fertility testing

Intro 

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

What is egg freezing?

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

Should I freeze my eggs?

There are many, many reasons why someone might choose to freeze their eggs but the decision is a deeply personal one that requires some careful consideration. When making that decision though, it’s important to know that egg freezing is not an “insurance policy” for your fertility. While egg freezing can take some of the stress of having a baby right now off your shoulders, it is not a guarantee that you’ll have a baby in the future. 

Why not? Well, not all the eggs that get frozen will actually be viable. It’s expected that some eggs will not survive the warming process. In addition, the chances of the eggs that do survive being successfully fertilized depends partially on how old you were when you froze them (more on this later). Beyond that, fertility and pregnancy risks change with age. If you freeze your eggs at 30 and use them when you're 40, you'll have to deal with the realities of pregnancy at 40.

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

Pros of egg freezing

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

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

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

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

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

Cons of egg freezing

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

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

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

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

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

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

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

When should I freeze my eggs? 

Let me start by saying that there is no perfect age at which to freeze your eggs. However, the TL;DR is that the younger you can do it, the better. According to the American Society for Reproductive Medicine (ASRM), an optimal time to freeze your eggs is in your 20s and early 30s, while you have a higher ovarian reserve and eggs are healthier. So whether you’re 25 or 35, you can absolutely freeze your eggs!

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

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

These findings bring up a common question–is it worth freezing eggs after age 35? Well, it depends. The ASRM does not recommend egg freezing for people older than 38, but this isn’t a strict cutoff. Everyone’s fertility goes down at a different rate. Having your fertility hormones checked can sometimes help you and your doctor get a general idea of what your ovarian reserve is. This can better help you decide if egg freezing is right for you.

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

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

It may not come as a surprise to learn that the prime time for freezing your eggs is actually a lot earlier than you think. According to the American College of Obstetrics and Gynecologists (ACOG), freezing your eggs while you’re still in your 20s can help boost your chances of a successful pregnancy—and a 2010 report from the Center for Disease Control and Prevention (CDC) says that those eggs have a higher chance at resulting in a live birth no matter your age when you decide to start your family. 

For many women, that means the best time to freeze their eggs is likely the moment they start wondering when they should start. Read on to see what you need to know about why freezing your eggs before you’re even sure what you want to do with them is the best way to ensure you’ll be able to make the decision for yourself when the time is right. 

Your body produces a different number of eggs at different times

Your late 20s and early to mid-30s are considered the peak time to retrieve eggs—with a 2015 study from the American Society for Reproductive Medicine saying you’ll see the best results prior to the age of 34 — because your body has reached complete development and your eggs are at their most healthy and plentiful point.

That doesn’t mean that the quality of your eggs takes a major dip when you celebrate your 38th birthday. Instead, it means that as you add more and more candles to your birthday cake each year your body begins to produce fewer eggs. This becomes important when you realize how many eggs you’ll need to retrieve when you begin the process of freezing your eggs.  

Take the 2020 study from Assisted Reproduction Technologies (ART) that showed women under the age of 35 were retrieving an average of 21 eggs during their first round of egg freezing while women between the ages of 35-37 were retrieving an average of 17. Four eggs may not seem like that big of a difference at first, but once you take into account how many eggs experts say you should have on hand when it comes time to start fertilization you’ll begin to realize just how quickly those numbers add up. 

Producing fewer eggs may increase costs

The saying less is more doesn’t apply too much in the world of fertility, where your chances of going on to have a live birth increase based on the number of eggs you have on hand when it comes time to fertilize and implant them. 

That 2020 ART study that showed the average number of eggs retrieved each cycle also showed that if you're under the age of 35 you will need 9 eggs for a 70% chance at having a baby. However, if you’re looking to hit that same 70% mark in your later years (think 38-40), you’ll need closer to 18 eggs to have the same chances at a live birth. With women in that age range only averaging 17 eggs per retrieval, that may mean multiple cycles, and with a $10,000-20,000 price tag that can quickly add up.

The best time to freeze your eggs is, unfortunately, usually before you can afford it

Not many people have that much money readily available in their 20s, which is why egg freezing is often financially out of reach for those who would benefit most from it. With programs like Freeze by Co you can take advantage of those peak fertility years even if you can’t exactly swing the costs. 

One program offered by Freeze by Co is Split. Split Members benefit by offsetting the cost of freezing their eggs by donating half of them to a family that cannot otherwise conceive. Split Members match with intended parents, and undergo an egg freezing cycle where half of their eggs are donated to the perfect intended parents (after testing and meeting qualifications, of course). The other half are then stored (for free) for the split member for up to 10 years. 

If you’d rather hold onto all your eggs until you’ve decided what your fertility future holds, you can use Freeze by Co’s Keep Member plan. These members can still benefit from lower costs, thanks to things like reduced medication fees, consultation discounts, and more. 

This is the most cost-effective age to freeze your eggs

With all these numbers flying around you may be wondering where the health benefits and the financial benefits meet. According to a 2015 study published in the journal Fertility and Sterility, the two numbers seem to cross paths at the age of 35.

Women who freeze their eggs at 35 for use by the age of 40 spend an estimated $15,000 less than those who are trying to have a baby at 40. And that’s not the only good news, that math seems to hold up all the way until the age of 38. 

Freezing your eggs should be a positive experience

With the accessibility Cofertility gives women to take control of their fertility process, you can feel empowered to make decisions based on what’s in the best interest for you and your body without having to worry about your bank account. 

Getting an earlier start at freezing your eggs through Freeze by Co (even if you don’t have a partner or aren’t even sure that your dream future includes children yet) will: 

• Give you a higher chance at eventually achieving a live birth even if you wait until your late 30s or early 40s.
• Allow you to wait on making major decisions about your education, career, and future until you’re ready.
• Offer you the freedom to make medical decisions based on what’s right for you instead of what type of coverage your employer offers at the time. 
• Provide peace of mind because no matter what your future family may look like you’ve already taken the first step to making your dreams a reality. 

Even if you’ve missed that peak window into your fertility there are still plenty of benefits to freezing your eggs. With all of the new plans offered by Freeze by Co you’re likely to find one that will fit your current needs while giving you a chance to plan for your future.

Many folks who have made the big (and exciting) decision to freeze their eggs want to improve their egg quality before freezing. But is egg quality really something you can control? What kinds of lifestyle changes should you make before freezing your eggs? Read on for a look at what the research says about egg quality — and what you can do to improve it before the egg freezing process begins. 

What is egg quality?

As you’ve been exploring the egg freezing process, you may have heard your fertility doctor mention that freezing during your 20s can be beneficial because your egg quality will likely be higher. 

It’s annoying, but true: as women age, our egg quality typically goes down further and further. The American College of Obstetricians and Gynecologists (ACOG) estimates a woman’s chances of getting pregnant begin to decrease at age 32 and continue to gradually go down until about age 37 when the decrease becomes more rapid. ACOG links this decrease in what they call fecundity — another word for fertility — to egg quality. 

