egg retrieval

Let's address the question that's likely on your mind if you're considering egg freezing: will this hurt? 🥴

The short answer is that egg freezing involves some discomfort, but it's typically manageable and temporary. Most people tell us the process was less uncomfortable than they expected. The most challenging parts tend to be the bloating near the end of your cycle and some cramping after the egg retrieval - similar to what you might experience during a heavy period.

Since egg freezing is an elective procedure, you'll want to know exactly what you're signing up for. In this article, we'll walk through each step of the process - from daily hormone injections to the retrieval procedure - and explain what to expect. You'll learn how others have managed any discomfort, what tools and techniques can help, and how to best prepare yourself for the experience. We'll also share specific strategies for those with lower pain tolerance and tips for communicating effectively with your medical team about pain management.

The daily medication routine

The egg freezing process begins with hormone injections stimulating your ovaries to produce multiple eggs. These shots are given subcutaneously (under the skin) using a small needle. While not exactly pleasant, most people find them manageable, especially after the first few days.

Tips for more comfortable injections:

• Ice the injection site for a few minutes before
• Choose a comfortable position (many prefer lying down)
• Consider having someone else administer the shots
• Rotate injection sites to minimize bruising

You might experience some bloating and tenderness as your ovaries respond to the medication. This is normal and typically feels similar to PMS symptoms.

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

Monitoring appointments

Throughout your cycle, you'll have regular monitoring visits that include transvaginal ultrasounds and blood draws. The ultrasounds involve a wand inserted into the vagina to check follicle growth. While not painful, you may feel pressure with this. Blood draws are quick, with most people reporting only brief discomfort.

If you're nervous about blood draws or have a history of feeling faint, make sure you let your care team know. They can use smaller needles or different techniques to make the experience more comfortable.

The egg retrieval process

The final step is the egg retrieval, a 30-minute procedure performed under sedation. Here's what to expect:

Before: An IV line will be placed for your sedation medication. You might feel a quick pinch.

During: You'll be unconscious and won't feel the retrieval process.

After: Most people experience cramping and bloating similar to menstrual pain. This typically resolves within a few days. Your doctor can recommend appropriate pain medication if needed.

Managing expectations

It's helpful to understand that while egg freezing isn't painless, most people report that it was less uncomfortable than they anticipated. The process involves:

• Brief, manageable moments of discomfort rather than sustained pain
• Predictable timing of procedures
• Medical support throughout
• Clear protocols for pain management

Tips for people with low pain tolerance

If you're particularly sensitive to pain or anxious about medical procedures:

• Communicate your concerns with your medical team upfront
• Consider speaking with a therapist about anxiety management
• Practice relaxation techniques
• Use music or other distractions during procedures
• Ask about all available pain management options

Making your decision

When weighing whether to freeze your eggs, pain concerns shouldn't be the deciding factor. Most people find the process very manageable with proper support and preparation. Focus instead on your long-term fertility goals and discuss any specific concerns with your doctor.

Remember that everyone's experience is different. What one person finds uncomfortable, another might barely notice. The key is to:

• Ask questions upfront
• Prepare mentally and physically
• Trust your medical team
• Advocate for yourself
• Have support systems in place
• Focus on your reasons for freezing

How to freeze your eggs for free

While pain concerns shouldn't stop you from freezing your eggs, cost often does (understandably). That's why at Cofertility, we've created an innovative program called Split that makes egg freezing accessible to more people. Here's how it works:

When you freeze your eggs for free through our Split program, you keep half your retrieved eggs for your own future use, and donate the other half to a family who needs donor eggs to conceive. Cofertility covers all your costs - including medications, procedures, genetic testing, and storage for up to ten years. 

The Split program isn't just about making egg freezing affordable - it's about helping another family while helping yourself. Our members tell us that the ability to give someone else the chance at parenthood adds meaning to their own egg freezing experience.

Summing it up

Understanding the potential discomfort involved in egg freezing helps you approach the process with realistic expectations. While there may be some uncomfortable moments, most people find them temporary and manageable. With proper preparation and support, you can navigate the process successfully, keeping your focus on your “why”. 

You may not be ready to have kids quite yet, but perhaps you’re starting to think about your future. If you’re exploring fertility preservation or assisted reproductive technologies, you might be considering whether egg freezing and embryo banking is right for you. 

Both options offer unique advantages and considerations, and understanding their differences is important for making an informed choice that aligns with your goals and values. In this guide, we'll dive into both egg freezing vs. embryo banking, empowering you to navigate this important decision with confidence.

How does egg freezing and embryo banking differ?

Both egg freezing and embryo banking begin with the same medical procedure: about 10-14 days of fertility medications and monitoring appointments, followed by an egg retrieval. 

The fertility medications encourage the development of multiple mature eggs, followed by a minimally invasive procedure to retrieve those eggs. The medical process, medications, and monitoring are identical whether you ultimately choose to freeze your eggs or create embryos.

The key difference between egg freezing and embryo banking lies in what happens after your eggs are retrieved.

• Egg Freezing: The retrieved eggs are immediately frozen using vitrification technology and stored until you're ready to use them. In the future, when you decide to pursue pregnancy, these eggs will be thawed, fertilized with sperm, and the resulting embryos will be transferred to your uterus.
• Embryo Banking: The retrieved eggs are fertilized with sperm in the laboratory, creating embryos. These embryos are then cultured for a few days and the healthiest ones are selected and frozen. When you're ready for pregnancy, the embryos are thawed and transferred to your uterus.

In essence, the medical journey up to the point of retrieval is the same for both options. The decision point comes after retrieval, where you choose whether to freeze the eggs unfertilized or to fertilize them and freeze the resulting embryos. Which option is right for you may depend on factors like whether you have a partner or access to sperm at the time of retrieval, or your personal preferences around timing and future family planning.

Egg freezing: increasing your options down the line

Egg freezing, also known as oocyte cryopreservation, is a process where your eggs are retrieved, frozen, and stored for future use. This technology has revolutionized fertility preservation, providing women with the opportunity to delay childbearing and increase their chances of having a biological child later in life.  

Pros of egg freezing

• Flexibility and autonomy: Egg freezing offers women greater control over their reproductive timeline. It allows them to focus on career goals, personal development, or finding the right partner before starting a family.  
• Medical reasons: Women facing medical conditions that may impact their fertility, such as cancer treatment or certain surgeries, can benefit from egg freezing as a way to preserve their options.  
• Technological advancements: Advances in vitrification (flash-freezing) technology have significantly improved the success rates of egg freezing, making it a more reliable option.  

Cons of egg freezing

• Age-related factors: While egg freezing can preserve fertility, the age at which eggs are frozen plays a critical role in their viability and potential for successful pregnancy.  
• Additional procedures: If you decide to use your frozen eggs, you'll need to undergo in vitro fertilization (IVF) to fertilize them and transfer the resulting embryos.  
• Cost: Egg freezing and subsequent IVF can be expensive, and insurance coverage may vary.  

Embryo banking: a step closer to parenthood

Embryo banking, or embryo cryopreservation, involves creating embryos through IVF using a woman's eggs and a partner's or a donor's sperm. These embryos are then frozen and stored for future use.  

Pros of embryo banking

• Known fertility potential: With embryo banking, you have a better understanding of the fertility potential of the embryos, as they have already undergone fertilization and, if you choose, can undergo preimplantation genetic testing (PGT). This allows you to understand the genetic makeup of your embryos sooner and determine whether additional egg retrievals might be needed.
• Higher success rates: Embryos have slightly higher survival rates after thawing compared to eggs, potentially increasing the chances of a successful pregnancy.
• Gender selection: With embryo banking, you have the possibility of learning the sex of the embryos sooner through preimplantation genetic testing), whereas with egg freezing, you would need to wait until fertilization and further testing at a later stage.

Cons of embryo banking

• Requires sperm: Embryo banking requires the use of sperm, which may not be ideal fo r those without access to sperm or those who haven't found a partner yet.  
• Ethical and legal considerations: Embryo banking could raise ethical and legal questions regarding ownership, disposition, and potential future use of the embryos, particularly in cases of divorce or death.
• Can’t be undone: Once embryos are created with someone’s sperm, they can’t be turned back into eggs, meaning you can’t change your mind on the biological father for those fertilized eggs down the line.

Questions to ask yourself

Choosing between egg freezing and embryo banking is a deeply personal decision, and will depend on your individual circumstances, goals, and values. To help you navigate this choice, here are some good questions to ask yourself:

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• What are my current relationship goals and family plans? Are you planning to have children with your partner? Or are you unsure about your future plans?
• What is my financial situation, and can I afford the associated costs? Both egg freezing and embryo banking can be expensive. Does your insurance cover the costs? Does your employer, or a partner’s employer, offer any fertility benefits?
• What are my thoughts regarding embryo creation and storage? Embryo banking involves creating and potentially storing embryos that may not be used. Would you be okay with that?
• Am I comfortable with the potential outcomes and uncertainties associated with each option? Both egg freezing and embryo banking have varying success rates, and there's no guarantee of a successful pregnancy. 
• Have I discussed my options with my partner and/or a fertility doctor? Open communication with your partner and seeking guidance from a fertility doctor will help you make an informed decision that aligns with your goals and values.

