Determining whether to freeze your eggs is a difficult and personal decision. Yet there are important facts available that can guide you.
I don’t know about you, but my social media feed is filled with messages about how women must freeze eggs to preserve their fertility. I decided to investigate this topic by attending seminars, listening to various organizations’ pitches, and speaking to Reproductive Endocrinologists (REIs) and patients.
First, it is important to know where I’m coming from. I have dealt with infertility for several years and have seen 10 of the best REIs in the country. I come from the biopharma industry and have been monitoring and assessing the industry. I’ve become frustrated by the marketing angle that has taken over the industry, causing misinformation or half-truths to be available.
So what are the egg freezing facts?
We all want an answer
When it comes to our fertility, we must come to terms with the fact that each of us is different and there is no answer. Instead, it is extremely important we focus our efforts to get to know our body, understand the facts, and partner with a great team (i.e., REI, acupuncturist, friends, support group).
Ethically permissible as of 2012
The American Society for Reproductive Medicine (ASRM) stated in 2012 that egg freezing is “ethically permissible.” However, for delaying motherhood, they state, “Marketing this technology for the purpose of deferring childbearing may give women false hope.” They also share important caveats. Examples include asking your provider for clinic-specific statistics, efficacy, safety, benefits and risks. Click here to read their entire statement.
Number of eggs one should freeze
One clinic stated that, for every child you hope to have, freeze 10 eggs. Another clinic stated this number should be about 15 eggs per child. Yet another stated the number is unknown. Quite frankly, this last statement is the most true and so hard to accept. I’ve listened to plenty of stories where one froze 20 eggs and could not achieve pregnancy. Read this article from the Chicago Tribune to learn more about the uncertainty.
The Society for Assisted Reproductive Technology (SART) data shows 7,987 eggs were frozen in 2016. Yes, the numbers are going up, where estimates for 2018 were 75,000 eggs. However, as REIs will tell you, many women don’t even use their eggs as they may get pregnant on their own or change their mind. Additionally, given that the largest number of eggs were frozen in recent years, we have to wait for more data. Thus, we don’t yet fully understand success rates and what drives them.
Testing the egg
Given that our eggs are only one cell, they cannot be tested. This can only be done with embryos. It is critical to know up front that there are an infinite number of factors that impact one’s ability to get pregnant. Thus, while retrieving and freezing eggs are a well-known process, the “getting pregnant” part is a completely separate story. Please focus on the big picture rather than just “how many eggs should I freeze?”
Where to freeze your eggs
This is clearly a personal choice. In speaking to patients trying to make the decision, the underlying question is really, “What do you want?” I strongly recommend you make a list of what is important to you in a doctor/clinic and why you want to freeze your eggs. Then make your decision.
Also, set your budget up front as the ride can be addictive and anxiety provoking. For instance, you have in your head you will be able to freeze 15 eggs after one procedure, but you only produce 5. You panic and decide “one more try.” Again, you get an unexpected result. I think you get where I’m going with this.
Know your costs up front
The costs include monitoring, retrieval and freezing process, annual storage fees, medications, and genetic testing. I was surprised to see inconsistencies in whether a full fertility workup or genetic testing are done. Some clinics only test your AMH (anti-Mullerian hormone) levels, which indicates your ovarian reserve.
Patients reported some egg freezing centers are still working through logistics. For example, nurses aren’t following up as agreed, tests are done but unexpected, exorbitant bills are sent after the fact. Thus, get it in writing and if you feel uncomfortable from the get go, move on to another clinic.
For the monitoring/egg retrieval process, the prices seem to be either $5,000 to $6,000 or $9,000 to $10,000. After assessing business models, it seems those on the lower end are focused on getting you in the door in hopes you will stay on as a patient for other women’s health products they may add in the future. They also don't have the same overhead as larger fertility centers that offer a full set of services. Those charging the higher rate are established or have established clinics they partner with and as a result, have higher overhead.
Know your plan for IVF now
While your focus may be on freezing your eggs — whether to freeze, where to freeze, how many to freeze — you need to think through the back end. For example, plan to do the IVF with a clinic that is reputable — check out FertilityIQ for doctor ratings and SART for whether your clinic reports its data and what their success rates are. This might actually help you make your decision on where to freeze.
Additionally, understand both your and your family’s medical history as it relates to fertility. Determine what work ups can be done now so you have an even more informed future than just how many eggs you have banked. Remember, it takes an average of 2.7 IVFs to get pregnant.
I do hope you take all of this to heart and don’t let the marketing tactics scare you. Perhaps in our lifetime, we will have better diagnostic testing and data analytics to better understand what truly contributes to successful pregnancies so that women aren’t left to make their best guess every step of the way.
Wishing you the best on your journey, whatever you choose to do. The good news is, today, you have a choice!
Originally published on Medium.