This is one of the many reasons Freeze by Co partners with local fertility clinics to create opportunities for women in their 20s to freeze eggs more affordably. We want you to have more control over your reproductive choices, even if you’re not looking to get pregnant during this peak egg quality period.

But what does “egg quality” (also called oocyte competence) actually mean? Are doctors being a tad judgmental about a woman’s age? Not at all. 

When fertility specialists use this term, they’re referring to whether your eggs are considered genetically normal or abnormal, and it’s tied pretty closely to the chances that an egg could ever result in pregnancy.  

Euploid vs. aneuploid embryos 

While sperm health is undeniably important, it all starts with the egg. The quality of embryos made from your eggs comes down to two different types:

• Euploid embryos 

• These embryos are genetically “normal.” 
• They contain the right number of chromosomes at 46. 

• Aneuploid embryos

• These embryos are genetically “abnormal.” 
• They contain either fewer or more chromosomes than normal. 
• Embryos created with a low quality egg may inherit either too many or too few chromosomes. 
• Most aneuploid embryos will either fail to implant or result in miscarriage as they are usually not compatible with life. 

There’s also a significantly higher risk that an aneuploid embryo will not implant in the uterus after an in vitro fertilization (IVF) transfer — one study found as much as 96 percent of abnormal embryos transferred into the uterus did not implant. On the other hand, that same study found when euploid embryos were transferred, the pregnancy rate was 82 percent. 

Do I need to improve my egg quality before freezing? 

So if euploid embryos start with healthy eggs, you’re probably wondering: do I need to improve my egg quality before freezing? 

Some factors that affect egg quality such as your personal genetics and the passing of time can’t be controlled. But there are ample steps you can take to influence the health and quality of your eggs. 

Here are some simple changes that research shows may improve egg quality. We recommend you consider making these changes at least three months prior to egg freezing: 

1. Quit smoking 

If you’re using cigarettes, now is a good time to stop. Studies have found that smoking can have a detrimental effect on fertility. Puffing on cigarettes can increase the risk of infertility by as much as 60 percent with negative effects on the menstrual cycle, uterus, and ovaries. It’s the effect on the ovaries that is particularly troubling when it comes to egg quality with smoking damaging the DNA of the eggs themselves. 

2. Avoid marijuana

Although there aren’t a lot of studies on the effect of marijuana on fertility, those that exist indicate THC — the psychoactive ingredient in marijuana — can result in an impaired ability to produce viable embryos. According to a study published in the Journal of the Endocrine Society in 2020, the exposure of oocytes to THC was linked to a “significant decrease in the expression of genes called connexins.” These connexins are an important marker of egg quality. For our Split members, we require them to stop using marijuana products at least one month prior to retrieval.

3. Improve your diet

There is never a bad time to eat a healthy diet, and if you’re planning to freeze your eggs in the near future there are extra reasons to make smart choices at meal time. Eating a diet rich in leafy greens, whole grains, and lean proteins can all help those egg cells. 

Here are some rock star foods you might want to consider adding to your diet when you’ve got an eye on improving egg quality (plus the benefits they bring):

• Fish such as salmon, mackerel, and trout — Omega 3 fatty acids
• Egg yolks — Vitamin D
• Beans, oats, oranges, and cantaloupe — Inositol
• Fruits and veggies of any kind — Antioxidants
• Oysters, beef, chickpeas, lentils, hemp seeds, pumpkin seeds, and pine nuts — Zinc

Before embarking on any major diet changes, check with a registered dietician. They can help you craft a plan that’s just right for your body. 

4. Talk to your doctor about supplements

If you’re not already taking vitamins, you may want to chat with your reproductive endocrinologist about whether you should add Vitamin A, Vitamin B, folate and zinc — or maybe one of the four — to your daily routine. Studies have linked all three of these micronutrients to egg quality over the years, affecting the synthesis of DNA and other factors in oocyte development. 

Your doctor may want to check your vitamin D level with some bloodwork or go over your current vitamin regimen before deciding if adding on additional supplements is necessary. Make sure to bring any dietary changes you’re making into the conversation too — there can be too much of a good thing when it comes to some vitamins!

5. Talk to your doctor about your weight 

Being told you need to hop on the scale when you’re at the reproductive endocrinologist’s office can be frustrating, especially if you’ve struggled to lose or gain weight in the past, or if you have a condition such as polycystic ovarian syndrome (PCOS) that affects your weight. 

Still, the weight conversation is one worth having with your fertility specialist if you’re worried about your egg quality. Both being over and underweight has been linked to egg quality by researchers time and again. 

Obesity in particular has been found to affect the hormones that guide an egg as it matures. On the other hand, being underweight can stop the body from ovulating entirely. 

The “right” weight for your body is one you and your doctor can discuss. If changes are in order, they can help craft a plan for healthy changes — or recommend a dietician who can. For our Split program, there are BMI requirements, which you can read more about here.

The bottom line

The quality of your eggs may not be completely in your control, but you do have solid options when it comes to improving your egg quality before freezing. What you put into your body makes a difference, and making changes now can make a real difference down the line. 

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.

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

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

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

Age

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

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

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

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

Health-related factors 

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

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

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

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

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

Medical and family history

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

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

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

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

Psychological screening

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

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

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

Genetic screening

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

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

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

Physical screening

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

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

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

The following could also be deal breakers: 

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

Anti-Mullerian hormone (ovarian reserve) levels

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

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

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

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

State-specific qualifications

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

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

Additional disqualifying factors

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

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

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

The net net

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

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

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

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

Age

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

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

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

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

Health-related factors 

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

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

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

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

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

Medical and family history

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

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

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

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

Psychological screening

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

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

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

Physical screening

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

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

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

The following could also be deal breakers: 

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

Anti-Mullerian hormone (ovarian reserve) levels

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

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

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

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

Genetic screening

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

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

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

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

State-specific qualifications

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

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

Additional disqualifying factors

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

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

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

The net net

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

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

There's something about trying to get pregnant that seems to bring out the worst advice from your friends and family. Sure, they mean well, but when your cousins are swearing up and down that they know absolutely the only thing that will help you conceive, it can be hard to tell truth from fact.  

Take the myth that checking your cervical position will help you pinpoint just when you're ovulating so you can rush to the bedroom for some good old-fashioned babymaking sex. Yes, we said it's a myth.  

Although it's widely touted by some women as "the thing" that helped them tell just when they're ovulating, the fact is the only time the cervix goes through major changes is when a woman's giving birth, says Alyssa Dweck, M.D., an OB/GYN and author of The A to Z for Your Vag. Not to mention, "most women can't even feel their cervix" to determine its position, she says, so if it were to change, it would hardly help folks determine where they are in their menstrual cycle.  

If tracking my cervix won't help, how can I tell when I'm ovulating?