Remember, knowledge is power. Understanding the processes and considerations involved will help you make the choice that best suits your individual needs and aspirations.

Summing it up

Choosing between egg freezing and embryo banking is a big decision with long-term implications. You’ll want to carefully consider your individual circumstances, goals, and values before moving forward. 

Remember, you can always turn eggs into embryos but the opposite is not true. So if you have any doubt, freezing eggs may provide more flexibility for future decisions.

Egg freezing and embryo banking with Cofertility

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

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

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

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help individuals overcome the biological constraints of their reproductive timeline, giving egg freezers greater control of their career goals and family planning while promoting social justice and advancing gender equality.

Read more:

• Should I Freeze Eggs or Embryos?
• We Asked Four Women: Did You Freeze Eggs or Embryos?
• How Much It Costs to Freeze Your Eggs
• Should Your Partner Help Pay For Your Egg Freezing?

If you just started researching egg freezing, you might feel like you’ve been introduced to a whole new language. Whether clinical in nature or just shortened slang, with egg freezing comes its own terminology. And even if you’ve already educated yourself on what’s involved with egg freezing, chances are, you’ll come across an acronym you’ve never heard of. 

Fear not. Below, you’ll find a comprehensive list of acronyms, abbreviations, and terms you should know when diving into an egg freezing cycle. Read this, and soon you’ll rattle off egg freezing lingo like a pro. 

Hormones and general fertility 

• AMH: One of the first hormones your reproductive endocrinologist will investigate, Anti-Müllerian Hormone is measured early in a woman’s cycle to determine her ovarian reserve. A higher AMH level correlates to a higher ovarian reserve, or in other words, more eggs.
• CD: "Cycle day"—or the day of one's menstrual cycle, with CD1 = the first day of a period. Understanding your cycle length is super important, as it may indicate your most fertile window of dates. It will also help you determine any irregularities to consider as you embark on an egg freezing cycle. 
• DPO: "Days past ovulation." In a typical menstrual cycle, women can expect their period at 14DPO.
• Dx: Diagnosis, the medical identification of a condition or issue affecting fertility, which may impact decisions regarding egg freezing and related treatments.
• E2: Estradiol, a female hormone that's produced by ovarian follicles and determines how well a woman is responding to controlled ovarian hyperstimulation with fertility drugs. If you're freezing your eggs, you’ll have several routine monitoring appointments that include ultrasounds and bloodwork that measures estradiol levels. The higher the estradiol, the more follicles that are likely developing and (fingers crossed) the more eggs that may be retrieved.
• FSH: Follicle stimulating hormone, a hormone released from the pituitary gland to stimulate the ovaries or testicles. When getting an initial fertility workup, you'll get tested for your existing FSH. If you're taking FSH as a drug as part of your egg freezing protocol, it's also known in the United States as Follistim, Gonal-F or Bravelle.
• hCG: Human Chorionic gonadotropin, a hormone produced by an implanting embryo. If this hormone is present in a woman's blood, it indicates a possible pregnancy. It can also be given to women undergoing an egg freezing cycle to trigger ovulation right before a retrieval procedure.
• LH: Luteinising Hormone, a hormone released by the pituitary gland to stimulate the gonads (ovaries and testicles). If you're freezing your eggs, you'll have levels of this hormone measured often via bloodwork in order to determine ovulation timing.
• LMP: "Last menstrual period," or the start date of a woman's last menstrual period.
• MII: Metaphase II, the stage of egg maturation where the egg is ready for (hypothetical) fertilization, with chromosome alignment necessary for successful embryo development.
• PCOS: "Polycystic ovarian syndrome," a condition where the ovaries develop many small cysts, which results in irregular periods and ovulation. It can contribute to future infertility, so if you know you have PCOS, regardless of whether you’re freezing your eggs or not, chat with a reproductive endocrinologist to ensure a safe and healthy plan.
• TSH: Thyroid stimulating hormone, a hormone produced by the pituitary gland meant to stimulate the release of thyroid hormone by the thyroid gland. Recent research has suggested that slightly low TSH may associate with fertility challenges.

Egg freezing 

• AFC: “Antral follicle count,” a count of the number of small follicles in a woman's ovaries, seen via ultrasound early on in her cycle. Used to measure ovarian reserve, you'll have a lot of these if you're freezing your eggs to monitor how you're responding to ovary-stimulating medication.
• ART: “Assisted reproductive technology,” including any procedure involving egg retrievals and manipulating eggs and sperm outside the body. It includes things like egg freezing, gamete intrafallopian transfer (GIFT), in vitro fertilization (IVF), and zygote intrafallopian transfer/tubal embryo transfer (ZIFT/TET). 
• BCP: Birth control pills. If you’re freezing your eggs, your doctor may prescribe these as part of a medicated cycle in order to regulate the timing
• COH: “Controlled ovarian hyperstimulation,” when several follicles mature simultaneously in response to fertility drug treatment. The key word here is controlled. Your follicle growth will be carefully monitored by your doctor, who will adjust your medication protocol accordingly to stimulate or halt further growth.
• ER: "Egg retrieval" — not "emergency room!" An ER will be performed as part of an egg freezing cycle, and may also be referred to as a VOR (“Vaginal Oocyte Retrieval”).
• IM: Intramuscular, a method of injecting medication directly into a muscle. This method is often used for hormone treatments during the egg freezing process.
• OC: “Oocyte Cryopreservation,” which is another term for egg freezing. 
• OHSS: “Ovarian hyperstimulation syndrome,” a condition where the ovaries become excessively swollen and painful due to the overproduction of eggs from fertility medications. This is very rare, but can happen.
• REI: "Reproductive endocrinologist," or a doctor who specializes in treating male and female fertility.
• SD1: “Stimulation Day 1,” or the first day of medication administered to stimulate the ovaries for egg production during the egg freezing process.
• SQ: Subcutaneous (also abbreviated as SC), a method of injecting medication into the fatty tissue just under the skin, commonly used for administering fertility hormones during an egg freezing cycle.
• TVUS: “Transvaginal Ultrasound,” an imaging technique used to visualize the ovaries and follicles internally, providing information about egg development and ovarian health. If you’re undergoing an egg freezing cycle, you’ll have a lot of these, but they are quick and painless. 

Egg donation

• DE: “Donor eggs,” or eggs provided by another woman to be fertilized with sperm and transferred to the uterus of an intended parent or gestational carrier.
• IP: “Intended parent,” which is a person who becomes the legal parent of a child born through third party reproduction.

If you’re feeling totally overwhelmed by all that’s involved with egg freezing, we’ve got you covered. Take our quiz to see how you may qualify for our more accessible egg freezing opportunities, including our Split program, through which you can freeze your eggs for free when you donate half to another family who can’t conceive. 

We’re wishing you the best of luck on your egg freezing journey! 

Egg donation plays a crucial role in helping many individuals and couples achieve their dreams of parenthood. At Cofertility, we recognize the significance of this decision for our donors and are committed to ensuring that every aspect of the donation process is conducted with the utmost care, transparency, and respect for our donors' autonomy.

This article provides a comprehensive overview of how informed consent works at Cofertility, where women can freeze their eggs for free when donating half to a family that could not otherwise conceive. 

We'll explore the various aspects of informed consent, including its definition, its specific application to egg donation, and the medical, psychological, genetic, and legal considerations involved. By the end of this article, you'll have a clearer understanding of our commitment to ethical practices and donor well-being throughout the egg donation journey.

What is informed consent?

Informed consent is a fundamental ethical and legal principle in healthcare and medical research. It refers to the process by which a fully informed patient or participant can participate in choices about their healthcare or involvement in research. For consent to be considered "informed," several key elements must be present:

1. Disclosure: The healthcare provider or researcher must provide all relevant information about the proposed treatment, procedure, or study. This includes potential risks, benefits, alternatives, and the option to refuse or withdraw.
2. Understanding: The patient or participant must comprehend the information provided. This may involve explaining complex medical terms in plain language or using visual aids to ensure clarity.
3. Voluntariness: The decision to consent must be made freely, without coercion, undue influence, or pressure from healthcare providers, researchers, family members, or others.
4. Competence: The individual must have the mental capacity to make the decision. This means they must be of legal age and sound mind to understand the implications of their choice.
5. Consent: The patient or participant must explicitly agree to the treatment, procedure, or participation in the study, usually by signing a consent form.

Informed consent in egg donation

At Cofertility, we take donor consent very seriously. In the context of egg donation, informed consent ensures that donors fully understand all aspects of the donation process, including medical procedures, potential risks, psychological implications, and legal considerations. It empowers donors to make autonomous decisions about their bodies and genetic material, protecting their rights and well-being throughout the donation process.

