egg retrieval

If you're considering egg freezing or have already started the process, you've likely heard rumors about the "trigger shot." This important step in the egg freezing journey can, like much of the process, seem mysterious and perhaps a bit daunting. But don't worry – we're here to demystify the trigger shot and provide you with all the information you need to feel confident and prepared.

In this guide, we'll explore what the trigger shot is, why it's necessary, how it works, and what you can expect when it's time for you to take this important step in your egg freezing cycle. We'll also address common concerns, potential side effects, and tips for ensuring the best possible outcome.

What is the egg freezing trigger shot?

The trigger shot, also known as the "ovulation trigger" or simply "the trigger," is a hormonal medication given near the end of your egg freezing cycle. Its primary purpose is to mimic the natural surge of luteinizing hormone (LH) that occurs in your body just before ovulation. This surge signals your ovaries to complete the final maturation of the eggs and prepare them for retrieval.

In a normal menstrual cycle, this LH surge would lead to ovulation – the release of a mature egg from the ovary. However, in an egg freezing cycle, the trigger shot allows your doctor to precisely time the egg retrieval procedure, ensuring that your eggs are at the optimal stage of maturity for freezing.

What does the trigger shot do?

The trigger shot serves two important functions in the egg freezing process:

1. Final egg maturation: It prompts the final stage of egg maturation, ensuring that the eggs are ready for retrieval and freezing.
2. Timing control: It allows your fertility doctor to precisely schedule the egg retrieval procedure, typically 34-36 hours after the trigger shot is administered.

These two functions of the trigger shot work together to optimize the egg freezing process, helping to ensure the best possible outcome for preserving your fertility.

Is the trigger shot necessary?

In short, yes. The trigger shot is an important part of the egg freezing process. Without it, it would be extremely difficult to time the egg retrieval accurately, and the eggs might not be at the optimal stage of maturity for freezing. The trigger shot ensures that you get the best possible outcome from your egg freezing cycle.

Types of trigger shots

There are two main types of medications used for the trigger shot:

1. hCG (Human Chorionic Gonadotropin): Brands include Ovidrel, Pregnyl, and Novarel. This medication directly mimics the LH surge, and requires some mixing before administration.
2. GnRH Agonist: Brands include Lupron (also known as leuprolide acetate). This alternative trigger medication works by causing your body to release its own surge of LH.

Your doctor will decide which type of trigger shot is best for you based on your individual circumstances and how you've responded to the stimulation medications.

How is the trigger shot administered?

The trigger shot is typically given as a subcutaneous injection (into the fatty tissue just under the skin) or intramuscular injection (into the muscle). Your fertility clinic and/oor pharmacy will provide detailed instructions on how to administer the shot, which is usually done at home.

The timing of the trigger shot is very important. Your doctor will give you very specific instructions about when to take the shot, often down to the exact hour. It's essential to follow these instructions precisely to ensure the best outcome.

Is the trigger shot painful?

Most women report that the trigger shot is not particularly painful. The needle used for subcutaneous injections is very small, and while you might feel a slight pinch, any discomfort is usually brief. There are tactics you can use to make the injection less painful, like icing the area beforehand.

Read more in I'm Afraid of Needles; Can I Still Freeze My Eggs?

Common mistakes to avoid

While the trigger shot is straightforward, there are a few common mistakes to be aware of:

1. Timing errors: Administering the shot at the wrong time can significantly impact the success of your egg retrieval. Set alarms and double-check your instructions.
2. Incorrect dosage: Make sure you understand exactly how much medication to inject.
3. Wrong injection site: Follow your clinic's instructions carefully regarding where to administer the shot.
4. Forgetting to mix medications: Some trigger shots require mixing before injection. Make sure you understand the preparation process.
5. Not asking for help: If you're unsure about anything, don't hesitate to contact your clinic for clarification.

Potential side effects

Like all medications, the trigger shot can have side effects, although many women experience few or no side effects since it’s just one shot. Possible side effects may include:

• Injection site reactions: Redness, swelling, or mild pain at the injection site.
• Breast tenderness: Your breasts might feel swollen or sensitive.
• Feeling restless or irritable: Hormonal fluctuations can sometimes affect mood. .
• Headache: Some women report feeling headaches.
• Ovarian Hyperstimulation Syndrome (OHSS): In rare cases, the trigger shot can contribute to OHSS, a condition where the ovaries become swollen and painful. Your doctor will monitor you closely for signs of OHSS.

Most side effects, if they occur, are mild and resolve on their own. However, always inform your doctor of any side effects you experience. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

What to expect after the trigger shot

After administering the trigger shot, you'll likely be asked to abstain from sexual activity to prevent unintended pregnancy. You may notice some increased discomfort or bloating as your eggs complete their final maturation.

Your doctor will schedule your egg retrieval procedure for approximately 34-36 hours after the trigger shot. It's important to arrive on time for this appointment, as the timing is precise!

Tips for Success

To ensure the best possible outcome with your trigger shot:

• Follow instructions carefully: Pay close attention to your clinic's instructions regarding timing, dosage, and administration.
• Create a comfortable environment: Set up a clean, well-lit area for administering the shot.
• Stay calm: If you're nervous, try deep breathing exercises or ask a friend or partner for support.
• Be prepared: Gather all necessary supplies before starting.
• Track everything: Keep a log of when you administered the shot and any side effects you experience.
• Stay in touch with your clinic: Don't hesitate to reach out if you have any questions or concerns.

At this point in your egg freezing cycle, you are nearly finished! Celebrate how far you’ve come and start making plans to treat yourself after the cycle is over.

Frequently Asked Questions

• Can I exercise after the trigger shot? It's generally recommended to avoid strenuous exercise after the trigger shot. Light activities like walking are usually fine, but consult with your doctor for personalized advice.
• What if I miss the timing of the trigger shot? If you realize you've missed the scheduled time for your trigger shot, contact your clinic immediately. They will advise you on the best course of action.
• Can I travel after the trigger shot? It's best to avoid travel between the trigger shot and egg retrieval. The timing of the retrieval is crucial, and travel could potentially interfere.
• Will the trigger shot affect a pregnancy test? Yes, the hCG trigger shot can cause a false positive on a pregnancy test for up to 14 days after administration. If you need to take a pregnancy test during this time, inform your doctor about the trigger shot.
• What happens if the trigger shot doesn't work? While rare, if the trigger shot doesn't work effectively, your doctor might cancel the egg retrieval and adjust your protocol for a future cycle.

Final thoughts

The trigger shot is a huge step in your egg freezing journey. While it might seem intimidating at first, understanding its purpose and what to expect can help alleviate any anxiety. Remember, this shot is bringing you one step closer to increasing your fertility options for the future.

As with all aspects of egg freezing, the key to success with the trigger shot is clear communication with your clinic’s team. Don't hesitate to ask questions or voice concerns. Your clinic is there to support you every step of the way.

By following your fertility doctor's instructions carefully and staying informed, you're setting yourself up for the best possible outcome. The trigger shot is more than just another injection – it's the final step before your egg retrieval, bringing you to the culmination of your egg freezing cycle!

As you prepare for your trigger shot, take a moment to appreciate the journey you're on. Egg freezing is a proactive step towards taking control of your reproductive future, and each step of the process, including the trigger shot, is a part of that empowering decision.