Forget what your cousins, best friends, and that overbearing lady at the supermarket swear will help you tell when it's time to have sex. Here are some bona fide ways actual doctors say you can tell if you're ovulating:

• Cervical mucus changes: Although the cervix doesn't move, it does produce a discharge during ovulation that can be a clear sign that you're at your most fertile, says David Diaz, MD, a reproductive endocrinologist at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif. If you insert a few fingers in your vagina, and they come out with a clear, slippery, stretchy mucus on the tips, it's a good indication you're ovulating.  
• PMS-like symptoms: It doesn't sound quite fair, does it? Double the PMS? For some women, symptoms such as breast tenderness or bloating that many associate with the days before their period arrives may actually show up even earlier…when they're ovulating. The good side of this? If this is you, it may help you get a handle on your cycle.
• Cycle-tracking apps: Technology has come a long, long way in recent years, and many of the cycle-tracking apps on the market may help a woman pinpoint her most fertile period, Dweck says. Not all apps are created equal, so it's best to talk to your provider about your cycle and needs (or check out our guide here) to find out if there is an app they recommend you use.  
• Follicle ultrasounds: Cycles vary. Your best friend might have a 28-day-cycle, while yours might be more like 34 days…or maybe 21. If you haven't been able to nail that ovulation window at home, a reproductive endocrinologist may be able to help using ultrasound technology.    

The net-net

You can skip the cervix checks (and you might want to stop taking medical advice from your cousin). But there are plenty of other methods that may help you figure out the perfect time to schedule some baby-making sex sessions. Good luck!

When the first baby was born from a frozen egg in 1986, it was considered a miracle of modern science. Today, egg freezing has evolved from an experimental procedure to a mainstream fertility option, with thousands of babies born from frozen eggs worldwide each year. But as more women consider freezing their eggs, debates continue about the medical, ethical, and social implications of this technology.

Some view egg freezing as a powerful tool for reproductive autonomy, allowing women to increase their chances of pregnancy later in life by preserving their younger, healthier eggs. Others worry about everything from medical risks to societal implications. 

This article explores the six “controversies” surrounding egg freezing. We'll examine these criticisms, look at what the research actually shows, and discuss how the conversation continues to evolve. Let’s dive in.

1. Medical considerations and concerns

Some people have concerns about egg freezing, particularly regarding the safety of the procedure. However, many of their concerns stem from earlier days of the technology. 

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

Read more in Is Egg Freezing Safe? An OBGYN Answers Your Top Questions

2. The "false hope" debate

Another criticism is that egg freezing provides false hope to women about their future fertility. Critics raise a few concerns, so let's examine each one alongside current data and understanding.

Success rates

Critics point to declining success rates with age at freezing. While it's true that egg quality decreases with age, this is precisely why egg freezing can be valuable. By preserving eggs at a younger age, women can freeze younger eggs to use later on. A woman who freezes her eggs at 32 can use those same 32-year-old eggs when she's ready to build her family, whether that's at 36 or 42. Because IVF success depends more on the age of the eggs than the age of the mother when carrying the pregnancy, egg freezing can increase the chances of a healthy pregnancy in the future.

Thawing

Another concern is that not all frozen eggs will survive the thaw process. However, modern flash-freezing techniques (vitrification) have dramatically improved survival rates. Current data shows that 95% of eggs now survive the thawing process. This is why fertility doctors typically recommend freezing multiple eggs, accounting for both thaw rates and the typical number of eggs needed for a successful pregnancy.

Read more about Egg Freezing Thaw Rates

No guarantees

Critics also argue that having frozen eggs doesn't guarantee a future pregnancy. This is true – no fertility treatment comes with a guarantee. However, framing egg freezing as a way to increase your chances of a healthy pregnancy down the line, rather than a guarantee, helps set realistic expectations. One study found that a woman under 35 will need 9 eggs to achieve a 70% chance of having at least one live birth. 

Oversimplified marketing

Some suggest that marketing oversimplifies the complexity of fertility. This is a valid concern, and it's why transparent education about the process is so important. However, most women who pursue egg freezing do so after careful research and consultation with board-certified fertility doctors. They typically understand that it's one option among many for family planning.

Rather than providing false hope, egg freezing can offer realistic hope when women receive accurate information about success rates and limitations. We aim to ensure that women have access to clear, evidence-based information to make informed decisions about their reproductive futures.

3. Workplace benefits controversy

The addition of egg freezing to corporate benefits packages has sparked particular debate. Some critics argue that these benefits send a problematic message to female employees, suggesting they should prioritize work over starting a family. Some view it as a subtle form of pressure to delay parenthood, keeping talented women at their desks longer rather than taking maternity leave. Others see it as companies avoiding more meaningful family-friendly workplace reforms, like comprehensive parental leave policies, flexible work arrangements, or on-site childcare facilities.

However, supporters of these benefits present a different perspective. They argue that providing egg freezing coverage simply expands the range of reproductive choices available to women, particularly given the significant cost of the procedure. With egg freezing often costing $15,000 or more per cycle (plus annual storage fees), employer coverage can make this option accessible to more women who might otherwise be unable to afford it. Additionally, these benefits acknowledge the reality that many professionals want to pursue both career advancement and parenthood, but may not be ready for children during their most fertile years.

While the debate continues about the implications of these benefits, let’s acknowledge that egg freezing coverage remains relatively rare. Despite headlines about tech giants and large consulting firms offering this benefit, the vast majority of American women lack access to any fertility coverage through their employers. This means most women must pay out of pocket for the procedure, creating a significant gap between those who have employer support and those who don't.

Looking at the bigger picture, egg freezing benefits shouldn't replace comprehensive family-friendly workplace policies, but they can be part of a larger benefits package that supports employees' diverse needs and life choices. These benefits should exist alongside, rather than instead of, other family-supporting policies. When implemented thoughtfully, egg freezing coverage can be one component of a workplace that truly supports women's reproductive and career choices. The real issue may not be whether companies should offer these benefits, but why more companies don't provide any fertility coverage at all.

4. Social implications and pressures

The increasing popularity of egg freezing reflects and influences broader societal conversations about reproduction, careers, and modern family planning. As the procedure becomes more common, it raises questions about how we view the timing of parenthood in contemporary society. Some worry that the availability of egg freezing might create an expectation that women should delay having children until they've reached certain career milestones or financial goals, potentially shifting our cultural norms around when and how people choose to start families.

The reality is that both men and women are having children later in life - a trend that mirrors other demographic shifts like longer life expectancy, extended years of education, and later marriages. While we're living longer and healthier lives than ever before, our reproductive biology hasn't evolved at the same pace. A woman born today might live well into her 80s or 90s, but her eggs are most viable in her 20s and early 30s - creating a disconnect between our biological and social timelines.

