egg quality
.png)
Egg Freezing: Chances of Live Birth by Age and Number of Eggs Retrieved
In this guide, we’ll try and answer one of the most common questions around egg freezing: the chances of live birth.
Embarking on the path of family planning is an exciting journey filled with hope and, often, uncertainty. One area that typically gives rise to a multitude of questions revolves around oocyte cryopreservation, commonly known as egg freezing. While this medical breakthrough has provided countless women with greater reproductive autonomy, it's still not a definitive guarantee of biological motherhood.
In this guide, we’ll try and answer one of the most common questions around egg freezing: the chances of live birth.
From frozen eggs to baby
At every stage of the in vitro fertilization (IVF) process (which is technically what egg freezing is, plus embryo fertilization in a lab), there's a certain level of attrition. Some collected eggs may be immature, making them unsuitable for freezing. Others may not withstand the thawing process. When you’re ready to fertilize those eggs into embryos, they will not necessarily all fertilize, and some fertilized embryos may fail to mature into viable embryos suitable for transfer. Even embryos that reach the transfer stage might not be genetically normal. And those that are genetically normal may not result in a viable pregnancy or live birth.
As a result, egg freezing is better viewed as a way to increase your chances of pregnancy down the line, rather than an insurance policy or a surefire plan. It’s a path filled with potential, and definitely gives you greater optionality when you’re ready to have kids, but — and we are always very transparent about this — there is unfortunately no absolute promise of a live birth at the end of the egg freezing process.
How many eggs should I freeze?
Given these complexities, a pressing question for many women is, “how many eggs should I freeze to increase my chances of having a baby?” The answer is nuanced and largely depends on two variables: the age at which the eggs are frozen, and how many children you want.
Unfortunately, the quality of eggs can't be assessed before fertilization is attempted, adding another layer of uncertainty to this equation. Still, we can provide an approximate guide based on averages, which can inform individualized counseling, treatment planning, and expectation management.
One study out of Harvard Medical School of 520 cycles found the chances of live birth varies based on age and number of eggs frozen (see chart below). This guidance is not precise, but offers an approximate benchmark to guide you through your fertility journey.
How many eggs will I get?
Another common inquiry from patients is how many eggs are likely to be retrieved and preserved in a single egg freezing cycle. The good news is that this is fairly easy for fertility doctors to predict using two crucial measures: anti-Müllerian hormone (AMH) and antral follicle count (AFC).
AMH and AFC, both estimators of ovarian reserve, can provide an approximation of the number of eggs that can be retrieved from a stimulated cycle. For instance, an AMH level of 15 pmol/L (2.1 ng/mL) could predict a yield of approximately 12 to 18 eggs. Similarly, AFC's numerical value directly correlates with the number of eggs potentially collected in one cycle, with a rough ratio of 1:1. So if your fertility doctor counts 15 antral follicles during the transvaginal ultrasound, you could potentially retrieve 15 eggs in a single cycle (note this number could be lower or higher based on other factors).
Will I have enough eggs to share?
Cofertility’s 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.
Since the number of eggs is predictable with AMH and AFC, we’re only able to accept people into the program if we are confident they would have enough eggs to “split”.
Setting expectations
You can look at the probabilities and hormonal indicators, but everyone’s egg freezing journey is unique. Age, health, lifestyle, and genetic factors can all play a role in your path to motherhood. Remember, egg freezing is a science, but it's not an exact one. The uncertainties are part of the process. And while the prospect of attrition can seem daunting, it's important to remember that every step forward is a step closer to the potential for success.
Navigating these complexities can feel overwhelming, which is why support and guidance are crucial. At Cofertility, our mission is to guide you through this journey, providing you with the necessary information, support, and encouragement to make the best decisions for your fertility future.
Although egg freezing can't offer guaranteed outcomes, it has undoubtedly provided hundreds of thousands of women worldwide with expanded options and increased flexibility in their reproductive timelines. By understanding the process's intricacies and setting realistic expectations, we can navigate this journey together, with optimism, resilience, and hope.
Freeze your eggs with Cofertility
Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:
Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure — medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.
The benefits for 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.
Read more:
.png)
Can I Freeze My Eggs If…
Common egg freezing questions answered!