To ensure that an egg donor is making a knowledgeable and autonomous decision about becoming an egg donor through our Split program, the potential donor is required to be fully educated about all aspects of the donation process. This includes:

• Medical implications: Understanding the procedures involved and potential health risks.
• Psychological considerations: Exploring the emotional aspects of egg donation.
• Genetic implications: Comprehending the long-term genetic connections created through donation.
• Legal aspects: Understanding the rights and responsibilities of egg donors.
• Egg sharing vs. financial implications: Grasping the differences between our Split program and traditional financial compensation models.

It is crucial that the donor demonstrates she understands all the information provided and has ample opportunity to ask questions before deciding to move forward. Another important aspect of informed consent is that it must be given voluntarily, without coercion or undue influence. The egg donor must understand that she has the right to withdraw from the process at any time before the egg retrieval.

This process of informed consent is just one aspect of how we work to educate each member through various aspects of the process— on top of providing support and guidance— all in the name of supporting our donors in making the best decision for themselves.

Medical risks and side effects

Just like any other medical procedure, egg donation has medical risks and side effects. Understanding the medical side effects of egg donation is vital for ensuring that donors can give informed consent, prepare for and manage potential risks, and safeguard their physical well-being. It also empowers donors to make confident, informed decisions about their participation in the donation process.

Typically, during the menstrual cycle only one egg is released. So when donating eggs,  medications are given to help produce multiple eggs at one time. Sometimes ovaries over respond to these medications and cause side effects. Ovarian Hyperstimulation Syndrome (OHSS) is one possible side effect. The ovaries swell because they are producing more than what is typical and can become painful. Symptoms can range from mild bloating and nausea to severe symptoms such as shortness of breath, blood clots, and even kidney failure. According to the Cleveland Clinic, OHSS occurs in less than 5% of women undergoing retrieval. And severe cases are less than 1%.

Because a needle is involved to remove eggs from the ovaries, an infection is possible. However, according to the American Society for Reproductive Medicine (ASRM), pelvic infections after egg retrieval are pretty rare. Severe infections may require hospitalization and/or treatment with intravenous antibiotics. Rarely, surgery may be required to remove one or both of the ovaries, tubes, and/or uterus. Light vaginal bleeding or spotting for 1–2 days after an egg retrieval procedure is also very normal. Since the retrieval involves puncturing and aspirating ovarian follicles, it can lead to varying degrees of bleeding.

These and other potential side effects will be fully discussed and covered in detail before any procedure begins. The donor will have ample opportunity to learn about all the possible side effects and opportunity to ask questions until she feels fully informed and comfortable with moving forward. We believe that being aware of the medical side effects empowers donors to take an active role in their healthcare. This knowledge allows them to advocate for themselves, ask the right questions, and make decisions that are in their best interest.

Psychological and emotional considerations

The decision to donate eggs involves a lot of personal considerations as well, not just medical. And donors must be counseled on the potential emotional and psychological impacts of donation, including the potential for regret. Donors may experience stress related to the medical procedures, the hormones used, and the overall commitment required. But the emotional and psychological impacts can impact a donor well past the donation phase and into the future. The knowledge that their genetic material may result in the birth of a child can create a sense of connection or identity-related concerns. Donors may wonder about their genetic offspring and may feel a sense of loss or confusion regarding their role in the child's life. Donors may find that their decision affects their relationships with partners, family members, or friends, particularly if those around them have differing views on egg donation. 

This and other psychologically complex reasons are why donors undergo an extensive psychological screening to assess their emotional readiness and understanding of the potential psychological impacts of egg donation. Understanding the potential mental health implications ensures that they are prepared for the emotional journey ahead. By being aware of these potential effects, donors can make more informed decisions, seek appropriate support, and manage their mental health throughout and after the donation process. We provide access to professional mental health support that can help donors process their emotions and manage any psychological challenges that arise.

Over time, a donor's feelings about their decision might evolve. What seemed like a straightforward decision at one point in life might be reconsidered as the donor’s circumstances or perspective changes, potentially leading to feelings of regret or doubt.  So before proceeding with the donation, we discuss this with our donors to reduce the likelihood of misunderstandings or regrets later in life. This is where we spend time discussing the genetic implications of egg donation. 

Genetic implications of egg donation

The egg provided by the donor contains half of the genetic material that will combine with sperm to form an embryo. This means that the donors and recipients' family tree will be tied forever. We want our donors to understand the significance of this implication. Being informed about potential future impacts allows donors to develop coping strategies and seek support networks, whether through professional counseling, support groups, or trusted individuals in their lives.

At Cofertility, we offer potential egg donors the choice of how, if at all, they want to be connected to the family they help. Two broad options for the the relationship include: 

• Disclosed, you exchange contact information and can communicate directly. The scope and degree of communication (both during and post-match) is what both parties make of it. 
• Undisclosed, you do not exchange contact information and only communicate through Cofertility. With an undisclosed donation, you and the family can choose to allow the donor-conceived child to receive your contact information when they turn a certain age (usually 18). This is called Open ID, an increasingly popular option.

Some egg donation agencies promise the opportunity to be anonymous. However, with the rise of direct-to-consumer genetic testing services, we know that anonymity is simply not possible. It has become easier for children conceived through egg donation to discover their genetic origins and potentially locate the egg donor and other biological relatives. It’s important for donors to carefully consider this implication and discuss them with medical, psychological, and legal professionals before proceeding with the donation. 

Legal rights and responsibilities

Before the donation process begins, the donor must sign legal contracts that outline their rights, responsibilities, and the terms of the donation. The legal rights and responsibilities of an egg donor are carefully defined in a legal contract to protect both the donor and the recipients. These rights and responsibilities involve issues of parental rights, disclosure, and confidentiality and are legally binding. 

In the contract it will be explicitly directed that the egg donor relinquish all parental rights to any children born as a result of their donation. This means they have no legal responsibilities or rights regarding the child. So the donor has no legal claim to the child, no right to contact or visitation, and no responsibility for the child's upbringing. Although research and guidelines encourage transparency, suggesting that children should be informed about their genetic origins, it is up to the recipient parents to decide if and when they will disclose the egg donation to their child. 

At Cofertility donors are required to have independent legal counsel to review these contracts and ensure they fully understand their rights and obligations. There is no cost to the donor. 

Egg sharing vs. financial compensation

Egg sharing is a program in which a woman shares some of her eggs with another individual or couple who need donor eggs. In the case of Cofertility, the donor gives half of her retrieved eggs to a family who cannot conceive otherwise and keeps the rest for herself. Every expense associated - medications, supplement, travel, insurance, freezing, legal etc - are completely free of charge.

Egg sharing and financial compensation are two very different models used in the context of egg donation. Both involve women donating their eggs, but the motivations, benefits, and processes differ. 

Egg sharing is a program in which a woman shares some of her eggs with another individual or couple who need donor eggs. In the case of Cofertility, the donor gives half of her retrieved eggs to a family who cannot conceive otherwise and keeps the rest for herself. Every expense associated— medications, supplement, travel, insurance, freezing, legal, and 10 years of storage— are completely free of charge. What’s beautiful about egg sharing is that both the donor / egg sharer and the recipient benefit from the process. The donor gains access to free egg freezing, while the recipient receives donor eggs that increase their chances of conception. 

In a financial based model of egg donation, a woman donates her eggs in exchange for a direct financial payment. This compensation is for her time, effort, and the physical and emotional demands of the donation process. Donors receive a pre-agreed sum of money as compensation for the donation. This payment is not for the eggs themselves but for the donor’s participation in the process, covering time, discomfort, and any associated risks. 

With cash compensation, ethical issues can arise regarding the commodification of human eggs, the motivations of donors (financial need versus altruism), and the potential for exploitation, especially in economically disadvantaged populations. Plus, a 2021 Harvard study found that 62% of donor-conceived adults felt the exchange of money for donor gametes was wrong, and 41% were troubled by the fact that money was exchanged around their conception. 

The bottom line

Egg donation is a complex process, and it is important for potential donors to receive comprehensive information before giving their consent. This includes information regarding medical, psychological, genetic, legal, and egg sharing vs financial implications, before voluntarily agreeing to participate. They have the right to ask questions and receive clear, unbiased answers to ensure that they are making fully informed decisions at every stage of the donation process. This right is crucial for safeguarding their health, legal rights, emotional well-being, and autonomy. It also upholds ethical standards by ensuring transparency, trust, and the protection of donors from exploitation or coercion.

If you're considering egg freezing or donation and are just curious about its long-term effects, you may have heard a rumor: "Does egg donation cause early menopause?" It's a valid question, and in this article I will break it down for you with the latest scientific information and my professional insights as a board-certified OB/GYN.

I have guided countless patients considering egg freezing and donation processes, and I understand the importance of addressing these concerns head-on. After all, your reproductive health is a big deal, and you deserve clear, accurate information to help you make informed decisions.