Today's families often want to achieve financial stability, advance in their careers, find the right partner, and feel emotionally ready for parenthood before having children. These are reasonable goals, but they can conflict with optimal fertility timing. Rather than creating pressure to delay parenthood, egg freezing technology merely provides an option for those already planning to have children later, helping bridge the gap between biological and social timelines.

These social discussions reflect deeper cultural tensions about work-life balance, gender roles, and reproductive choices. While egg freezing offers increased flexibility in family planning, it also raises questions about how society can better support people in building families when and how they choose. This leads to broader discussions about workplace support for parents, the cost of childcare, and how to create environments where people don't have to choose between career growth and family planning.

5. Cost and access concerns

The significant cost of egg freezing raises important questions about equity in reproductive healthcare. With prices typically ranging from $15,000 to $20,000 per cycle, plus annual storage fees, many women are priced out of this option entirely. This creates a troubling dynamic where fertility preservation becomes accessible primarily to higher-income women or those working for companies that provide coverage. Some argue this deepens existing reproductive healthcare disparities, while others say that as the technology becomes more common, costs will naturally decrease.

These financial barriers become particularly concerning when considering that many women might need multiple cycles to freeze enough eggs for future family building. The high costs can force women to compromise on the number of eggs they freeze, potentially affecting their future chances of success.

This is why we started Cofertility - to help make fertility care more accessible. Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.

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

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

6. Control over women’s reproductive choices

Perhaps the most fundamental controversy surrounding egg freezing stems from a sadly familiar source: resistance to women having control over their reproductive choices. Just as with birth control and abortion, egg freezing faces criticism simply because it gives women more reproductive autonomy. Some critics mask their discomfort with women's bodily autonomy behind concerns about "natural" conception or traditional family structures.

This resistance often manifests in subtle ways: dismissing egg freezing as "selfish," suggesting women are "playing God," or implying that women should simply have children younger rather than wait until they are ready. These criticisms ignore the complex realities of modern life and the valid reasons women might want to preserve their fertility options.

The bottom line

At Cofertility, we believe women deserve access to accurate information about their reproductive options and the ability to make informed choices about their futures. We're working to make egg freezing more accessible while maintaining high standards for patient education. We understand that egg freezing isn't right for everyone, but we believe women deserve the opportunity to make that choice for themselves.

Rather than letting these controversies discourage women from exploring their options, we should focus on addressing the underlying issues: improving access, ensuring transparent success rate reporting, developing better insurance coverage, and most importantly, defending women's right to make their own reproductive choices. The future of egg freezing lies not in whether women should have this option, but in how we can make it more accessible, successful, and supported for those who choose it.

We’ve helped thousands of women freeze their eggs over the years in our Keep and Split programs. For those considering Split, where you freeze your eggs for free when donating half to a family that couldn’t otherwise conceive, there are even more questions about the donation piece. It's a big decision, and it's natural to want to know everything before moving forward. This article aims to address the most common questions we receive, providing clear and honest answers to help you make an informed choice.

Will egg donation affect my future fertility?

This is one of the most frequent concerns we hear. The short answer is no, egg donation does not harm your future fertility. Here's why:

• During a typical menstrual cycle, your ovaries prepare several eggs, but usually, only one matures and is released during ovulation. The rest of the eggs that month naturally break down and are reabsorbed by your body.
• The hormone medications used in egg freezing/donation allow all the eggs in that menstrual cycle to mature instead of just one. The key is that you're not losing more eggs than you would have otherwise—you're just maximizing the potential of your current cycle.  
• You get a new group of eggs each menstrual cycle, so donating doesn't deplete your overall egg reserve.
• Research has not shown any long-term negative impacts on fertility from egg donation.

Our Medical Advisor, Dr. Mare Mbaye, wrote more about this topic: Does Donating Eggs Affect Your Fertility?

Why might I need to take birth control pills during the donation process?

Birth control pills are sometimes used in egg donation cycles for two main reasons:

1. Timing: They help synchronize your cycle with the recipient's treatment schedule.

2. Follicle synchronization: They help ensure your follicles are all uniform and small before the stimulation phase. When follicles are similar in size, they respond more evenly to the stimulation medications, allowing a greater number of eggs to mature at the same pace. 

3. Ovarian cyst prevention: The hormones in birth control pills can help suppress the growth of ovarian cysts during the stimulation phase. 

Not all cycles require birth control pills. Your medical team will determine if they're necessary for your specific situation.

Read more: Egg Freezing and Birth Control: An Overview

What's the difference between mature and immature eggs?

During the egg retrieval process, doctors aim to collect mature eggs, also known as metaphase II (MII) oocytes. MII eggs are the ones that are fully mature and ready for fertilization. Metaphase I (MI) stage eggs have started maturing but aren't fully developed yet. MI eggs can sometimes mature into the more developed MII stage with the right conditions, but this doesn’t always happen. Germinal vesicle (GV) stage eggs are the most immature and can be recognized by having a visible nucleus. Here's a brief explanation:

• Mature eggs: These are ready for fertilization and have the best chance of developing into healthy embryos. The hormone medications used in egg donation help maximize the number of mature eggs retrieved.
• Immature eggs: These eggs haven't completed their developmental process and are less likely to result in successful pregnancies today. However, members of our Split program get to keep all the immature eggs if their clinic policy allows in hopes of being able to use them in the future.

Our Medical Advisor Dr. Meera Shah wrote more about this: Egg Freezing: Mature vs. Immature Eggs

How does the disclosure process work?

At Cofertility, Egg donation range on a spectrum from undisclosed to disclosed. Many donors have questions about what this looks like:

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

It's a common misconception that disclosed donation means frequent or ongoing contact. In reality, the level of communication can vary greatly:

• It might be limited to medical updates or questions.
• Some families choose to have more open relationships, while others prefer minimal contact.
• You and the recipient family can discuss and agree on communication preferences.

Read more: Disclosed vs Undisclosed Egg Donation: How Do I Choose?

Will egg donation be painful?

The egg retrieval process is typically not painful, but you may experience some discomfort:

• The procedure is done under sedation, so you won't feel pain during the retrieval.
• After the procedure, you might have some cramping or bloating for a few days.
• Most people describe the discomfort as similar to menstrual cramps.

Read more: Is It Painful to Freeze or Donate My Eggs?

What are the costs associated with egg donation?

As a Split member, you don't incur any costs. All of your office visits, screenings, medication, procedures, and travel expenses, plus 10 years of storage with our preferred biorepository partner, are completely covered. 

The only expenses you would encounter is in the future, when you ship the eggs to a clinic to fertilize.  

Can I donate if I have a particular medical condition?

Eligibility for egg donation depends on various factors. Some medical conditions may disqualify you, while others may not affect your ability to donate. The best way to find out is to reach out to us, or apply. 

Read more in Can I Freeze My Eggs If...

How many times can I donate eggs?