Egg freezing, also known as oocyte cryopreservation, is a process in which a woman's eggs are retrieved, frozen, and stored for future use. It has become an increasingly popular option for those who want to preserve their fertility for later in life, whether due to medical reasons or personal choice. We get a lot of questions from people wondering if egg freezing is an option for them, given their unique circumstances. In this article, we will share the most common questions we get and hopefully settle some debates once and for all.
Can I freeze my eggs if I have PCOS?
Absolutely. Like others, women with PCOS may want to freeze their eggs to proactively increase their chances of having children down the road. It’s best to freeze when you are younger, in order to get a greater number of eggs and the highest quality eggs possible.
You’ll want to make sure you work with the best doctors, because women with PCOS are more susceptible to developing ovarian hyperstimulation syndrome (OHSS) during egg freezing. This is because they are likely to have more follicles, and the more follicles an ovary has the more likely it is to be overstimulated by HCG, one of the drugs used during egg freezing.
Can I freeze my eggs if I have endometriosis?
Yes. Some doctors will actually recommend egg freezing for women with endometriosis while they're young and the condition is still in the early stages. Because some surgeries for endometriosis can worsen fertility by inadvertently removing healthy ovarian tissue or compromising vascular supply to the ovary, egg freezing should be done before any such surgeries.
Can I freeze my eggs if I’m a virgin?
Being a virgin does not prevent you from being able to freeze your eggs for future use. The egg freezing process is the same for all patients, and it does not involve any kind of sexual contact. If you are considering egg freezing, reach out to see if we can help.
Can I freeze my eggs if I’m on birth control?
It depends on which type! Hormonal birth control methods work by regulating hormones in the body to prevent ovulation, while non-hormonal methods physically prevent sperm from reaching the egg or alter the environment in the uterus to prevent implantation. While it is possible to freeze your eggs while on various types of birth control, it depends on which one.
- Definitely okay: condoms, diaphragms
- Generally okay: IUD, birth control implant
- Need to stop: the pill, the patch, NuvaRing
- Potential wait of three-six months: Depo-Provera
Of course, do not start or stop your current birth control regimen without talking to your fertility doctor first.
Can I freeze my eggs if I have HPV?
An HPV diagnosis alone should not affect your ability to get pregnant or to freeze your eggs. Most fertility specialists will require an up to date pap smear and HPV test as part of their evaluation and you’ll usually be allowed to continue with the freezing process as long as the HPV is low-risk, since those cases are expected to clear on their own.
If you do have a high-risk HPV, you’ll need to discuss those results with both your OB/GYN and your fertility doctor to figure out what next step is right for you. Depending on the specific HPV strain, if there are any lesions and how advanced they are, your doctor will recommend continuing with egg freezing or delaying until after treatment.
Can I freeze my eggs if I’ve had gender affirming surgery?
It depends on what was involved in the surgery. If the ovaries were removed (an oophorectomy or total hysterectomy), you will not be able to freeze your eggs. This is because egg freezing requires the ovaries to produce mature eggs, which are then retrieved and frozen for future use. If the ovaries have been removed, then the eggs were removed too and egg freezing is not an option.
Can I freeze my eggs if I have started hormone therapy?
If you have already started hormone therapy, such as testosterone (T) therapy, it may still be possible to freeze your eggs. However, your doctor will likely recommend discontinuing testosterone until your period returns (usually under six months) to begin the egg freezing process.
Can I freeze my eggs if I’m afraid of needles?
Yes, it does involve both injections and blood draws. This is because the process of egg freezing involves stimulating the ovaries with hormones (aka fertility medication) to produce multiple eggs, which are then retrieved with a needle. There are also blood draws to determine your hormone levels, and an IV for sedation during the retrieval itself. If you are afraid of needles, it's important to acknowledge your fear and work through it. Ignoring or avoiding the issue will only make it worse.
Can I freeze my eggs if I vape?
While the effects of vaping on fertility are still largely unknown, many fertility clinics advise their patients to quit vaping in an effort to improve egg freezing outcomes related to quality and quantity based on the above research on smoking. Lower quality eggs with a higher DNA damage rate could impact the success of a future pregnancy using these frozen eggs, as these eggs may be less likely to fertilize into embryos (or result in a successful implantation). In addition, fewer eggs retrieved from those who vaped may result in fewer options for future use, which can increase the likelihood of needing additional egg freezing cycles.
