Should I freeze my eggs?
An exciting time for egg freezing science...
Why should I freeze my eggs?
The birth of the world’s first frozen egg baby in 1986 was a major fertility milestone, opening up the possibility of women delaying motherhood until a time of their choice.
Egg freezing is mainly beneficial for two groups of women: those who are about to undergo potentially sterilising medical treatment, such as chemotherapy, and those who don’t want to start a pregnancy right now, but want to keep the option open of being a mother one day (this is often called ‘social freezing’).
Today, hundreds of women a year choose to freeze their eggs; figures from the Human Fertilisation and Embryology Authority (HFEA), which regulates fertility treatment in the UK, shows the number of egg freezing (/treatments/fertility-preservation/egg-freezing-and-storage/) cycles has increased from fewer than 300 in 2010 to 1,463 in 2017. It’s not surprising the number of cycles has increased, especially considering the great advancements in egg-freezing technology…
Why egg freezing success rates have increased – ICSI and vitrification
Back in the 1980s, egg freezing was not a very successful treatment; not only was the egg fertilisation rate in the laboratory low, but many eggs perished during the freeze-thaw process. As eggs are essentially fluid-filled bubbles, the early ‘slow freeze’ process risked ice crystals forming inside the cells, which often damaged their delicate structure and DNA, causing them to perish. There were also issues with fertilising these previously-frozen eggs, resulting in many eggs being wasted.
It was said that one hundred frozen eggs were needed to make the first ‘deep-freeze baby’, but thankfully we have come a long way since then - the success rate of fertility treatment using frozen eggs is now the same as using fresh eggs in young women and egg donors!
My clinic produced the UK’s first 'frozen egg' baby in 2003, and I think there are two developments which have transformed the success rates of frozen eggs in fertility treatment: ICSI and vitrification.
What is ICSI?
Intracytoplasmic sperm injection (or ICSI) is where a single sperm is injected into each egg. This approach is more direct than IVF, where eggs and sperm are placed together in a petri dish, and the ICSI breakthrough completely overcame previously low fertilisation rates when first introduced in 1992.
ICSI is particularly helpful for cases with male fertility issues, such as low sperm count, poor sperm quality, or for men who require a testicular or epididymal biopsy in order to conceive (such as after a vasectomy).
What is vitrification?
One of the main issues with early egg-freezing was the cell DNA being damaged by the freezing process, but vitrification solved this. Introduced in the early 2000s, vitrification uses a special ‘anti-freeze’ of liquid nitrogen to ‘flash freeze’ the eggs at -196⁰C. This technique instantly freezes eggs, preserving their cell structure. This is now the standard method of freezing eggs throughout the world.
What is the frozen egg success rate now?
Thanks to the developments of ICSI and vitrification, around 95% of good grade embryos survive the entire freeze-thaw process – an amazing improvement! The success rate of fertility treatment using frozen eggs is now the same as using fresh eggs in young women and egg donors, but success rates do decline with age, as with every fertility treatment.
When is the best time to freeze my eggs?
The ideal time for women to freeze their eggs is when they are in their late 20s or early 30s. This is when eggs are of the best quality and would have the highest chance of successful treatment in the future.
From the early 30s, the quality of eggs naturally starts to decline, and by the age of 40 a third of all eggs have chromosomal abnormalities, making them unable to form a viable pregnancy.
Yet currently, the average age of a woman in the UK freezing her eggs is 37 – arguable already too old to give them the best chance of having a baby in the future.
Using the vitrification process, all biological processes within the egg stop as soon as it is frozen. That means the eggs remain the biological ‘age’ they were at the exact moment of freezing, preventing any further quality deterioration. Therefore, the earlier a woman freezes her eggs after her late 20s, the better the chance of a successful pregnancy in the future.
How many frozen eggs do I need to increase my chance of becoming pregnant?
In the UK, there isn’t an official recommendation for the number of frozen eggs you will need to increase your chances of becoming pregnant. However, the American Society for Reproductive Medicine advises that women need at least 15 frozen eggs to have a realistic chance of successfully achieving pregnancy.
The number of eggs we can collect for freezing per cycle varies depending on age and personal history. For example, a woman in her late thirties might get anywhere between two and 20 eggs to freeze from a single cycle! Age also affects egg quality, so a consultant might recommend freezing a larger number of eggs the older the patient.
As part of our EGGsafe egg freezing and storage package, we aim to collect and store 20 eggs for you from up to 4 cycles, which we believe will give you your very best chance of success when you’re ready to start your family.
Vitrification in action; Louise Kellam, Deputy Laboratory Manager at CARE Nottingham, explains the vitrification process in detail, with a video of the thawing process!
What is the cost of egg collection, egg storage and egg thawing?
The cost of having eggs collected and frozen with CARE is between £3,050–£3,710, and storage costs are an extra £125 to £360 a year. Thawing the eggs and using them in IVF might then cost another £3,500, so the whole process of egg freezing, thawing, and implantation can cost around £8,000.