The American Society for Reproductive Medicine (ASRM) is an organization that provides guidance and recommendations to fertility clinics and professionals. One of the guidelines that the ASRM has established is regarding the maximum number of egg donation cycles that an egg donor can undergo in their lifetime. According to their recommendations, egg donors should undergo no more than six cycles of egg donation throughout their lifetime. However, most of our Split members donate only one or two times. 

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While this article covers many common questions, please reach out if you have any other questions or want to talk through the process with one of our Member Advocates. At Cofertility, we're committed to providing transparent information and support throughout the egg donation process.

If you're considering egg freezing, or have already frozen your eggs, you may have encountered terms like "mature" and "immature" eggs. Understanding the distinction between these two types of eggs can help you grasp the egg freezing process and its potential outcomes. 

This article will delve into the biological differences between mature and immature eggs, their significance in egg freezing, and what this means for your fertility journey.

The basics of egg development

To comprehend the difference between mature and immature eggs, it's helpful to understand the process of egg development, also known as oogenesis. This process begins before birth and continues throughout a woman's reproductive years.

Primordial follicles: The starting point

At birth, a female's ovaries contain approximately 1-2 million primordial follicles, each housing an immature egg (oocyte). These primordial follicles represent the total pool of potential eggs a woman can produce in her lifetime.

The menstrual cycle and egg maturation

During each menstrual cycle, a subset of these primordial follicles begins to grow and develop. However, typically only one follicle (occasionally more) will fully mature and release an egg during ovulation. The rest of the developing follicles will naturally degenerate.

During egg freezing

The egg freezing process aims to optimize this natural cycle by using medication to produce multiple mature eggs in one cycle, significantly increasing the number of mature eggs available for freezing compared to a natural menstrual cycle.

What are mature eggs?

Mature eggs, also known as secondary oocytes or metaphase II (MII) oocytes, have completed the first meiotic division and are ready for fertilization. 

Mature eggs several distinct features:

• First polar body: The most obvious sign of a mature egg is the presence of the first polar body in the perivitelline space (the area between the egg and its outer shell, called the zona pellucida).
• Size and shape: A mature egg is typically round and of a standard size. However, the study linked above notes that egg size can vary, and this variation doesn't necessarily affect fertilization or embryo quality.
• Cytoplasm: Ideally, a mature egg should have a homogeneous (evenly distributed) cytoplasm. However, slight variations in cytoplasmic appearance are common and may not indicate any problems.
• Zona pellucida (ZP): This is the outer shell of the egg. In a mature egg, it should be clear and of normal thickness.
• Perivitelline space: This is the space between the egg itself and the zona pellucida. In a mature egg, this space should be of normal size, not too large or too small.
• Meiotic spindle: While not visible under regular microscopy, specialized techniques can reveal the presence of a meiotic spindle, which is crucial for proper chromosome alignment.
• Absence of certain features: Mature eggs should not have a visible nucleus (called a germinal vesicle), which is a sign of immaturity.

While these are the ideal characteristics, many eggs retrieved in egg freezing may show one or more variations from these "ideal" criteria. Some variations are considered normal and don't necessarily impact the egg's ability to be fertilized or develop into a healthy embryo. However, certain features, like the presence of smooth endoplasmic reticulum clusters, are considered potentially problematic.

What are immature eggs?

Immature eggs, also called primary oocytes or immature ovum, are eggs that have not completed the process of meiosis, a specialized type of cell division necessary for reproduction. 

During egg freezing, not all eggs will mature, and some will be retrieved that are considered immature. These eggs are generally smaller than mature eggs, and cannot be fertilized by sperm today.

Immature eggs fall into two categories:

1. Germinal vesicle (GV) stage eggs: These are the most immature and are identifiable by the presence of a visible nucleus.
2. Metaphase I (MI) stage eggs: These eggs have begun the maturation process but haven't completed it. They lack both a visible nucleus and a polar body.

While immature eggs are usually not frozen, at Cofertility we try and ask clinics to keep them for our members. It is our hope that in the future, these immature eggs will be able to be reliably matured in the laboratory. 

How many eggs will be mature?

On average, approximately 80% of eggs retrieved during egg freezing are mature, while 20% are immature. 

Several factors can influence the number of mature eggs retrieved:

1. Age: Younger women typically produce a higher percentage of mature eggs. As women age, not only does the total number of eggs decrease, but the proportion of mature eggs may also decline.
2. Ovarian stimulation protocol: The medications and dosages used during the stimulation phase can affect egg maturity. Your fertility doctor will tailor the protocol to optimize the number of mature eggs retrieved.
3. Timing of the trigger shot: The timing of the final maturation trigger is critical. If given too early or too late, it can affect the maturity of the eggs at retrieval.
4. Individual response to stimulation: Every woman's ovaries respond differently to stimulation. Some may produce a higher percentage of mature eggs, while others may have more immature eggs.
5. Underlying fertility conditions: Certain conditions, such as polycystic ovary syndrome (PCOS), can affect egg maturity rates.

During the egg retrieval process, the embryologist will examine each egg under a microscope to determine its maturity. The presence of some immature eggs is normal and expected. In fact, having a mix of mature and immature eggs can be a sign of a healthy response to ovarian stimulation.

While it's natural to focus on the number of mature eggs retrieved, it's important to remember that quality matters as much as quantity. A smaller number of high-quality mature eggs can be more valuable than a larger number of lower-quality eggs.

What’s the difference between immature and mature eggs?

Today, mature eggs are the gold standard. Here's why:

Higher survival rates after thawing

Mature eggs have completed critical developmental stages, making them more resilient to the freezing and thawing process. They're better equipped to withstand the physical stress of vitrification (flash-freezing) and subsequent warming.

Greater potential for fertilization

Once thawed, mature eggs are immediately ready for fertilization. They've already undergone the necessary cellular changes to allow for the entry and processing of sperm DNA.

Improved embryo development

Eggs that were mature at the time of freezing tend to result in higher-quality embryos after fertilization. This can lead to better chances of successful implantation and pregnancy.

What Split Members should know

If you’re part of our Split program, where members freeze their eggs for free when donating half to a family that otherwise can’t conceive, there are a few things you should know:

• You will receive immediate ownership of half of the mature eggs retrieved. If there is an odd number, the intended parent will keep the extra egg.
• You also receive 100% of immature eggs retrieved to the extent clinic policy allows (not all clinics are able to cryopreserve GV eggs).
• We cover ALL egg freezing expenses and 10 years of storage. Of course you can get the eggs sooner if needed.

The reason we give 100% of immature eggs to the Split Member (egg donor) is because, while it’s not possible today, we hope that in the future that embryologists will be able to mature immature eggs in the lab. 

Summing it up

Grasping the difference between mature and immature eggs is helpful to understanding the egg freezing process and setting realistic expectations. While mature eggs are the primary goal of egg freezing, the presence of some immature eggs is normal and doesn't necessarily indicate a problem.

As you consider or proceed with egg freezing, remember that your fertility doctor is your best resource for personalized information. They can provide insights into your individual situation, explain your results, and help you understand what they mean for your fertility preservation goals.