In this article, I’ll explain the science behind egg freezing and donation, explore common misconceptions, and look at what the research really says about its impact on your future fertility. I'll also share some insights on what actually influences the timing of menopause and offer tips on how to take care of your reproductive health. Alright, let’s go!

The short answer

Let's start with the good news: No, neither egg freezing nor egg donation causes early menopause, also known as premature ovarian insufficiency (POI). But I know you're looking for more than just a simple "no." You want to understand why, how we know this, and what these processes actually do to your body. So let’s go even deeper.

Understanding your ovaries and egg supply (aka ovarian reserve)

Before we get into the specifics of egg freezing and donation, let's refresh our understanding of how ovaries work. You were born with all the eggs you'll ever have – about 1-2 million of them! By the time you hit puberty, that number has already decreased to about 300,000-500,000. Throughout your reproductive years, you'll typically release one egg per month during ovulation.

Your body is constantly losing eggs, whether you're trying to get pregnant, on birth control, or not thinking about fertility at all. It's a natural process called atresia. Each month, several eggs begin to mature, but usually only one reaches full maturity and is released during ovulation. The rest are reabsorbed by the body.

What happens during egg freezing and donation?

When you freeze your eggs or donate them, you're given hormones to stimulate your ovaries to mature multiple eggs in a single cycle – typically anywhere from 10 to 20 eggs. These are eggs that would have otherwise been lost to the natural process of atresia. We're not dipping into some secret egg reserve or using up eggs that your body was "saving" for later.

The main difference between egg freezing and donation is what happens to the eggs after they're retrieved. With egg freezing, they're stored for your future use. With donation, they're provided to someone else who needs them to build their family. And with an egg sharing program like we offer at Cofertility, you keep and store half of your eggs retrieved for up to 10 years for free when you donate the other half to a family who can’t conceive otherwise.

Why the misconception exists

So, if the science is clear, why does this myth persist? There are a few reasons:

• Misunderstanding of ovarian stimulation: The process of stimulating multiple eggs to mature at once can sound unnatural, leading some to worry it's "using up" eggs too quickly.
• Confusion with natural fertility decline: As we age, our fertility naturally declines. Both the quantity and quality of our eggs decreases. Some people might attribute this normal process to their past egg freezing or donation.
• Individual variations: Someone who froze or donated eggs might experience fertility issues later, but this isn't necessarily caused by the procedure. Remember, 1 in 6 people are affected by infertility, whether they froze their eggs or not.
• Lack of long-term studies: While we have good medium-term data, very long-term studies (30+ years) are still ongoing. This can lead to uncertainty for some people.

What egg freezing and donation actually do to your body

Okay, so if these procedures don't cause early menopause, what do they actually do to your body? Let's break it down. During the stimulation cycle, you'll experience short-term hormonal changes, with higher levels of some hormones circulating in your system. This can lead to symptoms like bloating, mood swings, and breast tenderness – similar to what you might experience during your menstrual cycle, just more pronounced. These effects are temporary and typically subside after the egg retrieval process.

I break down all of the side effects and risks of egg freezing here. 

The medications used in egg freezing and donation will temporarily override your natural menstrual cycle. This is a necessary part of the process to stimulate multiple eggs to develop. After the egg retrieval, it usually takes about 1-2 months for your cycle to return to its normal rhythm. During this time, you might experience some irregularity in your periods, but this is generally nothing to be concerned about.

There is a minor risk of complications, primarily ovarian hyperstimulation syndrome (OHSS), where the ovaries become swollen and painful. However, serious cases of OHSS are rare, especially with modern protocols and careful monitoring throughout the process. Your medical team will be vigilant in watching for any signs of OHSS and can adjust your treatment if necessary.

Perhaps most importantly, current evidence shows no significant long-term impact on your fertility or the timing of menopause from egg freezing or donation procedures. Your body continues its natural reproductive processes after these procedures, and your remaining eggs are unaffected. This means that your future fertility and the onset of menopause should follow their natural course, just as they would have without the egg freezing or donation process.

Factors that actually influence menopause timing

Now that we've cleared up the egg freezing and donation myth, let's talk about what really can influence when you'll hit menopause:

1. Genetics: The age your mother went through menopause is a good indicator of when you might do so.
2. Your period: The age when you had your first period can influence the timing of menopause, especially if you got your first period before age 11. So can an irregular menstrual cycle.
3. Number of pregnancies: Compared to those who had never been pregnant or who had been pregnant for less than six months, women who had one full-term pregnancy had an 8% lower risk of early menopause. Those who had two pregnancies had a 16% lower risk, and those who had three pregnancies had a 22% lower risk.
4. Lifestyle factors: The use of tobacco and alcohol, as well as your level of physical activity, can influence when menopause occurs.
5. Medical history: Procedures that remove your ovaries or uterus can affect menopause timing. So too can autoimmune diseases.
6. Diet: Your diet, particularly the consumption of polyunsaturated fats, may have an effect.

Notice that egg freezing and donation aren't on this list!

Taking care of your fertility

Whether you're considering egg freezing, donation, or neither, there are several important steps you can take to support your reproductive health. First and foremost, regular check-ups are key. Keeping up with your gynecological exams allows you to stay on top of your reproductive health and provides opportunities to discuss any concerns with your doctor. These regular visits can help catch potential issues early and ensure you're taking the best possible care of your reproductive system.

Adopting a healthy lifestyle is another key aspect of maintaining your fertility. This includes eating a balanced diet rich in nutrients that support reproductive health, exercising regularly to maintain a healthy weight and promote overall well-being, and avoiding harmful habits like smoking. These lifestyle choices not only benefit your reproductive health but also contribute to your overall health and longevity.

If you're concerned about your future fertility, considering options like egg freezing can be a proactive step. At Cofertility, we understand the importance of having options when it comes to your reproductive future. 

• Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.
• Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.

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

Final thoughts

So, there you have it – the long and short of egg freezing, egg donation, and menopause. The bottom line is that current scientific evidence does not support the idea that these procedures cause early menopause. Your body is incredibly resilient, and these processes work within your natural reproductive system, not against it.

That being said, egg freezing and donation are still significant medical procedures. It's important to work with reputable clinics (like our partner clinics!) that prioritize your health and provide comprehensive information.

Understanding your body and your options is key to making informed decisions about your reproductive health. Whether you're considering egg freezing, thinking about donation, or just curious about how it all works, I hope this information has been helpful.

If you have more questions about egg freezing, donation, or reproductive health in general, don't hesitate to reach out. At Cofertility, we're here to support you every step of the way on your fertility journey.

Read more:

• What are the Side Effects and Risks of Egg Freezing?
• Does Donating Eggs Affect Your Fertility?
• What’s the Best Age to Freeze My Eggs?

As you embark on your egg freezing journey, you're likely to encounter a whirlwind of medical terms, tests, and metrics that can feel overwhelming at first. Among these is an especially important one: the Antral Follicle Count (AFC). This key indicator plays a significant role in understanding your chances of success with egg freezing by measuring the number of follicles in your ovaries.

But what exactly is AFC, and why does it matter so much? More importantly, is it a fixed number, or can it change over time? These are questions that many folks grapple with as they navigate egg freezing.

In this article, we'll dive into the world of AFC, demystifying this important metric and exploring its variability. We'll break down the science in a way that's accessible and relevant to your egg freezing journey, helping you understand what your AFC means for your fertility and how it might influence your treatment plan.

Whether you're just starting to consider egg freezing or you're already in the midst of the process, understanding AFC can empower you to make informed decisions about your reproductive future. It's not just about numbers on a chart; it's about gaining insight into your body's unique fertility landscape and working with your healthcare team to optimize your chances of success.

By the end of this article, you'll have a clearer understanding of what AFC is, how it's measured, why it matters, and yes - whether it can change. Armed with this knowledge, you'll be better equipped to navigate your egg freezing journey with confidence and clarity.

What is AFC and how is it measured?

Antral Follicle Count is a key indicator of your ovarian reserve - essentially, it's a snapshot of your egg supply. Whereas AMH measures your ovarian reserve through a hormone blood test, AFC is an actual look at your antral follicles, which are small fluid-filled sacs containing immature eggs. But what is an ovary follicle exactly? An ovary follicle is a structure within the ovary that contains a developing egg. To assess AFC, a fertility doctor performs a transvaginal ultrasound, typically early in your menstrual cycle, to count these follicles in your ovaries.

The number of visible follicles, your AFC, is a helpful predictor of how your ovaries might respond to fertility medications during the egg freezing process. A higher count generally suggests a better ovarian reserve and potentially more eggs that can be retrieved.

Fertility doctors use this information to tailor your treatment plan, determining which medications to use and in what doses. It's like creating a personalized roadmap for your egg freezing journey.

Does AFC change within a cycle?

While it's often recommended to perform the AFC early in your menstrual cycle, experts suggest that it can be assessed at various points. However, it's important to remember that there can be some fluctuation depending on when the ultrasound is done. In fact, studies have shown that AFC can vary by as much as 30-34% within a single cycle. This variability is worth keeping in mind as you interpret your results.

