To Freeze (Your Eggs) or Not to Freeze, That Is the Question

And should you choose to freeze your eggs, the sooner, the better

For those who have been in the field of reproductive medicine for many years, the fairly recent demonstration that egg-freezing technology has finally succeeded in allowing us to freeze and thaw eggs without significant detriment to pregnancy rates was probably one of the biggest advances in the field since the introduction of in vitro fertilization (IVF).

Although sperm has been frozen and thawed successfully for decades, until the past five years or so, egg freezing has been plagued with problems and poor survival rates, primarily due to the very large size of mature human eggs, their high water content, and the tendency for damaging ice crystals to form during the freeze/thaw process. However, with advances in a freezing technique called vitrification (aka, flash freezing), many studies have now demonstrated that vitrified eggs produce pregnancies at comparable rates to eggs that have never been frozen.

But enough with the biology lesson. My intent with this blog is not to make you an expert in reproductive freezing technology, but to address the social issues that arise for women now that the capability exists to successfully freeze your eggs (as a sort of fertility insurance policy, if you will).

As a physician in this field, I’ve watched the technology emerge with fascination, as I was sure that many women in their 30s would be thrilled to have an option to help protect their fertility, especially those who consider delaying motherhood due to career aspirations or those who have not yet met “Mr. Right.” However, being single and in my mid-30s myself (and having many friends in a similar boat), I have had almost as many conversations about whether to freeze eggs with my friends over happy hour as I have with patients in the office.

And the less formal conversations I’ve had with friends have given me better insight into the complex questions that often arise when making this decision. Here are some examples:

  • How likely is it that I’ll need my frozen eggs to get pregnant?
  • How many should I freeze? Is there a number that will guarantee pregnancy in the future?
  • What message does it send to the guy I’m dating if I freeze my eggs? I’m worried he’ll think I feel uncertain about our future.
  • I know I have to have some fertility testing done to freeze my eggs, what if it is abnormal? What do I do then?

No definitive answers

Overall, there are no definitive answers to these questions. Given that the technology to freeze eggs effectively is still fairly new, there are no studies yet that can give us insight into the percentage of women who ultimately will need to use their frozen eggs to achieve pregnancy, and we probably won’t know the answer to that question for many years to come. And the answer will probably vary significantly depending on how old you are when you freeze your eggs and when you start actually trying to get pregnant.

I typically tell both my friends and my patients who are considering egg freezing that there are three possible outcomes from freezing your eggs:

  1. You will get pregnant on your own, and you won’t end up using your frozen eggs;
  2. You will have trouble getting pregnant on your own in the future, but you will be able to get pregnant using your frozen eggs;
  3. You will not be able to get pregnant either on your own or using your frozen eggs.

I think one of the most important things to remember when considering egg freezing is that there is no 100 percent guarantee you will be able to get pregnant using them in the future. However, if you freeze your eggs at age 35 and then need to do IVF when you are 40 because you can’t get pregnant on your own, the likelihood of getting pregnant will be better using your frozen 35-year-old eggs.

Typically, if you do decide to freeze your eggs, the sooner you do it, the better. It is not only the number of eggs that decline as we get older but the health of the eggs also declines (obviously, there is a bit of a catch-22 here, since the younger you are when you freeze your eggs, the longer natural fertility window you have and the less likely it is that you may need the eggs in the future). So, if you know you won’t start trying to get pregnant till your later 30s, freezing your eggs in your earlier 30s may be a good back-up plan.

At the end of the day however, whether to freeze your eggs is a personal decision that involves many factors that are specific to you, your age and your circumstances. If you are considering egg freezing, I would encourage you to meet with a reproductive endocrinologist so you can discuss your specific circumstances to determine whether it is the right decision for you.