We wish you all the best!

If you're participating in Cofertility’s Split Program, where you freeze your eggs for free when donating half to another family that can't otherwise conceive, a necessary step in the process is carrier screening. Carrier screening is a type of genetic test that can tell you whether you carry a gene for certain genetic disorders. This critical step ensures the best possible outcomes for both you and the recipient family.

You may have some questions or find yourself wondering about its necessity, what it involves, and how the results could affect you and the intended parents. This article aims to clarify the process and provide you with essential information to help you feel informed and confident.

By understanding the role of genetic testing, you'll be better equipped to make informed decisions and communicate effectively with healthcare providers, genetic counselors, and anyone else.

Why is genetic testing required for egg donors?

The American Society for Reproductive Medicine (ASRM) has developed guidance for the screening of egg donors that most clinics and egg donation agencies (like ours) follow. This  guidance includes genetic risk assessment, and specifically carrier screening. Why is carrier screening important?

Carrier screening plays an important role in ensuring the health of any potential children resulting from the donation. Many genetic conditions are recessive, meaning a person can carry the gene without showing symptoms. By screening egg donors, we can identify these genetic variants and minimize the risk of passing on inherited disorders.

Importantly, this genetic information is also valuable for you as the donor. It provides insights into your own genetic makeup, which can be beneficial for your future family planning. If you discover you're a carrier for a particular condition, you can make informed decisions about your own reproductive health and discuss potential risks with your healthcare provider.

Additionally, genetic testing helps in the matching process between donors and intended parents. By understanding the genetic profiles of both parties, we can ensure compatibility and reduce the risk of passing on inherited disorders. This contributes to the overall success and safety of the egg donation process.

What is carrier screening?

Carrier screening is a type of DNA test that looks for variants (mutations or DNA changes) in certain genes. These genes are associated with "recessive" conditions, which means a person needs to inherit two copies of the variant gene - one from each parent - to develop the condition.

Understanding autosomal recessive inheritance

We inherit two copies of every gene - one from the egg provider and one from the sperm provider. Autosomal recessive diseases occur when someone has a gene variant in both copies of a certain gene. Individuals who carry only one variant for a recessive disease are called "carriers" and generally don't have any symptoms of the disease.

X-linked inheritance

Some conditions are linked to genes on the X chromosome. Females typically have two X chromosomes, while males have one X and one Y chromosome. For X-linked conditions, males who have a variant are usually affected, while females are typically carriers. This is important in egg donation because a female carrier has a chance of passing the condition to male offspring.

The testing process

Genetic testing for egg donors typically involves the following steps:

1. Sample collection: Either a blood draw, saliva, or cheek swab sample is taken.
2. Laboratory analysis: The sample is sent to a specialized genetics laboratory for analysis.
3. Waiting period: Results usually come back within 2-3 weeks.
4. Result interpretation: A healthcare provider or genetic counselor will interpret the results for you, at no cost to you.

Today’s carrier screening tests often examine more than 100 genes associated with various inherited conditions. This comprehensive approach has replaced older methods that only tested for conditions common in specific ethnic groups.

What can you learn from genetic testing?

Genetic testing, particularly carrier screening, can provide you with a wealth of information about your genetic makeup. Primarily, you'll learn about your carrier status for the genetic conditions included in the panel. Being a carrier means you have one copy of a gene variant associated with a particular condition, but you don't have the condition yourself. This information is helpful for understanding potential reproductive risks, both for your role as an egg donor and for your own future family planning.

In addition to carrier status, genetic testing can sometimes offer insights into your ethnic background. Certain genetic variants are more common in specific populations, which can provide clues about your genetic ancestry. While this isn't the primary purpose of the screening, it can be an interesting secondary finding for some individuals.

Occasionally, carrier screening might reveal unexpected information about your own health. For instance, being a carrier for certain conditions might be associated with an increased risk of developing related health issues. While rare, these findings can be valuable for your long-term health management.

Furthermore, genetic testing results can sometimes shed light on your family health history. You might gain a better understanding of why certain conditions run in your family or discover previously unknown genetic factors that could be relevant to your relatives.

While genetic testing provides valuable information, it doesn't predict everything about your health or your potential offspring. Many factors beyond genetics contribute to overall health and development. Nonetheless, the insights gained from genetic testing can be a powerful tool for making informed decisions about your health and your participation in the egg donation process.

Types of conditions included in carrier screening

Carrier screening generally tests for genes associated with:

• Moderate to severe childhood diseases
• Conditions that lead to a shorter life expectancy
• Disorders causing disability
• Diseases with limited or no treatment options

Some examples of conditions often included in carrier screening are:

• Cystic fibrosis
• Spinal muscular atrophy
• Thalassemia/hemoglobinopathy
• Fragile X syndrome
• Tay-Sachs disease
• Sickle cell anemia

Specific conditions tested can vary depending on the screening panel used.

How genetic test results affect your donor status

In most cases, being a carrier for a genetic condition won't prevent you from being an egg donor. The key is ensuring that your genetic profile doesn't match with any variants carried by the intended parents or sperm provider.

However, there are some rare situations where a positive carrier screen might affect your eligibility, like if you're a carrier for a serious X-linked condition, like Fragile X.

What does a negative carrier screen mean?

A negative or normal screen means that no changes were found in any of the genes on the panel tested by the lab. While this is good news, it's important to remember that no test is perfect. Carrier screening doesn't test for all recessive diseases and can't identify all carriers for the diseases that were tested.

What does a positive carrier screen mean?

A positive carrier screen means that you have been identified as a carrier for one or more genetic conditions tested in the screening. Being a carrier doesn't mean you have the condition yourself. Instead, it means you have one copy of a gene variant associated with a particular condition.

Being a carrier is actually quite common. Most people are carriers for at least one genetic condition, and this usually doesn't affect their health. However, it can have implications for reproductive planning, both for egg donation and your own future family planning.

If you receive a positive result on your carrier screen, there's no need to worry. We cover the cost of talking to a genetic counselor to help you understand what your test results mean. The genetic counselor can explain your results in detail, discuss any potential implications, and answer any questions you may have. This ensures that you have a clear understanding of your genetic status and can make informed decisions moving forward.

Remember, a positive carrier screen doesn't necessarily disqualify you from being an egg donor. The implications depend on the specific condition and the genetic status of the intended parents or sperm provider. The genetic counselor and your Cofertility Member Advocate will guide you through what your results mean for your participation in the egg donation program.

Summing it up

Genetic testing is a required part of the egg donation process. It is a tool to ensure the best possible outcomes for all involved. The information you gain can be valuable not only for your role as an egg donor but also for your own future family planning.

As you go through this process, it's normal to have questions or concerns. Don't hesitate to ask your fertility doctor, genetic counselor, or your Cofertility Member Advocate for clarification or support. They're there to guide you through this important step in your egg donation journey.

