized embryo or pregnancy. The general principle is, the more eggs you retrieve, the greater chances you’ll have of having enough high quality eggs for future use. 

One of the more applicable studies is a 2023 Frontiers in Endocrinology meta-analysis, which looked at seven clinical randomized controlled trials (RCTs) that ultimately included 516 women. Although the quality of those studies may have been questionable, this meta-analysis showed that the use of acupuncture increased the number of eggs retrieved and the antral follicle count, while improving the patients’ estradiol and FSH levels. However, there was no difference in fertilization rate or pregnancy rate. This analysis suggests that acupuncture does not improve the ultimate outcome most egg freezers care about: chances of a healthy baby down the line. 

On the flip side, a 2006 Fertility and Sterility study of 273 women in Denmark showed no statistical difference in the number of eggs retrieved between those who received acupuncture and those who did not. For what it’s worth, this study did, however, show a substantial improvement in pregnancy and live birth rates among those who received acupuncture on the day of their embryo transfer.  

What to expect at your acupuncture appointment

If you’ve decided to move forward with acupuncture, you’ll first need to find a local practitioner. At your first treatment, your acupuncturist will ask you tons of questions about your medical history, just like any Western doctor would. Then they’ll take your pulse and look at your tongue (seriously). 

Here’s what they’re looking for: patterns of disharmony, which may be missed by your regular doctor because they don’t show up as illnesses. Let’s say you have trouble sleeping and you feel anxious and your skin is dry and your hair is falling out. In Chinese medicine, that grouping of symptoms together indicates a “blood deficiency.” It wouldn’t be severe enough for your main doctor to call it anemia, but there may be enough symptoms to show some imbalance is going on in your body. With that information, your acupuncturist can determine where to insert the needles to best address your individual needs.

When it’s time for your treatment, you may be asked to undress and put on a gown or cover yourself with a sheet and lay down or face up on a table, like you’re getting ready for a facial. The practitioner will then reenter the room and begin “tapping” the needles into the points they’ve selected specifically for your needs.

The insertion of the needles doesn’t usually hurt — maybe just a pinch — but it shouldn’t stay painful because the needles are as fine as a strand of hair. If you’re not comfortable, just let your practitioner know and he/she will make an adjustment. Comfort is key. Once all the needles are in, the acupuncturist will leave the room (ideally turning on some music or relaxing white noise) and you’ll rest there on the table for about 30 minutes. You may fall asleep right away, or you may need a couple of sessions to get used to it.

To experience the full desired effects of acupuncture, some practitioners say it could take about 3 months of weekly treatments. Think of it this way: it takes about 100 days for red blood cells or sperm to mature, so according to acupuncturists, if you want acupuncture to make changes in your body’s functioning, you’ll want to give it the time it naturally needs. At the very least, you should leave your treatment feeling like you just got a really good night’s rest.

The TLDR on acupuncture and egg freezing

There’s so much more research to be done regarding the relationship between acupuncture and egg freezing outcomes. But, based on the scouring we’ve done through existing studies, there does not appear to be evidence that acupuncture could directly help your egg freezing experience. Acupuncture cannot influence structural issues, like fallopian tube blockages, for example. 

But while it may not help you retrieve more eggs or increase your chances of pregnancy down the line, it may be something you want to do purely for relaxation. You can think about it like a massage or day at the spa. 

With that in mind, the only nuisances may be appointment scheduling or dealing with insurance to see what’s covered. But, beyond that — the goal of acupuncture is to make your mind and body feel good. So, if you have the time and willingness to pay, we support that! In my case, I’m incredibly lucky; my insurance covers unlimited acupuncture visits throughout the year, including for pain or anxiety (note: I do not believe fertility is a billable reason for my acupuncture coverage). If you’re interested in pursuing acupuncture, it is definitely worth having a conversation with your acupuncture clinic and with your insurance provider. But if you can’t squeeze it in or justify the cost…please do not worry about it. You’ve got enough going on as it is.

Remember, when freezing your eggs with Freeze by Co, our team of medical experts (plus our free member community of others freezing their eggs, just like you!) will be with you every step of the way to answer questions like this and more. Our Split program even offers those ages 21-33 the chance to freeze their eggs for free! With a Split cycle, you would donate half of the eggs retrieved to a family that’s trying to conceive and freeze the remaining half for yourself. 

If you’re over 34 or not interested in donating half of the eggs retrieved, you can still participate in our Keep program up to age 40. With Keep, you can freeze your eggs and keep them all for yourself, on your timeline while having access to valuable community support. 

Regardless of which path you choose, our team is here to guide you through the process to keep your family-building options on the table.