Fertility Meds

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

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

How the egg donation process begins

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

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

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

The stimulation process

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

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

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

Navigating with ease

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

Anti-Müllerian hormone (AMH) has gained significant attention in the field of reproductive medicine as a valuable marker of ovarian reserve. It provides insight into egg quantity and can be useful in assessing fertility health and predicting the chances of egg freezing success. 

However, there are certain medications that can potentially influence AMH levels, raising questions about the accuracy and interpretation of AMH testing while on them. In this article, we will explore the relationship between medications and AMH levels, shedding light on the impact of specific drugs and discussing their implications for women's reproductive health.

What is AMH?

AMH is a hormone produced by the cells within ovarian follicles. Its primary role is to promote the growth and development of follicles. AMH levels are generally stable during the menstrual cycle, making it a reliable marker for assessing ovarian reserve. It is measured through a simple blood test and has become an important tool in fertility evaluations and treatment planning.

What causes AMH to change?

AMH levels naturally decline as we age. The highest levels of AMH are typically found in women during their early reproductive years, and the levels gradually decrease as we approach menopause… making age the most common reason for AMH to change.

But there are other reasons AMH may change over time. The most common reason is simply age. Since AMH is considered a reliable marker of ovarian reserve, which refers to the quantity of eggs remaining in the ovaries, this hormone naturally decreases as we get older.

Certain medical conditions, such as ovarian tumors, can also affect AMH levels. Additionally, treatments like chemotherapy or radiation therapy that target the ovaries can significantly reduce AMH levels.

While the direct impact of lifestyle factors on AMH levels is not yet fully understood, some studies suggest that factors such as smoking, obesity, and extreme exercise may be associated with lower AMH levels. However, more research is needed to establish definitive conclusions.

Lastly, certain medications can impact AMH levels. For example, oral contraceptives and drugs like clomiphene citrate used in fertility treatments can temporarily decrease AMH levels. On the other hand, supplements like DHEA (dehydroepiandrosterone) and vitamin D have been associated with increased AMH levels. We’ll go more into detail about these below.

Remember that individual variations exist, and AMH levels should be interpreted in conjunction with other fertility assessments to gain a comprehensive understanding of your reproductive health. If you have concerns about your AMH levels or fertility, it's best to consult with a fertility doctor for personalized guidance and recommendations.

What medications can affect AMH levels?

Several medications have been found to influence AMH levels, potentially complicating its interpretation as a marker of ovarian reserve. Here are some examples:

Oral birth control 

Oral contraceptives are commonly used for birth control and to regulate menstrual cycles. Studies have suggested that oral contraceptive use may lead to decreased AMH levels in the short term.

One study compared the AMH levels of 228 hormonal contraception users and 504 non-users. They found that users of birth control had 29.8% lower AMH concentrations. Because of this, the authors concluded that AMH may not be an accurate predictor for women using hormonal contraception.

You may want to consider the timing of the AMH test when using hormonal contraceptives. Estrogen can suppress the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are necessary for the development and maturation of follicles. 

As AMH levels are influenced by FSH and LH, you could wait for a few weeks after discontinuing birth control before measuring AMH levels for a more accurate assessment of ovarian reserve. Or, you could take the test knowing the results may be lower due to birth control. It’s best to discuss this with your doctor.  

Metformin

Metformin is a medication commonly used in the treatment of polycystic ovary syndrome (PCOS), a complex endocrine disorder associated with metabolic and reproductive disturbances, and for managing insulin resistance. Research has shown that metformin use may be associated with decreased AMH levels.

Clomiphene Citrate

Clomiphene citrate (brand name Clomid©), is a medication used to stimulate ovulation in women who are trying to conceive. Similar to metformin, clomiphene citrate has been associated with decreased AMH levels. When undergoing fertility treatments involving clomiphene citrate, you’ll want to take this potential impact into account when interpreting AMH results.

What supplements can affect AMH levels?

Dehydroepiandrosterone (DHEA)

DHEA is a natural hormone that can be converted into other hormones in the body, including testosterone and estrogen. Some studies have suggested that supplementation with DHEA may lead to increased AMH levels. These findings suggest that certain nutritional interventions may have a positive effect on ovarian reserve.

Vitamin D

Vitamin D is essential for overall health and has been linked to various biological processes in the body, including reproductive health. Some research indicates that vitamin D supplementation may lead to increased AMH levels. However, more studies are needed to fully understand the relationship between vitamin D and AMH levels.

Is there anything I can take to increase AMH levels?

While there are medications and supplements that have been associated with changes in AMH levels, the impact of these medications is typically temporary or specific to certain conditions. 

Currently, there is no definitive medication or treatment specifically designed to increase AMH levels. However, there are lifestyle factors that may positively influence overall reproductive health, such as maintaining a healthy weight, adopting a balanced diet, managing stress levels, and avoiding smoking and excessive alcohol consumption. These lifestyle choices can contribute to optimal ovarian function and potentially support healthy AMH levels.

Summing it up

AMH testing has revolutionized our ability to assess ovarian reserve and guide fertility treatment decisions. However, it's crucial to consider the potential influence of certain medications on AMH levels. Understanding how specific drugs and supplements may affect AMH results can help you interpret the findings accurately and make informed decisions about fertility treatments. 

Remember that these effects are usually temporary or specific to certain conditions. It's always best to consult with your fertility doctor who can provide personalized guidance based on your specific situation. 

Better yet, focusing on maintaining a healthy lifestyle, managing stress levels, and adopting a balanced diet can contribute to overall reproductive health and support optimal ovarian function. By staying informed and working closely with your healthcare team, you can navigate the complexities of AMH testing and make informed decisions about your fertility journey.

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Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. With our Freeze by Co platform, women can freeze their eggs for free when they donate half of the retrieved eggs to a family who can’t otherwise conceive. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.

Egg freezing, also known as oocyte cryopreservation or fertility preservation, is a process where they stimulate the follicles in the ovaries and retrieve unfertilized eggs to preserve them for future use. While egg freezing has taken off in recent years, the cost of the procedure can be a significant barrier for many. Why is egg freezing so expensive and what are your options? Let’s dive in.

So how much does egg freezing really cost?

The question of how much does it cost to freeze your eggs will come down to a few factors. These include the clinic, your geography, and how long you keep the eggs in storage. On average, egg freezing patients will spend $30,000 - $40,000 on treatment and storage. 