Exactly what happens during the egg donation procedure, anyway? You’re excited about Cofertility’s Split Program, where those qualified get to freeze their  eggs for free when they donate half to a family that can’t conceive. Still, you're unsure about one thing — the egg retrieval procedure itself. You want to understand what goes into maturing more eggs, and how those eggs will be retrieved. It’s a big deal — we get it!

We outlined all the details about what to expect during the procedure—including the protocol leading up to your retrieval. The stimulation and retrieval process is the same as what takes place during egg freezing or IVF. Use this guide to get a glimpse into and help you navigate the process. 

How the egg donation process begins

At the start of your cycle, there are many tiny follicles with the potential to produce mature eggs. A follicle is a fluid-filled sac that continues to grow while the contained egg matures.

Usually, one follicle takes the lead. It grows faster than the rest, maturing before the others can. Once the egg inside fully develops, the follicle ruptures, releasing the egg during ovulation. This halts the other egg follicles in their tracks and never gives the immature eggs inside these follicles a chance to develop. These eggs are lost each month. 

If a woman is not pregnant, the cycle restarts with a new batch of potential follicles. But with the aid of certain medications, doctors can help ensure that many - not just one - follicles mature at the same time. 

The stimulation process

While the medications prescribed may be a little different for every cycle, most protocols to stimulate the ovaries during the egg donation are designed to do the following: 

1. Shut it down. Doctors will prescribe birth control or a progesterone-only pill to  shut your ovaries down for a couple of weeks before your cycle begins. This sets the stage for fertility drugs and makes it easier to control your ovaries' response to those meds. 
2. Stim it up. When it's time to start the cycle, your doctor will prescribe medication to stimulate your ovaries. These drugs are similar to hormones that your body already makes, but in higher amounts. One of these hormones produced by the body is the follicle-stimulating hormone (FSH), while the other is the luteinizing hormone (LH). Your doctor may prescribe medication similar to either of these, or a combination of the two. These medications are injectables, but you’ll receive proper training from your clinic before you have to give your first dose at home. You’ll need to take these injections once or twice a day for about two weeks. 
3. Ongoing check-ins. During the two weeks that you’re taking these medications, the doctor will continually monitor your progress. Blood work will help monitor your estrogen levels while a vaginal ultrasound will be used to view follicle growth. These monitoring visits will help your doctor decide if and how to adjust your medication doses. If you've never had a vaginal ultrasound, it may sound a little scary, but the probe is slightly bigger than the size of a tampon. It’s totally comfortable, but it shouldn’t hurt. 
4. Prevent Ovulation. Once your follicles reach a certain size, or your estrogen reaches a certain level, your doctor may start you on a medication to prevent premature ovulation. This medication is also done via injection and, if necessary, will be added to your daily routine. 
5. Go time. Once the doctor decides that your follicles are ready for retrieval, you'll take what's known as a “trigger shot.” This injection will help the growing eggs mature and prepare them for retrieval.
6. The egg retrieval. This is the only real “procedure” - the retrieval will be done outpatient (at the clinic, not the hospital) and will be done within 30 minutes. Your doctor will use a vaginal ultrasound with a needle attached. The needle will be guided into your ovary and used to aspirate the fluid in each follicle. With this fluid, will come eggs that can be used to create embryos. You will be under light anesthesia, so you won’t feel a thing and you will be provided medication to help you avoid any discomfort during or after the process. 
7. Recover. Right after the procedure, you may feel a bit foggy. The clinic will give you time to rest and your doctor will likely reiterate that you'll also need to take it easy for the next day or two. Physically, you can return to work or school the following day, but if you have the flexibility, you may want to take a day or two off to relax.

A highly-skilled clinical team will guide you through each of these steps in the egg donation process. Importantly, this team will help ensure that you don't develop  any issues, such as ovarian hyperstimulation syndrome. Ovarian hyperstimulation syndrome is when your body responds too actively to the fertility medication and produces too many eggs. If you have symptoms of OHSS, these usually will resolve after a couple of weeks, says the American Society for Reproductive Medicine (ASRM).

Navigating with ease

If you’re considering the Split program, remember that while you may be new to the process, your team is not. Your doctors and nurses (and Confertility’s community) will guide you every bit of the way and answer any questions you may have.

Anti-Mullerian hormone (AMH) is a hormone produced by the follicles in the ovaries (the fluid filled sacs that contain eggs). It requires a simple blood draw and is most often used as a marker of ovarian reserve. Ovarian reserve is the term for the number of healthy eggs left in your ovaries. Since people with ovaries are born with a fixed number of eggs, this number naturally declines over time. 

A low AMH level is usually related to natural aging, but it can also have other causes. In this article, we’ll explore what a low AMH result means and answer some common questions that can come up.

AMH and its role in fertility

So what exactly can AMH tell you about your fertility? As mentioned, your AMH level is positively correlated with the number of follicles you have in your ovaries. Simply put, the more follicles you have, the higher your AMH level typically is. As a result, AMH levels have been shown to be a good predictor of ovarian reserve and someone’s expected response to fertility treatments. 

In fact, several studies have shown that there is a strong correlation between what your AMH level is and the number of mature eggs retrieved during an egg freezing or in vitro fertilization (IVF) cycle. To learn more about those studies, check out AMH and Egg Retrieval Outcomes. 

What your AMH level can’t tell you is the exact number of eggs you have left in your ovaries or what your chances of pregnancy are. There are a number of other factors like your age, overall health, and genetics that also affect the number and quality of eggs and your overall fertility. So while AMH can be a useful tool in assessing your fertility, it shouldn’t be the only factor when making decisions about fertility treatments.

What is a low AMH result?

As with most things in medicine, there’s no absolute answer here. What is considered a low, normal, or high AMH level depends on your age and the lab where you take the test. Since there is no international standard, it’s best to use the reference ranges that come with your test results.

In general, an AMH between 1.0 and 3.5 ng/mL is considered to be in the “normal” range, which means you’re likely to have a good response to fertility treatments. Anything below 1.0 ng/mL is considered low and a sign of a declining ovarian reserve.

What does a low AMH mean?

Having a low AMH level can be a sign that your ovaries are making less of the preantral follicles. The lower the number of follicles, the lower your ovarian reserve is. 

So what does this mean in terms of fertility?

First, having a lower AMH does not automatically mean you aren’t ovulating regularly or that you won’t be able to get pregnant naturally or with assisted reproductive technologies. However, research has found that what AMH is good at predicting is the response to ovarian stimulation and the number of eggs retrieved, regardless of a person’s age. So, someone with a higher AMH is generally expected to be able to get more eggs in one cycle than someone with a lower AMH. Because of this, fertility doctors typically use AMH levels (along with other information) to figure out the drugs and dosages you’ll need to maximize your response to ovarian stimulation medications. 

If you’re trying to conceive naturally, you’ll be glad to hear that multiple studies have shown that AMH does not correlate with how likely you are to actually get pregnant. In fact, one study looked at levels of AMH, FSH, and another ovarian hormone, inhibin B and tracked people for a year. They found that there was no correlation between someone’s ovarian reserve and their ability to conceive and that a low ovarian reserve was not associated with lower fertility. As a result, they did not recommend the use of FSH or AMH levels to “assess natural fertility.”

