Considering Freezing Your Eggs? What you Need to Know
With so many women choosing to have children later in life, egg freezing (or its fancier name, oocyte cryopreservation) is becoming more and more popular. Even with its gain in popularity, I find women's views of the process tend to be riddled with misinformation and myths.
Often considered a feminist beacon of hope, egg freezing can allow women to have more control over their reproductive options, extending the window they would normally be able to get pregnant, and allowing more flexibility for when they choose to build a family. Yet so few women are accurately informed about what the whole process actually looks like, who it works best for, and how to improve their chances at successfully conceiving.
It's my mission to clear up that misinformation, debunk those myths, and give women real, actionable information about their options. That way, they can feel empowered to make informed decisions about their health.
So, who am I?
First things first, if you're new to The Sweet Spot I want to let you know who I am, so you know exactly who's talking to you and where I'm coming from.
My name is Jacqueline Gabardy, L.Ac., I'm an acupuncturist, herbalist, and holistic fertility coach. I've been in practice for over 5 years and I've treated and coached hundreds of women while they undergo egg freezing and in vitro fertilization.
I am not a Western medical doctor or a reproductive endocrinologist, so I don't perform the procedures of IVF or egg preservation myself, but I support women physically and emotionally through the process. I'm well acquainted with what it entails, I specialize in improving women's success rates, and I even attend embryo transfers with most my patients so I can perform acupuncture before and after the procedure.
I also hold a Bachelor's degree in Biology and a Master's in traditional Chinese medicine. I am licensed to practice acupuncture and herbal medicine in California, which means I am legally a primary care physician, and I work closely with many fertility doctors (aka Reproductive Endocrinologists) to treat our patients with the highest level of care.
The IVF process
If you're considering egg freezing, it's important to know what the process looks like before you jump in so you can properly prep for it, and because I find a lot of anxiety and frustration is just in the not knowing. So let's talk about it.
The IVF process involves 4 main steps: stimulation, egg retrieval, fertilization/growing embryos, and embryo transfer. Egg freezing involves the first 2 steps, then the retrieved eggs are frozen and saved for later, at which point the last 2 steps are performed.
Some women don't actually realize that by undergoing egg freezing, they are locking themselves into IVF if they want to actually use those eggs. I find some women prepping for egg freezing only focus on the road immediately ahead of them, but I think it's important to be well informed about the whole process you're signing up for.
This is the stage when medications are taken to stimulate egg growth. It doesn't actually make you grow more eggs, but it does catch a batch of eggs while they are small and encourages them all to grow at the same rate, rather than one egg hogging all the hormones and causing the rest to deteriorate (which is what happens during normal menstrual cycles.)
This is the part of the process that tends to be the most uncomfortable and strenuous, since it involves several visits to the doctor, injections, and medications that may cause fatigue, irritability, and bloating.
Depending on how many eggs you have growing, the ovaries may feel full or heavy. It's also usually advised you avoid exercise and alcohol during this phase.
Despite the fact that this can be the most uncomfortable part of the process, keep in mind, it usually only lasts 1 .5-3 weeks and most women are still able to go to work and function normally. Also, the side effects of the medications can vary widely, some women feel mostly fine during stimulation.
This is fairly minor surgical procedure in order to retrieve the eggs that were grown during stimulation. Usually they are retrieved trans-vaginally and besides some bloating, minor soreness, and perhaps some spotting, most women feel back to normal within a day or two.
The clinics I work with all typically use general anesthesia during egg retrieval, but the whole procedure usually only takes 20-30 minutes. Some clinics use local anesthesia for retrieval.
Many women are fearful of this step in the process, but I find most women are surprised by how fine they feel afterwards. Usually just stopping the stim meds is enough to make you feel so much more like yourself.
For egg freezing, whatever is retrieved is then frozen. At some point in the future, if you choose to use them, you'll undergo the following 2 steps to actually use those eggs.
