Elective Egg Freezing and Fertility Preservation Services

Not everyone is ready to start a family during their peak fertility years. Some may choose to delay pregnancy for personal or professional reasons. Other patients may have conditions or medical treatments that affect fertility and want to preserve their ability to have biological children in the future.

At the Center for Infertility and Reproductive Surgery (CIRS) at Brigham and Women's Hospital, we offer a well-established egg freezing program for women and people assigned female at birth (AFAB) who want to expand their reproductive options and postpone childbearing. Our program has shown that pregnancy success rates with frozen and thawed eggs are comparable to those with frozen embryos.

What is Elective Egg Freezing?

Elective egg freezing (also called vitrification) is the process of retrieving, freezing, and storing a woman's eggs in liquid nitrogen for later use. When you are ready to become pregnant, your eggs are carefully thawed, fertilized in the lab, and transferred to your uterus as embryos.

Fertility Preservation for Patients with Conditions Affecting Fertility

Egg freezing is also an important option for patients with cancer or other conditions that may affect fertility.

Conditions that may affect your ability to conceive include:

• Cancer and certain cancer treatments (chemotherapy, radiation, surgery)
• Ovarian cysts/polycystic ovary syndrome (PCOS)
• Endometriosis
• Family history of early menopause
• Lupus and other autoimmune disorders
• Genetic conditions like Turner syndrome
• Genetic mutations, such as BRCA1/2 gene mutations, that are linked to early ovarian failure

Also, some patients without a medical condition can benefit from fertility preservation. For example:

• Women at risk of losing ovarian function at a young age due to genetic causes
• Women concerned about age-related egg decline
• Women who need to delay pregnancy for personal reasons

These patients may consider elective egg or embryo freezing to keep their options open for the future.

If your own eggs may not be enough to achieve pregnancy, you may also want to learn about egg donation and gestational carrier IVF as additional family-building options.

How does cancer affect my fertility?

Some cancers, like ovarian and uterine cancers, directly damage the reproductive system.

Additionally, treatments such as chemotherapy, radiation to the pelvis, or total body irradiation can reduce or permanently affect ovarian function, sometimes causing premature menopause. In some cases, even lower doses of chemotherapy may decrease egg supply and make it harder to conceive later.

What options do I have to preserve my fertility during medical treatment?

The below treatment options are available for all patients who have a condition that may affect their fertility:

• Egg freezing: Eggs are retrieved after ovarian stimulation and stored for later use.
• Embryo freezing: Retrieved eggs are fertilized with sperm from a partner or a donor and frozen as embryos for future use. It takes approximately two weeks to undergo the ovarian stimulation for an in-vitro fertilization treatment, but shorter course treatment is sometimes possible.
• Ovarian tissue replacement: For patients who can’t delay cancer treatment, ovarian tissue can be removed and reimplanted after treatment ends. The replaced ovarian tissue typically functions for three to eight years. Women have become pregnant naturally after ovarian tissue replacement or using in-vitro fertilization (IVF) treatment. Ovarian tissue replacement is also an option for girls who have not yet reached puberty but at high risk of being sterilized by cancer treatment. This approach has also led to a reversal of menopause occurring as a result of chemotherapy. After puberty, some patients choose to do both ovarian stimulation with egg freezing and ovarian tissue freezing.
• Ovarian suppression (leuprolide acetate): The use of leuprolide acetate (Lupron) may help protect ovarian function during chemotherapy, though research findings are mixed.

The Center for Infertility and Reproductive Surgery is one of the few centers in the world that offers comprehensive evaluation and fertility preservation services for cancer patients. Our specialized services include:

• Fertility preservation before chemotherapy
• Surgery to move ovaries out of the radiation field
• Advanced reproductive technologies
• Care for cancer survivors experiencing infertility

Egg Freezing for Transgender Patients

If you’re undergoing gender affirmation treatment or surgery, you may decide to freeze your eggs to preserve your ability to have biological children in the future. Brigham and Women’s specialists are here to discuss your goals and your options. We support you every step of the way.

Fertility Testing and Evaluation

Before your fertility preservation treatment, your fertility specialist will guide you through testing to evaluate your fertility potential and how you may respond to treatments.

Common tests include:

• Anti-mullerian hormone (AMH): A blood test that checks how many eggs you have. Higher levels of AMH usually mean more eggs in your ovaries.
• Follicle-stimulating hormone (FSH): A blood test hat also measures ovarian reserve. High levels of FSH may indicate a lower number of eggs, though this test is generally seen as less reliable than AMH testing.
• Antral follicle count (AFC): An ultrasound that counts the number of potential eggs (follicles) in your ovaries.
• Estradiol (E2) test: A blood test that measures the level of estradiol, a hormone produced by your ovaries, in your blood to check ovary function.

Fertility Treatments for Patients After Reproductive Surgery

Patients who have undergone reproductive surgery may still have options to build their families:

• If you had a hysterectomy but still have ovaries: You can have children through in-vitro fertilization (IVF) with a gestational carrier. The eggs are retrieved and fertilized in the lab, and the embryos are placed into the uterus of another person (gestational carrier), who will carry the pregnancy for the intended parent(s).
• If you have had both ovaries removed but still have a uterus: You can become pregnant using donor eggs. The donor eggs are fertilized outside the body and transferred to your uterus.

Although these treatments are not medically complicated, counseling and testing are important steps to make sure the experience goes well. If you already have a gestational carrier, both of you will receive counseling and testing. Our fertility counselors are available 24/7 for you, no matter what you want to discuss.

To better understand this option, you can watch this short video from our fertility experts: