How Does Egg Freezing Work? A Fertility Doctor Explains

Is that your biological clock ticking? While egg freezing doesn't guarantee your future fertility, it does allow you to preserve your current egg quality and quantity, which can give you more family-building options when you decide you're ready to have children.

So, how does egg freezing work? In this comprehensive guide, you'll learn what the process looks like from start to finish, how much egg freezing costs, and much more.

In this article:

• What is egg freezing?
• How long does egg freezing take?
• What age should you freeze your eggs?
• How does egg freezing work?
• Reasons to Consider Freezing Your Eggs
• Egg Freezing FAQs
• How many eggs should I freeze?
• How much does it cost to freeze eggs?
• Can you freeze your eggs after a tubal ligation?
• Freezing Eggs vs Embryos

What is egg freezing?

Egg freezing is a method of fertility preservation that involves five phases: consultation and diagnostic testing, ovarian stimulation and monitoring, egg retrieval, cryopreservation (freezing), and finally, thawing and fertilizing those eggs to achieve a pregnancy.

Oocyte cryopreservation (egg freezing) involves extracting, freezing and storing eggs to preserve reproductive potential for those born with ovaries. The science behind egg freezing has advanced greatly over the last decade, and as of 2012, egg freezing was no longer considered an experimental procedure by the American Society for Reproductive Medicine.

Keep reading to learn how egg freezing works, some reasons you may want to consider it, and get answers to the most commonly asked questions about the process. 

How long does egg freezing take?

The timeline from your initial consultation with a physician to starting your egg freezing cycle is typically around 6-8 weeks. Of course, this doesn't take into account any time you may have to wait for an available appointment - so schedule it sooner rather than later!

The egg freezing process only takes around 2-3 weeks, and depending on the urgency of your situation, your fertility clinic may be able to fast-track certain aspects if you are facing a cancer diagnosis and need to begin treatment as soon as possible. 

At Illume Fertility, we regularly work in conjunction with oncologists to coordinate treatment schedules and ensure cancer patients receive prompt attention and streamlined care. 

What age should you freeze your eggs?

To give yourself the highest chances of success, we typically recommend freezing your eggs in your late 20s or early 30s. Any time before age 35 is optimal, but fertility preservation at any age is better than no fertility preservation at all

Of course, if you are diagnosed with an illness that may decrease the quality and quantity of your eggs (i.e. cancer), you might want to consider undergoing an egg freezing cycle even sooner. Similarly, if you plan to transition with hormone therapy or gender-affirming surgery, egg freezing offers the benefit of preserving your current fertility beforehand. 

"The timing of big life choices are not always on our side (or easy to plan for), but taking steps to protect your ability to start a family when you want to and when you feel ready, is to me, the most liberating action you can take."

- Alexandra, egg freezing patient

How does egg freezing work?

Phase 1: Consultation & Diagnostic Testing

The first part of an egg freezing cycle involves an initial consultation with a reproductive endocrinologist to discuss the process in detail and begin your fertility work-up.

This typically entails scheduling an ultrasound and blood work with your next menstrual period (or to see where in your cycle you are if you do not regularly get menstrual periods).

These diagnostic tests are important for assessing the number of potential eggs in the ovaries and designing the best protocol for your body. After testing is completed, you will have a second and final visit to go over your results and discuss what will happen next.

Phase 2: Ovarian Stimulation & Monitoring

The second part of the egg freezing process is the cycle itself.

We work to synchronize your egg growth, usually with a short course of birth control or estrogen pills (taken for 7-14 days). After this, you will begin taking two ovarian stimulation medications, which are essentially your body’s natural hormones, just in much higher doses.

These are taken as small injections (at Illume Fertility, we mix them together, so you only have to take one injection per night). These medications are taken for an average of 8-12 days.

During this phase of the process, you are also coming in to your fertility clinic’s office every 2-3 days for an ultrasound and blood work to monitor the growth of the follicles (which are the fluid-filled sacs in the ovaries where the eggs reside).

A third medication is then added to prevent premature ovulation of the eggs. Once there are several large follicles, the ovarian stimulation medication is stopped and you take a "trigger shot" which prompts your body to finish maturing the eggs. 

Phase 3: Egg Retrieval

The egg retrieval is performed around 35 hours after you take your "trigger shot."

