fertility clinics

If you're considering egg freezing, you've likely come across information about ovarian hyperstimulation syndrome (OHSS). While OHSS is a potential complication of the egg retrieval process, its occurrence has decreased significantly in recent years, thanks to improved protocols and preventive strategies.

This article will explore how fertility doctors work to minimize your risk of OHSS during egg freezing cycles, ensuring a safer and more comfortable experience.

What is OHSS?

Before diving into prevention strategies, let's first understand what OHSS is and why it occurs.

Ovarian hyperstimulation syndrome (OHSS) is an exaggerated response to the hormonal medications used to stimulate egg production. In OHSS, the ovaries become swollen and fluid can leak into the abdomen and sometimes the chest. This can cause a range of symptoms from mild bloating and discomfort to, in rare severe cases, more serious complications.

OHSS is typically classified into three categories:

1. Mild OHSS: Characterized by abdominal bloating and mild pain. This form is common and generally resolves on its own.
2. Moderate OHSS: Involves more noticeable abdominal pain, nausea, and sometimes vomiting. Ultrasound may show fluid in the abdominal cavity.
3. Severe OHSS: A rare but serious condition that can involve severe abdominal pain, rapid weight gain, severe nausea/vomiting, decreased urination, and shortness of breath. This form requires immediate medical attention.

Data suggest the incidence of mild OHSS is 20%–33%, moderate OHSS is 3%–6%, and severe OHSS occurs in 0.1%–2% of cycles. In rare cases, OHSS can be life-threatening, so it's important to be aware of the potential risks and to inform your doctor of any symptoms (severe abdominal pain, bloating, and nausea). 

Read more in What is OHSS and What Are My Risks?

Seven ways doctors try to minimize OHSS risk

Fertility doctors have several strategies to reduce your risk of OHSS if they believe you are at a high-risk. The body of evidence and research is constantly evolving, and new approaches are continually being studied and refined. What's considered the best practice today may be updated in the future as we learn more about ovarian stimulation and OHSS prevention.

While these strategies may reduce the risk of OHSS, they can't eliminate it entirely. Every patient responds differently to fertility treatments, and what works well for one person may not be as effective for another. This is why personalized care and close monitoring throughout your treatment cycle are so important.

Personalizing your treatment

Gone are the days of "one-size-fits-all" approaches to ovarian stimulation. Modern fertility clinics use personalized protocols based on each patient's individual characteristics. This process typically involves:

• Thorough pre-treatment assessment: Your doctor will consider your age, BMI, ovarian reserve tests (AMH and AFC), and any history of PCOS or previous OHSS.
• Tailored medication doses: Based on your risk profile, your doctor will choose an appropriate starting dose of gonadotropins (the hormones used to stimulate egg production). Women at higher risk of OHSS often start with lower doses.
• Dose adjustments: Throughout your stimulation, your doctor will monitor your response through blood tests and ultrasounds, adjusting medication doses as needed.

Picking the right protocol

During IVF, your fertility doctor will prescribe medications to stimulate your ovaries to produce multiple eggs. This process helps to control the egg development so they can retrieve a safe number of mature eggs at the best time. There are a few ways (stimulation protocols) to do this:

• "GnRH agonist protocol or "long protocol": This involves taking medications for several weeks to essentially rest your ovaries before stimulating them.
• GnRH antagonist protocol: This approach has a shorter duration of injections, and uses an “antagonist to prevent your body from releasing eggs too early.
• Flare protocol: Also known as the microdose flare or low dose Lupron protocol, uses a low dose of Lupron to trigger the pituitary gland to release follicle stimulating hormone (FSH).

Research has shown that the newer method (GnRH antagonist protocol) is safer and reduces the risk of ovarian hyperstimulation syndrome (OHSS).  A very large review and meta-analysis, including 73 RCTs with 12,212 participants, demonstrated a statistically significant reduction in all types of OHSS in cycles using GnRH antagonists, due to the Lupron trigger shot. 

Most clinics prefer the GnRH antagonist protocol because it's easier for patients and gives clinics more flexibility to adjust your treatment if needed. However, there may be cases where a doctor will choose the best protocol for you based on your individual situation. You can always ask your doctor which protocol they have chosen and why!

