What is egg freezing?
Egg freezing (also known as oocyte cryopreservation) is a way for women to preserve fertility by freezing their eggs (ideally when egg quality is highest) so that they can try to have a baby in the future.

Why do it?
Cultural shifts over the last few decades have led to women postponing having children to later in life (mid-thirties onwards) when unfortunately, egg quality and quantity start to diminish and the chances of getting pregnant decrease. These factors, coupled with advances in cryopreservation techniques have led to a number of women considering egg freezing as a way of preserving fertility. Maybe you can’t afford your own place let alone children or maybe you haven’t yet met the right partner. Maybe you’re on the fence about having kids or perhaps your career is your priority right now. Whatever your situation, egg freezing is an interesting option  but there is a lot to consider.

What is the process?
Prior to going ahead with egg freezing you will have an assessment to evaluate your ovarian reserve (the number and quality of your eggs). This includes blood tests to check your hormones and exclude infections and an ultrasound scan of the ovaries and uterus. Egg freezing involves stimulating the ovaries with hormone injections to boost egg production and maturation.  Once the eggs have matured, egg collection can be carried out. For the best chance of success you need around 20 mature, high quality eggs. You may not produce 20 eggs during your first round of ovarian stimulation so bear in mind that 2-3 rounds may be required (and the cost implications of this!). To collect the eggs, a minor operative procedure is carried out under sedation or general anaesthetic where a needle is passed through the vagina to access the ovaries and collect the eggs for freezing. The best freezing technique currently available is ‘fast freezing’ (vitrification) and once eggs have been frozen they are stored in tanks of liquid nitrogen. Once you are ready to start a family your eggs can be thawed but bear in mind that only those that survive the thawing process can be injected with partner or donor sperm.

What else should you consider?

• Age: As aforementioned, egg quality and quantity decline with age, so egg freezing should ideally be performed before the age of 35 after which egg quantity and quality start to decline and the risk of chromosomal abnormalities increases. Ironically, the vast majority of women only start to think about freezing when they reach their mid thirties and most women who undergo egg freezing are closer to 40. It is also important to remember that as you get older there is a higher risk of pregnancy related complications for both mother and baby.

• Cost: Egg freezing can be pretty expensive which is a real barrier to women having it done at the ‘optimal’ time between 20-30 years of age, a time when disposable income is usually scarce. A typical round of freezing, medications and storage can cost you around £5000 with further costs of £2500 to have eggs thawed, fertilised and implanted later on.

• Side effects: The hormonal treatment required for egg freezing is not without it’s side effects. These can include: mood swings, bloating, cramping tummy pains and headaches. Due to the fact that the ovaries are stimulated to produce more mature eggs than is normal, there is also a small risk of ovarian hyperstimulation syndrome (OHS) which can potentially be fatal so it’s important to be aware of the signs and symptoms before undergoing treatment. The egg collection procedure is also quite invasive and as with any operation carries risks such as infection, injury or failure, so it’s worth bearing this in mind before going ahead. Your doctor will counsel you on all risks involved prior to going ahead.

• Egg freezing is not an ‘insurance policy’: Contrary to popular belief, egg freezing by no means guarantees future fertility. Once a woman is ready to go ahead with IVF, eggs will need to be thawed and injected with your partner’s or donor sperm. Unfortunately not all will survive the thawing process or be successfully fertilised and the quality of the eggs cannot be assessed until an embryo is formed.

• Success rates: The chances of success (live birth from frozen eggs) depends on factors such as the age at which your eggs are frozen as well as the age at which you get pregnant and your general state of health. However, due to advances in cryopreservation it is worth considering that older data may not be comparable with current success rates. If you are considering egg freezing, make sure you read the statistics around success rates carefully as they are often based on different stages of fertility treatment and can vary from 1% to 20%. For example, success rates based on healthy embryos (where the egg has been through the freezing process and successfully thawed) will be far higher than success rates based on the number of live births occurring from eggs that have been frozen in total. It’s a good idea to ask your clinic for data on their most recent success rates for women of your age who have used their own frozen eggs and make sure you understand what the success rate is based on.

Reasons you may want to freeze your eggs
Deciding when to have children or whether to have children at all can feel like a real dilemma at times and the option to freeze your eggs, albeit without any guarantees can really take the stress and pressure out of this life-changing decision – including the pressure it can put on our romantic relationships! For women with health problems affecting their fertility it can be a great comfort and although there are no guarantees, it is a welcome option in addition to other ways one can become a parent such as donor eggs, surrogacy and adoption.

Is egg freezing available on the NHS?
Egg freezing is not normally funded by the NHS unless you are undergoing (or may need to undergo) medical treatment that could affect your fertility (e.g. treatment for cancer). Egg-freezing must ther

efore be self-funded as it is considered a ‘social decision’ as opposed to medical necessity. If you think you may have a condition that meets the criteria for egg freezing funded by the NHS you can check with your GP or by writing to your local Clinical Commissioning Group (CCG).

Further reading:
The Human Fertilisation and Embryology Authority (HFEA)

Podcast: Freezing Time by Sophia Money-Coutts

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Original piece: here

Published: 9th June, 2021

Words: Dr Lafina Diamandis