Can I freeze my eggs if I drink?
Yes, but alcohol consumption is not recommended during the egg freezing process itself. Studies have shown that alcohol consumption can negatively impact fertility and may also increase the risk of certain complications associated with egg freezing. The good news is there are loads of EANABs (equally-appealing, non-alcoholic beverages) these days. Try a soda water with lime and no one will bother you!
Can I freeze my eggs if I’m a smoker?
Smoking is not recommended during the egg freezing process (or ever!). Studies have shown that smoking can negatively impact fertility and may also increase the risk of certain complications associated with egg freezing. Smoking can decrease the number and quality of eggs retrieved, and increases the risk of ovarian hyperstimulation syndrome (OHSS), a potentially serious complication of the egg freezing process.
Can I freeze my eggs if I'm over a certain age?
American Society for Reproductive Medicine (ASRM) does not recommend egg freezing for people older than 38, but this isn’t a strict cutoff. Everyone’s ovarian reserves declines 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.
Can I freeze my eggs if I'm not ready to have children yet?
Absolutely! Egg freezing is often chosen by those who are not yet ready to start a family, but want to keep options open for the future. It’s important to understand that the younger you are when you freeze your eggs, the higher the chances of success.
Can I freeze my eggs if I have already had children?
Absolutely. In fact, some people choose to freeze their eggs after having children, including those who went through divorce, as a way to preserve their fertility for future pregnancies.
Can I freeze my eggs if I have had my tubes tied?
If you have had a tubal ligation (commonly known as "getting your tubes tied"), you can still be a candidate for egg freezing as the process does not require the fallopian tubes to be open.
Can I freeze my eggs if I’m on antidepressants?
For sure. The most commonly used antidepressant (SSRIs) and anti-anxiety medications (benzodiazepines) don’t have any clear, long-term impacts on egg quantity or quality, ovulation, or chances of conception (though SSRIs do have short-term effects on sperm).
Can I freeze my eggs if I have diabetes?
While egg freezing can be a game-changer, it's not without risks. Women with diabetes may have an increased risk of ovarian hyperstimulation syndrome (OHSS). However, with proper medical supervision and careful management of blood sugar levels, most women with diabetes successfully undergo egg freezing.
Let us help you freeze those eggs!
Cofertility is a human-first, tech-enabled fertility ecosystem that provides people agency over if, how, and when they have babies — today or someday. We have two programs for egg freezers:
- Our Split program, which offers women a chance to both freeze their own eggs and donate half the eggs to a family who cannot conceive otherwise. 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 — is completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
- Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.
The benefits for 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.
.png)
What Does a High AMH Result Mean?
Anti-Mullerian hormone (AMH) is a hormone produced by ovarian follicles. It is commonly used as a marker of ovarian reserve and can be measured in the blood. A high AMH level is often associated with polycystic ovary syndrome (PCOS), but it can also have other causes. In this article, we will explore what a high AMH result means and answer some common questions about AMH testing.
Anti-Mullerian hormone (AMH) is a hormone produced by ovarian follicles. It is commonly used as a marker of ovarian reserve and can be measured in the blood. A high AMH level is often associated with polycystic ovary syndrome (PCOS), but it can also have other causes. In this article, we will explore what a high AMH result means and answer some common questions about AMH testing.
First off, what is AMH?
AMH is a hormone that is produced by the granulosa cells in the ovarian follicles. It plays a role in the growth and maturation of ovarian follicles in females. AMH levels are relatively stable throughout the menstrual cycle and can be measured in the blood.
AMH is commonly used as a marker of ovarian reserve, which is a rough number of eggs that a female has remaining in her ovaries. Since females are born with a fixed number of eggs, this number naturally declines over time.
What are normal AMH numbers?
What is considered a “normal” AMH level depends on your age, as well as the lab where you take the test. Since there is no international standard, it’s best to use the reference ranges included on the test results (your doctor can share those with you if you did a test through a clinic).
In general, however, an AMH between 1.0 and 3.5 ng/mL suggests a “normal” range that is likely to have a good response to egg freezing.
If you are looking to donate your eggs, however, minimum AMH requirements may be slightly higher. For example, with Cofertility’s Split program, we require a minimum AMH of 2.0, though clinics may have their own unique requirements. This is to increase the chances of retrieving enough eggs to actually split, to ensure positive outcomes for both parties involved.