Lower starting doses plus oral medication

To reduce OHSS risk, your fertility doctor may start with lower doses of gonadotropins (the injectable hormones used to stimulate egg production), especially if you have risk factors for OHSS. This "low and slow" approach allows your body to respond more gradually, reducing the risk of over-stimulation.

Your doctor might also add oral fertility medications (pills) to your protocol, such as:

• Clomiphene citrate (Clomid): This medication helps stimulate egg production and can allow for lower doses of injectable hormones.
• Letrozole (Femara): Originally a breast cancer drug, letrozole is now commonly used in fertility treatments. It can help stimulate egg production while potentially reducing OHSS risk. It also lowers estradiol levels which can aid in reducing OHSS risk and lower side effects.

By combining lower doses of injectable hormones with these oral medications, doctors may be able to minimize the risk of overstimulation while still achieving good outcomes. This approach is especially beneficial for women with PCOS or other risk factors for OHSS.

Alternative trigger medications

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

Traditionally, the trigger shot has been human chorionic gonadotropin (hCG), which mimics the natural LH surge. However, hCG has a long half-life and can increase the risk of OHSS. To mitigate this risk, doctors now have alternative options:

• GnRH agonist trigger (eg. Leuprolide, Lupron): For cycles using a GnRH antagonist protocol, a GnRH agonist can be used to trigger ovulation. This causes a short, self-limited LH surge. Research has found this can dramatically reduce OHSS risk.
• Dual trigger: Some doctors use a combination of a low dose of hCG along with a GnRH agonist. This approach aims to balance OHSS risk reduction with optimal egg maturation.
• Low-dose hCG: If a GnRH agonist trigger isn't possible, some doctors might use a lower dose of hCG. However, research has not found a consistent or statistically significant differences in the rate of OHSS when comparing hCG-only triggers of 4,000 IU compared with 6,000 IU or 10,000 IU.

Medications called dopamine agonists, particularly cabergoline, have been shown to reduce the risk of OHSS when given around the time of the trigger shot. These medications work by reducing VEGF activity, which is thought to play a key role in OHSS development.‍

Metformin for PCOS patients

For women with PCOS who are at higher risk of OHSS, some doctors prescribe metformin during the stimulation phase. While the evidence is mixed, some studies suggest it may help reduce OHSS risk in this population.

Monitoring: The key to OHSS prevention

Perhaps the most important aspect of OHSS prevention is careful monitoring throughout the stimulation process. This typically involves:

• Frequent ultrasounds: To track the number and size of developing follicles.
• Blood tests: To monitor estradiol and other hormone levels.
• Symptom tracking: Your doctor will ask about any symptoms you're experiencing.

This close monitoring allows your fertility team to adjust your treatment plan quickly if you show signs of over-responding to the medications.

What about other strategies?

You may hear about other OHSS prevention methods, such as taking aspirin, certain supplements, eating a high-protein diet, or drinking lots of electrolyte solutions. While some of these may have anecdotal support, current scientific evidence doesn't strongly back their use for OHSS prevention. 

Always consult with your doctor before taking any additional medications or supplements during your egg freezing cycle.

What to expect after egg retrieval

Even with all these preventive measures, it's normal to experience some mild OHSS symptoms after egg retrieval, such as bloating, mild abdominal pain, and feeling full quickly when eating. These symptoms usually resolve within a week.

However, it's crucial to contact your doctor if you experience:

• Severe abdominal pain
• Significant abdominal swelling
• Nausea or vomiting
• Decreased urination
• Shortness of breath
• Rapid weight gain (more than 2-3 pounds per day)

These could be signs of more severe OHSS and require prompt medical attention.

The bottom line

While OHSS remains a concern in ovarian stimulation cycles, modern protocols, and preventive strategies have dramatically reduced its occurrence and severity. By working closely with your fertility doctor, asking questions, carefully following their instructions, and promptly reporting any concerning symptoms, you can minimize your risk and focus on a successful egg freezing cycle.

Remember, everybody responds differently to fertility medications. What works best for one person may not be ideal for another. That's why individualized care and open communication with your medical team are so important throughout the egg freezing process.