At CARE, we offer a range of funding options, including multicycle packages, egg and sperm sharing, and even IVF Unlimited: a one-of-a-kind funding plan that provides unlimited IVF or ICSI treatment cycles over a two-year period, with a 100% refund if you don’t have a baby. You could also choose our EGGsafe egg freezing and storage package, which includes everything involved with the collection and storage of up to 20 eggs. So, it’s always worth getting in touch with our team to find out how we could fund your treatment! You can find our full fee schedules here.
How long can I freeze my eggs?
How long a woman can freeze eggs currently depends on her reason; women having cancer treatment which could leave them infertile can freeze their eggs for 55 years, whereas those freezing their eggs for social reasons can usually only store them for 10 years. However, in recognition of the he potential impact that the COVID-19 pandemic may have on those wishing to start a family, the Government has confirmed that the current 10-year storage limit for eggs will be extended by two years for those who already have eggs frozen and are nearing the 10-year limit.
This 10-year rule, introduced by the Human Fertilisation and Embryology Authority in 1990, is highly contested by fertility experts.
Can you freeze eggs for longer than 10 years?
There is no medical reason why eggs should not be frozen for longer than 10 years – as shown by women being able to freeze them for 55 years if undergoing cancer treatment and the recent extension to the limit in light of COVID-19. Women freezing their eggs for social reasons can even extend their freezing period if they can provide compelling medical evidence that they should be frozen for longer.
Should the HFEA 10-year egg freezing rule be changed?
The HFEA 10-year rule – which has no clear reasoning – is completely arbitrary, not backed by scientific medical evidence and, in my opinion and that of many other fertility experts, needs to change, as it is actually rather cruel and blatantly sexist. In fact, fertility charity the Progress Educational Trust said recently that this 'outdated' legislation was a 'very clear breach of human rights' and 'harms women's chances of becoming biological mothers'.
I would argue that the 10-year rule is encouraging women to delay freezing their eggs, meaning that the quality of their eggs has declined and making future treatment less likely to work. Surely the fact a woman’s fertility naturally deteriorates with the passage of time is just as potent a piece of medical evidence as other infertility causes, such as toxic cancer therapies?
The flawed 10-year rule is also pushing those freezing their eggs at the best time (late twenties and early thirties) into an intolerable dilemma: allowing their eggs to perish after 10 years, potentially losing their chance of genetic motherhood, or thawing their eggs, creating embryos with donor sperm, and then storing these embryos for a further 10 years – at unnecessary cost and stress!
If the idea behind this rule is that it will prevent post-menopausal women – women in their 50s and 60s – from having children, then it is misguided. I believe that a society which permits women to achieve a pregnancy up to the age of 50 using donor eggs should surely allow women to keep their own eggs 'on ice' for more than 10 years. This would not only give women more choice about when they have children, but would also give them more time to find someone with whom they want to start a family.
How many women use frozen eggs to have a baby?
Many women who freeze their eggs don’t actually use them to start a family. Belgian research in 2018 found that only 7.6% of women who freeze their eggs for social reasons ever go back to use them. Of the women in the study, the majority found a suitable partner they wanted to pursue motherhood with, and one third then became pregnant naturally.
Whether allowing women to freeze their eggs for longer would lead to a significant increase in the number of babies born using frozen eggs is unclear, but we will never know unless the rule is changed!
‘Running out of time’ – Should I freeze my eggs now?
I conducted a survey of my patients and found that women ‘socially’ freezing their eggs chose to do so for a number of reasons; 40% froze their eggs because they weren’t in a relationship, 25% because they had recently ended a long-term relationship they had hoped would lead to a baby, and many others because they were worried about ‘running out of time’.
Rather than the stereotypical ‘alpha female’ often portrayed by the media, desperate to climb the corporate ladder rather than have children, most of my patients are just normal women who have friends and colleagues who had struggled to get pregnant in their late 30s, and so froze their eggs just in case things don’t go their way in the future.
This is one of the main reasons why I think the 10-year time limit for egg freezing is greatly flawed. These frozen eggs allow women to buy a little more 'biological time', and almost act like an insurance policy. No-one plans on struggling to get pregnant, so the frozen eggs are there if necessary. We don’t counsel people against taking out fire insurance even though the chance of a house fire is very low, and neither should we deter women from freezing their eggs as a preventative measure. The arbitrary 10-year rule needs to change so that as many women as possible are empowered to fulfil their desire to become a parent at the time of their choosing. Even if it only helps a small number of women, surely they should be given that chance?
Regardless on your opinion of the HFEA 10-year rule, now is an excellent time to consider freezing your eggs. With all the exciting advancements in egg storing procedures and technology, the egg survival and subsequent pregnancy rate has never been higher. Do you know exactly where you’re going to be in 10 years’ time? I don’t, and I doubt many people do. So, why not plan ahead? The choice and opportunity is yours to prepare for the future.