Reasons AMH would be low

There are a few reasons that could explain a low AMH. Let’s explore them.

Natural decline with aging

By far, the most common reason for a low AMH is age. People with ovaries are born with all the eggs that they’re going to have in their lifetime. These eggs are then slowly used up over time as you ovulate during each menstrual cycle until menopause is reached. As a result, ovarian reserve naturally decreases over time, meaning the AMH level also decreases. 

Hormonal birth control

Research suggests that hormonal birth control may affect AMH levels but it depends on the type of birth control. Specifically, birth control use is associated with a lower average AMH level than for people who are not on birth control, with the exact effect depending on the type of birth control. 

The amount of time you’re on birth control may also be a factor. Multiple studies have shown that AMH doesn't change if you use combined oral contraceptive pills for less than six months. However, you may have a lower AMH if you’ve been a long-term user of the pill (or other hormonal methods). Thankfully, this is temporary – AMH levels typically rebound after a person stops using birth control.

You can learn more about birth control and AMH here.

Tobacco use

Studies have shown that tobacco use, usually cigarette smoking, decreases AMH levels. This effect appears to be reversible though–it was only seen in people who were active smokers, not people who had previously smoked. 

Less common causes 

There are several other, less common causes for a low AMH level. These include:

• Genetic disorders that affect the X chromosome.
• Medical treatments like radiation or chemotherapy.
• Having surgery on your ovaries.
• Losing one or both of your ovaries.
• Autoimmune conditions.

Can I still donate my eggs with a low AMH?

If you are looking to donate your eggs, minimum AMH requirements are usually 2.0 or above. 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 to do if you have a low AMH result

Finding out you have a low AMH can be disheartening, especially if you had future fertility plans that you’re worried may be affected. While there’s unfortunately not much that can be done to reverse a low AMH, there is still hope for starting a family someday even with a low AMH. With the exception of birth control or cigarette smoking, most studies have shown that lifestyle changes like diet or supplements have an insignificant effect on AMH levels but despite this, I promise it’s not all gloom and doom. 

Let’s go through a few things you can do as you move forward with this new information. 

Lean on your village

The first thing to do is take a deeeeeep breath… There are a lot of nuances involved here which can make it hard not to get lost in the weeds. Fertility is impacted by so many different things that you can drive yourself crazy trying to manage all of them. 

Having friends, family, and mental health specialists available to support you when you need it is going to be crucial. Navigating fertility is hard no matter what, so having people around you who you can lean on on bad days and celebrate with on good days will help immensely. 

Consult a fertility specialist

Speaking of your village, it should definitely include a fertility specialist. Consulting with a fertility doctor can help you better understand your reproductive health and provide guidance on any concerns or questions you may have. They’ll be able to review your specific options and work with you on a plan that helps you reach your family-building goals. This treatment plan will depend on a lot of things including how soon you want to have a child, how many children you want to have, your finances, and your desire to have a child who is genetically related to you. 

So does this mean I have to freeze my eggs ASAP?

This is typically the first question people ask and the answer is not necessarily. As mentioned before, there are many other factors involved in assessing your fertility and modern technology has allowed for advances that make family building a possibility for virtually everyone. Your fertility specialist will be able to discuss all the options for starting a family based on your unique family-building goals. This could certainly include freezing your eggs for later use but it could also mean trying to conceive unassisted, undergoing IVF with your own eggs or with donor eggs, using a gestational carrier, or even options beyond these. Again, this is something that will require you to examine your personal goals and work with your provider to figure out the best way to reach them. 

You are not a number

Repeat after me: you are more than one number! Your AMH level provides valuable insights into your ovarian reserve, but it’s just one piece of the puzzle when it comes to your fertility. AMH is always used as part of a full fertility evaluation, which often includes information about your medical history and age, a partner semen analysis, an ultrasound of the pelvis, an x-ray of the uterus and fallopian tubes, and/or additional lab work.

If that sounds like a lot, it is. This process can be overwhelming but focusing on the things that you can control can help you feel more grounded during your fertility journey, whatever that may look like.

How Cofertility can help

Cofertility is here to help you every step of the way on that journey. Our Split program offers women a chance to freeze their eggs for free when donating half the eggs retrieved 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 — 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.

In our Keep program, you can freeze and store your eggs for your own future use, with lower prices on things like storage and medication. as well as our team’s support and access to our community.In addition, you’ll have access to our team’s support and access to our community where you can engage with other people freezing their eggs at the same time! 

Your journey is uniquely yours and our team is here to help you through it in whatever way you need.

Whether you’re about to go through the egg retrieval process for egg donation, egg freezing, or a full in vitro fertilization (IVF) cycle, you’re likely going to have some questions. While this procedure seems intimidating to a lot of folks, it’s actually not as scary as it seems. Understanding how the process works and what to look out for can help ease some of those pre-procedure jitters, so let’s break it all down. 

Before

Questions for your provider

Knowing what’s coming is half the battle when it comes to medical procedures.Here we’ve listed some great questions to ask your provider before your egg retrieval.

• Can you walk me through the timeline for the egg retrieval, from when I give myself the trigger shot (a medication sometimes used to help your ovaries release mature eggs) to the recovery room after the procedure?
• What anesthesia options are available?
• What is your best estimate of how many eggs you think you’ll be able to retrieve?
• What are the most common side effects you see after the procedure? What do you recommend I do to manage those symptoms if I have them?
• Is there anything you recommend I do leading up to the procedure to minimize my risk of ovarian hyperstimulation syndrome (OHSS)? 
• When and how will the clinic update me about the eggs after the procedure (e.g., phone, email, app, etc.)?
• How can I reach your clinic if I have questions or concerns?
• Who do I contact if I have a problem outside the clinic’s normal hours?

Depending on your particular situation, you may need to ask more questions, but this is a good place to start. 

Anesthesia/sedation options

For egg retrievals, an anesthesiologist will be on site to provide your sedation. Most clinics use monitored sedation that is propofol-based. This is not the same as general anesthesia, which is used for longer and more invasive procedures and requires a breathing tube. With monitored sedation, a medication is given through the veins (IV) to make sure you feel no pain or discomfort during the procedure. No breathing tube is used, so you’ll be able to breathe on your own. This is commonly called “twilight” sedation—think of it as a really great nap! 

Unfortunately for some folks, nausea can be a side effect of the anesthesia. If you’ve had anesthesia before and you know you’re prone to nausea, make sure to let the anesthesiologist know about it. There are a few other ways to help manage nausea due to anesthesia.

• Stay hydrated. Postop nausea is sometimes due to dehydration, usually because you haven’t had anything to eat or drink before your surgery. Dehydration leads to low blood pressure, which can make you even more queasy. As soon as you’re able to after your procedure, start rehydrating. Staying really hydrated up until the night before your procedure can also help. 

• Take anti-nausea medicines. Some over-the-counter (OTC) options like antacids, ginger root tablets, and others can be helpful for mild to moderate nausea. Ask your doctor before using any of these though! Some medications can’t be taken together. If the OTC options don’t help, you can also ask your doctor about prescription options.
• Avoid activities that require too much movement or concentration. Things that involve concentration or changes in your perception (like reading or riding in a car) will often make symptoms worse. Closing your eyes and keeping your room dimly lit can help calm your nervous system while the anesthesia wears off fully.