If you have any questions or concerns about OHSS or any other aspect of egg freezing, don't hesitate to discuss them with your doctor. They're there to support you and ensure the safest possible experience as you take this important step toward preserving your fertility options.

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

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

Breaking down the egg freezing process

Choosing a clinic

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

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

Consultation 

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

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

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

Evaluation and bloodwork

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

This testing may include:

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

Connecting with your community

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

Medications

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

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

Medications commonly prescribed in the egg freezing process include:

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

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

More blood tests and monitoring

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

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

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

Egg retrieval 

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

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

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

Cryopreservation

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

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

A second egg freezing process

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

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

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

Costs of the egg freezing process

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

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

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

Bottom Line

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

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

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

Reputation

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

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

Experience and outcomes

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

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

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

Accreditation and certification

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

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

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

Technology and facilities

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

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

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

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

The team

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

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

Cost 

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

Read more in How to Pay for Egg Freezing.

Cofertility can help

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

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

Even if you’re years off from wanting children, discussing your fertility with your primary care physician or OBGYN is a good idea. Being proactive and addressing your fertility concerns can help you make informed decisions and confidently navigate this phase of your life.

In this article, we’ll share some tools and knowledge necessary to empower yourself when discussing fertility-related matters with your doctor. By asking the right questions and advocating for yourself, you can ensure that your concerns are taken seriously and receive the support and guidance you deserve.

Educate yourself

Before your doctor's appointment, take the time to educate yourself about fertility and reproductive health. Familiarize yourself with the basics of female reproductive anatomy, menstrual cycles, and fertility potential. You can start by checking out our Learn section, which offers comprehensive information on fertility-related topics, including egg freezing, hormones, and more. 

Get some family history

You might also want to ask females in your family (your biological mother, older sisters, etc.) about their fertility experience. This will help you gain insight into any potential hereditary factors that could impact your own fertility. Their health history may be helpful for your provider to assess any genetic predispositions or conditions that may affect your fertility journey now or down the line.

Prepare ahead of time

Preparation is key to effective communication with your doctor. Make a list of questions or concerns you want to address during the appointment. This will help you stay focused and ensure that all important points are covered. Include specific questions about your fertility, potential testing or treatments, and the possibility of egg freezing. Think through your desired family-building timeline (if you have one) as this will play a role in determining the best next steps. 

Here are some questions you can consider asking:

• Given my family-building timeline, what steps should I take now to give me the best chance of success down the line?
• Are there any potential factors that could be affecting my fertility?
• Are there any tests or evaluations that can help determine my fertility potential?
• Based on my medical history, are there any specific concerns or conditions that may impact my fertility?
• What lifestyle changes can I make to optimize my fertility?
• Are there any specific dietary recommendations or supplements that can support fertility?
• Can you provide me with a referral to a fertility specialist or clinic if needed?
• Are there any long-term contraceptive options that provide reliable protection while allowing flexibility for future plans?
• Are there any factors in my medical history that might affect the choice of contraception or impact fertility in the future?
• Can you provide guidance on resources or support groups for people who are planning to delay parenthood for a few years?

Seek a fertility specialist

If you feel like your OBGYN doesn’t have the necessary expertise in fertility, or you have a gut feeling you may have a fertility issue, consider seeking a referral to a fertility specialist. These specialists, often reproductive endocrinologists (REIs), have specialized knowledge and experience in diagnosing and treating fertility issues. They can provide you with a more thorough evaluation and personalized advice.

Establish open communication

When speaking to your doctor, establish a comfortable and open line of communication. Explain your concerns clearly and concisely, emphasizing the importance of the topic to you. Use "I" statements to express your feelings and personal motivations for seeking fertility guidance. This approach helps create a more collaborative relationship with your doctor.

