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Egg Freezing Program: Where You Freeze Your Eggs Matters!

Egg freezing is quickly gaining popularity as the service is promoted heavily by commercial interests, and we want to start with a word of caution: Where you freeze your eggs matters!

Freezing eggs is like buying insurance: One hopes never to have to use it, but should something happen, we want to be certain that the insurance company will fulfill its obligations. In other words, once one decides to freeze eggs, it matters how eggs are frozen, who does the freezing, which methods of freezing are employed and, most importantly, of course, how good the eggs are a few years later, should they be needed. How well they thaw out, is then the principal question.

Even if parents often help out their daughters financially, because egg freezing primarily serves younger single women, many just starting their professional careers, it must be cost-effective and honest in presentation. Watching the increasing commercialization of the procedure and often grossly misleading information provided, we decided to intervene with, likely, the most progressive, honest and cost-effective egg freezing program available.

With that in mind, here is what CHR offers in our egg freezing program:

  • Proper counseling by experienced physicians and full informed consent process
  • Personalized egg freezing programs tailored by expert physicians to suit each woman’s exact needs
  • Excellent laboratory with experience in both freezing and thawing of eggs and embryos, as well as subsequent IVF
  • Storage of frozen eggs right here at our center
  • Accountability, follow-up and quality control over time
  • Affordable egg freezing cost structure, starting at $4,000 for one cycle
  • Economical “package” pricing for multiple cycles and egg number goals

CHR Explains

Problems in the egg freezing “industry”

Getting on the commercial bandwagons has never been CHR’s way of doing things. Our patients have greatly benefitted from this approach for over three decades. When it comes to egg freezing, like the American Society for Reproductive Medicine (ASRM), CHR still considers egg freezing an experimental procedure (except in cases of cancer), and advises patients accordingly. The reason is simple: accurate outcome data are either lacking or inadequate at this time, and that makes the procedure “experimental.”

Most centers don’t see it that way and, certainly, do not communicate it this way to their patients. In some IVF centers, egg freezing cycles have, indeed, become the “main” business; unbelievably, in others, it is the “only” business. They produce and freeze eggs, and then mostly ship out those eggs to cryobanks for long-term storage. Whether these eggs result in successful pregnancies, often years later, is then no longer their concern. There is no follow-up, no quality control and no reporting to the Centers for Disease Control and Prevention (CDC), unlike IVF cycles.

As social egg freezing spread, with increasing frequency, CHR physicians have been hearing from patients that, upon thawing of their eggs, they were devastated to find out that none, or only very few, of their eggs had survived the thawing process—essentially, their “insurance policy” turned out to be not what they were promised to be.

How can this happen? How a woman’s ovaries are stimulated to develop eggs for retrieval is essential in determining ultimate egg quality; then, how an embryology laboratory cryopreserves eggs, is the single most important aspect of how well those eggs will thaw later. Differences between comprehensive IVF center like CHR and egg freezing centers can be crucial.

Who needs egg freezing?

Though these statements will not appear on many egg freezing websites, not every young woman needs egg freezing; not everybody needs egg freezing at the same age; and not everybody needs egg freezing with the same urgency. One reason is that not all women age their ovaries in the same way and on the same time table. In approximately 10% of women, their ovaries age prematurely (a condition called premature ovarian aging, or POA). Women with POA have fewer eggs left in their ovaries than the other 90% at any given age.

If at all possible, women with POA, therefore, should freeze eggs at younger ages than women with normally aging ovaries. Egg freezing in a 26-year-old with POA may, therefore, be much more urgent than in a 33-year-old with normal ovarian reserve (OR). This example emphasizes the importance of diagnosing POA as early in life as possible.

Any first assessment of young women at CHR, therefore, includes an assessment of risk to develop POA. If a young woman is at risk of POA, we can monitor her ovarian reserve and she can adjust her timeline for egg freezing (or pregnancy) to ensure the best results.

Whether and when to freeze eggs is often a balancing act between education, career, social life, ovarian function and other factors in each woman’s life. With this understanding, CHR’s expert physicians can work with each woman’s individual circumstances and help her make her own decision.

In general, the younger a woman is when she freezes her eggs, the better will her eggs freeze and thaw. Should she later in life need them, the younger they were when eggs were frozen, the better their pregnancy chances will be.

Most experts recommend against egg freezing after age 36-38, and freezing eggs when a woman is in her 20s is clearly superior to freezing them in her 30s. After age 38, our advice usually is to attempt pregnancy right away rather than freeze eggs. However, social circumstances at times do not permit first choices. Rightly, therefore, the patient are always the ultimate decision-maker at CHR.

How many eggs should be frozen?