Under IV sedation (no intubation necessary) with a board-certified anesthesiologist, eggs are removed from the follicles via transvaginal ultrasound. This means that there are no incisions on your abdomen - you won’t be able to tell anything even happened from the outside!

At Illume Fertility, we will give you a card that reveals the final number of eggs the doctor was able to retrieve while you are in the recovery area following your egg retrieval procedure. 

Get a step-by-step guide to egg retrieval:

A fertility nurse and mom through IVF shares what you can expect before, during and after your egg retrieval.

Phase 4: Egg Freezing

During your egg retrieval procedure, the eggs are carefully removed from the ovaries, then passed to an embryologist, who immediately assesses the quality and maturity of each egg. Those mature eggs are then cryopreserved (frozen) using vitrification later that day.

What is vitrification? Egg vitrification is a "flash freezing" method in which cells are immersed directly into liquid nitrogen, cooling them so quickly to -196ºC that they become "glass-like" or "vitrified." While traditional slow freezing takes hours, vitrification is almost instant, significantly reducing the chance that ice crystals will form and damage the egg's delicate structure.

Phase 5: Using Your Eggs

While some people freeze their eggs and never end up using them, the goal of most egg freezing patients is to eventually thaw and fertilize those eggs to attempt pregnancy. 

Whether you choose to wait three years, five years, or ten years, your eggs will stay the same "age" as you were when you had your egg retrieval, and the process of utilizing those eggs (when you are ready) will follow these steps:

• Step 1: Eggs are carefully thawed 
• Step 2: Eggs are fertilized (using sperm from male partner or sperm donor)
• Step 3: Fertilized eggs develop into embryos over the next five days
• Step 4: Embryo transfer to uterus of intended parent or surrogate
• Step 5: Wait for pregnancy test results

What are the chances of getting pregnant after freezing your eggs?

The survival rate of eggs after freezing and thawing is over 90%. Successful fertilization rates are between 71% and 79%, and successful implantation rates vary depending on multiple factors (your age at time of freezing, age at transfer, male fertility, clinic protocol, etc.)

How many eggs will I be able to freeze?

Various factors come into play, but one 2017 study looked at 520 people (with "average" ovarian reserve) who had undergone egg retrieval and found the following averages:

• For ages 36 and under: About 14 mature eggs were retrieved
• For ages 37-39: About 10 mature eggs were retrieved
• For ages 40-42: About 9 mature eggs were retrieved
• For ages 43 and over: About 7 mature eggs were retrieved

Should I freeze my eggs?

There are many different reasons someone might consider cryopreserving (freezing) their eggs. Each situation is unique, and it is a deeply personal choice. However, there are typically four main reasons people freeze their eggs. Let's explore what they are.

4 Reasons to Consider Freezing Your Eggs

The Biological Clock

Egg quality and quantity decline as you age, leading to a decrease in the chances of a successful pregnancy. Whether you are spending your 20s and 30s climbing the corporate ladder or simply focusing on other things before becoming a parent, "stopping" the biological clock by freezing your eggs is a great way to preserve your fertility for years to come.

The best part? Any eggs you freeze now will have the same reproductive potential as when they were frozen - even when used many years in the future.

This means that if you decide to attempt pregnancy at age 40 using eggs you had frozen at age 28, you will be using eggs preserved at a time when they were at their healthiest, giving you higher chances of success. 

Reproductive Autonomy

You have “sole custody” over your frozen eggs. This means that they are your biological property, regardless of what happens in the future.

If embryos are created using eggs and sperm, and the sperm is not from a sperm donor, the male partner has a say in what happens to those embryos in the future. This is not the case with frozen eggs.

Relationship Status

Freezing eggs can take some pressure off of your relationships. As we get older, it’s common to start thinking about your timeline for building a family, and sometimes this can strain relationships or cause stress around choosing a partner and settling down.

Maybe your current partner isn't certain if they even want children. Perhaps you want to enjoy dating without added pressure of finding a future co-parent. Or maybe you are already in a relationship but want to enjoy more time as a couple before pursuing parenthood.

Having your eggs frozen allows you to focus on the present moment instead of feeling rushed to try to conceive before you feel ready.

Fertility Preservation

Egg freezing is also an important consideration for those facing cancer or gender transitions. You can protect your future family-building options before undergoing gender-affirming hormone therapies or procedures, or before beginning life-saving treatments (i.e. chemotherapy/radiation) that could impact your fertility. 