Some examples of these statements might include:

• “I think I might want to have children someday, and I want to understand more about my fertility to make informed decisions about when to start trying to conceive.”
• “I have a medical condition that could affect my fertility, and I would like to discuss the potential impact and/or treatment.”
• “I am at an age where I feel a sense of urgency to explore my fertility options, because I don't want to experience challenges building my family down the line.” 
• “I have a family history of reproductive issues, and I want to be proactive in understanding my own fertility health to prevent any potential complications in the future.”
• “I'm considering delaying pregnancy for a few years due to personal or career reasons, but I'm concerned about how that might affect my fertility. Can you provide information on fertility preservation options?”
• “I have irregular periods, and it's been challenging for me to track my ovulation. Can you help me understand my cycle better and provide advice on optimizing my fertility?”
• “I've always had a strong desire to become a parent, and understanding my fertility is essential to fulfilling that dream. Can we discuss tests or assessments that can give me a clearer picture of my reproductive health?”

Remember, these are just examples, you should personalize your questions and comments based on your specific situation and concerns. Your OBGYN will appreciate your openness and willingness to discuss your fertility goals and worries. If your OBGYN is dismissive of these questions or concerns, it may be time to consider talking to another doctor. 

Share your medical history

Come prepared. Be ready to provide your doctor with a comprehensive medical history, including any previous or current reproductive health issues. What kind of birth control are you on? Have you had any STIs, miscarriages, or abortions? Knowing your cycle – if it’s regular or not – is vital information too. . The more information you provide the doctor, the better they will be able to understand your unique circumstances and tailor recommendations to suit your needs.

Discuss fertility testing

If you have concerns about your fertility, or are just curious about your ovarian reserve, ask about appropriate tests to assess your reproductive health. Understanding your fertility potential can help guide discussions about future family planning or the need for egg freezing.

Possible tests include:

• Hormone level assessments: These are blood tests that measure hormone levels related to fertility. They can include assessments of anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone, and thyroid hormones. These tests help evaluate ovarian function, the menstrual cycle, and potential hormonal imbalances that may affect fertility.
• Pelvic ultrasounds: A pelvic ultrasound is a non-invasive imaging procedure that uses sound waves to create images of the reproductive organs. It can help evaluate the health and condition of the uterus, ovaries, and fallopian tubes. This assessment can identify any structural abnormalities, such as fibroids, cysts, or polyps, that may impact fertility.
• Semen analysis: A semen analysis is a test performed on a male partner to assess the quantity, quality, and movement of sperm. The analysis involves collecting a semen sample, which is then examined under a microscope. It evaluates sperm count, motility (movement), morphology (shape), and other factors that can affect male fertility.

Ask your doctor which tests make sense now, and which ones can wait until you’re ready to start trying.

Inquire about egg freezing

If you are considering egg freezing, approach the topic directly with your doctor. Ask about the process, success rates, potential risks, and the ideal age to consider this option. If you’re already chatting with an REI, seek information on the specific protocols followed at the clinic, including the number of eggs typically recommended for optimal chances of future conception. 

Read more in Questions to Ask Your Doctor at an Egg Freezing Consultation

If you’re curious to see if you qualify for Freeze by Co’s Split program — where you can freeze your eggs for free if you give half of the eggs retrieved to another family who can’t conceive — you can take our quiz here. Additionally, our self-pay Keep program allows women to freeze their eggs and keep them all for their future use, with partnerships and discounts to lighten the financial load of egg freezing and as access to our member community.

Request second opinions

If you feel your concerns are not adequately addressed or your doctor dismisses your fertility-related questions, do not hesitate to seek a second opinion. A different perspective may offer fresh insights and alternative treatment options that can better meet your needs.

Trust your gut

Lastly, trust your instincts. If you feel unheard, rushed, or dismissed during your appointment, it is crucial to advocate for yourself. Remember, you are an active participant in your own fertility journey, and your concerns and desires deserve attention and respect.

Summing it up

Remember, every individual's journey is unique, and there is no one-size-fits-all approach to family planning. Your doctor is a valuable resource who can provide personalized guidance tailored to your specific needs. By opening up the lines of communication and actively participating in discussions about your fertility, you can embark on this phase of your life with confidence and peace of mind.

Taking control of your reproductive health and discussing fertility concerns or options like egg freezing with your doctor can be an empowering and transformative experience. With the right tools and a proactive mindset, you can ensure that your fertility journey is supported and guided by a healthcare professional who values your concerns and helps you make informed decisions about your reproductive future.