Sperm (either fresh or thawed from frozen) is introduced to the egg. Sometimes, just adding them both in the same petri dish will result in fertilization. In some cases your doctor may recommend injecting the sperm into the egg, which is called ICSI (intracytoplasmic sperm injection.)
If you are using frozen eggs, obviously they must be thawed before this step can take place. Keep in mind, the unfortunate reality is that not all of these tiny little cells always survive the thawing process.
Fertilization takes about 24 hours, so typically your doctor or their embryologist will give you an update by phone the next day to let you know how many of your eggs fertilized. Typically they are then allowed to continue growing until they form into day 3 embryos (if they are going to be transferred immediately) or day 5 or 6 embryos (if they are going to be frozen again and transferred later.)
Why would embryos be frozen again after you already froze your eggs? Well, once embryos reach day 5 they are finally large enough to biopsy and get genetically tested, so you can determine if they are chromosomally normal before transfer. Especially for women who had their eggs retrieved after 35 or when their ovarian function was always diminished, this may be a very important step.
Once again, typically not all eggs will fertilize or grow into embryos, and if using genetic screening, not all may be chromosomally normal. In some cases a few may be lost in the process, in other cases only 50% or 25% may make it through, and unfortunately sometimes none make it all the way through the process.
Because of this, your doctor may recommend a certain number of eggs to aim for freezing. Typically my patients are recommended to freeze at least 10-20 eggs if the goal is one live baby, more may be recommended if you want multiple children. In some cases your doctor may recommend multiple stimulation cycles and egg retrievals in order to get the desired number of eggs.
Egg quality has a lot to due with how your eggs develop into embryos and ultimately a baby. Your doctor will typically estimate your egg quality based on your hormone levels and egg count, but unfortunately we don't really know how your genetic material will react until this step.
I don't say this to be discouraging, rather to let you know the reality of the situation some women face when they decide to thaw their eggs. It's an unfortunate misunderstanding that egg freezing guarantees you a future baby, that's not always the case.
This is when one or more embryos get transferred into the uterus in order for pregnancy to occur. It usually involves some hormonal medication to prep the uterus, but it's a very different protocol than stimulation, typically it causes much fewer side effects.
If the embryos are frozen, they must be thawed for this step. This is usually done right before the transfer.
The transfer is usually a breeze compared to everything else you've already been through. It involves threading a catheter (a thin tube) through the cervix and into the uterus, then transferring the embryo into the uterus. Even though this step is uncomfortable, it doesn't involve any anesthesia and the transfer itself typically only lasts a few minutes. Bed rest may be recommended afterwards, but it's usually only for 36 hours.
When it comes time to prepare for your embryo transfer, check out my recommendations.
Once again, not every transfer will result in pregnancy, but typically the chances of conception increase substantially when using genetically tested embryos.
Who should freeze eggs
Ideally, the younger we are the better result we'll get, especially if you have any family history of infertility. But few women think to or have the financial means to freeze eggs at a young age.
Most often, women are inclined to freeze eggs later in life, when they are really thinking critically about family planning. However, it's usually recommended women freeze eggs prior to age 38-40, depending on their ovarian function.
This is because the lower ovarian function gets, the lower egg count gets, and the fewer eggs that they're are able to retrieve. If egg count and ovarian function is low, egg freezing may not even be recommended. Or, in a lot of the cases I see, your doctor may recommend you try acupuncture, herbs, supplements, diet and lifestyle changes for at least 3-6 months, then re-check to see how your egg count has responded.
I've seen my patients' egg counts double and triple after making these changes. It's not because they're actually producing more eggs, rather we're encouraging their ovaries work more efficiently and to wake up more dormant eggs.
Who should consider freezing embryos
Like I mentioned above, eggs are sensitive little cells that don't always survive a thaw. Especially if you have a low egg count and can't retrieve very many eggs, it may be more successful to fertilize the eggs right away, see if they develop into embryos and then freeze them, they may be more viable when thawed.