fertility treatments

Egg donation is a medical procedure where a woman donates her eggs to individuals or couples who are unable to have children using their own eggs. The egg donor undergoes a series of medical and psychological screenings and hormonal treatments to stimulate egg production. Once the eggs are mature, they are retrieved through a short surgical procedure done on an out-patient basis. The eggs are then fertilized with sperm (either from the intended father or sperm donor) and the resulting embryos are either transferred to the recipient's uterus (intended mother or gestational carrier) or frozen for later use. 

Many times donors have seen first hand their own friends or family struggling with infertility. Witnessing this creates a desire to help and motivates them to donate their eggs. This act of giving can be deeply fulfilling on a personal level knowing that they are creating family trees or relationships (parents, grandparents, aunts, uncles, etc.) that might otherwise have never existed. 

Anonymity is often a primary question for potential donors as they may believe that anonymity to be a way to protect themselves from the emotional complexity that is egg donation. They may believe that by remaining anonymous they can avoid forming any type of relationship with the child or recipients thereby also potentially avoiding feelings of guilt, responsibility, or attachment. Or they may not want it to interfere with future relationships or their own family dynamics. While anonymity is no longer realistic, disclosed and undisclosed egg donation offers benefits and the chance for meaningful future connections.

Donor anonymity

The traditional concept of anonymous donation prioritizes privacy and confidentiality for donors, the intended parents, and any resulting children. In traditional anonymous donation, there is no exchange of identifying information between the egg donor and the intended parents. If there is contact, it is very limited and is facilitated by the fertility clinic or agency.

But in recent years, DNA testing services, like 23andMe, have had a profound impact on egg donor anonymity. The ability to uncover genetic connections through these tests undermines the anonymity promised in traditional egg donation arrangements. Even if donors and recipients agreed to anonymity, individuals who were conceived using donor eggs may take one of these tests and uncover genetic connections to relatives, including their egg donor.

In the past, when anonymity was promised in egg donation arrangements, it was often based on the understanding that the identities of both the donor and the recipient would remain confidential and undisclosed to each other. However, as mentioned above, with the increasing popularity of direct-to-consumer genetic testing services, maintaining complete anonymity in egg donation is basically impossible. If an egg donation agency or egg bank promises anonymity, be very weary. They are not able to guarantee it due to DNA testing.

There is an increasing trend towards greater openness in egg donation arrangements in many countries, with increasing recognition of the importance of providing donors and offspring with the option for contact. For example, the United Kingdom has a regulated system for egg donation overseen by the Human Fertilisation and Embryology Authority (HFEA). Donors are required to provide non-identifying information that may be shared with offspring at the age of 18.

Disclosed and undisclosed donation

At Cofertility, we offer donors and the families they match with two general types of relationships.

In a disclosed relationship, the egg donor and recipient exchange contact information and can communicate directly. So, both the donor and the recipients are aware of each other's identities. The scope and degree of communication (both during and post-match) is what both parties make of it. This can range from occasional updates to ongoing relationships and involvement in each other's lives.

In an undisclosed relationship, identifying information is not exchanged and communication is facilitated through Cofertility. With an undisclosed donation, the donor and the family can choose to allow the donor-conceived child to receive the donor’s contact information when they turn a certain age (usually 18). This is called Open ID, an increasingly popular option.

Benefits of non-anonymous donation

Non-anonymous donation offers a more personalized approach. It provides donors and intended parents the opportunity to establish meaningful relationships and make informed choices based on mutual understanding and respect. This openness can offer opportunities for building positive relationships and can enable donors and intended parents to provide emotional support to one another throughout the donation process. This support network can be valuable in navigating the emotional complexities and challenges associated with egg donation. 

Considerations for potential egg donors

The level of desired openness in egg donation is a personal choice and can vary significantly from individual to individual.  Some individuals may prioritize transparency and openness in all aspects of their lives, including reproductive choices, while others may prefer privacy and discretion. Some may feel comfortable with potential future contact whereas others do not. Both are completely acceptable.  

Summing it up

The concept of egg donor anonymity has evolved over time, with increasing recognition about the benefits of disclosure in egg donation. Initially, anonymity was commonly practiced to protect the privacy of all involved. However, as attitudes towards third party reproduction in general have shifted and advancements in technology have made maintaining anonymity difficult, there has been a growing trend towards disclosure and openness in egg donation. Every donor needs to prioritize their own comfort and values while understanding the positive possibilities of connection. It's essential for individuals considering egg donation to be aware of the potential risks and limitations regarding anonymity and to carefully consider the implications before proceeding with the donation process.