Remember, being a carrier for a genetic condition is common and doesn't necessarily impact your overall health or ability to be an egg donor. By participating in genetic testing, you're contributing to informed decision-making and potentially helping create families while gaining valuable insight into your own genetic makeup.

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

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

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

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

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

What is AFC and how is it measured?

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

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

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

Does AFC change within a cycle?

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

Can AFC change month to month?

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

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

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

Can I increase my AFC?

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

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

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

What is a normal AFC by age?

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

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

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

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

What does this mean for you?

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

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

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

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

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

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

Why people choose to freeze their eggs

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

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

At what age should you freeze your eggs?

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

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

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

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

Is it worth freezing eggs after age 35?

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

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

Egg freezing success rates by age

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

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

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

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

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

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

The right number of eggs to freeze for your age

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

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

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

Should I do multiple egg retrievals?

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

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

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

The right number of eggs to freeze to have multiple children

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

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

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

Can frozen eggs guarantee a successful pregnancy in the future?

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

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

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

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

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

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

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

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

The egg freezing process: step-by-step

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

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

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

Will egg freezing hurt my future fertility?

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

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

Is egg freezing safe?

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

Egg freezing vs embryo freezing 

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

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

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

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

Read more in Should I Freeze Eggs or Embryos?

Cost of egg freezing

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

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

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

Learn more about egg sharing

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

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

Ask us anything

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

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

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

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

What is FSH and why should you care?

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

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

Average FSH levels by age

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

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

What is a good FSH level for egg freezing?

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

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

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

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

What abnormal FSH results may mean

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

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

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

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

Testing your FSH

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

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

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

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

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

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

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

The bottom line: knowledge is power

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

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

Ever scrolled through that health and wellness side of social media and stumbled upon something called AMH? Maybe your best friend casually mentioned getting her AMH tested, and you were too embarrassed to ask what the heck she was talking about. You're young, you feel great, and having babies isn't even on your radar right now. But here's the thing: understanding this thing called AMH could be a major game-changer for your future.

What is AMH?

AMH stands for Anti-Müllerian Hormone.  Think of it as a little signal your ovaries send out. This hormone level tells your doctor about how many eggs you have left – also known as your ovarian reserve. Basically, AMH is one clue into your fertility.  And, here's why you should care even if kids aren't on your mind yet.

Why does AMH matter in your 20s and 30s?

AMH can be a helpful biomarker for your health and fertility. Why?

1. Knowledge is power: Knowing your AMH levels gives you valuable insights into your reproductive timeline. It helps you make informed decisions about when you might want to start a family and whether fertility preservation options (like freezing your eggs) might be something to consider down the road.
2. Fertility isn't forever: You might think of your 20s as your prime fertility years, and while you're not wrong, it's not the full picture.  Your fertility peaks in your early 20s and starts a gradual decline in your mid-30s. For some people, this decline is faster, and AMH levels can give you a heads-up.
3. Unexpected roadblocks: AMH testing can help detect potential fertility issues early on, like Polycystic Ovarian Syndrome (PCOS) or premature ovarian insufficiency. Getting this info sooner rather than later can help you take steps to manage these conditions and protect your fertility.

What can AMH test results tell you?

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

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

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

So, you got your AMH tested. Now what? Here's a basic breakdown of what those numbers usually mean: 

• Normal AMH means you're right on track for your age – good news!  
• High AMH might suggest a good number of eggs remaining, and potentially even point towards conditions like PCOS where your egg count is unusually high. 
• Low AMH could mean you have fewer eggs remaining than typical for your age group.  It might signal a faster decline in fertility, but it doesn't mean you can't get pregnant at all.  

Remember, your AMH level is just one piece of the fertility puzzle. Other factors like your overall health, other hormone levels, family history, and lifestyle habits matter too!

What are normal AMH numbers?

What is considered a “normal” AMH level depends on your age, as well as the lab where you take the test. Since there is no international standard, it’s best to use the reference ranges included on the test results (your doctor can share those with you if you did a test through a clinic). 

In general, however, an AMH between 1.0 and 3.5 ng/mL suggests a “normal” range that is likely to have a good response to egg freezing.

Common reasons for high AMH

The most common reason for high AMH is that you are very fertile and likely to retrieve more eggs in an egg freezing cycle.  But, it does not necessarily mean that the eggs are of good quality. Egg quality is determined by factors such as your age, genetics, and environmental factors, and cannot be measured directly by AMH levels.

But a high AMH level may also indicate PCOS, which is a hormonal disorder that affects 8–13% of females of reproductive age. Those with PCOS typically have high levels of androgens (male hormones) and may have irregular periods, acne, and excess hair growth. Patients with an average AMH level ≥ 4.45 ng/ml have a 9.35 times higher likelihood of developing PCOS, but not all patients with a high AMH have PCOS.

In rare cases, abnormally high AMH could be a sign of an ovarian tumor. Certain types of ovarian tumors, such as granulosa cell tumors, can produce high levels of AMH. 

Read more in: What Does a High AMH Result Mean?

Common reasons AMH would be low

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

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

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

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

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

Read more in: What Does a Low AMH Result Mean?

Factors that can influence AMH levels

It's important to know that some things can temporarily or even permanently change your AMH:

Birth control

Certain types of birth control can suppress your natural AMH levels. One study looked at data from women on various types of birth control and found: 

• Combined oral contraceptive pill led to 23.7% lower AMH
• Progestin-only pill led to 14.8% lower AMH
• Vaginal ring led to 22.1% lower AMH
• IUD led to 6.7% lower AMH
• Implant led to 23.4% lower AMH
• Copper intrauterine device led to 1.6% lower AMH

The authors concluded that birth control use is associated with a lower mean AMH level when compared to those who are not on contraceptives, with variation depending on the type of birth control

Health conditions

Things like PCOS, endometriosis, vitamin D deficiency, or even a recent ovarian surgery can impact your AMH levels.

Chemotherapy 

Chemotherapy treatments for conditions like cancer can significantly lower AMH levels. Research indicates that pre-chemotherapy AMH levels may be helpful in predicting ovarian function and potential fertility after treatment. A prospective study of women treated with chemotherapy for early breast cancer showed that long-term ovarian function after treatment was predictable using serum AMH levels before treatment. 

Obesity

Studies suggest a connection between obesity and lower AMH levels, though the exact relationship is complex. Obesity is linked to hormonal imbalances and inflammation, which can disrupt ovarian function and potentially affect AMH production. However, it's important to note that not everyone with obesity experiences lowered AMH, and other factors could also be at play. More research is needed.

Smoking

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

What is a good AMH level for egg freezing?

Research has found that AMH is a good predictor of the response to ovarian stimulation and the number of eggs retrieved. Because of this, fertility doctors typically use your AMH levels (along with other biomarkers) to determine the drugs and dosages you will need to maximize your response to ovarian stimulation. 