You can learn even more about all the anesthesia and sedation options here.

Prep

Most clinics will go through their specific requirements and recommendations at your preoperative visit. The most important thing to avoid is having anything to eat or drink the day of the procedure. 

A common question people ask is whether they need to shave before their egg retrieval. The answer is no—shaving (or not shaving) does not impact the procedure at all so come as you are! If you prep anything, it should be everything you need for when you come back home to recover. Here’s a checklist of things to have ready on the day of your procedure:

• Comfortable, loose clothes
• Heating pad(s)
• OTC medicines like Tylenol, stool softeners, and anti-nausea 
• Plenty of fluids and electrolytes (water, Gatorade/Powerade, coconut water, etc.) 
• Activities like audiobooks, movies, etc. that don’t require too much concentration
• Someone to take you home

During

Is egg retrieval painful?

This is the most common question we get and it’s totally understandable! Thankfully, with the anesthesia that’s given, you will be asleep so won’t feel or remember anything during the procedure. 

What exactly happens during an egg retrieval?

Alright, let’s get into how this procedure actually works. First, the doctor will use a transvaginal ultrasound to find your ovaries, which should by now have clusters of tiny follicles. Your doctor will then gently guide a long needle through an opening in the ultrasound probe and into the vaginal wall. This needle is attached to a catheter and the catheter is attached to test tubes labeled with your name and unique patient identification number. One by one, the eggs will be drawn out of the ovaries using light suction and collected in the test tubes. These test tubes are  then handed off to the embryologist, an expert in the science of oocyte cryopreservation (the technical term for egg freezing).

Once all the eggs that can be retrieved are collected, the doctor will remove the needle. They will examine your ovaries and your vaginal wall to make sure there isn’t too much bleeding. It’s normal for these sites to bleed a little–they did just have a needle inserted into them. Typically,  your doctor will be prepared to apply pressure or, rarely, to use a cauterizing (heated) agent to control any bleeding. 

That’s it! You’ll leave with no stitches or scars. Pretty cool, huh?

How long does an egg retrieval take?

The process described above may sound really complicated but in reality, it only takes about 15 minutes. That’s less time than most people spend scrolling TikTok while on the toilet. 

After

Waking up

Immediately after the egg retrieval, you’ll definitely be a little groggy as you recover from the anesthesia. You’ll usually be told to rest for 30–60 minutes in the recovery area, where someone will monitor you as you wake up from the anesthesia. Most anesthesia takes about 24 hours to be fully out of your system, but you’ll feel close to normal by the time you leave the office.

During your recovery time, your doctor will come in to let you know how many eggs were successfully retrieved. They will also let you know how many eggs were deemed mature by the embryologist. What does that mean? Well, let’s go way back to middle school biology. Mature eggs have reached the metaphase II (M2) stage and are therefore considered to have “meiotic competence”. Meiosis is the process of cutting the number of chromosomes and genetic material by half so that when it combines with sperm, the resulting embryo has the proper number of chromosomes and all the genetic material it’s supposed to have.

Immature eggs are not capable of fertilizing because they are not “meiotically competent”. However, sometimes it is possible to have eggs mature in the lab (in vitro maturation or IVM) and then fertilize them. While this isn’t popular now, we do ask our partner clinics to freeze immature eggs for when this technology is more widespread in the future. 

In our Split program, where you freeze for free when donating half, you keep half of the mature eggs PLUS 100% of any immature eggs if they are retrieved and vitrified.

Common side effects and how to manage them

After everything is said and done, the most common side effects people have are constipation, bloating, cramping, spotting, and pain. Rest, over the counter medicines like Tylenol and stool softeners, and staying hydrated are usually all that’s needed for these symptoms. Heating pads can also be really helpful for those who have cramping or pain. If you have any bleeding, make sure to use pads—not tampons—so you can monitor the amount.

The majority of people are back to their normal activities by the next day, but it’s recommended that you go home and relax for the rest of that day with another adult with you, just in case. You also should not drive for at least 24 hours after your procedure. 

Your doctor may prescribe an antibiotic or other medications depending on your case. You may be asked to avoid sexual intercourse for a period of time or avoid things like taking a bath. Make sure to follow any specific instructions your provider gives you for your recovery. 

Red flags

If you notice any of the symptoms below, report them to your healthcare provider asap:

• Temperature above 101 F
• Severe abdominal pain or swelling
• Severe nausea or vomiting that doesn’t go away
• Heavy vaginal bleeding (soaking through a pad in an hour; some light bleeding is normal)
• Difficulty urinating, or painful urination
• Fainting or dizziness

Good Luck!

If and when you decide to pursue egg freezing, Freeze by Co is here to help you every step of the way. As mentioned earlier, our Split program allows those who qualify to freeze their eggs for free! In a Split cycle, you donate half of the eggs retrieved to a family that can’t otherwise conceive and freeze the remaining half for yourself, so you get half the mature eggs and all the immature ones. 

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

The best way to feel comfortable and confident about your egg retrieval is to know what to expect. The process won’t be exactly the same for everyone but with the tips we shared above, you’ll be more than prepared when the big day comes. Whatever you choose, our team is here to support you and help you feel empowered as you determine which family-building options are right for you!

Intro 

If you're thinking about freezing your eggs and you've started to gather information about it, you're probably coming across a lot of information. This can definitely be overwhelming but there’s no need to panic! We're here to help you figure out if egg freezing is the right choice for you, no matter what age you are.

What is egg freezing?

Before we dive further into this topic, what is egg freezing? Egg freezing, known as oocyte cryopreservation in the medical world, is a technique used to preserve someone’s fertility.  Eggs are collected from the ovaries and frozen so they can be used in the future. If the person is unable to get pregnant naturally, the eggs are unfrozen and used in an assisted reproductive technology (ART) procedure, like in-vitro fertilization (IVF). Whether you know you want to have kids or you aren’t sure and want to give yourself more time to figure it out, think of egg freezing as a way to keep your options open for the future.

Should I freeze my eggs?

There are many, many reasons why someone might choose to freeze their eggs but the decision is a deeply personal one that requires some careful consideration. When making that decision though, 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). Beyond that, fertility and pregnancy risks change with age. If you freeze your eggs at 30 and use them when you're 40, you'll have to deal with the realities of pregnancy at 40.

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.

Pros of egg freezing

Ok, now that we’ve gone through the basics, let’s discuss the pros and cons.

Perhaps the biggest advantage of freezing your eggs is the fact that it lowers the risk of having children with genetic abnormalities associated with ovarian aneuploidy. Ovarian aneuploidy refers to when an egg has an abnormal number of chromosomes which leads to an abnormal pregnancy. Most people are born with 46 total chromosomes (23 pairs). The most common aneuploidy risk seen by far is Down syndrome. Babies with Down syndrome have an extra copy of one of these chromosomes, chromosome 21. The medical term for having an extra copy of a chromosome is “trisomy” so Down syndrome is also known as Trisomy 21. Freezing your eggs at a younger age decreases (but does not totally eliminate) the risk of an abnormal number of chromosomes.

Another 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 getting a 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. 

