For the ELANZA Wellness Egg Freezing Survey we analyzed hundreds of Reddit and Quora posts to better understand the motivations and concerns people have about fertility preservation, and to get more insights into the world of egg freezing.
Specifically, we looked at the types of questions people are asking, and how many times they were viewed by others seeking out the same information. Egg freezing is a hot topic that polarizes opinion. From feminist scholars to lawmakers, plenty of public figures are vocal about fertility preservation but we don't often hear the thoughts, concerns and questions of the people considering the procedure or undergoing it.
With the hard work of our superstar apprentice Nicole Imoru, who led the research, we uncovered some illuminating findings that help to build a picture of what's going through the minds of the people trying to decide if egg freezing is right for them.
And now we're going to share with you what we discovered.
The top 10 questions women have about egg freezing:
1. What are the pros and cons of egg freezing? (37,367 views)
2. How many eggs should I freeze? (35,355 views)
3. What is the right age to freeze eggs? (20,978 views)
4. How does egg freezing work? (12, 636 views)
5. What is the success rate of egg freezing? (11, 799 views)
6. How does AMH affect fertility and/or egg freezing? (10, 793 views)
7. How much does egg freezing cost? (10, 527 views)
8. How does it feel to freeze your eggs? (2, 222 views)
9. What are the risks and the side effects of egg freezing? (1, 910 views)
10. Are there things I can do to improve my fertility before egg freezing? (1, 673 views)
...And the real answers:
1. What are the pros and cons of egg freezing?
Short answer: It gives you more of a chance to conceive a biological child in the future, however, it's expensive and it's not guaranteed.
Reality check: Storing younger eggs gives you a better chance of pregnancy, using those eggs, than using your older eggs in the future. Some people say it helps them relax and takes the pressure off in the search to find the right partner. Egg freezing also helps people who facing health conditions such as endometriosis or cancer treatments that can cause fertility problems preserve their fertility. However, one of the largest cons is the price of egg freezing (see more below). In addition, there is always the chance that egg freezing will not successful - some people do not produce many eggs during a stimulation cycle and some previously frozen eggs will not be able to become a baby. See more on success rates below.
2. How many eggs should I freeze?
Short answer: It depends on age, but freezing at least 10 mature eggs is recommended.
Reality check: The amount of eggs you freeze impacts the odds of those eggs successfully leading to a baby one day. The amount of eggs you should freeze to ensure a 'good' chance at a live birth in the future is dependant on your age at the time of freezing and on how many children you wish to have in the future. For example, a 30-year-old women with 15 frozen eggs has an 83% chance of one live birth from those eggs and a 50% chance of two, and a 22% chance of three live births.
3. What is the right age to freeze eggs?
Short answer: There is no one "right" age, but 30-37 is considered optimal.
Reality check: There's no one perfect age for egg freezing, as the right time will depend a great deal on individual circumstances and health. Having said that, the best biological age to freeze your eggs is technically in your 20s when you are very fertile. Your egg quality declines with age.
Most doctors, meanwhile, would recommend balancing this biological input with practical considerations: waiting to freeze your eggs until your are age 30-35 means there is more like likelihood of you actually needing to use the eggs someday, and you are still likely to have a good result. Again, that depends very much on your personal situation - people with health conditions (cancer; severe endometriosis; lupus etc. ) or those with generous fertility benefits through their workplace may freeze their eggs much younger.
Meanwhile, independent researchers pinpoint the best "value for money" age to freeze eggs was 37 years old at the time of the study. That's because eggs frozen at that age were deemed still young enough to be likely to have a reasonable chance of resulting in a live birth if you need to use them, but the people were old enough at the time of freezing to be more likely to struggle with fertility and end up needing to turn to their frozen eggs for family building.
Most clinics will accept patients up to around 43 years of age for egg freezing treatment, though this will depend on your individual ovarian reserve test results and the clinic's own policy.
4. How does egg freezing work?
12, 636 views
Short answer: It preserves some of your eggs now to potentially use at a later date
Reality check: An egg freezing cycle involves10-14 days of hormone injections that stimulate your ovaries to mature more eggs than they usually would in a given month. During a short, usually painless outpatient procedure the fluid that these eggs sit in is retrieved using a fine needle and the eggs are frozen in liquid nitrogen. As you age, your body will lose the ability to mature healthy eggs. If you encounter problems conceiving in the future you have the option to thaw your younger, frozen eggs and attempt pregnancy using those eggs in an IVF cycle.