Now, what about a correlation between AMH and actual babies born (live birth rate)? Well, while AMH does seem to have some association with live birth rates after IVF, its ability to actually predict a live birth is not that great. This is especially true for younger people. A 2021 study found that AMH is a good predictor of live birth in older (>39 years old), but not younger, people. They found that younger participants (≤38 years old) could get pregnant even with low AMH levels as long as they had frequent egg retrievals. 

Does AMH predict the number of eggs you will retrieve during egg freezing?

The overall success of an egg freezing cycle largely depends on the number and quality of eggs retrieved. Studies have shown that AMH levels can be used as a predictor of egg quantity, and can thus help to predict the potential success of egg freezing. Those with higher AMH levels tend to have better outcomes with egg freezing, as they are likely to have more eggs retrieved and a higher chance of success in future fertility treatments. 

But by no means does a high AMH level guarantee a lot of eggs during an egg retrieval procedure for fertility treatments. The number of eggs retrieved during an egg freezing cycle depends on several factors, including your age, ovarian response to stimulation medications, any other underlying medication conditions, and the skill of the fertility doctor performing the procedure.

When eggs are retrieved, only a portion of those eggs will be mature. A mature egg is one that’s ready and able to be fertilized. At most clinics, any non-mature eggs are discarded, though you can talk to your clinic about whether they’re open to freezing those too. 

Multiple studies have shown a strong correlation between AMH levels and mature eggs retrieved during egg freezing or IVF.

Let’s look at a few of the studies:

The study: Correlation between anti-Müllerian hormone, age, and number of oocytes 

Who: 1500 patients in Brazil between July 2012 and April 2019

The findings: “A positive correlation was found between serum AMH levels and total number of retrieved and mature oocytes from stimulated cycles”

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The study: Different anti‐Műllerian hormone (AMH) levels respond to distinct ovarian stimulation methods in assisted reproductive technology (ART) 

Who: 1,112 patients undergoing an egg retrieval as part of ART

The findings: “AMH showed a stronger correlation with egg number compared with age over a wide age range”

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The study: Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy 

Who: 314 infertility patients with an average age of 31.0 ± 4.5 years

The findings: “the AMH level of women of all ages was positively correlated with the number of retrieved oocytes “

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The study: Antimullerian hormone (AMH) is a predictor of the number of eggs retrieved and D3 embryos in women with fluctuating and persistently elevated FSH levels 

Who: 58 women with fluctuating and persistently high serum day 3 (D3) FSH.

The findings: “These data demonstrate for the first time that serum AMH is a prognostic indicator independent of age and FSH of the number of eggs retrieved”

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The study: Random anti-Müllerian hormone (AMH) is a predictor of ovarian response in women with elevated baseline early follicular follicle-stimulating hormone levels 

Who: 73 women undergoing ART with elevated early follicular FSH levels

The findings: “Random AMH levels were strongly correlated with the number of oocytes retrieved during an ART cycle among women with elevated FSH”

Read more in AMH and Egg Retrieval Outcomes

What AMH do I need to donate my eggs?

Through Cofertility’s Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive. In the context of donating through our Split program, having an appropriate level of AMH is important. 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. Note that some clinics have a higher requirement.

This level suggests that you are 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 the egg retrieval process in a manner that is both safe and effective.

However, if your AMH level is lower than this, it does not necessarily mean you cannot freeze your eggs. You can still qualify for our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.

Everyone is unique, and AMH is just one factor of many that we consider during the evaluation process. You can learn more about qualifications for our Split program here. 

When should I test my fertility? 

So, when is the “right” age for testing your fertility, anyway? 

It depends.

And ultimately, it’s up to you! It’s your body, and your data, and there is no one-size-fits-all answer. We’re firm believers that knowledge is power and you deserve this information. Studies do show that our ovarian reserve declines with age — in other words, it’s a good idea to assess your fertility potential sooner rather than later. That way, if you do want to preventatively freeze your eggs, you can do so while your ovarian reserve is still higher. 

According to the American Society for Reproductive Medicine (ASRM), the optimal time to freeze your eggs is in your 20s and early 30s. This study also indicated that, as we get older, our chances of needing to do multiple egg freezing cycles increase in order to achieve a 70% live birth rate. We know we’re a bit of a broken record here, but: the younger you are, the healthier and more plentiful your eggs are.

Should I test my fertility at home or in a clinic?

At-home fertility tests have gained popularity in recent years due to their convenience and privacy. These tests typically involve collecting blood or urine samples and mailing them to a laboratory for analysis. On the other hand, in-clinic fertility tests are conducted at a medical facility, where specialized equipment and healthcare professionals are available.

The pros of at-home fertility tests include:

• Convenience and privacy: Samples can be collected in the comfort of your home.
• Cost-effective: At-home tests are often more affordable than in-clinic procedures.
• Early assessment: At-home tests allow you to gain insights into your fertility potential before actively trying to conceive. Plus, you won’t have to wait to get squeezed in for an appointment at the clinic!

The pros of testing your fertility at a clinic:

• A broader scope: At-home tests may not provide a comprehensive evaluation of fertility health, while testing your fertility at a clinic provides a more comprehensive picture of your fertility. An important note is, when testing your fertility at a clinic, you’ll also undergo a transvaginal ultrasound, where the technician or doctor will be able to get a view of what’s going on in those ovaries and the number of follicles available this cycle.
• Better accuracy: Some at-home tests may have varying levels of accuracy when compared to in-clinic tests.
• Facetime: At a clinic, you’ll have the ability to chat directly with a doctor, before and after your results.

If you do end up going with an at-home test, we have an exclusive discount with the LetsGetChecked Ovarian Reserve Test. It’s $139, and you can get 25% off with code COFERTILITY25. But there are many other options as well.

Although at-home fertility tests are a great way to get a peek behind the curtain of your fertility, they aren’t without limitations. For starters, according to recent studies, measuring AMH alone may not predict your time to pregnancy. As mentioned above, testing your fertility with a doctor at a clinic will likely provide a more comprehensive picture of your fertility outlook, especially as they consider your medical history, and conduct a physical exam and transvaginal ultrasound. Of course, you’ll also get professional interpretation of the results that you may not receive with an at-home fertility test. 

All of that being said, any fertility testing (whether at home or in a clinic) only measures your fertility at that given point in time. It should not be taken as a guarantee for future outcomes. It also can’t tell you anything about your egg quality, which cannot be truly observed until it comes time to actually fertilize those eggs. 

You are not a number

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

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

Read more:

• Which Matters More for Fertility: AMH or Age?
• What AMH Level Do I Need to Freeze My Eggs?
• What Does a High AMH Result Mean?
• What Does a Low AMH Result Mean?
• Birth Control and AMH Levels
• What Medications and Supplements Affect AMH Levels?
• What AMH Do I Need to Donate my Eggs?
• AMH and Egg Retrieval Outcomes