Let’s look at one case of a 23-year old egg freezer whose insurance did not cover the procedure. Here’s what she paid out of pocket at a New York City clinic:

Fertility workup and blood work - $1,500

Monitoring, blood work, and ultrasound - $2,500

Medications - $4,479

Oocyte retrieval, anesthesia, egg freezing - $15,650

One-year of egg storage-  $1,500

Total - $22,629

This specific patient retrieved 34 eggs, which gives her a good chance at a live birth if she uses those eggs down the line. But most people don’t have an extra $20,000 laying around.

But why is egg freezing so expensive?

One major reason for the high cost of egg freezing is the expense of the technology and equipment required for the procedure. The process of freezing eggs involves:

• Anesthesia and the cost of an anesthesiologist at your egg retrieval
• An operating room and equipment for the egg retrieval
• A freezing process called vitrification, which requires specialized equipment and materials
• A cleanroom IVF laboratory with good air quality
• Safe gamete storage with backup generator in case the power goes out

There’s also a high cost for the people who make egg freezing possible. Reproductive endocrinologists – also known as fertility doctors – make between $236,472 and $315,827 a year according to Salary.com. And anesthesiologists make between $359,300 and $470,200. There are also embryologists, nurse practitioners, physician assistants, and patient coordinators. All these specialists go to school for years and have specific training to ensure the process is successful and safe. 

Another reason for the high cost of egg freezing is the cost of the medication used during the process. The medication used to stimulate the ovaries in preparation for egg retrieval can be quite expensive, and the cost of these medications varies depending on dosages you are given and your insurance coverage.

According to the GoodRx list price index, the list price for drugs used in egg freezing has increased 50% from 2014 to 2020. There are several medications used to stimulate your eggs during egg freezing: Gonal-F, Menopur, and Follistim AQ. And they are all brand drugs without a generic option… meaning the manufacturer gets to set whatever price they want.

Lastly, egg freezing is so expensive because most health plans don’t cover it. Health insurance companies have a lot of leverage; and if they’re good at one thing, it’s negotiating prices. 

How can I get more affordable egg freezing?

If you’re looking for a more affordable option, you’re in the right place. Cofertility was founded to reshape the cost structure of egg-freezing, specifically through our Freeze by Co platform.

We have discounts with clinic partners, egg storage facilities, and pharmacies that we pass along to our members. Also, our members get access to our active online community, where you can connect openly with others freezing at the same time.

We stand for choice and offer two accessible programs:

• With our Split program, those who qualify can freeze their eggs for free when you give half of the eggs retrieved to a family who can’t otherwise conceive, including couples with infertility, gay dads, and more. 
• Those in our Keep program can freeze their eggs and store them all for their own later use, while taking advantage of discounts throughout the process to lighten the financial load. 

Summing it up

If you want children someday, egg freezing may help keep that option on the table. But egg freezing can be an expensive process. That’s because of the cost of the technology, equipment, and people required, as well as the cost of medication. Cofertility can help make your egg freezing journey more affordable – or even free. Take this 1-minute quiz to see which programs you qualify for!

So you’re freezing your eggs - congratulations! This is such an empowering step in your life, and we hope that you can experience the process with positivity and hope for the future. 

We know the process can also be confusing and overwhelming, especially when it comes to understanding what activities are safe and not safe during egg freezing. First and foremost, it's important to understand that egg freezing is a medical procedure and should be treated with the same level of care and attention as any other medical procedure. This means that you should always follow the instructions of your provider and avoid any activities that may put your health at risk.

In this article, we will explore some of the things you can and can't do during egg freezing. Let’s go!

Can I work out while freezing my eggs?

Exercise is generally considered safe during the egg freezing process, but it's important to note that you should avoid any intense or high-impact activities. Because your ovaries will be enlarged from being stimulated, exercise could increase the risk of a rare condition called ovarian torsion, when the ovary twists on the surrounding tissues.

Gentle exercise such as yoga or walking is recommended. If you are someone who has a serious workout regime, we recommend talking to your fertility doctor about what’s safe.

Can you go to work during egg freezing?

Working during the egg freezing process is generally considered safe, but it's important to be mindful of any physical demands or stressors that may be associated with your job. Your fertility doctor may recommend taking some time off work to rest and recover if you're experiencing any side effects from the medication used in the egg freezing process. And after the egg retrieval, it’s recommended you give yourself time to rest (although I know women who felt fine enough to go back to work!). Most people are able to return to work within a day or two of an egg retrieval.

Can you drink coffee during egg freezing?

Caffeine consumption is generally considered safe during the egg freezing process, but it's important to be mindful of your intake. Some experts recommend limiting your caffeine intake to less than 200 milligrams per day, which is roughly equivalent to one cup of coffee. While most of the research on the impact of caffeine is on pregnancy, we think it’s better to play it safe during egg freezing too. 

Can you drink alcohol during egg freezing?

Alcohol consumption is not recommended during the egg freezing process. Studies have shown that alcohol consumption can negatively impact fertility and may also increase the risk of certain complications associated with egg freezing. The good news is there are loads of EANABs (equally-appealing, non-alcoholic beverages) these days. Try a soda water with lime and no one will bother you!

What about smoking?

Smoking is not recommended during the egg freezing process (or ever!). Studies have shown that smoking can negatively impact fertility and may also increase the risk of certain complications associated with egg freezing. Smoking can decrease the number and quality of eggs retrieved, and increases the risk of ovarian hyperstimulation syndrome (OHSS), a potentially serious complication of the egg freezing process.

Can you have sex during the egg freezing process?

(Gentle) sexual activity is generally considered safe during the egg freezing process, but it's important to be mindful of any potential risks associated with the fertility medications. After all, your ovaries may be enlarged and sensitive. Some fertility doctors may recommend avoiding intercourse or using contraception during certain parts of the process, due to higher risk of pregnancy. This is one you should definitely ask your doctor about.

Note: If you’re participating in our Split program, where you freeze your eggs for free by donating half of the retrieved eggs to another family, you’ll need to avoid sex entirely, since becoming pregnant or contracting and STD would result in your cycle being canceled.

What can you eat during egg freezing?

Eating a healthy and balanced diet is an important part of overall health and wellness, and it's especially important during the egg freezing process. Eating a diet rich in fruits, vegetables, lean protein, and healthy fats can help support your overall health and may improve the success of the egg freezing process. Once the eggs are retrieved, you can indulge in dessert, a cocktail, and resume your normal diet!

What supplements can I take during egg freezing?