5. What is the success rate of egg freezing?
11, 799 views
Short answer: That depends. But roughly the same as for IVF.
Reality check: The success rate of egg freezing shifts depending on the age at which you freeze, how many eggs you store and factors like your own general health and ovarian reserve. For example, if a woman freezes her eggs at age 35 the likelihood of having a live birth from those eggs (assuming she retrieves the average number of eggs a 35 year old retrieves) is 85%. However, for a woman freezing at age 42 that same likelihood is 26%. The younger you are, the more likely to are to freeze more, better quality eggs per cycle. But, these are just averages - for some people the chances will be higher and for some it will be lower. Your own doctor can help you understand more about the chances for you individually based on your ovarian reserve test results and your own medical history. These percentage likelihoods are also based on just one cycle. To increase the likelihood of having a life pregnancy from previously frozen eggs, some people do more than one cycle of egg freezing to store as many eggs as possible.
6. How does AMH affect fertility and/or egg freezing?
10, 793 views
Short answer: High Anti-Mullerian hormone (AMH) levels tend to predict a better response to an egg freezing cycle.
Reality check: AMH, or Anti-Mullerian hormone, is a hormone that is made by granulosa cells in the ovaries. These cells look after eggs, so the more eggs, the more granulosa cells are present and the higher the AMH level will be. Therefore, AMH levels are an indication of egg reserve.
Testing levels of Anti-Mullerian hormone is just one test that goes into building up a picture of your ovarian reserve. The "gold standard" of ovarian reserve measurement that fertility doctors use is a combination of fertility tests, including a transvaginal ultrasound to count the number of antral follicles in the ovaries, as well as other hormone levels. Women with low AMH will also have lower antral follicular counts (AFC) and are likely to produce a lower number of eggs during the egg freezing cycle. Women with higher AMH values will tend to have a better response to ovarian stimulation for egg freezing and for IVF. That means it indicates more eggs will be retrieved.
An AMH above 1.2 is relatively reassuring. If the AMH level is less than 1.2, that is more concerning for fertility potential. Levels fall with age: by the early 40s it’s common for women to have a low AMH. However, some women continue to have high AMH levels into their 40s, while others experience declining AMH levels in their 30s, or even 20s, due to environmental, genetic or health factors. The age at which your biological mother went through menopause is often a good guide to the rate of your own fertility decline.
Egg freezing is possible with a low AMH, but when levels indicate the early stages of menopause (peri-menopause), fertility treatment will be unlikely to be successful and typically doctors will advise against a cycle. Whilst AMH levels are used to measure ovarian reserve, they are likely not a measure of egg quality. Low AMH levels also do not mean it is impossible to get pregnant naturally. However, when there are fewer developing eggs in the ovaries, the chance of a mature and healthy egg being released and fertilised decreases.
7. How much does egg freezing cost?
Short answer: It depends where you get it done, but in the US: $9,000-$15,000.
Reality check: The egg freezing price tag can vary quite dramatically depending on location and variables, like the amount of medication required. In the US, the average cost of one egg freezing cycle is $12,500. However, some insurance coverage may be available for aspects of treatments, such as diagnostic testing and consultation with a fertility specialist. In other countries such as the UK, Spain, Mexico and South Africa the procedure is radically less expensive. To find out an accurate cost estimate for you, it's best to talk directly to a fertility clinic.
8. How does it feel to freeze your eggs?
2, 222 views
Short answer: There's usually some physical discomfort, and it can be an emotional rollercoaster.
Reality check: Physical side effects of egg freezing for most people are limited to PMS-like symptoms, with fatigue and bloating coming out top of the list. These normally disappear within a couple of days after the procedure. (See more on risks and side effects below.)
A lot of people say egg freezing was unexpectedly tricky emotionally. Hormones can run all over the place, and it's usually a time for introspection and reflection on how your life is going and where you want it to in the future. Preparing well and surrounding yourself with a support mechanism will help you manage any anxieties.