Can AFC change month to month?

Does antral follicle count change? Yes, your AFC isn't set in stone. Indeed, it can vary from one menstrual cycle to the next. This variability is one reason why fertility specialists often consider AFC alongside other markers, like Anti-Müllerian Hormone (AMH) levels, to get a more comprehensive picture of your ovarian reserve.

Remember, AFC correlates with the number of eggs retrieved during an IVF cycle, which is why it's such a valuable predictor for egg freezing outcomes.

A very low AFC (typically less than 5-7) is associated with a smaller number of eggs retrieved and potentially reduced pregnancy rates down the line. On the flip side, a high AFC (20 or more) could indicate a risk of ovarian hyperstimulation syndrome (OHSS) during fertility treatments.

Can I increase my AFC?

While AFC generally declines with age, there are factors that can influence it. For instance, if you're using hormonal contraceptives or certain other medications, your AFC might appear lower than it actually is. Once you stop these medications, you might see an increase in your AFC.

To increase your chances of a successful egg freezing cycle, optimize your fertility health as soon as possible. This step will look a little different from person to person since everyone has their own unique medical history and concerns. Generally speaking though, optimizing your health will include following a balanced diet and making other healthy lifestyle choices. In some cases, you may want to consider adding certain vitamins and supplements to your regimen too. Make sure to talk to your fertility specialist if you’re not sure!

You may also want to consider doing multiple egg retrieval cycles. If you have the resources and time to do multiple cycles, this can vastly improve the pool of eggs to choose from in the future. This is an especially helpful option for people who are older or have a low AFC. If your fertility provider thinks more cycles will improve your chances, they’ll discuss those recommendations with you.

What is a normal AFC by age?

The normal range of antral follicle count can vary depending on your age. In general, those who are younger tend to have a higher number of antral follicles, indicating a larger ovarian reserve. As a person ages, the number of antral follicles naturally declines, reflecting the diminishing ovarian reserve.

While the specific numbers can vary, a typical AFC for someone in their 20s and early 30s may range between 10-20 follicles, in their late 30s around 8-15 follicles, and by their 40s, it could further decline to under 10 follicles. It's important to remember that these numbers are approximate and can vary based on individual factors such as genetics and overall reproductive health.

One study of infertile women looked at exactly how antral follicle count declines with age, finding the median AFC to be:

• 14 at age 25
• 12 at age 30
• 10 at age 35
• 8 at age 40
• 6 at age 45

What does this mean for you?

Understanding the variability of AFC can help you approach your egg freezing journey with realistic expectations. If your first AFC measurement isn't what you hoped for, remember that it can change. Your fertility doctor might recommend retesting in a subsequent cycle or adjusting your treatment plan based on your individual AFC trends.

Remember, AFC is just one piece of the puzzle. Your age, overall health, and other fertility markers all play crucial roles in determining your egg freezing outcomes. The goal is to create a personalized plan that gives you the best chance of success.

As you navigate this process, don't hesitate to ask your fertility doctor questions. Understanding your body and your options is empowering, and it can help you make informed decisions about your fertility preservation journey.

Have you ever considered donating your eggs? It's a decision that can profoundly impact not only your life but also the lives of another family that could not otherwise conceive. However, it's not a choice to be made lightly. As you consider this possibility, you may find yourself grappling with myriad questions and emotions. Is egg donation right for you? How will it affect your life, both now and in the future? What are the physical and emotional implications?

In this article, we'll explore the key factors to consider when deciding if egg donation is the right choice for you. From understanding the medical process to examining your motivations and considering the long-term impacts, we'll provide you with a comprehensive guide to help you navigate this complex decision. Whether you're seriously considering donation or just starting to explore the idea, this information will help you make an informed choice that aligns with your values and life goals. Let's dive in and discover if egg donation might be your path to making a difference in someone else's life.

Understanding the egg donation process

To decide if egg donation is right for you, you should first understand what it entails. Egg donation is a process in which a woman donates her eggs to another person or couple (known as the recipients, or intended parents) with the aim of helping them conceive a child. During the initial egg donor process, the potential donor undergoes rigorous medical, psychological, and genetic screening to ensure they qualify according to industry guidelines. 

Once deemed fit, the egg donor is matched with intended parents. After legal documents are completed, they begin the egg retrieval process, which includes hormonal treatments to stimulate your ovaries to produce multiple eggs in one cycle. Typically, after about a week of hormone treatments, the eggs are retrieved through a 30-minute outpatient surgery.

The retrieved eggs are fertilized with sperm (either from the intended father or sperm donor) to create embryos. The resulting embryos are then transferred to the recipient’s uterus (intended mother or gestational carrier), or they may be frozen for future use.

The growing acceptance of egg donation

Data from fertility clinics and SART registries indicate a steady increase in the number of egg donation cycles performed over the last decade. As women are becoming more educated about their biology paired with growing support for diverse families, and advances in technology, egg donation is gaining greater acceptance as a viable option to have a child. Changes in legal and ethical guidelines have also helped regulate egg donation, making it safer and more transparent for all parties involved.

Even though the need for egg donation is increasing and social and regulatory factors are changing the landscape, potential donors need to be fully educated about the medical procedures and potential side effects including psychological implications.  Donating eggs can have emotional consequences, such as feelings of attachment or concerns about the future children born from the donation. Access to psychological counseling can help donors process their emotions and make informed choices. Informed decision-making empowers potential egg donors to make choices that are right for them, ensuring they are fully aware of and comfortable with the implications of their decision.

Making an informed choice

A fertility psychologist can play a crucial role in helping the donor with the decision-making process by helping ensure that potential donor makes well-informed, emotionally sound decisions. 

The psychological evaluation is the first step in ensuring that the egg donor is psychologically stable and capable of handling the emotional aspects of egg donation. At the same time, the evaluation can help identify any pre-existing mental health conditions that could be exacerbated by the donation process. The psychologist can also provide follow-up counseling to help the donor process their experience and any feelings that may surface afterward.

Considering your motivations

Women consider egg donation for various reasons. You may be influenced by altruistic motives, such as wanting to help someone struggling with infertility. The compensation – either financial or the opportunity to freeze your eggs for free - might be appealing. For some, the personal fulfillment of knowing they've made a meaningful contribution to someone else's life offers a sense of purpose.

Also, certain personality traits may play a role in donating. One study found agreeable, extraverted, and open/intellectual participants reported more civic engagement, especially volunteerism and charitable giving.

Reflecting on your motivations is essential to ensure you're making a well-informed, emotionally sound decision that aligns with your personal values and beliefs. This reflection can help you set realistic expectations about the outcomes and the process, reducing the risk of disappointment.

Evaluating emotional readiness

It's normal to have mixed feelings about egg donation. Some women are certain from the outset that they want to donate, while others may be intrigued by the idea but have concerns. If you're on the fence, it's important to spend time researching and gathering information to understand how donation could impact your life.

It’s important to recognize that having mixed feelings or being uncertain about egg donation is a common experience. Many women go through a period of contemplation before making their final decision. There is no right or wrong way to feel - each woman’s journey is unique, and it is okay to take the time needed to make an informed decision. And that is the key… ensuring informed decision making. 

Consider the potential for feelings of grief, loss, or attachment to offspring, even if you intellectually understand your role as a donor, not a parent. Remember, there's a significant difference between being a donor and being a parent. As a donor, you provide genetic material but don't play a role in the child's upbringing.

How will I feel after donating my eggs?

There is always the potential for feelings of grief, loss, or regret after donating one’s eggs. Some egg donors have concerns about the genetic connection to offspring and worry about developing emotional attachments to the children born, even if they are not involved in their upbringing. Some have concerns about whether the offspring might seek them out – especially if they aim to be anonymous. There can be grief for the loss of relationship with the child conceived from their eggs, even if the donor intellectually understands the nature of the donation. Donors might regret their decision if they feel they were not fully informed about the process or its implications, or if they felt pressured into donating. 

However, research shows that egg donors are generally happy with their decision and usually do not regret it – especially if they have had comprehensive counseling, informed decision-making, and strong support systems in place.

A very important point to remember is that there is a big difference between being a donor and being a parent. As a donor, a woman provides the genetic material (egg) that contributes to the creation of a child. However, she does not play a role in the child's upbringing. Parents are the ones who are responsible for the social, emotional, and physical upbringing of the child. This includes providing care, nurturing, education, and support throughout the child's life.

Assessing the impact on future relationships

Egg donation can have a significant impact on future relationships and family dynamics. Understanding and addressing these potential impacts is crucial. It’s important to discuss egg donation with future partners, as it’s a significant part of one’s personal history and can impact the relationship. Partners may have varying reactions, from supportive to concerned. Discussing potential implications and addressing any worries can help manage these reactions.