In addition to eating a healthy diet, taking supplements may also be beneficial during the egg freezing process. Folic acid, for example, has been shown to improve reproductive outcomes and is often recommended for women undergoing egg freezing. Other supplements such as CoQ10, DHEA, and omega-3 fatty acids may also be recommended by your fertility doctor. It's important to note that you should always talk to your fertility doctor about what you’re taking – and what you want to be taking – before you start egg freezing, as some may interact with fertility medications.

Can you use a hot tub or steam room during egg freezing?

There’s conflicting info here. Some doctors say hot tubs, steam rooms, and saunas should all be avoided during the egg freezing process, citing that they can cause a spike in body temperature, which can be harmful and may negatively impact the success of the egg freezing process. While others say it’s fine. Knowing that there’s always a small risk that public hot tubs are carrying bacteria or can cause allergic reactions, it’s safest to wait until after the egg retrieval. 

Can you take a hot bath during egg freezing?

This is another controversial one – some fertility clinics say hot baths are fine, while others say you should stick with showers. Some providers even recommend avoiding baths from the day of your retrieval and several days after, in order to allow your body to safely heal. Ask your doctor what they think, or just stick to showers to play it safe!

Summing it up

Egg freezing is such an intense (and often expensive) process. In order to get your best outcomes possible, it’s probably better to err on the conservative side. Always follow the instructions of your fertility doctor, and avoid any activities that may put your health at risk. We are wishing you the best!

‍Cofertility is in the “family” business, striving to make egg freezing and third-party reproduction more human-centered and accessible for all. Our Freeze by Co program allows you to freeze your eggs for free, when you give half to a family who can't otherwise conceive.

Egg freezing, also known as oocyte cryopreservation, is a procedure that allows women to retrieve eggs when they are most healthy and have them for use later in life. The process of freezing eggs involves a series of steps, including ovarian stimulation, egg retrieval, and cryopreservation. One of the most common questions that women have about egg freezing is whether or not it is painful. In this article, we’ll review all your questions about the egg freezing process and pain.

Egg freezing shots

The first step in the egg freezing process is ovarian stimulation, which is done using fertility medications. These medications are designed to stimulate the ovaries to produce multiple eggs, rather than the single egg that is produced during a typical menstrual cycle. These medications are typically administered subcutaneously (under the skin) using a small needle. The shots themselves aren’t pleasant, but they’re quick. 

Some women may have a higher pain tolerance than others and some may have more discomfort than others. I personally have a really low pain tolerance, so I was nervous about the shots. But the process was super manageable, and the pain was not as bad as I thought it would be. Here’s what helped for me:

• Icing the spot for a few minutes to numb the area
• Laying down during the process
• Having my husband give me the shots instead of doing them myself
• Remind myself that “you have to want it more than you’re afraid of it”
• Having a good show and some chocolate ready for right after 

After a few days of injections in the same area, you may find some bruising. The bruising is usually normal and should disappear within a few days. Most people also experience mild bloating during the process, but it is generally not considered to be painful.

Vaginal ultrasounds

During the egg freezing process, you will get to know “Wanda” – what many in the fertility community affectionately call the ultrasound wand. Vaginal ultrasounds use high-frequency sound waves to create images of the uterus, ovaries, and fallopian tubes. This helps your doctor understand how your follicles are growing, and if the medications are working. 

The ultrasound wand (covered in a condom and gel) is inserted into the vagina, which can cause a feeling of pressure. The procedure itself is not considered to be painful, but some describe it as short-lived mild discomfort.

Blood draws

You will likely need several blood draws during your egg freezing journey to see how your hormones are responding. Blood draws, also known as venipuncture or phlebotomy, is a procedure in which blood is taken from a vein in your arm for laboratory testing. 

The pain associated with a blood draw is usually minor, and often described as a "sharp" or "stinging" sensation that lasts for a moment. The discomfort can also come from the tightness of the band that is often used to make the vein prominent and easier to find the vein.

Pain tolerance can vary from person to person, some people may experience a minimal discomfort while others may experience more pain. To minimize the discomfort during the blood draw, it's recommended to relax and breathe deeply during the procedure. If you have a fear of blood draws or needles, inform the technician who may be able to use a smaller needle or a different technique to minimize pain. And if you are prone to experiencing lightheadedness when getting your blood drawn, make sure to let your technician know. Asking if they can do the blood draw while you’re laying down rather than sitting up can make a huge difference!

The egg retrieval

The final step in the egg freezing process is the egg retrieval, where the eggs are then removed using a transvaginal ultrasound-guided needle. This is typically done under anesthesia or sedation, so you are fully relaxed during the procedure. Anesthesia is administered through an IV (intravenous) line so the amount of medication can be adjusted to achieve the desired level of sedation. Because it is not general anesthesia, you can breathe on your own and don’t need breathing tubes (phew!). Okay let’s break down this process and how painful it is:

• Getting the IV line: An IV line will be inserted into a vein, typically in your hand or arm. Some people describe a "sharp" or "stinging" sensation that lasts for a moment when the needle is inserted into the vein. 
• The egg retrieval: If you use anesthesia (and most people do), you will be unconscious and unable to feel pain or sensation during the 30-minute procedure. 
• Post-retrieval: After the egg retrieval procedure, it's normal to experience some mild to moderate cramping or bloating, similar to the discomfort experienced during menstruation. Your fertility doctor may prescribe pain killers, or give you over-the-counter pain medication to manage any discomfort.

Overall, the egg retrieval is not too painful. The bloating (and constipation) afterwards is considered the most unpleasant part, similar to period cramping.

What to do if you have a low pain tolerance

Even people with low pain tolerance can successfully freeze their eggs. But if you’ve had bad prior medical experiences, the entire process can feel daunting.

First and foremost, it is important to communicate this with your fertility doctor. Let them know that you have a low pain tolerance and ask about the level of pain you can expect at each step, and if there are safe pain management options.

There are a couple of other techniques to help make any pain more manageable:

• Therapy. If your low pain tolerance is rooted in medical anxiety, talk to a therapist. They can help you find techniques (or even medication) to help you go into the procedure with  more confidence.
• Practice deep breathing or relaxation techniques. Focusing on your breath and practicing mindfulness can help to distract you from the pain and reduce your perception of it.
• Ice packs. Applying a cold compress to the affected area before and after shots can help to reduce inflammation and numb the area.
• Acupuncture or massage. These therapies can help to reduce pain and promote relaxation.
• Music. I find it helpful to listen to music through headphones during any medical procedure (from a cavity filling to a blood draw). Music can help transcend you to a calmer place, and distract your mind.

Everyone's pain tolerance is different and what may be unbearable for one person may be manageable for another. Don’t ever be ashamed or embarrassed about having a low pain tolerance, it’s totally normal (and manageable!). 