Most people who have frozen their eggs say doing it made them feel "relieved", lifted some pressure, and was the right thing for them. However, others regret the decision, especially if the cycle was not successful. It's important to consider how you might feel with any outcome.
9. What are the risks and the side effects of egg freezing?
1, 910 views
Short answer: The short-term side effects of the procedure are clear and are generally minor.
The top body overseeing fertility medicine in the US, the American Society of Reproductive Medicine (ASRM) says ovarian stimulation and retrieval is “well established and safe for women and babies”, as does Europe’s respected fertility body, the European Society for Human Reproduction and Technology (ESHRE).
Despite some scare stories, it's reassuring to know that no causal link with cancer has been identified, egg freezing does not reduce your risk of having a natural birth in the future and babies from frozen eggs are not more likely to have birth defects. But that’s not to say egg freezing, like any medical procedure, doesn’t come with potential risks and side effects.
While there are usually no dramatic or serious side effects, the main thing you should expect is that during and immediately after ovulation stimulation and egg retrieval, your ovaries will be enlarged due to the stimulation hormones, which can feel really uncomfortable. For most women, this temporary bloating and some PMS-like symptoms are the extent of the egg freezing side effects. These side effects should only last for the days the medication is taken and subside a few days after the procedure. There are some other things to be aware of though, including unlikely risks of bleeding or infection due to the procedure and developing Ovarian Hyper Simulation Syndrome, a rare but serious complciation. (Read more about the risks and side effects in detail here.)
Your own medical history and individual health may mean an increased risk of one or more of these side effects, so always discuss these with your doctor at length.
Doctors and scientists are still building up the empirical data to understand the full risk profile for egg freezing. In the meantime, much of what is understood about the risks and safety of egg freezing is derived from studies that looked at IVF cycles. ASRM state, “while short-term data appear reassuring, long-term data on developmental outcomes and safety data in diverse (older) populations are lacking.
10. Are there things I can do to improve my fertility before egg freezing?
1, 673 views
Short answer: Yes.
Reality check: Your lifestyle choices can have an effect on the quality and quantity of eggs retrieved. Hundreds of studies show, for instance, that improving diet translates to better fertility treatment outcomes, such as a higher number of eggs retrieved.
The top two pivotal lifestyle changes you can make, according to the data, are ceasing smoking and maintaining an optimal BMI for fertility of between 20 and 25.
Your lifestyle choices impact your hormone levels, oxidative stress, inflammation and ability for your body to mature healthy eggs. So whilst making lifestyle changes is not a silver bullet for infertility by any means, getting Fertility Fit - including refining diet, sleep and exercise patterns, addressing deficiencies, adding in proven supplements, minimizing environmental hormone disruptors and addressing stress - can certainly set up your body with the best conditions for a successful egg freezing cycle.
Nicole’s summary and reflection on the key findings:
Nicole Imoru was an apprentice at ELANZA Wellness and helped run the ELANZA Wellness Egg Freezing Survey. She has a passion for women's health and is studying a BS in Medicinal Chemistry at the University of Waterloo, Canada. Here are some of her reflections on the research:
This project has been eye opening. As a university student, fertility is not something that often crosses my mind. Through this project I have come to better understand the sorts of questions running through people's minds about fertility when they are in their 20s, 30s and 40s.
How people are thinking about fertility is changing, and yet there is clearly still a lot of work to be done to make sure their concerns and needs are being met.
These are some of the insights we gleaned from doing this research:
A lot of people seem to be looking for reassurance
There were a lot of posts, views and comments around logistics. A bit thing that I saw was this sense of: "I’m 80% certain I want to egg freeze, but these are my doubts..." I think a lot of people posting are seeking reassurance, but also clarity around some of the practical considerations as they have outstanding questions. Two really prominent ones seemed to be: How is it going to affect my body? How much is this going to cost? A lot of people who are considering this are quite busy and they want to know the downtime and if it’s going to get in the way of normal life.
Most people asking questions online are in their 30s
Most people who were posting were aged in their thirties across the whole span of the decade -- what struck me was that the people who were younger were way more hopeful, whereas the older people were more like: “have I missed my chance?” Mostly these people were single or said they had “just got out of a long-term relationship.”