Seeking professional guidance

Speaking with a fertility psychologist can be extremely beneficial. They can help you:

• Process your emotions and expectations regarding the donation process
• Practice conversations with family members
• Address potential questions and reactions
• Teach communication techniques to ensure discussions are clear yet sensitive to family dynamics

Counseling offers a safe environment and allows donors to express their fears, anxieties, and expectations regarding the donation process. A psychologist can also help donors feel confident and clear about the decision.

If you work with Cofertility, we cover the cost of speaking with a fertility psychologist, like myself. 

Egg sharing

For many women considering egg donation, egg sharing programs like the one offered by Cofertility present an attractive alternative to traditional donation. In this model, you freeze half of your retrieved eggs for your own future use while donating the other half to intended parents. 

This approach can feel like a win-win situation for many potential donors. It allows you to contribute to someone else's family-building journey while also preserving your own fertility options. Many women find this option aligns better with their personal goals and values, as it combines altruism with potential personal benefit. If you're unsure about traditional egg donation, exploring an egg sharing program might help you find a path that feels right for you.

Making an informed decision

Deciding to donate your eggs is a complex decision that requires careful consideration of personal motivations, medical and psychological impacts, and potential effects on future relationships. Thoroughly researching and reflecting on these key points, along with seeking support and counseling, can help ensure that your decision is well-informed and aligns with your values and long-term well-being.

Remember, there's no right or wrong way to feel about egg donation. Each woman's journey is unique, and it's okay to take the time you need to make an informed decision. By carefully considering these factors, you'll be better equipped to determine if egg donation is right for you.

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

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

How much does egg freezing cost?

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

A relationship litmus test

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

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

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

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

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

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

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

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

Key conversations to have with your partner

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

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

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

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

A new approach to funding egg freezing

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

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

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

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

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

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

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

Why people choose to freeze their eggs

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

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

At what age should you freeze your eggs?

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

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

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

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

Is it worth freezing eggs after age 35?

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

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

Egg freezing success rates by age

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

A study of 1,241 women found that the average number of eggs retrieved on the first egg freezing round was:

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

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

Now, you might be thinking: isn’t 14 eggs a lot?  It’s true that eggs retrieved from women under the age of 36 will have a 95 percent survival rate after being thawed.  But, not all thawed eggs will become viable embryos and lead to a live birth. The probability of a live birth varies with the age of the woman trying to conceive and the number of mature eggs available. In short, the older the woman, the more eggs required to achieve a high probability of a live birth. 

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

The right number of eggs to freeze for your age

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

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

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

Should I do multiple egg retrievals?

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

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

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

The right number of eggs to freeze to have multiple children

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

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

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

Can frozen eggs guarantee a successful pregnancy in the future?

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

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

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

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

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

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

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

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

The egg freezing process: step-by-step

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

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

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

Will egg freezing hurt my future fertility?

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

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

Is egg freezing safe?

Like any other procedure, there are risks and side effects when freezing eggs, including risks of anesthesia, bleeding, pain, and infection. Thankfully, the majority of people who go through with it deal with side effects for a few days at most. When it comes to the ovaries themselves, they generally recover quickly. The overall data indicate that the potential risks of surgical complications from egg retrieval are generally very small. However, in people with a history of endometriosis, pelvic inflammatory disease, pelvic adhesions or previous pelvic surgery, the risks are slightly increased so make sure to speak to your doctor about your medical history if you fall into any of these categories.

Egg freezing vs embryo freezing 

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

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

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

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

Read more in Should I Freeze Eggs or Embryos?

Cost of egg freezing

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

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

Or, if you want to freeze and store your eggs for your own future use without donating, Freeze by Co offers lower prices on things like consultations and storage, along with access to our community of freezers. ‍We partner with lenders, like Sunfish, to offer you fertility financial resources.

Learn more about egg sharing

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

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

Ask us anything

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

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

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

Follicle-stimulating hormone, or FSH, is a hormone that plays an important role in your reproductive health. As a woman, understanding your FSH levels can provide insights into your fertility potential and help you make informed decisions about family planning, including egg freezing. But what exactly is FSH, and what do your levels mean? Let's dive in and explore this essential hormone.

What is FSH and why should you care?

FSH, short for follicle-stimulating hormone, is a hormone produced by your pituitary gland, a small but mighty gland nestled in your brain. Its job is to stimulate your ovaries to grow follicles, the tiny sacs that house your eggs. As these follicles mature, they release estrogen, which triggers ovulation – the release of an egg that's ready for fertilization.

Your FSH levels aren't static; they naturally fluctuate throughout your menstrual cycle, peaking right before ovulation. However, consistently high FSH levels, especially at the beginning of your cycle, can be a red flag for diminished ovarian reserve.  This means your ovarian reserve may be decreasing, either in quantity or quality. While it doesn't mean you can't get pregnant, it does signal that your fertility might be declining.

Average FSH levels by age

FSH levels naturally creep up as you age. And results also depend on where you are in your menstrual cycle. For females, here are normal FSH test results by life stage:

• Before puberty: 0 to 4.0 mIU/mL (0 to 4.0 IU/L)
• During puberty: 0.3 to 10.0 mIU/mL (0.3 to 10.0 IU/L)
• Females who are still menstruating: 4.7 to 21.5 mIU/mL (4.5 to 21.5 IU/L)
• After menopause: 25.8 to 134.8 mIU/mL (25.8 to 134.8 IU/L)

What is a good FSH level for egg freezing?

Most clinics consider an FSH under 9 as a good number for egg freezing. Above that threshold, the response to egg freezing medication tends to decline.  

Here's a general idea of what's considered normal FSH for females on cycle day 3:

• <9: Normal FSH level, expect a good response to egg freezing medication
• 9-11: Fair FSH level, the response to medication is reduced 
• 11-20: Reduced ovarian reserve and lower changes of live birth rate
• 20+: Very poor chances of response to stimulation, egg donation is generally recommended

Remember, these are just guidelines, and results vary by lab. Your doctor will interpret your FSH levels in the context of your age, medical history, antral follicle count, and other hormone levels to assess your overall fertility picture.

What abnormal FSH results may mean

Abnormal FSH results can be a sign of various underlying conditions related to fertility and reproductive health. 

High FSH Levels (typically 10 mIU/mL+ in premenopausal people) can suggest:

• Diminished Ovarian Reserve (DOR): This means the number of eggs in your ovaries are declining. 
• Primary Ovarian Insufficiency (POI): Also known as Premature Ovarian Failure (POF), this condition occurs when the ovaries stop working normally before age 40.
• Menopause: Naturally occurring decline in ovarian function leading to the end of menstruation.
• Polycystic Ovary Syndrome (PCOS): FSH levels are often higher in people with PCOS, a metabolic and hormonal disorder caused by high androgen (male sex hormone) levels. It can also cause enlarged ovaries due to an increased number of follicles on the outer edges. 
• Turner Syndrome: A genetic condition that can impact ovarian function, leading to a higher FSH.

If you get an abnormal result, your doctor will talk to you about what it could mean and if they suggest any next steps.

Testing your FSH

Getting your FSH levels checked is simple – it's just a routine blood test, typically done on the third day of your cycle. Your doctor may order additional tests, such as an antral follicle count (AFC) ultrasound or an anti-Mullerian hormone (AMH) test, to get a more comprehensive picture of your ovarian reserve.

Or, if you want to take a test at-home, there are a few convenient options:

• Natalist Women’s Fertility Test ($149) measures 5 hormones: estradiol, LH, FSH, TSH, and total testosterone. Get 20% off with code Cofertility20.  
• Modern Fertility Hormone Test ($179) measures 7 hormones: AMH, TSH, FSH, estradiol, prolactin, fT4, and LH

What you need to know about FSH tests: the fine print

While FSH tests are a valuable tool for understanding your fertility, there are a few important caveats to keep in mind:

• FSH levels fluctuate: Don't panic over a single high result. FSH levels naturally change throughout your menstrual cycle and as you get older. 
• FSH is not a diagnostic tool: An FSH test alone can't diagnose a specific condition like menopause or polycystic ovary syndrome (PCOS). It's just one piece of the puzzle, and your doctor will consider other factors to make a diagnosis.
• FSH is just one indicator of fertility: While an abnormal result (high baseline FSH) tends to be very predictive of low egg quantity, a normal result does not necessarily mean that the egg quantity is good. Some people with normal levels can still experience age-related fertility decline or have low quality eggs.
• Invalid in some cases: If you're taking hormone therapies like birth control pills, FSH tests might not be accurate. Be sure to let your doctor know about any medications you're taking before the test.

The bottom line? FSH tests provide valuable information, but they're not the be-all and end-all of fertility assessment. Talk to your doctor about your results and what they mean for your individual situation.

The bottom line: knowledge is power

While FSH tests are a valuable tool for assessing ovarian reserve and determining if egg freezing could be a fit, it's important to remember that they're just one piece of the puzzle. A single FSH result doesn't define your fertility journey, and your doctor will consider various factors, including your age, medical history, AFC, and other hormone levels, to develop a comprehensive picture of your reproductive health.