What AMH level is considered high?
In healthy females of reproductive age, higher levels of AMH mean that the ovaries have a larger supply of eggs. This means one would be expected to have better than average outcomes for egg freezing.
Remember, there is no universal standard for AMH, so it can vary depending on the lab where the test is run. Your test results will include if your range is “normal”, “low”, or “high” and the cut-off can differ. For example, Atlanta Fertility considers over 4.5 ng/mL high. Advanced Fertility considers anything over 4.0 ng/ml high. While RMA would consider an AMH over 3.0 ng/ml as “very high”.
With high levels of AMH, you may be at higher risk for ovarian hyperstimulation syndrome (OHSS). This means your doctor may choose a specific protocol and/or do extra monitoring to decrease the risk of complications during egg freezing.
What AMH level is considered too high?
Again, this question depends on the lab. Your test results will come with a reference range, and will indicate if your number is high for your age. If your doctor considers your levels abnormally high and has concerns, they will discuss the results with you.
Common reasons for high AMH
The most common reason for high AMH is that you are very fertile and likely to retrieve more eggs in an egg freezing cycle.
But a high AMH level may also indicate PCOS, which is a hormonal disorder that affects 8–13% of females of reproductive age. Those with PCOS typically have high levels of androgens (male hormones) and may have irregular periods, acne, and excess hair growth. Patients with an average AMH level ≥ 4.45 ng/ml have a 9.35 times higher likelihood of developing PCOS, but not all patients with a high AMH have PCOS.
In rare cases, abnormally high AMH could be a sign of an ovarian tumor. Certain types of ovarian tumors, such as granulosa cell tumors, can produce high levels of AMH.
Does high AMH always mean PCOS?
While an increase in AMH levels has been reported to be associated with PCOS, high AMH alone is not enough to diagnose PCOS.
Not all patients with PCOS have high AMH levels, and not all patients with high AMH levels have PCOS. Diagnosis of PCOS requires a combination of symptoms, hormone levels, and imaging studies, such as ultrasound.
Does high AMH mean good egg quality?
Not necessarily. While a high AMH level is often associated with a larger number of ovarian follicles and eggs, it does not necessarily mean that the eggs are of good quality. Egg quality is determined by factors such as your age, genetics, and environmental factors, and cannot be measured directly by AMH levels.
Am I ovulating if my AMH is high?
AMH levels do not indicate if you’re ovulating or not. Ovulation is the release of a mature egg from the ovary and can be confirmed by monitoring the menstrual cycle and/or performing ultrasound studies.
Will I get a lot of eggs if I have a high AMH?
The success of egg freezing outcomes largely depends on the number and quality of eggs retrieved. Studies have shown that AMH levels can be used as a predictor of egg quantity, and can thus help to predict the potential success of egg freezing. Those with higher AMH levels tend to have better outcomes with egg freezing, as they are likely to have more eggs retrieved and a higher chance of success in future fertility treatments.
But by no means does a high AMH level guarantee a lot of eggs during an egg retrieval procedure for fertility treatments. The number of eggs retrieved during an egg freezing cycle depends on several factors, including your age, ovarian response to stimulation medications, any other underlying medication conditions, and the skill of the doctor performing the procedure.
What is a good AMH level for egg freezing?
Research has found that AMH is a good predictor of the response to ovarian stimulation and the number of eggs retrieved. Because of this, fertility doctors typically use your AMH levels (along with other biomarkers) to determine the drugs and dosages you will need to maximize your response to ovarian stimulation.
Now, what about a correlation between AMH and actual babies born (live birth rate)? Well, while AMH does seem to have some association with live birth rates after IVF, its ability to actually predict a live birth is not that great. This is especially true for younger people. A 2021 study found that AMH is a good predictor of live birth in older (>39 years old), but not younger, people. They found that younger participants (≤38 years old) could get pregnant even with low AMH levels as long as they had frequent egg retrievals.
Freeze your eggs with Cofertility
One option to make egg freezing better is working with Cofertility. 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. It also enables access to exclusive guidance, free expertise, and community events.
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
A high AMH level is generally a good sign for your ability to successfully freeze your eggs. But for some, it can also be one indicator of PCOS. While a high AMH level is often associated with a larger number of ovarian follicles and eggs, it does not necessarily mean that the eggs are of good quality (egg quality is more dependent on age).