There's a lot to consider when it comes to freezing your eggs. Here are some of the most commonly asked questions our practice receives from patients exploring their fertility preservation options:

Is egg retrieval the same as IVF?

An egg retrieval is also the second stage of in vitro fertilization (IVF), but can be performed without subsequent egg fertilization and embryo development for those who wish to preserve oocytes (eggs) only for future use.

How many eggs should I freeze?

We recommend freezing 10-15 eggs per planned pregnancy. For example, if you are hoping to have two babies, 20-30 eggs should give you a good chance at achieving two pregnancies.

However, there are additional considerations to keep in mind, like the number of mature eggs your doctor is able to retrieve, your chosen fertility clinic's success rates with freezing and thawing eggs, and other important factors.

How many egg freezing cycles will I need?

This will depend on a few factors:

• Your age
• Your desired family size
• Your baseline ovarian reserve
• Your body's response to ovarian stimulation

Many egg freezing patients undergo more than one cycle in order to retrieve the amount of eggs that gives them the best chance at a successful future pregnancy. In short, the more eggs you freeze, the better your odds are. 

How much does it cost to freeze eggs?

Egg freezing can cost up to $30,000+, but the average cost is around $11,000, with the typical range being $8,000 to $15,000 per cycle (if you pay out-of-pocket). Keep in mind storage fees will cost you anywhere from $500 to $1,000 annually.

Want to get a full pricing breakdown? Get our complete guide to egg freezing costs!

The exact cost you will pay depends largely on your insurance coverage, whether you qualify for discounted services or financial grants, and where you live in the United States. 

Some insurance providers cover portions of the egg freezing and IVF process, and some companies now offer egg freezing benefits. There are also grants (particularly for cancer patients) and other financial options.

Here are a few of our recommendations:

• Fertility treatment grants are available from organizations like Baby Quest Foundation, the Cade Foundation, the Hope for Fertility Foundation and the Nest Egg Foundation. 
• Grants specifically for cancer patients wishing to preserve eggs before cancer treatments: Livestrong Fertility, Team Maggie for a Cure, Verna’s Purse, the Alliance for Fertility Preservation, The Samfund, the Heart Beat Program, and Fertility Within Reach.

Can you freeze your eggs after a tubal ligation?

Yes! Studies show that those who wish to conceive after having their fallopian tubes "tied" have the same chances of IVF success as other patients struggling with infertility. This is due to the fact that your ovaries (and egg production) are not impacted by tubal ligation, which only affects the fallopian tubes. 

Is IVF right for me?

Download your free guide to IVF to learn more about how much treatment costs, how long it typically takes, and how it all works.

Can I work while doing egg freezing?

Yes, but plan ahead and prepare to be flexible. During Phase 2 of the process, you will have frequent monitoring appointments, which will be scheduled in the morning before work. You will need to be off work on your egg retrieval day, and potentially the day after too. 

Do I have to give myself shots?

Injections are a necessary part of the egg freezing process. However, you can enlist a trusted friend or family member to help administer the shots if you feel squeamish about giving them to yourself. By the end, we promise you'll be a pro!

Does egg freezing always work?

It's important to know that freezing eggs doesn't guarantee you’ll have a baby.

However, egg freezing does allow you to preserve your current fertility for the future. The quality of your clinic’s lab, your age, and other factors can affect the amount of mature, healthy eggs retrieved and frozen. 

Freezing Eggs vs Embryos

With egg freezing, there is no way to assess the quality of eggs, so you won’t know their reproductive potential until you decide to attempt pregnancy.

With embryo freezing, you are able to assess their quality with preimplantation genetic testing (PGT) prior to freezing. However, a sperm source is required to create embryos, which can add a layer of complexity.

Ask your doctor for guidance on the best option for your personal situation. 

Protecting Your Future Fertility

There are many different reasons to consider egg freezing, but all of them allow you to pause the biological clock and preserve your current fertility.

While pursuing cryopreservation can feel out of reach for many due to the cost of treatment, we encourage you to reach out to us to discuss your options and explore ways to bridge the financial gap.

Being able to protect your future fertility is an empowering choice that can relieve pressure, lower stress, and increase your chances of family-building success on your own personal timeline.