Egg freezing also gives you options in terms of having your own biological children. Of course, there is the obvious option of having the eggs fertilized and the embryos implanted into your uterus. But you also have the option of having those embryos implanted into a gestational carrier or into your partner if they have uterus. 

Finally, freezing your eggs does not affect your ability to get pregnant naturally. The egg freezing process and retrieval procedure simply rescue eggs that would have died with your next menstrual cycle. This means it does not affect your ovarian reserve (the number of eggs in your ovaries). Once you’ve completed the full process, your body will continue to ovulate and release an egg each month like normal.  

Cons of egg freezing

Now, let’s talk about the disadvantages of egg freezing. 

The most obvious downside is the cost. While some insurance plans may cover egg freezing, this isn’t the case most of the time. The out-of-pocket cost of egg freezing varies but it can be up to $20,000 depending on where you are and which clinic you use. This typically includes bloodwork, medications, ultrasounds, and the egg retrieval procedure. This does not include the annual storage fee (which can be up to $800 per year) and any follow-up procedures if you end up using those eggs. Learn how you can freeze for free with Freeze by Co. 

The next thing to consider is the hormone medications and egg retrieval process themselves. These medicines not only require injecting yourself (or having a partner or friend do it) but they can have some not-so-fun side effects. These can include fatigue, nausea, bloating, headaches, abdominal pain, breast tenderness, and irritability. A severe risk of hormone medications is ovarian hyperstimulation syndrome (OHSS). This condition can lead to blood clots, shortness of breath, abdominal pain, dehydration and vomiting. It may even require admission to the hospital to manage. Thankfully, OHSS is rare nowadays, affecting only up to 2% of patients.

The egg retrieval process is quick and the most common symptoms afterwards are pelvic or abdominal pain, constipation, bloating, and spotting. The main concern here is the time you need. One typical egg-freezing cycle can range from 10 to 14 days and during that time you'll be attending doctor appointments almost daily to make sure your eggs are maturing correctly.

If you’re taking any gender-affirming hormones like testosterone, you may need to take a break in order to freeze your eggs. One study showed that transgender men who used gender-affirming hormones and stopped a few months before fertility treatments ended up with the same number of eggs as cis women. But getting off hormones can be hard and could trigger gender dysphoria so the best option is to freeze eggs before transitioning if at all possible.

No one likes to be the bearer of bad news but this is an important one. Egg freezing may mean your eggs stay the same age forever but unfortunately, your body does not. As you age, the risks of pregnancy increase for both you and your potential child. These risks include gestational diabetes, preeclampsia, c-section delivery, preterm delivery of a baby with low birth weight and other risks related to the pregnancy being IVF. However, these risks vary widely depending on many other factors. 

One final caveat to remember is that egg freezing does not guarantee a live birth. It’s likely that not all eggs will survive the thawing process. Some will not fertilize. Others fertilize abnormally, and still others don’t implant successfully in the uterus. A large study at NYU in July 2022 showed a 39% live birth rate for people who used their frozen eggs. The two factors that affected the success rates the most were age at the time of egg freezing and the number of eggs thawed. Specifically, the live birth rate was over 50% for people who thawed at least 20 eggs or who were under 38 when they froze their eggs. Which brings us to our next question: what age is best for egg freezing? 

When should I freeze my eggs? 

Let me start by saying that there is no perfect age at which to freeze your eggs. However, the TL;DR is that 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. 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? 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.

Egg freezing can be a tricky process to navigate and you are not alone when it comes to questions and concerns around it. Freeze by Co is here to help you every step of the way. With our Split program, people between 21 to 34 years old have the chance to freeze their eggs for free! In 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, you can still participate in the Keep program up to age 40. You would be able to freeze your eggs and keep them all for yourself, on your timeline while having access to an additional valuable resource in our support community, The Nest. This community allows you to engage with other people freezing their eggs at the exact same time! 

Regardless of which path you choose, our team will be there to guide you through the process as we work to keep your family-building options on the table.

You might have heard at some point that freezing your eggs can help you preserve your fertility options for your long term future. But just how many eggs should you freeze? Is there an optimal number for egg freezing?

Let’s take a look at how many eggs you can expect to get during the retrieval process and how many eggs you should be freezing for fertility preservation. 

How many eggs do I have?

Before we talk about the number of eggs you should freeze during oocyte cryopreservation — more commonly known as freezing your eggs — we should probably talk about how many eggs are in your ovaries right now. 

Your fertility doctor may have mentioned the term ovarian reserve a few times. When they do that, they’re talking about the number of eggs in your body. But how many eggs are in that reserve?

There is no exact answer here. On average, women are born with anywhere from one to two million eggs. Some women are born with more. Some women are born with less. 

It may sound like a lot either way, but most of the eggs we’re born with don’t stick around. By the time most of us hit adolescence,we have about 300,000 eggs left. From there, the number of eggs in the body naturally decreases by about 1,000 every year, and the decline becomes more rapid after age 35.  

That’s where egg freezing comes into play. The doctors of the Association of Reproductive Medicine (ASRM) states that planned oocyte preservation is “ethically permissible” because it provides women with more autonomy over their reproductive choices. 

Doctors can get a sense of how large your ovarian reserve is before egg freezing by testing the level of the anti-Müllerian hormone (AMH) in your body. This test looks at both your ovarian reserve and how well your body may or may not respond to medications that will stimulate the ovaries. What it can’t determine, however, is the quality of those eggs. And ultimately, you need both quantity and quality.

How many eggs do I need to freeze?

OK, so you may have a lot of eggs in your ovarian reserve — or maybe not. But how many do you actually need to freeze?

This answer varies from person to person and depends on a few individual factors:

• How old are you right now?
• Do you plan to freeze all of your eggs or do you hope to also donate some to help intended parents grow their family? 
• If you think you may want to have children one day, how many do you have in mind?

This list presents a lot to think about, so let’s dive a little deeper to help you make informed decisions about the number of eggs you freeze. 

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:

How many eggs are retrieved?

For  egg donors aged 25-29, the average number of eggs retrieved is 18, and that number drops to 16 for people age 30-35 — although it varies from person to person.

Your reproductive endocrinologist will be able to tell you the day of your retrieval how many eggs were retrieved. This number will include both mature and immature eggs, so it’s not necessarily the total number of eggs that can be frozen. 

Immature Eggs

• May be partially or completely damaged or have its quality compromised in some way
• Lower chance of fertilization

Mature Eggs

• Have good egg quality
• Are more likely to be fertilized
• Can be frozen

After your retrieval, all of your eggs will be sent to an incubator to check maturity. The lab technicians will look for eggs to achieve meiosis, a kind of cell division that occurs in egg cells. 

The eggs that achieve meiosis will be frozen, and you will be notified of the total number. 

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. 

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. 

Of course, you should talk to your doctor about any risks or benefits that come with additional rounds. 

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 doctor about freezing more eggs. 

For example, the studies show that a woman under age 35 will need to freeze about nine eggs to achieve a 70% chance of a 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 to achieve that 70% chance each time. 

That number will increase with each number of children you foresee — provided your expectation is that each child will be conceived with the use of the eggs you are currently freezing. 

Bottom line

There is no “magic number” when it comes to freezing your eggs. Your age, your future plans, and more all come into play. 

We’re here to answer any questions you might have, and the Cofertility community is also here to lend support as you consider all the important factors to make the choice that is right for you.