Read more:

• Disclosed vs Undisclosed Egg Donation: How Do I Choose?
• Decoding the Lexicon of Egg Donation: A Guide for Donors on the Continuum of Disclosure
• The Ultimate Guide to Egg Donation

The demands of medical school can make it seem like there's never a good time to focus on personal goals like proactive family planning. But if egg freezing is on your mind, understanding the best timing can make the process much smoother. Medical school actually offers some unique advantages. You are better positioned to understand everything involved in the medical procedure.

When it comes to egg freezing, your age is the most important factor influencing future success rates with frozen eggs, so acting while you're younger (under 35) gives you the best possible options. Additionally, certain phases of med school might have slightly more flexibility than the intensity of residency.

So, when should you consider freezing your eggs during medical school? Optimal windows include summer breaks (most time available), fall/spring breaks (if you're a meticulous planner), or potentially elective periods (depending on your choices). Let’s dive in to learn more.

A quick overview of egg freezing

The egg freezing process itself typically takes a few weeks. It begins with ovarian reserve and fertility testing along with a consultation with a fertility doctor where you map out the plan. Once you’re ready to go, you'll take hormonal medications for about 10-12 days to encourage the development of multiple mature eggs. During this time, you'll have regular monitoring appointments to track your progress.  Once the eggs are ready, they'll be retrieved in a short, outpatient procedure under sedation.  After retrieval, your eggs are frozen and stored for future use.

A guide to the ideal timing during medical school

Here's the essential timeline to keep in mind:

2-3 months before your egg freezing cycle:

• Initial consult: Discuss your goals, the process, and costs with a fertility doctor.
• Baseline testing: Bloodwork and ultrasound to assess ovarian reserve.
• Stop birth control: Depending on the type of birth control you are taking, you may need to stop taking it ahead of the egg freezing cycle. 

The egg freezing cycle:

• Medications and monitoring: Begin ovarian stimulation with daily hormone injections for 10-12 days. This phase requires several monitoring appointments (ultrasounds and blood tests) at your fertility clinic or a local remote monitoring clinic. If you work with Cofertility in our Split program, we can work with you and your program to find the most convenient place for these appointments, including at your hospital.   
• Egg retrieval: Short, outpatient procedure under sedation where eggs are retrieved and frozen.
• Recovery: Expect a few days of cramping and/or bloating. Most people can return to light activities soon after.

Expect about 3 to 6 monitoring appointments (which last no more than an hour) and one day for the retrieval.  Ideally, you'll want to align the cycle with a break in your medical school schedule– such as spring break, summer break, or otherwise– to ensure you have the flexibility you need for appointments.

The key is being proactive! Don't wait to start the conversation with a fertility clinic. The earlier you plan, the less stressful it will be. Since medical schools publish their calendar in advance, use one of the week-long breaks as a target for the egg retrieval. You can then work backwards from that date to start the cycle. 

Be your own advocate with your school's administration about needing some flexibility for medical appointments. If you work with Cofertility, we can help you map out the egg freezing schedule and find a cycle start date that works with your schedule. 

If you join our Split program, you will be assigned a Member Advocate who will take the extra steps to understand your busy schedule and help schedule appointments in the most convenient way possible. In some cases this means reaching out to the hospital(s) connected to your medical school program for availability to perform labs and ultrasounds.

Freeze your eggs with Cofertility

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

1. Our Split program offers women a chance to freeze their eggs for free when donating half of the eggs retrieved to a family who cannot otherwise conceive. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.
2. Our self-pay Keep program allows women to freeze their eggs and keep them all for their future use. Through Keep, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

The benefits of working with Cofertility include:

• Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
• Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
• Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
• Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
• Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.

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

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

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

Does egg freezing affect future fertility?

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

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

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

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

Does egg freezing increase the risk of cancer?

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

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

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

Are there medical risks associated with egg freezing?

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

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

Are there long-term side effects from egg freezing?

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

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

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

Are children born from frozen eggs healthy?

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

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

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

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

Summing it up

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

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

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

Freeze your eggs– for free– with Cofertility

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

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

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

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

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

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

What is informed consent?

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

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

Informed consent in egg donation

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

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

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

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

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

Medical risks and side effects

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

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

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

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

Psychological and emotional considerations

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

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

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

Genetic implications of egg donation

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

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

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

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

Legal rights and responsibilities

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

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

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

Egg sharing vs. financial compensation

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

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

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

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

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

The bottom line

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

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

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

Hormones and general fertility 

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

Egg freezing 

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

Egg donation

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

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

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

In today's world, the path to parenthood is anything but one-size-fits-all. People are getting married later, and about 20% of women in the U.S. now have their first child after age 35. Whether you're focused on your career, haven't found the right partner, or are facing health challenges, your timeline for starting a family probably looks different from your parents. 

