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Elective Egg Freezing and Fertility Preservation

Not every woman is ready to start a family in their peak fertility years. Some may choose to delay childbearing for personal or professional reasons. Most women know that fertility declines with age, but many are not aware of how soon the decline begins. Egg quality begins to decrease in the early 30's, with a significant decrease in the quality and number of eggs around age 35.

The Center for Infertility and Reproductive Surgery (CIRS) at Brigham and Women's Hospital has a well-established elective egg freezing program for women who want to expand their reproductive options and postpone childbearing. According to the most up-to-date research, pregnancy success rates are comparable when comparing frozen, thawed eggs to frozen embryos.

Elective Egg Freezing: Planning for the Future

What is Elective Egg Freezing?

Egg freezing is a process in which a woman's eggs are retrieved, frozen and stored in liquid nitrogen for later use. When a woman is ready become pregnant, her eggs are carefully thawed, fertilized in vitro, and transferred to her uterus as embryos.

Who Should Consider Egg Freezing?

The decision to freeze your eggs isn’t a medical decision, but a personal one. We know that by the time a woman reaches her early 30s, egg quality and quantity start to decrease. Beginning around age 35, this decline becomes more rapid.

Many women choose to freeze their eggs, because they aren’t planning to become pregnant in the next few years, but they want the option to conceive in the future.

If you are considering egg freezing, you should consult a physician who specializes in fertility and assisted reproduction, preferably one who has experience with elective egg freezing.

How is Egg Freezing Performed?

The first step involves stimulating the ovaries to produce eggs with injections of fertility medications for about two weeks. Most of these injections are subcutaneous. The needle used is thin and short, causing minimal discomfort. The CIRS nursing team teaches you the proper technique to minimize discomfort.

Once your eggs have matured, they are retrieved by our fertility experts during an outpatient procedure at our state-of-the-art Center for Assisted Reproduction in Boston. After retrieval, your eggs are carefully evaluated by our embryologists prior to freezing.

Is Egg Retrieval Painful?

During the egg retrieval procedure, you will receive anesthesia and will be monitored closely to maintain comfort. As with any surgical procedure, some postoperative discomfort is expected; however, most patients experience minimal discomfort. The most common complaint is cramping. An anesthesiologist and nurse are present to assess your comfort and can provide any pain relief you may require.

When Should You Freeze Eggs?

The exact timing for egg freezing varies for each woman. Generally, the optimal time is during your peak reproductive years, between the ages of 25 and 40.

How Many Eggs Should You Freeze?

This is a personal decision. However, earlier this year, the fertility experts at CIRS developed and published an algorithm to help counsel women who are considering egg freezing. Our tool predicts, based on the number of eggs frozen, and the woman’s age, the likelihood of delivering one, two, or three babies in the future. This tool can help a woman decide how many cycles to undergo, and how many eggs to freeze. It’s important to recognize that egg freezing isn’t an insurance policy – no number of frozen eggs can guarantee a future baby with certainty.

How Long do Human Eggs Remain Viable?

Human eggs remain viable for many years. Research suggests that pregnancy rates using frozen, thawed eggs are excellent, almost comparable to those achieved using frozen embryos.

How Much Does Egg Freezing Cost?

Our egg freezing program is reasonably priced. The costs include fertility medications, egg retrieval and egg storage. Some insurance plans cover these costs. Our team can discuss the costs and help you determine if your insurance plan will help cover them.

Fertility preservation helps cancer patients or survivors avoid infertility which may result from to chemotherapy, radiation therapy, and/or surgical treatment. Also, patients with certain non-cancerous conditions including ovarian cysts, family history of early menopause, and lupus can benefit from fertility preservation. Other women at risk of losing ovarian function at young ages due to genetic causes, or women concerned about loss of eggs and fertility due to natural aging also are candidates.

Women at risk of losing ovarian function at young ages due to genetic causes, or women concerned about loss of eggs and fertility due to natural aging, or women who must delay pregnancy for medical or social reasons are candidates for elective oocyte or embryo freezing. Best results are achieved for women under age 35.

Fertility Preservation

Fertility and Cancer Patients/Survivors

Patients facing cancer treatment with either radiation to the pelvic area, or total body irradiation, or chemotherapy using drugs called alkylating agents, such as cyclophosphamide (cytoxan), may be at high risk of undergoing premature menopause. In some cases, doses of chemotherapy are not high enough to cause premature menopause, but will often result in the loss of eggs from the ovaries, which can lead to difficulty in conceiving and infertility.

Specialized Services

The Center for Infertility and Reproductive Surgery is one of the few centers in the world that offers specific evaluation and therapy for women undergoing chemotherapy and radiation therapy. Our specialized services include options to preserve fertility before undergoing chemotherapy, surgery to move ovaries out of the radiation field, assisted reproductive technologies prior to cancer treatment such as egg and embryo freezing prior to cancer treatment, as well as evaluation and treatment of cancer survivors who are experiencing infertility.

Fertility Preservation for Cancer Patients Undergoing Chemotherapy/Radiation
  • Egg Freezing
    Women can freeze eggs before undergoing cancer treatment. The first step involves taking injections of fertility medications for about two weeks to stimulate production of eggs, a process called ovarian stimulation. Once tests indicate that eggs have developed in the ovaries, the eggs are surgically removed by a fertility specialist using an ultrasound guided needle, under light anesthesia to avoid pain. Pregnancy and live birth rates using frozen eggs are excellent. As a result, the American Society of Reproductive Medicine no longer considers the procedure experimental. We have a well-established, tested program of egg freezing.
  • Embryo Freezing
    Eggs collected by ovarian stimulation may also be fertilized by sperm (from the male partner or a sperm donor, using in vitro fertilization, and frozen for future use. The use of frozen embryos is a well established fertility treatment with proven pregnancy rates. 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 women who have a rapidly progressing cancer or don’t have time to undergo ovarian stimulation, ovarian tissue can be removed and replaced in the abdomen after cancer treatment ends. This treatment will reverse menopause if it occurs as a result of chemotherapy. The replaced ovarian tissue typically functions for three to eight years. Women have become pregnant naturally after ovarian tissue replacement or using IVF treatment. Ovarian tissue replacement is also an option for girls who have not yet reached puberty but who are at high risk of being sterilized by cancer treatment. After puberty, some girls and women choose to do both ovarian stimulation with egg freezing and ovarian tissue freezing.
  • Leuprolide Acetate
    The use of leuprolide acetate (Lupron) to suppress ovarian function prior to and during chemotherapy may reduce the likelihood of losing eggs and undergoing menopause due to chemotherapy. However, findings supporting the use of Lupron are not consistent in published randomized trials.
Fertility Treatments for Cancer Patients After Reproductive Surgery

Women who have had a hysterectomy but still have their ovaries can have children through the use of in-vitro fertilization technology and a gestational carrier. The eggs of a woman are fertilized outside her body through the use of in-vitro fertilization, and the resulting embryos placed into the uterus of another woman, or gestational carrier, who will carry the pregnancy for the intended parent(s). This treatment is not medically complicated, but a great deal of counseling as well as testing is required to make sure the experience goes well for all involved.

For women who undergo removal of both ovaries, but retain their uterus, the use of donor eggs which are fertilized outside the body and then replaced into her uterus can be performed. This treatment is not medically complicated, but a great deal of counseling as well as testing is required to make sure the experience goes well for all involved.

Elective Egg Freezing Video - Brigham and Women's Hospital

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