Ladies: Don’t put all your eggs in one basket. Whether you’re single, dating or on the cusp of meeting Mr. Right, at some point, your mother, sister or best friend has probably told you this. And if your biological clock is also ticking, their advice might be literal.
But now, women can freeze their eggs, taking at least part of the pressure off finding the right partner in time to have a family. The news last week that Apple and Facebook will cover the steep costs of egg freezing for women employees highlights this growing option for women, whether they’re careerists who have delayed pursuing a family or women who were saddled with diseases like cancer and had to suspend hopes of childbirth.
The corporations’ decision to extend fertility treatment coverage has been met with mixed reviews: Some say it encourages women to unnaturally soldier on in their careers through their fertile years at the cost of experiencing the organic joy of natural conception on its own terms. But fertility specialists throughout the country are heralding the move as a supportive one for women — as well as a recognition of how egg freezing technology has blossomed.
“I think it’s great,” says Matthew Will, a reproductive endocrinologist at Midwest Fertility Specialists in Carmel, Indiana. “It’s a very empowering decision by those corporations to help women achieve their goals.”
But freezing eggs is not for everyone, so women should be aware of what they’re getting themselves into: It’s expensive, it might not work and your eggs might be too past their prime to make it a worthwhile endeavor.
Know Your Odds
The first step in the decision process is knowing your odds of success. Mylene Yao, a reproductive endocrinologist and OB- GYN formerly at Stanford University, created a tool to help people figure that out. Yao is now CEO of a company called Univfy, which has a website that provides fertility analytics that predict your success with fertility treatments.
This pre-IVF testing takes into account your age, BMI, reproductive history and mostly, your ovarian function, which is based on two hormonal tests: FSH (follicle- stimulating hormone) and estradiol, a form of estrogen. These two tests are done from a blood draw taken on the third day of your menstrual cycle. When you enter this data to the Univfy website, a personalized report is created that shows your relative chances of success with IVF treatments or egg freezing. The report costs $99.
From there, you can begin a conversation with a fertility specialist, Yao says. “The whole comprehensive analysis is extremely predictive,” Yao says, adding that people can call in with their data to make sure their numbers are in the right range before proceeding with the questionnaire. For example, if you get your blood drawn on the wrong day — say, the second day of your cycle — your numbers will be off, she adds.
Will has had a number of patients consult him after using Univfy. “It certainly matches up with our clinical estimates,” he says.
The Earlier, the Better
Egg freezing grew out of the dire situation young cancer patients found themselves in when they were struck with the disease before conception and faced treatments that would make them infertile. Researchers found a way to freeze patients’ eggs before treatment. Egg freezing has evolved to reach a broader population, mostly older, professional women who have delayed childbirth to pursue careers.
But now, even younger women — those in their mid-20s to early 30s — are seeing it as an option. Gilbert Mottla, a reproductive endocrinologist at the Shady Grove Fertility Center in the District of Columbia, says the clinic has traditionally seen a lot of older, professional women, the typical demographic of egg freezers in a cosmopolitan city. But increasingly younger women are seeking it, too. “Thirty-one to 32 … That’s an incredible opportunity to freeze eggs,” Mottla says. “It’s like an insurance policy. Those eggs may serve for her second or third pregnancy.”
Although fertility is highly individualized, freezing eggs before age 40 — or even 38, when fertility starts to rapidly decline — is recommended. Freezing eggs involves undergoing hormone treatments for a couple of weeks, at the end of which women’s eggs are extracted during a brief (10- to 20-minute) procedure in which the patient is sedated. The hormone medications can cause bloating and crankiness (like having the period from hell for two weeks), but otherwise, the process is relatively painless with minimal recovery time.
Yao recommends that women who freeze eggs follow a similar lifestyle as they would if they were conceiving naturally — so no smoking or alcohol three months beforehand, and limited caffeine and sugar.
Preserving Fertility
The beauty of egg freezing is that it takes your “younger” eggs from when you froze them and gives you leeway as to when you want to implant them and become pregnant. The uterus is a muscle that doesn’t age like your other reproductive organs, so you can carry a pregnancy well into your 40s — although for other health or personal reasons, you might not want to delay it too long, Mottla says.
The actual process of freezing and thawing is very important to the success of achieving a pregnancy as well. Mottla says vitrification, which uses anti-freeze, is much better than the old, slow-freeze method in which ice crystals formed, which were potentially harmful to the eggs. “It’s how the egg thaws that counts,” he says, adding that the success rate at Shady Grove, the country’s largest fertility clinic, is excellent: 80 percent of the frozen eggs return to life, and 80 percent of those are successfully fertilized.
Once the eggs thaw, they inject sperm into them and watch the embryos grow for five days. They choose the best one to implant. Women take hormonal medications for a couple of weeks, and then it’s usually clear whether a pregnancy will proceed, Will says.
Look at Reality, Not the Celebrities
The one prohibitive factor to egg freezing is the cost. Depending on how many eggs you freeze, it costs an average of $10,000; storage is at least $500 per year, and implantation is usually another $5,000, plus the cost of IVF treatments. You may also need additional rounds if the first set of eggs doesn’t pan out. Most insurance doesn’t cover egg freezing, even for cancer patients.
So, be proactive about finding out as much as possible from your fertility specialist, Yao says: “How many eggs can you expect to get for $10,000?” she suggests asking. “What is my chance of having a baby from these eggs?”
At the Shady Grove Clinic, Mottla says they’ve tried to make egg freezing reasonable: One treatment costs $7,500, and for $12,500, women can undergo up to four cycles of treatment to get 20 eggs. If they get all those on the first treatment, they’re reimbursed $4,000, Mottla adds.
The cost issue is in part why the news about Facebook and Apple was noteworthy, but beyond that, the companies’ gesture puts a healthy discussion of egg freezing on the table, Mottla says, adding that it can perhaps help clear the air about expectations of fertility as women age. “It’s been a bad public health message to watch celebrities have children deep into their 40s” with donor eggs, he says.
The best time biologically for women to conceive is still the early 20s, he adds, but fertility doesn’t go into real decline until the mid to late 30s. So if you want to stay ahead of the curve to meet other life goals, and you can afford freezing, it’s an empowering option to consider.
“If someone is really ready to do this, don’t wait,” Yao adds.
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Should I Freeze My Eggs? originally appeared on usnews.com