Read more:

• Questions to Ask Your Doctor at an Egg Freezing Consultation
• Can I Freeze My Eggs If… 
• What Can I Expect From the FSH Blood Test?

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Can you test your fertility from the comfort of your own home? The answer is a bit complicated. Isn’t it always when it comes to fertility? Yes, there are some tests that both men and women can take at home to get a better idea about some aspects of their fertility. But are they an acceptable substitute for an individualized appointment with a fertility specialist? 

Unfortunately, no—while these tests are often fairly accurate, that’s not really the issue here, says Dr. Jaime Knopman, a board-certified reproductive endocrinologist. It’s all the medical expertise you’re missing out on when you test your fertility at home. 

“The tests we run in our clinic are much more accurate because our job can’t be done completely by machine,” she explains. “It’s not just the tests, it’s the person interpreting them.”

But you still might not live close to a fertility clinic, have insurance that covers fertility appointments or testing, or even feel like you’re really at the point yet in your fertility journey where you need a formal eval from a specialist. We get that.

So whatever your reason for wanting to take an at-home fertility test, here’s what you need to know about what your options are, how they work, and what you can expect to learn.

How can I test my fertility at home: for women

When it comes to the ladies, there are two main varieties of tests you can do at home: you can check your ovarian reserve and you can do a broad panel screening for several different hormones that play a part in fertility health. Here’s the scoop.

Ovarian reserve tests measure the amount of follicle-stimulating hormone (FSH) in your blood with a pinprick. Typically, you collect a sample yourself and mail it back to the company so they can read and deliver your results. Very high levels of FSH can be a sign that you don’t have a lot of eggs, that they’re poor quality, or both, because your body is working overtime to produce enough FSH to release a healthy egg.

• Taking this test feels like a typical finger prick. It hurts for a sec and then you’re over it. You will have to squeeze out some blood into designated spots on a testing card, though, so if you’re blood-averse be prepared.
• The tests themselves can accurately check your FSH level, but there’s more than one way to figure out what your ovarian reserve looks like. Only measuring FSH will give you a piece of the puzzle...but could also cause you to unnecessarily panic about your fertility. Try not to do that! Remember, these tests are useful, but not foolproof.
• FSH levels alone may not be a great way to assess your fertility in the first place. A 2017 JAMA study found that biomarkers like FSH aren’t the best predictors of future fertility in women with reduced versus normal ovarian reserves.

Fertility health screenings capture your FSH level but also a bunch of other hormones that impact your fertility in one way or another. The exact hormones measured in an OTC fertility test differ between companies, but you can usually find out your FSH level and any or all of the following:

• thyroid-stimulating hormone, or TSH a marker of thyroid health)
• estradiol (helps with ovulation)
• anti-mullerian hormone, or AMH (an indicator of egg reserve)
• prolactin (makes breast milk after birth)
• luteinizing hormone, or LH (regulates your cycle, especially ovulation)
• testosterone (helps make follicles, but too much may mess up your fertility)

These tests all work like the ovarian reserve test: you prick your finger, collect some blood samples, send the samples back to the company, and then wait for your results to come in. Usually, you’ll get factual data (like, “your TSH is off”) but also an explanation of what that might mean for your fertility. 

Most companies allow you to see your results online and consult with an on-staff medical professional if you have questions or don’t understand your results. They’re pretty easy to order online, but many aren’t cheap—they’re usually about $150—and you’ll have to pay out of pocket.

How can I test my fertility: for men

The only kind of male fertility test that can be done at home is a sperm analysis. About half of all couples’ infertility problems can be caused by male infertility, so knowing if your swimmers are strong or not is a good place to start if you’ve been trying to conceive for a while. 

There are actually several different kinds of sperm analysis kits; sometimes you collect a sample and send it through the mail for testing, sometimes you put some sperm on a slide and insert it into a testing device, and sometimes you can even use your smartphone (yes, for real!). 