AMH levels are commonly used as a marker of ovarian reserve and can be helpful, in conjunction with other measures, in predicting the number of eggs that can be retrieved during an egg freezing cycle. However, it is important to keep in mind that egg quality is determined by several factors and cannot be measured directly by AMH levels. If you have concerns about your fertility or AMH levels, it is important to speak with a fertility doctor for personalized advice and treatment options.
Read more:
.png)
Can You Vape During Egg Freezing?
One area of concern is the impact of vaping on fertility, especially for those who are considering freezing their eggs for future use. In this article, we’ll dive into the research on if vaping is okay for egg freezing and donation.
Vaping has become a popular alternative to traditional smoking in recent years. But while it’s been marketed as a healthier option, the long-term effects of vaping are still not fully understood. One area of concern is the impact of vaping on fertility, especially for those who are considering freezing their eggs for future use. In this article, we’ll dive into the research on if vaping is okay for egg freezing and donation.
Impact of vaping on fertility
Several studies have found that vaping can have negative effects on reproductive health, including decreased fertility and increased risk of miscarriage. According to the American Society of Reproductive Medicine (ASRM), infertility rates in male and female smokers are twice as high as infertility rates among nonsmokers, with infertility rates rising with the number of cigarettes smoked daily. The main ingredients in e-cigarette liquids, such as nicotine and propylene glycol, have been shown to have toxic effects on the ovaries and the eggs they contain.
Nicotine has been shown to reduce the quality and quantity of eggs in the ovaries. It can also lead to decreased blood flow to the ovaries, which can negatively impact the development of the follicles, the structures in the ovaries that contain the eggs. Despite needing more medication during the egg freezing process, smokers often have fewer eggs available for retrieval during an egg freezing cycle, as well as 30% lower pregnancy rates compared with nonsmokers.
Propylene glycol, another common ingredient in e-cigarette liquids, has been shown to have a toxic effect on the ovaries and eggs. The same study has linked propylene glycol to oxidative stress, which can lead to damage to the eggs and decreased fertility. In addition, propylene glycol has been shown to cause DNA damage, which can affect the quality of the eggs.
How vaping may affect egg freezing outcomes
Egg freezing is a process where a woman's eggs are retrieved, frozen, and stored for later use once she is ready to fertilize them and start or grow her family. The more eggs that are retrieved, the better the chances of a live birth down the line.
While the effects of vaping on fertility are still largely unknown, many fertility clinics advise their patients to quit vaping in an effort to improve egg freezing outcomes related to quality and quantity based on the above research on smoking. Lower quality eggs with a higher DNA damage rate could impact the success of a future pregnancy using these frozen eggs, as these eggs may be less likely to fertilize into embryos (or result in a successful implantation). In addition, fewer eggs retrieved from those who vaped may result in fewer options for future use, which can increase the likelihood of needing additional egg freezing cycles.
Our programs offer the opportunity to freeze your eggs in a way that’s more empowering, positive, and affordable — even free. Take our quiz today to see if you qualify for Split, our free egg freezing program.
Can I donate my eggs if I vape?
If you are considering applying for our Split program, where you can freeze your eggs for free when you donate half of the eggs retrieved to another family, please note that you will not be considered eligible if you currently use any nicotine products, including vaping. If you engage in vaping regularly, you will need to quit for two to three months before re-applying for the program. If you only vape occasionally/socially, you will need to quit for one month prior to your retrieval date.
Summing it up
In conclusion, while data is somewhat limited, it appears that the effects of vaping on fertility can have an impact on women who are considering egg freezing. The ingredients in e-cigarette liquids, such as nicotine and propylene glycol, have been shown to have negative effects on reproductive health, including decreased fertilization rates and increased risk of miscarriage. In addition, it is possible that vaping can lead to a lower number of eggs retrieved during an egg freezing cycle and a higher rate of DNA damage in the retrieved eggs.
Our recommendation? Safe is better than sorry — in the interest of the best cycle outcome, it’s probably a good idea to hold off on the e-cigarettes leading up to and during your egg retrieval.
If you’re considering egg freezing, consult with a fertility specialist or take our quiz to learn more about how you can preserve your fertility.