If you're exploring options for future family planning, you may be wondering about embryo banking. Is it the right choice for you? Let's dive in and learn more.

How does embryo banking work?

In essence, embryo banking is the process of creating embryos through in vitro fertilization (IVF), then freezing and storing them for future use. It's like having a biological time capsule, waiting to be opened when you're ready for parenthood.

The journey begins with the same steps as IVF. First, you undergo ovarian stimulation to encourage the production of multiple mature eggs. Once ready, these eggs are retrieved through a 30-minute minimally invasive procedure. Then, in the lab, these eggs are fertilized with sperm (from a partner or donor), creating embryos. The embryos are carefully selected and frozen using a technique called vitrification, which allows them to be stored safely for many years to come.

Who is a candidate for embryo banking?

Embryo banking is for women who are absolutely sure they know who they want to be the biological father of their future children. It's a proactive choice for individuals and couples in a variety of situations:

• People undergoing IVF: If you’re undergoing IVF and want multiple children, some doctors will recommend embryo banking before doing an embryo transfer. 
• People delaying parenthood: Maybe you're not quite ready for kids, but you want to ensure you have the option later. Embryo banking can help you safeguard your chances of having a biological child.
• Individuals facing medical treatments: Cancer treatments, surgeries, or other medical conditions can impact fertility. Embryo banking offers a way to preserve your options before undergoing such treatments.
• Same-sex couples: Embryo banking, combined with egg or sperm donation, can help same-sex couples achieve their dream of having a genetically related child.
• Single individuals: If you're single but know you want to use a sperm donor, embryo banking can give you a head start on that goal.

How many embryos should you bank?

During the IVF process, not all fertilized eggs will develop into viable embryos suitable for transfer. This natural attrition rate can mean that you will likely start with a larger number of fertilized eggs but end up with fewer healthy embryos.

It’s generally recommended to aim for approximately two genetically tested embryos frozen per the number of children you'd like to have. So, if you're hoping for two children, aiming to bank around four genetically tested embryos would be a reasonable goal.

Of course, you’ll want to talk through this with your fertility doctor. They can take into account factors like your age, overall health, and any specific fertility concerns to provide personalized guidance on the ideal number of embryos to bank for your situation.

Is embryo banking right for you?

You’ll want to weigh the potential benefits of embryo banking against the considerations, and figure out if this is an investment you want to make. Here are some questions to ask yourself:

• What are my future family plans?
• Am I okay creating embryos I may never use?
• Can I afford the associated costs?
• Am I emotionally prepared for the process and potential outcomes?

Of course, egg freezing is an alternative option. You can learn more about that here. 

The bottom line

Embryo banking is one way to take control of your fertility journey. It's not just about preserving embryos, it's about increasing the chances and the possibility of building a family when the time is right for you. The path to parenthood is unique for everyone, and embryo banking might be the key to unlocking yours.

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

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.

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

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

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

The daily medication routine

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

Tips for more comfortable injections:

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

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

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

Monitoring appointments

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

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

The egg retrieval process

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

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

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

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

Managing expectations

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

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

Tips for people with low pain tolerance

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

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

Making your decision

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

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

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

How to freeze your eggs for free

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

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

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

Summing it up

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

Egg freezing starts with something called "ovarian stimulation" - which may sound technical, but it's actually pretty straightforward.

When you decide to freeze your eggs, your doctor will start you on a medication protocol to stimulate your ovaries. While your body naturally releases one egg per month, for egg freezing to be effective, we want to collect multiple mature eggs in a single cycle. That's what ovarian stimulation is: a process that uses injectable medications to help your ovaries produce several eggs at once, giving you a better chance of preserving good quality eggs for your future.

These medications mimic the natural hormones in your body - just at higher levels - encouraging your ovaries to mature multiple eggs instead of just one. The process typically takes 8-12 days, during which you'll have monitoring appointments to check your progress. Understanding what happens during ovarian stimulation and what you might experience physically can help you prepare for the process ahead. 

In this article, we'll break down the medications used, what to expect at each stage, and how to make the experience more manageable.

What is the purpose of ovarian stimulation?