• Testing at home is private and confidential. You don’t have to worry about being unable to provide a sample at an unfamiliar clinic or doctor’s office. 
• The kits you send off to labs via mail can be more accurate, but at the same time, there’s a lot that can go wrong here—like failure to keep the sperm stored at just the right temp, which can cause damage to the sample. At-home tests, while giving quicker results with no middle-man, have a lot of potential for both user and technology errors.
• Male fertility is about more than just the amount of sperm: there’s motility, shape, concentration...the list goes on. If your at-home kit is only looking at the number of sperm, your results may not be that helpful. Try to choose a test that looks at more than one type of factor—this will give you the most bang for your buck. 

Don’t forget about ovulation!

While ovulation predictor kits only tell you if and when you’re ovulating, this can be very helpful if you’re actively TTC. 

These kits work by detecting the presence of LH in the urine, says David Diaz, MD, reproductive endocrinologist and fertility expert. When your LH rises above a certain level, the test strip you’ve peed on will let you know that an ovary is just about to release an egg. This is a good time to get it on, since there’s a good chance that egg could become fertilized. 

According to Dr. Diaz, these tests are about 85 percent accurate and available as digital and non-digital tests. If you have fairly regular menstrual cycles, an ovulation predictor kit can be a useful tool in identifying exactly when your fertile window is, but if your cycles are irregular (because of PCOS, pre-menopause, or even just your personal biology), it can be harder to rely on them unless you’re taking a test every day.

Next steps

Okay, you took an at-home test and got your results back...now what? Well, you might not like our answer, but here it is: you should probably still go see a fertility doctor. Yes, even if your results are “normal.” Why? 

Because, like we told you upfront, a test you do at home gives you important data — but not the expertise and counsel of a doctor who has met you in person and knows your medical history. You’ll have the info, just not necessarily the context...and the context is super important when it comes to your fertility. At-home tests simply can’t paint the same kind of comprehensive picture that doctor-interpreted lab tests can. 

But you’re here because you want to take an at-home fertility test...and TBH, we kinda don’t blame you! We’re curious, too! Just make sure you know what you’re buying, (Dr. Knopman says that you should make sure any OTC test you buy comes from a legit manufacturer with a fertility doctor on their medical review board), what the tests can tell you, and what you’re going to do with the results. 

“Even if you don’t want to do fertility treatments [right now], there is no harm in coming in to talk to us about it,” says Dr. Knopman. “You can make better decisions when you have that information than when you don’t…[and] the worst thing to do is sit at home and ruminate, trying to interpret your own results or diagnose yourself.”

What’s the takeaway here? After taking an at-home fertility test, you might want to plan to make an appointment with a fertility specialist. It can be a simple introductory or informational appointment, and even a virtual one. But hopefully, it will give you peace of mind and — most importantly — answers. 

Read more

• Female Fertility Hormones: Everything They Didn’t Teach You in Sex Ed
• A Step-by-Step Guide to Freezing Your Eggs

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

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

What is Zika and where is it found? 

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

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

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

How Zika could impact your egg freezing cycle?

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

Fertility clinic regulations and guidelines

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

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

Zika guidelines for egg donation 

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

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

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

So, what should you do?

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

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

Egg freezing, also known as oocyte cryopreservation, has become an increasingly popular fertility preservation option for women who want to delay motherhood or preserve their eggs now due to medical reasons. 

Many egg freezers opt to do more than one cycle to increase the number of eggs they can preserve (read more in How Many Eggs Do I Need to Freeze?). One question that often arises is, "How long do I need to wait between egg freezing cycles?" In this guide, we'll delve into the factors that influence the waiting period between cycles and provide you with the information you need to make an informed decision.

Understanding the egg freezing process

Before we discuss the recommended waiting period between egg freezing cycles, it's important to understand the process itself. Egg freezing involves stimulating the ovaries with fertility medications to produce multiple eggs, which are then retrieved and cryopreserved for future use. 

It’s considered a safe procedure, but there are some side effects. The most common being:

• Mild bruising and soreness at the injection site
• Bloating, 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)

Every woman has a different experience. I’ve had some patients who feel great after the retrieval and go right back to work. But I do recommend that my patients take a day or two off to recover and pamper themselves before resuming normal activities.  