But younger women are asking questions to get informed, too
A lot of questions posted online about egg freezing are from women in their 30s, but there were a surprising number of questions asked by women in their late 20s and around age 30, too. I believe I should be knowledgeable on the subject for when a time comes where I am looking to conceive, so view this as a really positive sign.
“I also hope that this is something that will be less and less taboo for patients who are seen for regular checkups in their late 20’s for something to be prepared for instead of gynecologists saying it’s not necessary.” - Reddit post
There’s virtually no education around fertility - no wonder women are seeking out help online
Growing up, I did not receive comprehensive education about my own reproductive health and, like many of the people in our survey, went to seek the answers myself, spending hours scrolling the internet. Online allows for anonymous posting, but it’s also not clear who is providing the response - a lot of times the responses provided conflicting advice or weren’t rooted in fact.
There’s a lot of fence-sitting
Something that quickly became clear when going through the posts is that a lot of women seem stuck in the decision-making process. They are on the fence about whether it's a worthwhile venture and that is an uncomfortable place to be. Many posts use words like “lost” and “confused” and “anxious.” They wonder: "am I someone who would need egg freezing - should it be on the cards?"
Here are some examples from Reddit:
“Freezing Eggs - Should I? - I'm turning 35 this year, I'm feeling pretty anxious. In addition, my monthlies are changing in terms of time.”
“Freezing eggs option? - Could anyone give me some advice? Am I overthinking the situation?”
There then seems to be relief when a post receives replies. The posters are grateful, even when some of those replies seem to contain scientifically dubious information.
People really want information on pros and cons, to weigh it up and make an informed decision
Although there were a lot of burning questions around costs and practicalities, when we amalgamated questions into similar themes, we found most women seemed to crave balanced for and against arguments for egg freezing and ask what they "should know." This makes sense: it’s an elective medical procedure. Having all the facts at hand feels really important to make the right decision.
Women want to hear from other women, firsthand
There were a lot of posts asking for others to share first-hand experiences, like this one:
“Hi ladies, I'm turning 30 this year and mr. right is nowhere in sight. I'm thinking about freezing my eggs. The procedure isn't covered by insurance so it's really pricy out of pocket. I would love to hear your experience, what to do, what not to do, what you wish you knew before going into the procedure, and also did you end up using the frozen eggs later.”
That’s to say, women specifically asking for personal experiences and stories to learn from.
From my time analyzing posts and response rates, it turns out there are a lot of questions left unanswered!
It’s empowering to find answers
Even as a college student I worry about furthering my education and the effects it will have on my personal life and fertility in the future. When I started at ELANZA Wellness I wanted to expand my knowledge and help other women as they navigate their own health journeys. From working with the team to put together evidence-based answers to these questions, I also learned that the fear and guilt women often feel about reproduction is unwarranted and that the so-called biological clock is less scary and uncontrollable than most women think. More information is empowering. Knowing there are options is really important.
Everyone is on their own path
It's interesting to look ahead and see that I don’t have to have my life together at 30 and I’m not crazy for not wanting to have everything together at that point. If you do, great. If you don’t, no problem. Everyone is on their own timeline and you do things at the right time for you. I have yet to think past age 25, but that's school-based: I'm focused on getting my degree, figuring out what I’m doing after and traveling. Maybe a relationship if I can fit it in!
I need to get this degree, it's more important than ever get your education. I just think: get to where you want to be and then everything else will fall into place. I’m a female in a STEM field, so most of my peers are similarly motivated. My opinion is that in the future it would be nice to have a partner but it’s not the be all and end all. When I think of age 25, age 26... I actually just think of how much education I want to have, and so do a lot of my friends. But then again, a girl i went to middle school with was married at 19 and she’s super happy, she loves it. For my generation, I think it's a mix. But, generally, for a lot of girls now, it’s just not the be all and end all to have a kid by 30.
Get in touch
And now ELANZA Wellness would love to hear from you if you’re considering freezing your eggs to help us further understanding of this stage in people's lives and develop out ways to better support the egg freezing community: What’s the #1 thing holding you back, or a burning question you have about it?
Leave a comment below or send it through to firstname.lastname@example.org