Deciding to freeze your eggs can do more than put you in the driver’s seat of your reproductive journey. Going through the process of retrieving and freezing your eggs can give you insights into your health, offer you peace of mind about how you’ll accomplish your goals, and allow you to create a blueprint for building the family you’ve always dreamed of.

As you and your doctor work together to ready your eggs for retrieval you’ll end up learning valuable information about the state of your fertility and what you need to know before you’re ready to take the next steps. 

You could get a heads up about certain reproductive concerns

As part of the preparation for freezing your eggs your doctor will likely do ovarian reserve testing which uses a blood test called Anti-Mullierian Hormone (AMH). Using a blood sample collected on the third day of your period your doctor will be also able to see how much estradiol and follicle-stimulating hormones are present during this key window in your reproductive cycle.

AMH levels are generally higher during your childbearing years and then they begin to decline as you head towards menopause, becoming almost nonexistant afterwards. 

You’ll get a better picture of your reproductive schedule

According to the Mayo Clinic, after you’ve decided to move forward with the process you’ll begin taking hormone injections. These hormones will have two distinct jobs—ovarian stimulation and preventing premature ovulation—which your doctor will achieve using a variety of medications. 

Your doctor will begin monitoring you and checking two very important levels:

• Estrogen (an increase means your follicles are developing)
• Progesterone (low levels will mean you haven’t ovulated yet)

Not only will you discover how your body reacts to stimulation (giving you a great deal of information about how your egg production is going) but you’ll also have an idea of when you should ovulate. Knowing exactly when the clock starts ticking—your eggs will be ready for retrieval after 10-14 days—will let you know what you can expect for this cycle. 

Your doctor will find out how many follicles you have

Speaking of follicles, these are the sacs where your eggs will stay until they have matured. Your doctor will likely use a vaginal ultrasound to check the status of your ovaries to see how many follicles have developed, indicating how many eggs you’ll likely have for retrieval. That number is going to be very important (and very exciting) for both you and your doctor. 

To give you an idea of why that number matters so much, you’ll need to know how many eggs you need to increase the potential for a live birth. A 2020 study in the Journal of Assisted Reproduction and Genetics found that a woman under the age of 35 averaged 21 eggs on their first round of egg retrieval. At that age, you would need approximately 9 eggs to ensure a 70% chance of a live birth. Once you find out how many follicles you have you might have a better idea of your pregnancy success rate when the time comes. 

There will be additional health screenings 

Another thing you’ll learn about your fertility is whether you have any diseases that you can pass onto a future child, via a genetic carrier screening test. Your doctor will also likely have you undergo an infectious disease screening—which will check for things like HIV and certain varieties of hepatitis—as part of your work up. These tests are different from genetic screenings, which looks for the potential changes in your genetic blueprint indicating heredity conditions that can be passed onto your child.  

Some people who freeze their eggs may do genetic testing ahead of time, whether because they already know that certain conditions run in their family or because they have a limited understanding of their family history. According to the Centers for Disease Control and Prevention (CDC), genetic testing can even give you information about some types of cancers that could impact your reproductive system, making it another important tool in your fertility arsenal. 

Getting proactive can save you money

By being proactive about your fertility journey you not only get to make the decisions about what your future family will look like based on your terms, but you’ll also be able to get an idea of what may lie ahead for you if you decide to have a child.

Of course, freezing your eggs can be expensive. It costs an estimated $10,000-20,000 per cycle. Fortunately, there are egg freezing programs like Freeze by Co that can help you navigate financial pain points that may make planning for that future family a little bit harder by offsetting some of the costs associated with freezing your eggs. Freeze by Co offers members two different options for freezing their eggs. Split Members may qualify to freeze their eggs for free when they donate half of their eggs to other families looking to conceive.

There are even benefits for those who want to use the Freeze by Co’s Keep program. As the name indicates, Keep Members keep all of the eggs collected during retrieval while still benefiting from discounted costs in the way of less expensive medications and more. 

Our Split program offers women the chance to freeze half their own eggs and donate the other half to a family who cannot conceive otherwise. If you’re eligible for the program, by meeting Cofertility’s requirements, and decide to donate half of your retrieved eggs, your egg freezing procedure, medications, and ten years of storage will be completely free of charge. 

Freezing your eggs—and, potentially, donating some eggs—undoubtedly brings up lots of big questions that are important to talk about. Let’s dive into all the information you need to know about our Split program. 

Where do my donated eggs go?

Many types of families need donated eggs to grow their family, including couples facing infertility, LGBTQ+ couples, cancer survivors, women with age-related fertility decline, and more. We welcome all intended parents to use our platform to find their match. 

Who qualifies for the Split program?

While we’d love to have as many women join our Split program as possible, we do follow guidelines designed to protect the health and wellbeing of the donors and intended parents. 

To qualify for the program, among other factors, you must:

• Have both ovaries
• Be between ages 21-33
• Have a BMI less than 29, due to limitations on medication administration and egg retrieval complexities
• Be physically and emotionally healthy with no genetic or reproductive disorders/abnormalities
• Be a non-smoker and abstain from recreational drugs or Depo Provera birth control 

If you're currently pregnant or breastfeeding, you may still be eligible, but you'll have to wait until you have stopped breastfeeding and have had at least one menstrual cycle before you can begin your egg retrieval. Lastly, you must also be willing to provide a complete medical history about yourself and your biological family members, as they may have other disqualifying factors. 

How does the process work?

We’re so glad you asked. Here’s a quick overview of how the application, matching and retrieval process works. 

Take the quiz 

To kick off the process, take our quiz and tell us a bit about yourself. This only takes about a minute and gives a sense of what programs you might be qualified for.

Submit your program application 

Based on your quiz responses, if you’re eligible to move forward with applying for Split, you can complete the full program application at this time. This application determines if you qualify for the program, and helps create and personalize your profile so intended parents can get a feel for who you are and if you would be a good match for their family.

Call with our team 

Once you pass this first phase, you’ll have a call with a Member Advocate to ensure you are ready for the process. You’ll get to ask any outstanding questions before your profile is shared with intended parents. 

Once your profile is listed on the platform, intended parents will be able to determine whether you are the right match for their family. The timeline for this varies. But, know that you’ll always be able to switch into Cofertility’s Keep program if you decide you don’t want to wait any longer to freeze your own eggs. 

Sign the Split program agreement

After you have your call with our team, we will send you an agreement to signify your intent to proceed with the Split program. Don’t worry, this agreement is non-binding up until the point at which you start your egg retrieval. The agreement is written in easy-to-understand language and we are here to answer any questions you have! 

Complete initial testing (AMH)

After your program call and signing the agreement, you will complete a free AMH test, or Anti-Mullerian Hormone, at a local lab near you. Understanding your ovarian reserve through an AMH test is an important step for egg freezing and donation. 

Fertility doctors typically consider an AMH level above 2.0 ng/ml as a good indicator for egg donation, and this is the benchmark used at Cofertility. That's because this level suggests that a Split member is likely to respond well to fertility treatments and produce a sufficient number of eggs for both donation and personal use. This allows us to proceed with your egg retrieval process in a manner that is both safe and effective. If your AMH falls under this level, our team is here to help you find the best path forward in your egg freezing journey.