The honest answer is that nobody knows for sure how many eggs a young woman should freeze to preserve her fertility. However, there are general guidelines:

This number, of course, depends on the age of the woman: the older she is the more eggs will be required to achieve pregnancy.

Secondly, however, the answer also depends on the ovarian reserve (OR) of the patient. Even if young, a woman with very low OR will need more eggs frozen than a woman with normal OR because low OR is not only associated with smaller egg yields but also with poorer egg quality.

Furthermore, because egg numbers decline with advancing age and with declining OR, under both of these circumstances women will need more cycles to freeze an adequate number of eggs. For this reason, egg freezing after age 38 is no longer considered economical.

Table 1 offers recommended estimates for number of eggs that should be frozen at different ages for one desired child. For two desired children those numbers should be doubled, for three tripled, etc. The table also presents estimates for how many ovarian stimulation cycles it, likely, will take at various ages to reach this minimum egg number per child.

Table 1: Estimated number of eggs and retrieval cycles necessary for 1 child at different ages

Age 21-25 26-32 33-38 39-42
Estimated minimum number of eggs for a single child* 10 15 20 25-30
Estimated number of egg freezing cycles required to reach the above-quoted number** 1 2 3-4 4-6

*Approximately double the number for 2 children, triple it for 3, etc.

**These numbers are based on declining egg numbers with advancing age, and further assume that women have normal OR for age. Women with abnormally low OR for age (POA) should at minimum advance themselves by one age-category.

The number of eggs we recommend may surprise you. If so, it is important to understand that only very few eggs lead to pregnancy. Not every egg retrieved is a good quality egg of just the right maturity to be frozen. Not every frozen egg survives thawing. Not every egg that survives thawing gets fertilized by sperm, and not every fertilized egg becomes a good enough embryo to be transferred into the uterus. Not every embryo transferred into the uterus implants, and not every embryo that implants becomes a normal pregnancy leading to a normal delivery. In other words, there is considerable loss in human reproduction and this is the main reason why it takes so many eggs to make a baby.

Egg freezing cost considerations: A revolution

Table 1 noted that the estimates are based on women with normal OR, and they can, of course, vary upwards and downwards. Moreover, women with low OR will produce fewer eggs per cycle; how much fewer will depend on severity of their low OR. Before reaching final conclusions based on this table, therefore, a reproductive endocrinologist with experience in egg freezing should be consulted.

In order to accommodate the varying needs of each woman, we offer egg freezing options with highly competitive package pricing, starting with a single cycle up to a 6-cycle package. Table 2, to the best of our knowledge, describes the currently most rational and most cost-effective package costs for egg freezing offered in New York City and, maybe, in the country. Most importantly, however, this program is not offered by a fly-by-night outfit but by one of the most recognized IVF centers in the world.

Table2: Cost of egg freezing package plans*

Plan Maximum number of cycles Minimum number of frozen eggs Package costs**
A Single cycle No guarantee $4,000
B Up to 2 At least 10 $5,900
C Up to 3 At least 15 $7,900
D Up to 4 At least 20 $9,900
E Up to 5 At least 25 $12,900
F Up to 6 At least 30 $15,900

*Each plan, except for Plan A, offers a maximal number of ovarian stimulation cycles/egg retrievals and a minimum number of eggs frozen, whichever is reached first.

**The following is included in package cost: All ovarian cycle monitoring, follicular ultrasounds, hormone monitoring, egg retrievals and egg cryopreservation (vitrification). Not included are: Initial ($350) and subsequent physician consultation ($250), anesthesia services during retrieval ($350), medication costs (dependent on patients’ OR). Quarterly storage fees for each frozen egg batch is $250.

Alternatives to egg freezing

Egg freezing is a preventive medical treatment, and has alternatives, like any other medical treatment.

We noted before that not everybody needs egg freezing. Like with any medical procedures, cost-benefit and risk-benefit considerations must support performance of the procedure. Before making any final decisions, a consultation with a reproductive endocrinologist with special expertise in this subject is, therefore, strongly recommended.

One alternative to egg freezing is to not rely on egg freezing. This can take various forms: The simplest is doing nothing, which may be entirely appropriate in a young woman in her mid-20s with normal age-appropriate OR. Another frequently chosen alternative is to have children at earlier ages.

One also should not forget that, in contrast to egg freezing, embryo freezing has been an “established” procedure for decades with solid long-term outcome data. Especially for married couples and those in stable relationships, embryo freezing may be a more reliable method of fertility preservation.

Read more about Fertility Preservation

Last Updated: December 18, 2017

Additional Resources

Fertility Preservation News Aug/Sept, 2015 Some new information on the effects of egg freezing In this issue of Fertility Preservation News we focus on a

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Fertility Preservation News July, 2015 CHR’s FERTILITY PRESERVATION News                                

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