If you're considering egg freezing or have concerns about your fertility, don't hesitate to consult with a fertility specialist. They can help you interpret your FSH results, discuss your options, and guide you towards the best path for achieving your family-building goals. Understanding your FSH levels is a crucial step towards taking control of your fertility and shaping your future.

Egg freezing, also known as oocyte cryopreservation, has grown in popularity, with a 30% increase in egg-freezing cycles from 2021 to 2022 alone! While egg freezing is generally considered safe and effective, I still get a lot of great questions about it as an OBGYN.

Let's address some of the most common concerns I hear:

Does egg freezing affect future fertility?

Egg freezing does not guarantee future fertility, but it does offer a way to preserve your eggs at their current age and quality. This can be particularly beneficial for those who:

• Want to delay childbearing due to personal or career reasons.
• Are facing medical treatments that may affect fertility.
• Have a family history of early menopause.

But will egg freezing itself negatively impact your future fertility? The short answer is no, egg freezing won’t lower your egg reserve and it won’t affect your chances of getting pregnant naturally when you’re ready to do so.

Read more in Does Donating or Freezing Your Eggs Affect Your Future Fertility?

Does egg freezing increase the risk of cancer?

Current research suggests that egg freezing does not significantly increase the risk of most cancers. Overall, studies have shown that fertility treatments do not increase the risks of invasive ovarian cancer, malignant melanoma, or cancers of the endometrium, cervix, breast, thyroid, or colon.

There is limited evidence suggesting a potential, but small, increase in the risk of borderline ovarian cancer (a type of ovarian cancer with low malignant potential) associated with fertility treatments. However, this risk is minimal in absolute terms.

While the hormones used during the ovarian stimulation phase of egg freezing are similar to those used in IVF, the duration of exposure is typically shorter, further reducing any potential concerns. All that being said, more research is needed. It's important to discuss your individual risk factors and concerns with your doctor.

Are there medical risks associated with egg freezing?

Like any medical procedure, egg freezing carries some risks, primarily related to the ovarian stimulation and egg retrieval processes. 

In a single egg freezing cycle, the risk of a serious adverse event is under 2.5%. Severe ovarian hyperstimulation syndrome (OHSS) accounts for the majority of complications, occurring in 0.1-2% of cycles. The risk of other acute complications, including pelvic infection, intraperitoneal hemorrhage, or ovarian torsion, is small (<0.5%). The risks overall are generally low and can be minimized through careful monitoring and appropriate medical management.

Are there long-term side effects from egg freezing?

Some people do experience minor side effects from the medications and egg retrieval, but they are generally for a short period of time. These side effects can include:

• Mild bruising and soreness at the injection site
• Nausea and, occasionally, vomiting
• Temporary allergic reactions, such as skin reddening and/or itching at the injection site
• Breast tenderness and increased vaginal discharge
• Mood swings and fatigue
• Ovarian hyperstimulation syndrome (OHSS)

Read more in What are the Side Effects and Risks of Egg Freezing?

Are children born from frozen eggs healthy?

Yes, experts believe that babies conceived through IVF, including those born from frozen eggs, are generally just as healthy as babies conceived naturally. However, most studies have focused on IVF outcomes as a whole, rather than specifically isolating the effects of egg freezing.

One recent study, however, specifically examined the health and development of babies born after egg freezing. The findings were reassuring: there was no increased risk of low birth weight, preterm birth, or babies being too small (or too large) for their gestational age.

Additionally, the study found that children born from frozen eggs met developmental milestones at roughly the same rate as other children, with a 90% achievement rate overall. This percentage even increased as the children grew older, with 100% of six-year-olds meeting all developmental milestones.

While more research is always helpful, this study provides encouraging evidence that egg freezing is safe not just for the mother, but for the future children as well. 

Summing it up

Egg freezing is a rapidly evolving technology that offers people greater control over their reproductive choices. While it's not a guaranteed path to parenthood, it provides a valuable opportunity to preserve fertility for the future. With its growing popularity and increasing success rates, egg freezing is becoming a more mainstream option for people who want to prioritize their careers, relationships, or simply maintain their options.

While concerns about safety are natural, current research indicates that egg freezing is generally safe and does not significantly increase the risk of cancer or negatively impact the health of future children. As with any medical procedure, there are potential risks and side effects, but these can be minimized through careful monitoring and management by a qualified fertility specialist.

If you're considering egg freezing, don't hesitate to reach out to us. We can help answer your specific questions, address any concerns, and help you make an informed decision about whether egg freezing is right for you. Remember, knowledge is power – by understanding the facts and weighing your options, you can take proactive steps to protect your fertility and shape your future on your terms.

Freeze your eggs– for free– with Cofertility

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

• Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.
• Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.

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

I’ll be honest — prior to my first egg retrieval, I was a little bit nervous about the recovery process. Although everyone says it’s pretty manageable, you never know, especially when anesthesia is involved. At the time (this was in 2019), there weren’t a ton of online resources out there to help prepare myself, so I just trusted my fertility clinic and asked around. As a result, my expectations were only somewhat managed. I just didn’t know what I didn’t know. The good news is, it went smoothly and I now have a beautiful son from this cycle.

After reading this article, your experience, hopefully, will be different. Consider this your guide to egg retrieval recovery: what to expect, how to prepare, and tips and tricks to make sure your recovery process is as smooth and quick as possible. 

Preparing for an egg retrieval

You’ve already navigated your insurance to afford it (or perhaps you froze your eggs for free with Cofertility); you’ve already started injecting yourself with hormones daily…in hindsight, to me, those were actually the hardest parts, compared to the egg retrieval itself. But when you’re in the thick of it, the thought of an egg retrieval itself can feel kind of scary. Especially if it will be the first time you are under sedation.

Not only might you have concerns about sedation, pain, or recovery, but you also might have some nerves about the finality of it all: how many eggs they’ll retrieve, how many of those will be mature, how many of those might eventually fertilize down the line should you need them…it’s easy to let your mind wander. I get it. I’ve been there, too. 

Turns out, my personal retrieval experiences (yes — I did it more than once) actually felt like the best naps I’ve ever had. Honestly, the hardest part was not eating beforehand. If you can help it, see if you can get a time slot as early as possible in the day. The good news is, the retrieval itself is relatively quick (like, 15 minutes quick — though it’ll feel like you slept way longer). Once the sedation wears off, your clinic will likely provide you with some snacks and drinks to get your energy going again. If you’d like to learn more about what an egg retrieval is actually like, we’ve got a whole guide for you. 

What to buy for egg retrieval recovery

All of that being said, if you’re a big planner like I am, you might want to know what to buy in advance to make sure your egg retrieval recovery goes smoothly. Since I want you to be your most prepared self heading into your retrieval, there are a few things I’d recommend purchasing beforehand, even if recovery only takes about a day or two.

Egg retrieval recovery essential #1: heating pad

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When recovering from an egg retrieval, a good heating pad is a must. You might experience some cramping, and gentle heat will help make you feel more comfortable. We love the cute daisy pattern on this one and you can control the heat levels manually. 

Egg retrieval recovery essential #2: comfy clothes 

You probably already have your fair share of PJs, but why not give yourself an extra boost of post-retrieval joy with something new and super soft to lounge in while you get some rest? We love the lightweight jogger fit of these pants and they come in a ton of colors.  

Egg retrieval recovery essential #3: supplements and OTC medicines 

It’s a good idea to stock up on the following, just in case: 

• Fiber or stool softeners: to help you go, since you may experience some constipation or sensitivity in that area (we love this one from Natalist)
• Pain reliever (like Tylenol): for cramping
• Stool softeners: to help you go, since you might be sensitive in that area
• Anti-nausea meds (like antacids): since you might experience a bit of residual nausea afterwards

Egg retrieval recovery essential #4: water bottle

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You’ll need all the fluids you can get as you recover from your egg retrieval. We’re going to guess you already have an emotional support water bottle, but if not — now’s the time! We love this Owala version that comes in a bunch of colors. Bonus points if you fill it with something with lots of electrolytes, like coconut water. 

Egg retrieval recovery essential #5: pads

Because you may experience some residual bleeding after your retrieval (and since you can’t use tampons for at least a week), we recommend stocking up on some pads. This variety pack from August will keep you covered day and night.

Egg retrieval recovery essential #6: binge-worthy content 

Okay, so this isn’t something you necessarily need to purchase, but it’s worth downloading some mindless shows ahead of time so you won’t have to think about what to watch. 

What to expect after your egg retrieval

Now that you’ve done all your prep, you might be wondering what your recovery will actually be like. After your egg retrieval is done, you’ll wake up in your clinic’s recovery area as the nurses (and possibly an anesthesiologist) continue to monitor you. Your doctor or nurse will let you know how many eggs were retrieved, and if you’ve sufficiently woken up and are feeling mostly normal, they’ll give you permission to leave as long as you’re accompanied by someone. Note: you will not be allowed to drive yourself.

How long is egg retrieval recovery?