Is egg freezing safe?

Yes - egg freezing is considered a safe and well-tolerated procedure. However, like any medical procedure, there are risks.

Anesthesia, which most people opt for during the egg retrieval, is considered safe. Overall, there is only one death per every 200,000 to 300,000 cases. However, this number is even lower for women freezing their eggs. The biggest risk factors for complications from anesthesia are being male, being older, being obese, and having inpatient surgery – none of which are likely for egg freezers 

Ovarian hyperstimulation syndrome (OHSS) is the most common complication of egg freezing, but it is also rare. About 3-6% of cases experience mild or moderate OHSS (headaches, fatigue, nausea, irritability, breast tenderness, abdominal pain, weight gain, and enlarged ovaries). Severe or critical OHSS is less common at 1–3% of cases and presents as ascites and pleural effusion, shortness of breath, dehydration, vomiting, oliguria, hemoconcentration, thromboembolic events, and massive ovary enlargement, which are potentially life-threatening. If you have any of those symptoms, it’s critical to reach out to your doctor ASAP. 

There are other risks such as pelvic pain, intraperitoneal bleeding, pelvic infection, damage to organs, and ovarian torsion. It’s best to talk to your doctor about the risks of egg freezing.

Summing it up

Egg freezing is considered to be a safe procedure, with most women reporting mild to moderate pain or discomfort. If you have any concerns about pain or pain management, it’s best to talk to your doctor up front. Let them know your concerns and ask about the level of pain you can expect at each step, and ask if there are safe pain management options. We are here, rooting you on!

Egg retrievals, which take about 30 minutes, are considered a minimally invasive procedure. Women undergoing egg freezing often ask me if they are “put to sleep” (under anesthesia) during that time… and the answer is, usually yes. Not only is it important for you to remain still during the procedure, but anesthesia can help you relax and block pain. In this guide, we’ll review some of the most common questions we get about anesthesia and egg retrievals:

• What happens during an egg retrieval? 
• What is anesthesia and is it safe?
• What type of anesthesia is used for an egg retrieval?
• Is propofol used for egg retrievals?
• How is sedation administered during an egg retrieval?
• How long are you under anesthesia for egg retrieval? 
• What happens during anesthesia in an egg retrieval?
• How do you prepare for anesthesia during egg freezing?
• Why do you need anesthesia during egg freezing?
• Can you do an egg retrieval without anesthesia or sedation?
• What can you do if you’re afraid of anesthesia?

First, let’s review what happens during an egg retrieval

The egg retrieval is the final culmination of the egg freezing process. During an egg retrieval, the eggs are removed from the ovaries and frozen for your future use. 

Here is a general overview of what happens during an egg retrieval procedure:

1. You are usually given medication to help relax and reduce anxiety.
2. You are usually given a local anesthetic to numb the area where the eggs will be retrieved.
3. A thin needle is inserted through the vagina and into the ovary, guided by ultrasound imaging.
4. Fluid is gently suctioned through the needle to remove the eggs from the follicles.
5. The retrieved eggs are examined under a microscope to determine their number and quality.
6. The eggs are then frozen and sent to long-term storage.

The entire egg retrieval procedure typically takes about 30 minutes, and you can go home the same day knowing how many eggs were retrieved.

What is anesthesia and is it safe?

Anesthesia is a medical treatment that blocks the sensation of pain and other sensations during surgery or other medical procedures. It is administered by anesthesiologists, doctors who are specially trained to manage pain and other aspects of care during and after surgery.

Anesthesia is generally safe, but like any medical procedure, it does carry some risks. The type and severity of the risks depend on the individual patient and the type of anesthesia being used. Some common risks associated with anesthesia include allergic reactions, breathing problems, and blood pressure changes. However, these risks are rare and the benefits of anesthesia typically outweigh the potential risks.

It's important to discuss any concerns you have with your anesthesiologist and other members of your healthcare team before your surgery or procedure. They can help you understand the potential risks and benefits of different types of anesthesia and help you make an informed decision about your care.

There are several types of anesthesia:

• General anesthesia is used to render a patient unconscious and provide full body muscle relaxation. 
• Regional anesthesia numbs a larger area of the body, typically involving a nerve block.
• Local anesthesia numbs a small area of the body, such as a single tooth.
• Monitored anesthesia care (MAC) is a form of sedation used to keep a patient relaxed and comfortable during a procedure. 
• Sedation is used to help people relax and feel comfortable during a medical procedure. It can range from minimal sedation (also known as "conscious sedation") to deep sedation, in which the person is not conscious but can be aroused.
• Twilight sedation or twilight anesthesia is another term you may hear for sedation, when a patient is sedated but remains conscious in a “twilight state”.

The type of anesthesia that is best for you will depend on your medical history and your preferences. Your healthcare team will help you decide which type of anesthesia is best for you.

What type of anesthesia is used for an egg retrieval?

For egg retrieval procedures, a common type of anesthesia used is sedation, a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic). Conscious sedation lets you recover quickly and return to your everyday activities soon after your procedure.

According to board-certified anesthesiologists Dr. Steven Alfond of Extend Fertility, “There’s light sedation, like taking a dose of Valium; during light sedation, patients are awake, and they’ll probably remember what’s going on. Light sedation might be used for simpler procedures. The fertility procedures require something a little deeper; we call it deep sedation. Most patients require just one medication—propofol—and, depending on pain, a pain medication.”

Sedation for egg retrievals is generally a combination of propofol, fentanyl, and midazolam, and designed to keep you still (so the doctor can successfully perform the procedure) as well as relaxed and comfortable. In some cases, such as when a larger procedure is required, general anesthesia may be used. This type of anesthesia is designed to put the patient into a deeper sleep, allowing them to remain unaware of the procedure.

Propofol for egg retrievals

Propofol is a sedative-hypnotic medication that is used to produce sleepiness or drowsiness and to relieve anxiety before and during the egg retrieval. It is often used for intravenous (IV) conscious sedation, which means that you remain awake but relaxed and comfortable during the procedure. Propofol is a popular choice for conscious sedation because it takes effect quickly and wears off rapidly, so you typically feel alert soon after the procedure. 

How is sedation administered during an egg retrieval?

Propofol is administered through an IV line, and the amount of medication can be adjusted to achieve the desired level of sedation. Because it is not general anesthesia, you can breathe on your own and don’t need breathing tubes (phew!).

How long are you under anesthesia for egg retrieval? 