The main goal of ovarian stimulation is to help you freeze multiple mature eggs at once, improving your chances of having a baby in the future. Think of it like this: when you naturally try to conceive, you're working with one egg per month. If that egg isn't viable or doesn't fertilize, you try again next month. But when you're freezing eggs, you want to maximize your chances by collecting several mature eggs in a single cycle. Getting multiple eggs at once is particularly important because not every frozen egg will successfully thaw, fertilize, or develop into a healthy embryo later. By stimulating your ovaries to mature multiple eggs at once, you increase your options for your future family planning.

What happens in your body during ovarian stimulation

Ovarian stimulation follows a fairly predictable timeline, though each person's experience varies slightly. Here's what you can typically expect during the process:

• Day 1-5: Your ovaries begin responding to the medications, growing multiple follicles simultaneously. Each follicle contains an egg. You'll start regular monitoring appointments to track your progress.
• Day 5-10: Follicles continue growing, and hormone levels rise. Your monitoring appointments become more frequent as your doctor fine-tunes medication doses based on your response.
• Days 10-14: As your eggs reach maturity, your doctor will schedule your trigger shot and egg retrieval. Timing becomes very precise at this stage.

Throughout stimulation, you'll have regular appointments to track your progress:

• Blood tests measure your hormone levels, helping your doctor adjust medication doses for optimal results.
• Ultrasounds show how many follicles are growing and their size. These transvaginal ultrasounds are quick and help your doctor determine when you're ready for egg retrieval.

What you might notice

Physical changes during ovarian stimulation can vary person to person, but commonly include:

• Bloating, especially as follicles grow
• Tenderness in your lower abdomen
• Fatigue
• Breast tenderness
• Mood changes from hormonal fluctuations

Most women maintain their normal activities during stimulation, though you might want to scale back intense exercise as your ovaries enlarge.

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

What to do during ovarian stimulation

Success with ovarian stimulation often comes down to organization and support:

Create a medication schedule:

• Set alarms for injection times
• Keep medications properly stored
• Track your appointments
• Note any symptoms or questions for your doctor

Build your support system:

• Consider having someone help with injections
• Join egg freezing support groups (like Cofertility!)
• Keep your care team informed of any concerns
• Plan for rest when needed

Before beginning stimulation:

• Learn proper injection techniques from your fertility care team
• Organize your medication and supply storage
• Plan your monitoring appointment schedule
• Arrange any needed support
• Clear up any questions about your protocol

As stimulation progresses, your doctor will monitor your follicles' growth and hormone levels to determine the ideal time for egg retrieval. This precise timing helps ensure the highest number of mature, viable eggs for freezing.

Is ovarian stimulation painful?

While ovarian stimulation isn't typically painful, you may experience some discomfort during the process. The daily hormone injections use very thin needles - most women describe them as feeling like a quick pinch. Some report mild soreness at injection sites, similar to how your arm might feel after a flu shot. 

As mentioned above, during stimulation, you might feel increasingly bloated or experience tenderness in your lower abdomen as your ovaries grow larger. This is normal and expected. The monitoring appointments include transvaginal ultrasounds, which might be uncomfortable but shouldn't be painful. If you do experience significant pain during stimulation, it's important to let your doctor know right away

Read more in Does Egg Freezing Hurt?

What is overstimulation?

Ovarian hyperstimulation syndrome (OHSS) is a rare but potential complication where your ovaries respond too strongly to the fertility medications. Think of it as your ovaries becoming overachievers - they produce too many follicles, leading to excessive hormone levels. 

Mild OHSS can cause increased bloating, mild nausea, and abdominal discomfort. More severe cases might involve significant bloating, shortness of breath, or severe abdominal pain. The good news is that OHSS is largely preventable with modern protocols and careful monitoring. Your doctor will track your response to medications through regular blood tests and ultrasounds, adjusting your protocol if needed to minimize this risk. If you're concerned about OHSS, talk with your doctor about your personal risk factors and the precautions they take to prevent it.

The bottom line

Understanding ovarian stimulation is an important step in your egg freezing process! While the daily medications and monitoring appointments might seem overwhelming at first, remember that thousands of women have successfully completed this process before you. Your body is capable of amazing things, and with modern science and proper support, the stimulation phase is usually very manageable.

At Cofertility, we believe knowledge is power. That's why our Member Advocates will be with you every step of the way, ready to answer questions and provide support. Whether you're just starting to research egg freezing or ready to begin your medications, we're here to help you navigate this process with confidence.

Have questions about egg freezing or want to learn more about your options? Reach out to us. We'll help you understand what to expect and how to prepare for this important step in your fertility journey.