Some people feel completely themselves that day and technically could even go to work, but we do recommend at least a day of rest after an egg retrieval if possible. Some doctors may recommend refraining from heavy exercise for about a week (though walking or light movement is okay), and staying on pelvic rest for that same period — meaning, no tampons or sex. You may also be asked to avoid taking baths or swimming to avoid infection. 

Egg retrieval recovery side effects

In general, egg retrieval side effects might include: 

• Bloating
• Cramping
• Constipation
• Spotting

Some of the above recommended products, like heating pads and over the counter medicines can alleviate these symptoms. The most important element of egg retrieval recovery, however, is rest. And hydrate, hydrate, hydrate. 

When to call your doctor

After your egg retrieval, you should feel totally like yourself again within a few days. That said, there are a few red flags to watch out for. If you experience any of the following symptoms, report them to your doctor right away:

• Temperature greater than 101° F
• Persistent, severe nausea and/or vomiting
• Severe abdominal pain or swelling 
• Heavy vaginal bleeding (soaking through a pad every hour) 
• Painful or difficult urination
• Fainting or dizziness

You’ve got this

Just by reading this article, you’re already very prepared for your egg retrieval. Like I said, knowledge is power — and that’s what we’re here to give you. 

If you haven’t yet moved forward with the egg freezing process and you’re interested in learning more about how you can freeze your eggs for free with Cofertility, click here to take our quiz and get started. It just takes a minute. 

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

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

Who is a good candidate for egg freezing?

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

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

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

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

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

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

Who is not a good candidate for egg freezing?

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

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

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

Why would someone need to freeze their eggs?

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

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

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

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

At what age should you freeze your eggs?

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

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

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

Is it worth freezing your eggs after 35?

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

To freeze or not to freeze, that is the question

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

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

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

Freeze your eggs with Cofertility

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

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

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

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

Summing it up

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

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

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

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

What exactly is acupuncture, anyway?

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

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

What does acupuncture (supposedly) do?

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

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

Egg freezing and acupuncture: what the data says

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

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

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

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

Stress and fertility

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

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

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

Some more direct evidence

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

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

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

What to expect at your acupuncture appointment

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

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

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

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

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

The TLDR on acupuncture and egg freezing

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

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

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

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

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

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

The number of people choosing to freeze their eggs has been rising steadily for the past several years. At the same time, antidepressant use in the US has also been on the rise, especially during and after the peak of the COVID-19 pandemic. It goes without saying that given both these trends, many of the people who are freezing their eggs are also people who struggle with mental health conditions. If you’re on any medications for your mental health and you’re considering freezing or donating your eggs, you may be wondering if you’ll need to stop your antidepressant during the process. This is a common question and we’ll be answering it in today’s article so read on to find out. 

What is egg freezing?

Before we dive into the world of antidepressants, let’s briefly talk about what egg freezing even is. In a nutshell, egg freezing (aka oocyte cryopreservation) is a way to collect some of your eggs and preserve them for future use. The process takes about 10-14 days and involves taking hormone medication to stimulate your ovaries to grow mature eggs. The eggs are collected during a 30-minute outpatient procedure called an egg retrieval and then frozen until you’re ready to use them. 

Given how expensive egg freezing can get, you might be wondering why so many people are choosing to do it. There are many reasons but most of them go back to the same core issue: egg freezing is a way to keep your reproductive options open for later by preserving younger, healthier eggs for future use. 

Research has shown that many people are delaying starting their families for reasons that can be personal, professional, financial, psychological, or all of the above. In our own survey of Cofertility users, we asked over 28,000 gen Z and millennial women about their family planning and goals. The majority of responders (73%) said that building their career or going back to school is the most important thing to them right now. This was followed by traveling (53%), finding a life partner (43%) and cultivating new hobbies (32.1%). Additionally, egg freezing has received more and more media attention over the last several years which has certainly helped to increase public awareness of this intervention as a way to keep future fertility options as open as possible.

The low-down on antidepressants

Antidepressants are a group of drugs used to treat depression. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are the 2 classes (or types) of antidepressants that are most often prescribed but atypical antidepressants are another, newer class that are also used in certain cases. Each class of antidepressant has a different mechanism for how it changes neurochemical levels in the brain to improve the symptoms of depression and other mood disorders. When used correctly, they can improve mood, increase energy levels, and enhance overall functioning. Antidepressants as well as other drugs like benzodiazepines have also been found to be effective as anti-anxiety medications, though only two SSRIs are specifically FDA-approved for anxiety disorders.

Use of both antidepressants and anti-anxiety medications has been rising for over a decade in the US. According to the Centers for Disease Control and Prevention (CDC), 13.2% of adults aged 18 and over use antidepressant medications. Women, older adults, and non-Hispanic whites are the highest users.

Overall, during the decade between 2009 and 2018, antidepressant use increased to 14% from 11% and in all age groups, it was higher among women than it was in men. 

Based on these stats, it’s fair to ask why women are more depressed than men. The answer is complicated but women aren’t necessarily more depressed than men. While there is some evidence that fluctuating hormones and more sensitivity to internalized triggers (like relationship drama) may contribute to higher rates of depression in women, there’s also the simple fact that women are more likely to actually go see a doctor to take care of their symptoms. As a result, they are more likely to report depressive symptoms, be diagnosed, and be prescribed appropriate medication. 

Do antidepressants affect cycle outcomes?

Alright, let’s get into the reason you’re here: do antidepressants affect egg freezing or in vitro fertilization (IVF) cycle outcomes? The most commonly used antidepressant (SSRIs) and anti-anxiety medications (benzodiazepines) don’t have any clear, long-term impacts on egg quantity or quality, ovulation, or chances of conception (though SSRIs do have short-term effects on sperm). 

Studies of people using IVF to conceive suggest no effect of SSRI use on hormone levels, number of eggs retrieved, number of eggs that develop into blastocysts, number of embryos rated as “high quality,” or number of embryos transferred. So overall, antidepressants do not appear to affect cycle outcomes.

Let’s dive deeper into this. Since we know SSRIs and other antidepressants often work by changing levels of neurochemicals in the brain like serotonin, there is also the question of whether or not these medications influence reproductive hormones. Unfortunately, there are fewer studies to look at when assessing this (because most studies are done on men in order to avoid the hormonal fluctuations seen in women–lame, we know) but one study did look at almost 1,000 people with ovaries. The study found no differences in menstrual cycle characteristics as a function of SSRI use and no significant differences in pregnancy rates. Other larger studies have had similar findings and showed no differences in chances of conception between people using or not using SSRIs or benzodiazepines.

One thing to note though: there is some evidence that SSRIs increase prolactin levels and very high prolactin levels can mess with your period and prevent you from ovulating. That being said, there are other studies that have not shown this link between SSRI use and prolactin levels and even the studies that do, haven’t shown that prolactin levels are elevated to a high enough level to affect ovulation.

In the context of natural fertility, there is one sneaky, easy-to-miss way that these meds could impact chances of conception — by lowering your sex drive. Having sex less often during your fertile window could definitely lower chances of conception (the general rec is to have sex every 1-2 days in that window). However, how much an antidepressant affects sexual function will be different from person to person and will depend on the specific medication being used.

The CDC and the American Society for Reproductive Medicine (ASRM) consider antidepressant use to be safe during fertility treatments. Other organizations like the American Psychological Association (APA) and the American College of Obstetricians & Gynecologists (ACOG) also  recommend that people do not change their SSRI or benzodiazepine use once they’re pregnant unless instructed to by their provider.

Can you donate eggs if you’re on an SSRI?

This is a pretty common question for people considering donating their eggs. Current use of SSRIs or other antidepressants is considered a “relative exclusion criteria” by the ASRM. This means that it does not automatically disqualify someone from being an egg donor, however, it will be reviewed on a case by case basis by the fertility provider or clinic. Current use of antidepressants may be totally fine with one clinic, but not with another. Many providers feel that common antidepressants are overprescribed in the face of more situational challenges, like the pandemic or other big life changes. Some antidepressant use may also point to another medical condition that would disqualify someone.

Here’s a list of rejection criteria from the ASRM that would automatically make someone ineligible to donate:

• Having been institutionalized for a mental health disorder
• A positive family history of psychiatric disorders
• Two or more first-degree relatives with substance use disorders
• A history of emotional, sexual, or physical abuse without professional treatment
• Excessive stress
• Relationship instability 

If you’re interested in what the psych screening for an egg donor entails, you can find more information about it here.

We’re here to help

There’s a lot to consider when it comes to egg donation–and the psychological aspect of the screening is only one part of a larger process to ensure we’re doing right by you and by the receiving parents. The Cofertility team is here to guide you through every single step. By donating your eggs, you’re doing something remarkable for a family in need. We know that everyone’s situation is different, so our job is to make the process feel equally remarkable for you. Whether you continue or discontinue antidepressants during your own process is going to be a decision you make after weighing the risks and benefits and talking to your fertility provider. Whatever you end up choosing for yourself, our team is here to support you through it.