Here’s the good news – the egg retrieval is a relatively quick procedure that typically takes 30 minutes. The length of time you are “under” or “asleep” depends on the type of anesthesia being used and your response to the medication.

If general anesthesia is used, you will be unconscious for the duration of the procedure and will not be aware of the time passing. If conscious sedation is used, you will be awake but relaxed and comfortable, and may not remember much of the procedure.

Regardless of the type of anesthesia used, the anesthesiologist will carefully monitor your vital signs and adjust the medication as needed to ensure your safety and comfort during the procedure. After the procedure, you will need to rest in a recovery area until the effects of the anesthesia have worn off, which can take anywhere from a few minutes to a few hours. (This is why it’s important to bring a buddy to drive you home!)

What happens during anesthesia in an egg retrieval?

If your doctor uses conscious sedation during the retrieval, the medication can take effect quickly (within seconds), so you’ll begin to feel relaxed and drowsy soon after receiving it. You’ll remain conscious and able to respond to commands during the procedure, but may not remember much about it afterwards.

If you choose deep sedation, you will go into a state of unconsciousness or near-unconsciousness rather quickly. You will not be fully aware of your surroundings and may not be able to respond to commands or communicate with the doctor. In other words, you’ll be in a deep sleep. 

If your doctor uses general anesthesia, you will be unconscious and unable to feel pain or sensation. General anesthesia is typically administered through an intravenous (IV) line or with a gas that you inhale. It is used to relax and incapacitate the muscles in your body, so that you do not move during a surgical procedure.

In any of these situations, your vital signs, such as heart rate and blood pressure, are closely monitored by the anesthesiologist to ensure your safety. The anesthesiologist will adjust the dosage of the medication as needed to keep you in a deep state of unconsciousness. After the retrieval is completed, the anesthesiologist will slowly reduce the level of medication, and you will begin to wake up. It is common to feel groggy and disoriented when you first come out of a deep sleep, but you’ll be back to yourself in no time.

How do you prepare for anesthesia during egg freezing?

Here are some ways to prepare for your egg retrieval:

• Inform your doctor about all the medications you are currently taking, including prescription and over-the-counter drugs, supplements, and herbs.
• Follow any instructions given by your doctor or anesthesiologist regarding eating and drinking before your egg retrieval.
• Arrange for someone to drive you home after the egg retrieval.
• Remove all jewelry and leave it at home.
• Wear comfortable, loose-fitting clothing to the clinic.

Your doctor will give you instructions for preparing for the egg retrieval, and it is important to follow their instructions to reduce the risk of complications during and after the procedure. 

Why do they use anesthesia and sedation during egg freezing?

Sedation and anesthesia are often used for egg retrievals to keep you still (so the doctor can successfully perform the procedure) as well as relaxed and comfortable.

You can work with your doctor to determine which method to use, based on your preferences and medical history. It is important to discuss the options and any concerns you have before the procedure. Your doctor can help you understand the potential risks and benefits of different types of sedation and help you make an informed decision about your care.

Can I do an egg retrieval without anesthesia or sedation?

While sedation is standard of care for an egg retrieval procedure, it is usually not required. Some women have had medical reasons for not wanting sedation, while others are concerned with the drugs used during sedation and are looking for a more natural course of treatment. If you don’t want to use anesthesia for your egg retrieval, it’s important to talk to your doctor in advance of the procedure. 

Most women prefer egg retrievals under sedation/anesthesia. But doing an egg retrieval without anesthesia is cheaper and faster, and does not require the presence or assistance of an anesthesiologist. Research has shown that it results in good satisfaction among the patient and the physician. 

A study of 100 women undergoing egg retrievals found that women who chose to skip sedation were significantly more likely to express fear of anesthesia. Those women experienced more pain during egg retrieval, but all but one said they would do the same in future cycles. 

What to do if you’re afraid of anesthesia

If you are afraid of anesthesia, it is important to communicate your concerns with your healthcare team in advance of the procedure. They can help you understand the process of anesthesia, your options, and what to expect. It may also be helpful to speak with an anesthesiologist, who can explain the specific medications and techniques that will be used during your egg retrieval.

You may also choose to bring a trusted family member or friend with you to your appointments, so that you have someone to support you and ask questions (you should also have someone with you at the retrieval as well).

Lastly, you may benefit from practicing relaxation techniques, such as deep breathing or progressive muscle relaxation, in the days leading up to your retrieval. I also found it helpful to listen to music through my headphones as the IV was put in and I went under sedation. Remember that your doctors are trained to keep you safe and comfortable throughout the procedure. You’ve got this!

Cofertility is in the “family” business, striving to make egg freezing and third-party reproduction more human-centered and accessible for all. Our Freeze by Co program allows you to freeze your eggs for free, when you give half to a family who can't otherwise conceive

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

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

Where do my donated eggs go?

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

Who qualifies for the Split program?

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

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

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

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

How does the process work?

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

Take the quiz 

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

Submit your program application 

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

Call with our team 

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

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

Sign the Split program agreement

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

Complete initial testing (AMH)

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

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

Match with an intended parent 

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

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

Complete further screening 

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

Start your egg freezing cycle 

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

Retrieve your eggs

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

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

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

Next steps 

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

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

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

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

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

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

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

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

Summing it up

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

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

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

Affordable egg freezing programs

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

Paying for keeps

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

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

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

The Split cycle

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

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

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

Important X factors

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

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

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

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

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

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

Logistics

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

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

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

Can you freeze your eggs? 

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

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

Perhaps the idea of egg freezing is something that you’ve thought about before. For many of us, though, cost can be a big barrier. You might be hoping to find an affordable egg freezing program that can allow you to freeze your eggs now and store them without breaking the bank, as you pursue your own agenda.

Is this just a pipe dream? With Freeze by Co, it’s actually…not. Read about how our new option can enable you to give the idea of egg freezing another look, with—wait for it—free egg freezing. And you get to help a family along the way.

An affordable innovation

With some egg freezing programs, fees can run into the thousands initially and grow every year. But at Freeze by Co, it is our goal to make the process as affordable as possible. This led us to develop what we call our Split program.

With the Split program, if you are eligible, the premise is simple: for each cycle you undergo, you keep half of the eggs for yourself at absolutely no charge, plus up to ten years of storage, when you give the other half of the retrieved eggs to another family who can’t otherwise conceive. All of your medical expenses and travel related to egg freezing is covered as well.