Match with an intended parent 

Your profile will be listed on our platform for intended parents to view. Once you’ve been matched with intended parents, you’ll have a dedicated Member Advocate to walk you through next steps - and they’ll be with you throughout the entire journey! You will have the option to meet the intended parents - either in person or via Zoom - before moving forward with your screenings.

You could match with intended parents quickly or it could take a while, but know that you’ll always be able to switch into our Keep program if you decide you don’t want to wait. 

Complete further screening 

Once you have officially matched with the intended parents, you’ll undergo a physical screening based on FDA, ASRM and industry guidelines. This will also include bloodwork and a (fairly painless) vaginal ultrasound to determine how many eggs you have in your ovarian reserve and if you would be a good fit for Split. Depending on where you and the intended parents’ are located, the testing may take place at a clinic near you or there some travel may be required. Our team will organize the travel and help make this easy for you.

Start your egg freezing cycle 

If you get the green light and are accepted into Split, you’ll move onto the stimulation phase. This is the phase where you’ll take injectable medications to stimulate your ovaries to bring as many eggs to maturity as possible and get you ready for retrieval. This can sound scary, but we’ve got lots of helpful tutorials to walk you through it all. You’ll also be monitored  by a local fertility clinic throughout the process to check on how things are progressing. This full stimulation period usually takes 10-14 days. 

Retrieve your eggs

Once your eggs have reached the point of peak maturity and they’re ready to be retrieved, you’ll head back to the clinic for this procedure. This outpatient procedure takes about 30 minutes, and you’ll be under light anesthesia. The doctor will use a vaginal ultrasound to remove the eggs. 

Immediately upon retrieval, half the retrieved eggs will be frozen and stored for you for free for 10 years. You can access those eggs at any time and have them shipped to the fertility clinic of your choosing should you need them. The other half of the retrieved eggs will go to the intended parents and can be fertilized with the intended parents’ sperm of choice.

In the event that an odd number of eggs is retrieved, the “additional” egg will go to the intended parents. 

Next steps 

Depending on the number of eggs you’re able to retrieve in the first cycle, you can decide if you want to complete a second cycle so that you can donate again or have more eggs to keep for your future use. 

For women under 35, studies show that the average number of eggs retrieved is 18-21, a number that is tightly correlated with AMH (anti-mullerian hormone) levels—which are tested as part of the screening process. The same studies show that freezing just nine eggs gave those women a 70% chance at a live birth. 

What will I know about potential genetic offspring and what will they know about me? 

In the case a donor-conceived child experiences a serious medical condition, you may need to provide medical information to us, the fertility clinic, or the intended parents. Also, if new information comes up about your medical history, we’ll need you to let us know. The intended parents are required to do the same. This is in everyone’s best interest so everyone can be made aware of unknown medical conditions which can occur.     

That being said, when you apply, you’ll have the choice to indicate a desire for Disclosed or Undisclosed donation. 

• Disclosed: You meet the family (virtually or by phone is fine) before proceeding with the match. The level of relationship after the match is what both parties make of it. 
• Undisclosed: You match with a family without meeting them, and only communicate via Cofertility. No contact info is exchanged. Note that if both parties are interested, we can facilitate a phone or video meeting in which you can speak without sharing names.

Note that with today’s widely available genetic tests, it is extremely difficult to guarantee anonymity. There have also been changes in some state laws that give donor-conceived children more access to information about their donors, meaning it’s possible that identity and shared genetics may be discovered or made more broadly available by law even if you chose to be Undisclosed. 

Overall, we take a human-based approach. Based on psychological wellbeing research, we encourage families to be open to their children about their conception story and donor-conceived roots. As donor-conceived children grow up, they may be curious about their genetics and want to reach out with their own questions. This is something to consider prior to moving forward with the Split program. 

Summing it up

We know, first-hand, that freezing your eggs—especially when donating half—is a big decision that isn’t to be taken lightly. Our hope is that this overview (along with tons more helpful material along the way!) provides a solid foundation about our Split program so you can feel totally confident in navigating whether joining Split is right for you.

While in theory, the idea of egg freezing would have many raising their hands to give this a try, practically speaking it may be more complicated. There are real-world factors to consider: Do I need to freeze my eggs? Will I actually need them down the line? Am I a good candidate? And if so, would it actually fit into my budget, and are the logistics really feasible?

No need to wonder. Here’s what you need to know to make egg freezing possible in reality and the sort of programs where you can bring this to fruition.

Affordable egg freezing programs

We at Cofertility are dedicated to the idea that egg freezing should be more accessible. To make it possible for more of those who are interested, we have designed two different programs that prioritize different aspects of egg freezing. Take our quiz to see if you qualify for these programs.

Paying for keeps

With our “Keep” program, it’s about maximizing the number of eggs that you freeze, geared to enabling many people to be able to answer the question, “Can I freeze my eggs?” with a big, “Yes.”

As a member in this program, you get access to discounted prices we’ve negotiated with clinics and pharmacies, as well as a community of women also freezing their eggs at the same time. With this Keep program we give more leeway on exactly who can participate. While we are aware that research shows that fertility starts to decrease considerably after age 35, you can still take part in the program as long as you are under age 40.

This is egg freezing with real world families in mind, with steps taken to make fees more affordable. The idea is to lighten the load and to make budgeting for egg freezing that much easier, while bringing a little more joy and positivity to the process

The Split cycle

With our Split program, it’s all about taking budgeting out of the equation altogether, while helping another family. 

As a Split program member, if you qualify, you don’t have to set money aside for these burdensome costs at all – they are free as part of the program, including up to ten-years of storage. In return, you give half of your retrieved eggs from a cycle to someone who would be otherwise unable to conceive. The family receiving the donated eggs pays for all the costs to freeze and store your eggs, for their use to build a family now, and your use in the future. 

But, because we are splitting the number of eggs here, every single one counts that much more. So, we need to be more stringent in determining who can become a Split member. 

Important X factors

One of the factors that we weigh heavily for the Split program is age. In order to participate, you cannot be over age 34. That’s because data shows that, on average, those over 35 may not respond to fertility medication as well and therefore may not produce as many eggs. Also, research shows that, unfortunately, egg quality declines with age. 

Given the amount of time it may take to do initial testing and to match you with an intended parent, we have aligned our policy with ASRM (American Society for Reproductive Medicine) guidance on this and limit membership here to those who have not yet turned 34. This way if there’s a hiccup along the way, you won’t have to miss out — there should still be sufficient time to participate in the program.

Another factor to consider is what’s known as your anti-Mullerian hormone (AMH) levels. These levels signal how responsive your ovaries are likely to be to medication given to stimulate them to produce multiple eggs. If this number is pretty high, it usually means that your ovaries will respond well to stimulation. 

If at the time of initial screening, your ovarian reserve appears low based on your ultrasound and bloodwork, you, unfortunately, will not be eligible for the Split program, although you can still become a Keep member and achieve your goals that way. The ASRM guidance underscores the importance of considering biomarkers that indicate a donor’s potential ovarian reserve as part of the selection process. Scientists have found the AMH serum range of 2.20 to 6.8 ng/ml to be the one that research predicts will show if someone has enough ovarian reserve. This indicates how you will likely respond during an egg freezing cycle. 