Recommended waiting period between egg freezing cycles

While back-to-back egg freezing cycles is possible, it may or may not be the best path for you. 

After you complete your egg retrieval, you will get your period about two weeks later. At that time, you can work with your fertility doctor to assess how your body responded to the hormone injections from the previous cycle's treatment. Your fertility doctor will assess the ovaries to ensure they are healed and that there’s a new cohort of antral follicles. It’s important that you feel back to baseline before starting another cycle. 

In some cases, it is recommended to wait at least one full menstrual cycle before starting another egg freezing cycle. This means that if you complete your first cycle in January, you should wait until at least March to begin the next one, assuming you have a normal 28-day cycle. This waiting period allows your body to recover, your hormones to return to baseline levels, and your ovaries to be ready for another round of stimulation.

In other cases, your fertility doctor may advise a longer waiting period, especially if you experienced complications or had a particularly high response to the stimulation medications. You’ll want to get input from your doctor and also listen to your body's signals to determine the most appropriate time to start another cycle.

Other factors to consider:

1. Age: Age is a significant factor when it comes to fertility preservation. Women in their late 30s or early 40s may have a more limited time frame for egg freezing due to the natural decline in egg quantity and quality. In such cases, your fertility doctor may recommend a shorter waiting period between cycles to maximize the number of eggs retrieved while you still have good ovarian reserve.
2. Ovarian reserve: Your ovarian reserve, which refers to the number and quality of eggs remaining in your ovaries, can influence the waiting period between cycles. If you have a high ovarian reserve, you may be able to wait longer– even years– between cycles without compromising your chances of success. However, if your ovarian reserve is low, your doctor may suggest a shorter waiting period to retrieve as many eggs as possible while you still can.
3. Personal circumstances: Your personal circumstances, such as upcoming life events, work commitments, or financial considerations, may also play a role in determining the timing of your egg freezing cycles. 

Preparing for subsequent cycles

During the waiting period between egg freezing cycles, there are several steps you can take to optimize your fertility and prepare for the next round:

1. Maintain a healthy lifestyle: Adopting a healthy lifestyle can significantly impact your fertility. Eating a well-balanced diet, exercising regularly, managing stress, and getting enough sleep can all contribute to better egg quality and overall reproductive health.
2. Track your cycle: Keeping track of your menstrual cycle can help you and your fertility doctor determine the optimal timing for starting your next egg freezing cycle. Make note of the length of your cycles, any unusual symptoms, and the duration of your periods.
3. Supplement wisely: Certain supplements, such as CoQ10 and vitamin D, have been shown to support fertility. However, you must consult with your doctor before starting any new supplements to ensure they are safe and appropriate for you.
4. Communicate with your clinic: Maintain open lines of communication with your fertility clinic throughout the waiting period. Keep them informed of any changes in your health, menstrual cycle, or personal circumstances that may impact your egg freezing journey. They can provide valuable guidance and support every step of the way.

Summing it up

The decision of when to undergo another egg freezing cycle isn't a one-size-fits-all answer. The answer will be a combination of listening to your body and your doctor's expert advice. While it's often recommended to wait one full menstrual cycle between cycles to allow your body to recover and reset, it's not a hard and fast rule. 

Some women bounce back quickly after a cycle, while others need a little more time. Your fertility doctor can help you assess your individual response to the first cycle and tailor a plan that's just right for you. Plus, your personal circumstances, like work deadlines or financial considerations, also play a role. It's all about finding a balance that works for you.

The takeaway?  Trust your gut, listen to your body, and lean on your doctor's expertise.  They'll help you navigate the waiting game and find the perfect timing for your egg freezing journey.

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.

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

The purpose of monitoring appointments during egg freezing

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

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

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

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

Location and frequency of egg freezing monitoring appointments

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

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

What to expect during monitoring appointments

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

1. Transvaginal ultrasounds

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

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

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

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

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

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

2. Blood Tests

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

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

Interpreting your results

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

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

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

Tips for egg freezing monitoring appointments

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

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

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

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

Leading up to the egg retrieval

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

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

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

Summing it up

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

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

Freeze your eggs with Cofertility

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

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

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

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

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!