What you get as a Split member

In addition to giving a life-changing gift to another family, as a Split member, you are entitled to the following for free with your egg freezing cycle:

• Testing
• Medication
• Egg retrieval
• Egg freezing and storage
• Procedure insurance
• Travel
  

In addition to lightening your own financial load, the good you’ll be doing will be immeasurable.

Is it a fit?

To participate in Split, you must meet certain industry- and government-based criteria, including: 

• Being between 21 and 33 years old. Age is a factor that contributes to waning fertility, which, while not true for everyone, tends to decline at age 35. Since the process leading up to egg donation can take time, we cap the program at age 33, as consistent with guidelines set by the American Society for Reproductive Medicine (ASRM). 
• Having two ovaries
• Enjoying good physical and emotional health, without any reproductive issues or genetic abnormalities
• Having a body mass index (BMI) between 18 and 29 to enable optimal medication administration and egg retrieval outcomes
• Having avoided smoking and recreational drug use or Depo Provera injection as a mode of birth control

To learn more about all disqualifications for our Split program, click here.

To find out if our Split program is a way that we can help you reach your egg freezing goals, here’s how the process works:

Getting started

First, take our brief quiz to learn more about our Split program and see if you’re a potential fit. It just takes a few minutes. 

Applying for membership

Then, if you’ve pre-qualified, you move on to the application process. This is your chance to tell us more about your background and create a profile for intended parents to see and hopefully connect with. It will also help finalize your acceptance into the program.

The interview process

Next, we chat. You get to ask us any questions about the process and get to know us, as we get to know you as well. We’ll walk you through all program logistics and frequently asked questions so you feel completely comfortable with it all. 

Find a match

Once you’ve been fully accepted into the program, the matching process begins. When your profile has been selected by intended parents, you’ll have the opportunity to accept the match. If you agree it’s a good fit, then the screening and freezing process can begin.

Screening

During the screening phase, we’ll get a sense of your ovarian reserve and overall physical health to get a sense of whether you’ll have enough eggs available to fairly split for yourself and the intended parents. If your ovarian reserve appears strong enough that splitting the retrieved egg yield has the chance to result in a live birth for both parties involved, and you continue to qualify based on the other physical and psychological screening factors, you’ll be given the final green light.  

The cycle

Now it’s all about your cycle. This means you’ll start taking injectable medications needed to enable your ovaries to produce multiple eggs. We have loads of materials that can help you successfully manage this.

After close monitoring, when the time is right, you’ll be scheduled for the egg retrieval. During this 30-minute process, the doctor will remove the eggs with the aid of vaginal ultrasound while you’re under light anesthesia.

Free storage

Then, right away, your half of the eggs will be frozen. As a Split member, this whole process will be entirely free, including up to ten years of storage. In the case of an odd number of eggs, the extra one will be slated for use by the intended parents. However, any non-mature eggs retrieved will be frozen for you, since we don’t know what kind of medical advancements might take place over the next ten years. 

As a Split member, if you feel that it would be beneficial for you down the line, you can always consider doing another cycle. This will allow you to add to what you already have in storage and reap the benefits of additional free egg freezing, making the most of the program.

Adding it up

Our Split program puts egg freezing in reach for all members. It removes what’s often the biggest obstacle to taking charge of your fertility timeline — cost — while allowing an opportunity to help another family. 

Once you’ve completed the Split program, you can walk away knowing that not only have you figured out a way to make your goal of storing eggs a reality without the need for scrimping in other areas, but you’ve also succeeded in giving another family a golden opportunity they wouldn’t have had otherwise.

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

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

The process for freezing eggs

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

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

How your body responds to the process

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

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

The goals for women who freeze their eggs can differ

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

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

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

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

Some things to consider about freezing your eggs

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

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

Getting a jump start on your fertility is a wise choice

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

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

Take a look at your options

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

Worries about egg donation risks can hold you back from joining our Split Program, in which you can freeze your eggs for free in exchange for donating half to people who need help growing their families. But just how risky is egg donation? Are the rewards of helping grow a family enough to outweigh them? 

Here’s what the science says about the risks along with our take on some potential benefits. 

Egg donation risks

Overall, egg donation is considered a low-risk procedure and there are a number of steps along the way designed to ensure your safety. A 2017 Fertility and Sterility research study looked at more than 23,000 egg retrieval procedures performed on women in hospitals and fertility centers. Overall, the study found an overall complication rate of just 0.4%. 

The first stage of the process is a series of screenings to make sure you are prepared for what lies ahead.  You’ll undergo a general interview, blood testing, and a psychological assessment to make sure you are physically and mentally up for everything that egg donation entails. Importantly, these screenings help flag potential issues early, and mitigate any larger risks. 

The greatest risks exist for those who have pre-existing health conditions that put them in a higher risk category, these women are unlikely to pass the initial screening process. 

For those who are deemed healthy and ready for donation, the largest risks then lie in the egg production and egg retrieval phases of donation. 

Ovarian hyperstimulation syndrome

Just like the process for freezing your eggs, you will be prescribed injectable hormone medications to stimulate the ovaries to produce more eggs. This carries some risk of ovarian hyperstimulation syndrome (OHSS). OHSS is a condition in which the ovaries condition in which the ovaries can swell and fluid leaks into the abdomen, causing pain and discomfort. 

Cases of OHSS are rare, occurring in less than 5 percent of women who use these medications.  The symptoms are typically mild, causing bloating, nausea, and general discomfort that will go away one to two weeks after your egg retrieval procedure. OHSS cases that require medical attention occur in about 0.1% to 2% percent of women.  

Anesthesia risk

Once you’ve produced enough eggs, you’ll undergo a retrieval process at the fertility clinic. This process is outpatient, meaning you can go home that day, and typically only takes about half an hour. 

You’ll be under anesthesia for the procedure so it is worth noting that anesthesia does carry risks such as nausea, vomiting, low blood pressure, and allergic reactions. However, risks of major complications from anesthesia are rare, with just 1.1 per million each year across all types of procedures. If you have a history of nausea from anesthesia, talk to your doctor about it beforehand.

Egg retrieval complications

During the egg retrieval process, a fertility specialist will use a thin needle to aspirate eggs from  your ovaries. This does come with  risk of bleeding, infection or injury to something nearby – such as the bladder or bowels. If this were to occur, surgery may be required to correct the problem. But, as previously mentioned, only 0.4% of women encounter complications during this part of the egg donation process and just 0.29% percent require surgery due to those complications. 

More common after egg retrieval is some spotting and discomfort, both of which are temporary. Many women return to work the day after an egg retrieval, although some take a few days to recover.  

Will donating eggs affect future fertility?