No matter your ovarian reserve, you can still freeze your eggs. You just may not qualify for our Split program. That’s because we want to ensure that enough eggs are produced in the cycle to make it worthwhile for everyone after the eggs are divided, without your feeling that you’ve come up short and won’t be happy unless you do another cycle.

If you’re among those who qualify though, as many in their fertility prime may be able, this can be a golden opportunity. Feel free to read more about qualifications for joining our Split program.

Logistics

There is, of course, also the question of where you’ll need to go to make all this happen. 

If you’re a Split member, your initial physical screening takes place after you are matched with an intended parent. This includes some blood work and a vaginal ultrasound, which helps determine if this program will work for you, and will likely take place somewhere between where you and the intended parent’s locale. If any travel is needed though, our team will help you to make this happen, doing the necessary organizing. But monitoring for the cycle itself can be done at a local clinic right in your own area.

Meanwhile, Keep members have the flexibility to do the testing as well as the cycle locally, where it’s most convenient. 

Can you freeze your eggs? 

So, is this something that could practically work for you? Both of our programs are designed to make this feasible for a wide-variety of women. We try to keep costs down for Keep members while offering added flexibility to pursue their egg freezing goals. Meanwhile, for Split members the financial barriers are removed altogether.

Hopefully, this helps you to see how, practically speaking, you too can raise your hand up high and answer the question, “Can you freeze your eggs?” with a giant, yes, to make egg freezing in reality.

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

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

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

Age

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

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

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

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

Health-related factors 

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

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

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

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

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

Medical and family history

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

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

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

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

Psychological screening

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

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

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

Genetic screening

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

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

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

Physical screening

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

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

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

The following could also be deal breakers: 

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

Anti-Mullerian hormone (ovarian reserve) levels

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

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

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

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

State-specific qualifications

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

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

Additional disqualifying factors

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

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

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

The net net

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

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

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

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

The process for freezing eggs

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

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

How your body responds to the process

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

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

The goals for women who freeze their eggs can differ

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

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

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

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

Some things to consider about freezing your eggs

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

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

Getting a jump start on your fertility is a wise choice

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

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

Take a look at your options

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

Egg donor agencies are all about matching families with qualified egg donor candidates. And at Cofertility, we want to make sure we’re upfront about what might disqualify someone from egg donation. 

Through our Split program, if you qualify, you can freeze your eggs for free if you donate half of the eggs to a family who can’t otherwise conceive. But some factors may limit eligibility (for Split and egg donation in general). Some of these are official disqualifiers based on regulations by the FDA. Others are discretionary disqualifications based on recommendations by governing bodies like the American Society for Reproductive Medicine (ASRM).  Read on to get the full picture.

Age

Unfortunately, most doctors and agencies will turn a donor away if she’s over age 33. At Cofertility, we take a similar approach for our Split program. 

The reason for this age limitation is because data shows that, on average, those over 33 tend not to respond to fertility medication as well and therefore may not produce as many eggs. Also, research shows that, unfortunately, egg quality declines with age. 

If you are 34-39, you are still eligible to participate in our Keep program, where you can freeze your eggs and keep 100% of them for yourself. Also, if you are over 33 and donating for a family member or friend, a doctor may approve you for egg donation on a case-by-case basis. 

Please note, per ASRM guidelines, we also do not accept Split members who are under 21. If you’re younger than this and you’d like to participate, please reach out and we’ll get back in touch after you turn 21. 

Health-related factors 

As a preliminary step in the process, we will review several health-related factors before you can be approved for egg donation. 

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

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

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

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

Medical and family history

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

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

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

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

Psychological screening

Following this, there will be some psychological questions you’ll have to answer. We don’t expect you to be perfect. But some psychological factors may be more likely to disqualify you than others. 

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

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

Physical screening

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

Some disqualifications are set in stone by the Food and Drug Administration (FDA). They, understandably, want to ensure that egg donor tissue doesn't spread contagious diseases. If evidence of any of these conditions arises, you will be considered ineligible for the Split program. These are considered to be non-negotiable: 

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

The following could also be deal breakers: 

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

Anti-Mullerian hormone (ovarian reserve) levels

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

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

At Cofertility, if you appear to have low ovarian reserve at the time of screening, you will be ineligible for our Split program. We only accept Split Members with a higher AMH level as it helps mitigate the possibility of a second cycle to obtain enough eggs that could result in a live birth down the line (for yourself and for intended parents). Nevertheless, it is important to note that, even with high AMH levels, there is always a chance of having to do another cycle to improve the odds of a live birth. In the Split Program, once you are matched with intended parents, you’ll undergo your physical screening, which will include AMH-reading bloodwork. 

If you’d rather get a sense of your AMH ahead of matching, talk to us about helping you set up an initial egg freezing consultation at a local fertility clinic. While it’s not required until this later phase of the screening process, it can help you better understand your fertility outlook. We may offer discounted consult options in your area, and this could give you upfront peace of mind about your choice to pursue Split, Keep, or neither.  

Genetic screening

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

But even for serious diseases, not all disease-related genes are deal breakers. For example, if your tests reveal that you have a copy of a gene that can lead to cystic fibrosis, spinal muscular atrophy, or thalassemia, this may disqualify you depending on the clinic. Even if two copies of the gene are needed in order for the condition to occur, clinics and agencies handle this differently.

In line with ASRM guidance, in most cases where carrying one copy of a particular gene won't impact the child themselves, you can still donate. 

Agencies often screen for Fragile X syndrome. However, since this is an X-linked condition, just one copy of the gene can cause health issues. While most agencies will disqualify you if the X-linked health issues are severe, they may allow you to participate if you carry genes for milder conditions, such as red-green color blindness. Note that agencies will still inform potential parents that you carry this gene. 

State-specific qualifications

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

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

Additional disqualifying factors

In addition to the above, there are several factors that, unfortunately, would disqualify you from our Split program (and in many cases, per ASRM and/or FDA guidance, egg donation in general). These include if you:

• Are not a U.S. citizen
• Have served jail time for more than two days
• Have undergone body piercing and/or tattooing within the past twelve months in which sterile procedures may not have been used
• Have the highest education level of GED
• Have Indigenous American ancestry and are associated with a tribe—this is due to the Indian Welfare Act 

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

The net net

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

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

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

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

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

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

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

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

What are the egg freezing success rates by age?

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

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

Success rates for women in their 20s

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

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

Success rates for women in their 30s

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

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

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

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

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

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

Success rates for women in their 40s

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

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

Ask us anything

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

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

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

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

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

Here’s what you need to know about the process

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

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

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

Getting ready for retrieval 

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

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

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

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

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

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

Retrieving your eggs

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

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

Freezing and monitoring

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

Storage timelines

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

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

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

How much does it cost?

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

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

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

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

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

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

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

Breaking down the egg freezing process

Choosing a clinic

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

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

Consultation 

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

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

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

Evaluation and bloodwork

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

This testing may include:

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

Connecting with your community

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

Medications

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

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

Medications commonly prescribed in the egg freezing process include:

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

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

More blood tests and monitoring

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

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

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

Egg retrieval 

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

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

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

Cryopreservation

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

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

A second egg freezing process

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

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

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

Costs of the egg freezing process

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

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

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

Bottom Line

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