One common question that potential Split members ask is whether there’s a risk that donating eggs will affect their future fertility. The answer is a solid no. 

Not only will donating eggs not affect your chances of getting pregnant naturally in the future, it also won’t lower your ovarian reserve (number of eggs in your ovaries). The eggs retrieved in an egg donation cycle are eggs that would have been lost that month naturally.

As part of our Split program, members donate half of the eggs that they produce during a cycle and keep the other half for themselves — freezing them to use at a later date. The cost of storage is also covered for 10 years.

Other common egg donation concerns

As you consider the Split program, you may have some other non-medical concerns. It's important to think through them before deciding to join the Split program. 

Wanting to remain anonymous

How much identifying information you want to share is ultimately up to you, however the advent of DNA testing from companies like 23AndMe and Ancestry.com has made it impossible to guarantee true long-term anonymity. It’s best to make any decisions about donating your eggs with this in mind. 

Wanting to know potential donor-conceived children

On the flip side, you may be curious about potential offspring and want to have a window into their world as they grow up. Split members are given the chance to build a plan with intended parents that is comfortable for both parties and ultimately honor and respect the donor-conceived child. That plan can vary from just a holiday card update to regular communication — it really is unique to the parties involved. 

Egg donation benefits

The CDC estimates a fifth of women encounter infertility every year and egg donation is a true gift to many families. 

If you’re weighing the risks against the benefits, the satisfaction of helping someone else grow their family can be incredibly powerful. As a Split Member, you’ll also have the added benefit of free health screenings and a chance to talk to fertility experts about your own fertility planning. 

Lastly, if you choose to donate eggs through Cofertility, you will also be able to keep half of the eggs produced during your cycle, giving you a jumpstart on your future reproductive planning. 

Bottom line

Although overall risks of egg donation are low, there’s a lot to think about. It’s important to consider it all and to talk open and honestly with the fertility experts at your disposal. 

Making the decision to donate eggs can be a powerful and fulfilling experience. Still, it should only be something you do because you feel comfortable with the process and potential long-term implications. We’d love to be a resource as you consider this process - feel free to reach out with any questions or concerns along the way. 

When you’re considering Cofertility’s Split program, it’s natural to wonder where the process ends—what would actually happen to your eggs after you’ve donated? After all, you’re probably looking into this option with the hope that a family may be able to grow their family with your help. So how does that all happen? 

How to donate eggs

First things first: if you decide that you want to help intended parents grow a family, you can expect to go through a pretty rigorous screening process. You’ll answer a lot of questions and go through a medical assessment

Typically you can expect the process to look like this:

1. Application and Interview: You will share more information about yourself, including background on your health and whether you’ve donated your eggs or been pregnant in the past. We will also gather information about your education and family so we can share this with the intended parents down the line. 
2. Medical testing: If your initial screening indicates that you are a good candidate for Split, once you match with intended parents, you will be tested for diseases such as HIV and hepatitis.You may be tested for genetic conditions such as cystic fibrosis. Importantly, you will also undergo a psychological evaluation to ensure that you’re participating in the program willingly and that you’re prepared for the process ahead. 
3. Medications: If you go through with the procedure, you will take injectable medications to stimulate your ovaries to produce more eggs. You’ll make several visits to a fertility clinic over a period of 10 to 14 days so the doctor can perform ultrasounds and monitor your ovaries. 
4. Egg retrieval: The fertility specialist will use anesthesia and retrieve eggs from your  ovaries with a needle and special suction device. This is considered a minor surgical procedure that can be done right at a fertility clinic under light anesthesia. It’s quick too — the whole process can take as little as 30 minutes. 

So what happens to my eggs after I donate them?

So what happens to my eggs after the egg retrieval? The eggs you’re donating will now move on to be fertilized and hopefully help grow a new family. 

Here’s how your eggs will be used to help intended parents: 

• Fertilization via IVF — After eggs are retrieved from your ovaries, an embryologist will use them to start the process of in vitro fertilization — more commonly known as IVF. The fertilization, or insemination process, is performed in a lab and involves adding sperm to the eggs. The fertilized eggs will then develop in the lab and hopefully become embryos, the building block of a developing baby.  

• Embryo testing — Some intended parents may opt for preimplantation genetic testing (PGT) to be done on the embryos. This process checks for chromosomal abnormalities such as extra chromosomes or missing chromosomes. This process can also flag genetic abnormalities controlled by a single gene, like cystic fibrosis or BRCA mutation.

• Embryo transfer — If the fertilization process is successful and the embryo continues to divide after fertilization, it’s now ready to be transferred into the uterus of an intended parent or gestational surrogate. This step of IVF is also done in a fertility clinic, where a reproductive endocrinologist will use a catheter to place the  embryo — or sometimes multiple embryos — into the uterus. 

• Pregnancy — If all goes well, the embryo will implant in the uterus, and your donated eggs will result in a pregnancy for the recipient family! Of course, success will be based on a number of factors here — not just your donor eggs. These factors range from the age of the woman carrying the baby to the quality of the sperm used in the insemination process. CDC data from 2019 (the most recent year for which data is available) found that more than 9,000 babies were born that year with the help of donated eggs. 

• Birth — When a child is born, the intended parents will be listed on the birth certificate and be considered the child’s parents in the eyes of the law. 

Do egg donors meet the parents?

As you’re considering the Split Program, it’s natural to wonder if you’ll meet the intended parents. You may also be debating the type of relationship, if any, that you might want to have with the intended parents and any potential offspring. 

Many egg donor agencies keep donors anonymous — that means they only share details with intended parents about a donor’s genetic history, physical characteristics such as eye color, education, and hobbies. They don’t put the two parties in contact with one another and don’t share the egg donor’s email, phone number, address, or even their real name. In fact, many of them even allow contracts where both parties agree not to reach out to the other. 

At Cofertility, the decision about the relationship between Split Members and Intended Parents rests in the hands of both parties. We provide the education and data as to what relationship we know from research is most healthy for the future child. And you will be able to choose how much (or how little) contact you want, shaping a relationship that you are both comfortable with and one that takes the feelings of the donor-conceived child into consideration. 

Can I donate my eggs again?

Maybe you’ve formed a relationship with the intended parents who used your eggs and they want a sibling, or perhaps you want to help more families. Either way, you may want to donate your eggs again — and you can. The American Society for Reproductive Medicine guidelines allow for women to donate eggs up to six times. Know that this decision is entirely up to you.

Freeze your eggs for free by donating half to a family in need

We created the Split Program to give women the option to keep half of the eggs retrieved during the egg donor process. The costs of oocyte cryopreservation (the official medical term for egg freezing) along with 10 years of storage are entirely covered.

The number of eggs retrieved per cycle will vary based on your age and other factors. One study of 1,241 women found that, for women under 35, the average number of eggs retrieved on the first egg freezing round was 21. Depending on the number that you retrieve, some doctors may recommend completing a second cycle to ensure that you have enough eggs  frozen for your own future use. 

Bottom Line

While the process may end for you at the retrieval, it’s natural to wonder what happens next. Split Program members are giving an incredible gift to a family in need and we want to make sure that you feel honored and respected throughout that process. With Cofertility, you play a role in deciding how much - or how little - you know about what comes after your retrieval.

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

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

Here’s what you need to know about the process

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

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

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

Getting ready for retrieval 

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

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

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

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

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

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

Retrieving your eggs

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

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

Freezing and monitoring

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

Storage timelines

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

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

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

How much does it cost?

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

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

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

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

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

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

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

Breaking down the egg freezing process

Choosing a clinic

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

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

Consultation 

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

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

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

Evaluation and bloodwork

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

This testing may include:

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

Connecting with your community

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

Medications

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

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

Medications commonly prescribed in the egg freezing process include:

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

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

More blood tests and monitoring

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

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

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

Egg retrieval 

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

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

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

Cryopreservation

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

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

A second egg freezing process

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

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

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

Costs of the egg freezing process

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

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

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

Bottom Line

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

Your uterus creates extra tissue each month to create a cushy home for your potential baby. But if you have endometriosis, your uterine tissue grows wild, and can end up in places you don’t want it to be—including places where it could cause some serious fertility issues. In fact, a recent Journal of Assisted Reproduction and Genetics study estimated endometriosis is to blame for between 25% to 50% of all infertility cases. 

What is endometriosis?

Endometriosis develops when your body grows uterine lining (a tissue called endometrium) in places where it doesn’t belong. Most often, it shows up in areas near your uterus—your fallopian tubes and ovaries, on the outside of the uterus, in the vagina or cervix. In a few rare cases, it can even end up in other places, like your bladder. 

It may feel like you’re the only person in the world dealing with these symptoms, but the truth is, it’s just that people don’t talk about their symptoms. Endometriosis is extremely common. According to the Office on Women’s Health, more than 11% of women between the ages of 15 and 44 have developed it. Of those women, 30% to 50% experience some form of endometriosis infertility challenges. This is most common in women who: 

• Are in their 30s and 40s, especially those with family members who have had it 
• Started their period at a younger age
• Have never had children
• Have extremely long or short menstrual cycles

Signs of endometriosis

The most common red flag that you might have endo is severe cramping and pain, especially during your period. Here are some of the other telltale signs that you’re growing uterine tissue in odd places:

• Pelvic pain: Women with endometriosis often develop chronic severe back and pelvic pain. They may also experience severe menstrual cramps, pain when they pee, and even painful sex (which will definitely be a fertility hurdle). 
• Digestive upset: Stomach cramping, diarrhea, constipation and bloating occasionally accompany endometriosis, especially if you have your period. 
• Heavy periods—and spotting in between them: Women with endometriosis may bleed outside their typical menstrual cycle, or develop heavy bleeding when they have their period. Fun times! 
• Infertility: Scarring and excess tissue can literally cause a roadblock that can keep eggs and sperm from meeting, or even prevent a fertilized egg from implanting in the uterus.

How endometriosis can affect fertility

In case its other symptoms didn’t suck enough, endometriosis can also cause infertility, thanks to the scarring and excess tissue buildup. Ironically, all that uterine tissue that your body is producing for a baby could actually block the pathways to conception. 

“Endometriosis is thought to cause infertility because of the scarring and adhesions that result when endometrium grows on pelvic organs,” says Dr. Nataki Douglas, M.D., Ph.D, director of translational research for the Department of Obstetrics, Gynecology and Women’s Health at Rutgers University in New Jersey. The more extensive the disease and scarring, the greater the negative impact on fertility. “For instance, the adhesions can make it more difficult for an egg to be swept up by a fallopian tube and become fertilized.”

Can and should I freeze my eggs if I have endometriosis?

Absolutely. Some doctors will recommend egg freezing for women with endometriosis, while they're young and the condition is still in the early stages. Because some surgeries for endometriosis can actually worsen fertility by inadvertently removing healthy ovarian tissue or compromising vascular supply to the ovary, egg freezing should be done before any such surgeries.

If you are interested in freezing your eggs, we can connect you with a fertility specialist for a consultation to discuss your specific situation. Our Freeze by Co is making egg freezing more empowering, positive, and accessible — even free — when you give half of the eggs retrieved to a family who can’t otherwise conceive. 

What your doctor might recommend

The good news is, endometriosis can often be treatable. Depending on your situation, treatment might include:

• Hormone therapy: Often in the form of birth control pills, this prevents additional tissue growth and damage. 
• Pain relievers: Over-the-counter pain relievers can help manage the pain that comes with endometriosis at certain points in your cycle.
• A diagnostic workup: Thankfully, some women with endometriosis are still able to conceive, but talk to a reproductive endocrinologist if you don’t get a positive pregnancy test on your own within 6 to 12 months. A full diagnostic workup might be a good idea. Dr. Marra Francis, MD, FACOG, an OB/GYN in The Woodlands, TX, notes that this workup would likely include both diagnostic procedures for endometriosis and a hysterosalpingogram (HSG), which will show if your tubes are blocked. This may prevent pregnancy or increase the risk of an ectopic pregnancy, so you’ll want to work with your doctor on figuring out the best course of action.  
• Surgery: This is one of the most effective methods for treating endometriosis and preserving fertility, according to Dr. Douglas, but also the most invasive. These surgeries can remove adhesions and ovarian cysts, clearing tissue out of the fallopian tubes and making pregnancy a real possibility. 

Still, you might need a little boost to make that baby happen. While there are tons of treatments out there, depending on a host of factors—age, number of years trying, status of fallopian tubes, status of sperm—women can proceed with standard fertility treatments, like oral medication and IUI. However, while it is the most invasive, “IVF has the best results in the majority of women with endometriosis,” says Daniel Kort, associate medical director and practice director at Neway Fertility in New York City. 

Bottom line

Endometriosis can be a real pain—literally and figuratively—and infertility is one of the most common complications associated with it. Fortunately, with a little help from a reproductive endocrinologist, it’s still possible to conceive if you’ve developed endometriosis infertility.