Understanding Egg Freezing

A woman’s ability to become pregnant is largely dependent on the quality of her eggs. By her mid-30s, her chances of achieving pregnancy decrease, while the rates of miscarriage and genetic abnormalities rise. Egg freezing and/or embryo banking allows women to extend their fertility and relieve some of the stress of the proverbial “biological clock.”

When Is the Best Time To Freeze My Eggs?

Generally speaking, the sooner you do, it the better-quality eggs you will be saving for later. While there are no guarantees, frozen eggs can be stored indefinitely and used at any time in the future to achieve a pregnancy. Your frozen eggs can give you peace of mind that you can attempt to achieve a pregnancy when the time is right for you.

How Does Egg Freezing/Embryo Banking Work?

To determine if you are a good candidate for egg freezing/embryo banking, you and your partner (if applicable) will undergo a fertility work-up. If you decide to move forward with a cycle, the clinical team will order your medications, have you sign applicable consents, and provide you with an IVF or Egg Freezing Class.

Egg freezing and embryo banking cycles start out similarly, with a medicated stimulation phase to encourage many follicles, each containing an egg, to grow on the ovaries for eventual retrieval. The goal is to achieve a controlled stimulation to to be able to retrieve many mature eggs within a single treatment cycle. The more eggs retrieved, the better the chance for a successful pregnancy down-the-line.

The Egg Freezing Process, Simplified.

1. Ovarian Stimulation: The first phase of IVF is Controlled Ovarian Hyperstimulation (COH). We use various combinations of injectable hormones including Gonal-F®, Follistim®, and Menopur®, to stimulate a woman’s ovaries into preparing more than one egg.

Every egg develops within a sac of fluid called a follicle, and hormonal stimulation of the ovaries results in the development of several follicles. We carefully monitor this process, using blood tests to measure hormone levels and pelvic ultrasound examinations of the ovaries to assess the maturation of the growing follicle, and then adjust the dosage of medications as necessary.

2. Egg Retrieval: When the ovarian follicles are large, indicating that the eggs contained are near optimal maturity, you will be instructed to administer an injection of Human Chorionic Gonadotropin (hCG). This “trigger shot” activates the final maturation of the eggs.

Egg retrieval occurs approximately 36 hours after the hCG injection. Using ultrasound guidance to help us identify the follicles containing the eggs, the doctor inserts a thin needle through the vaginal wall and guides it into the follicles, gently removing the mature egg.

Egg retrieval is done here at the Fertility Institute in our procedure room, usually with the patient under conscious sedation or light anesthesia. The entire procedure takes approximately 15 minutes. The patient does not feel or remember anything and is able to breathe comfortably on her own during the procedure.

3. Cryopreservation: This is where the process diverges from an IVF cycle. During IVF, the eggs would be combined with sperm resulting in the creation of embryos. But with egg freezing, the eggs are prepared and frozen using a process called vitrification, which is a state-of-the-art ultra-rapid freezing process. Eggs frozen using vitrification technique have high rates of survival, fertilization, and embryonic development. The eggs can be stored indefinitely here at the Fertility Institute, or transferred to a specialized storage facility if the patient desires.

How Long Can My Eggs Be Stored For?

Due to the vitrification method of freezing, eggs and embryos can remain frozen, in a glass-like state, indefinitely. Countless women have had their eggs thawed, inseminated with their partner’s sperm or the sperm of a donor and gone on to have successful embryo transfers and pregnancies.

Using Your Frozen Eggs

When you are ready to attempt pregnancy, your practitioner will work with you to schedule a date for the embryologists to thaw your eggs to prepare them for insemination with your partner’s sperm or that of a donor. You will undergo additional testing and take daily medication to ensure your uterus is primed and ready to accept a viable embryo in a procedure called Frozen Embryo Transfer (FET).

Steps To Prepare for Transfer

1. Fertilization and Embryo Culture: As the eggs are thawed, they are placed in a special culture medium in the lab. Several hours later, the eggs are inseminated with sperm either from the male partner of the patient or from a screened donor chosen by the patient(s).

In vitro culture of the early embryos is performed under continuous and carefully controlled conditions in the Fertility Institute of NJ & NY’s embryology laboratory. Successful fertilization of the eggs can be seen under a high-powered microscope on the day following egg thawing and fertilization.

2. Embryo Transfer: After the early embryos have developed in vitro for several days in one of our state-of-the-art incubators in the laboratory, they are ready for preimplantation genetic testing (PGT) biopsy, or, if doing a fresh transfer, to be placed into the woman’s uterus in a procedure called the embryo transfer. Fresh transfers are typically reserved for those patients with fewer available embryos. The majority of patients opt for PGT testing which reveals if an embryo is genetically normal (euploid) or abnormal (aneuploid) and also reveals the sex, should the patient wish to do “gender selection.”

After the PGT results are received the patient can begin an FET cycle. Medications are prescribed to encourage the uterine lining, or endometrium, to increase in thickness to create a hospitable environment in which to transfer the embryo. Once the endometrium reaches an optimal stage, the date is set for the embryo transfer. On the morning of the transfer one embryo is thawed, and the transfer is completed in our procedure room.

The embryo transfer itself is painless and does not involve any needles or sharp instruments. The embryo (or embryos) is loaded into a long, thin, soft tube called a catheter, which is then threaded through the natural opening of the woman’s cervix and guided to a spot near the top of her uterus, all monitored via ultrasound. Once the soft tip of the catheter reaches its intended destination, the embryo (or embryos) is gently deposited in the appropriate location.

The embryo transfer procedure takes approximately 10 minutes.
*In general, egg and embryo freezing have similar success rates. Embryo freezing is slightly more successful compared to egg freezing alone, as it allows for preimplantation genetic testing opportunities and a better understanding of quality prior to cryopreservation.

Pregnancy test: Approximately ten days after a fresh transfer, or a week post-frozen transfer, you return to the office for a blood draw to confirm pregnancy. If pregnancy is established, your fertility care team will monitor your early pregnancy until you are approximately 8 weeks along,  when you “graduate” to the care of your regular OB/GYN. If your pregnancy test is negative,  you will be directed to discontinue any medications you are on and wait for your period. When you are ready to try again, another FET cycle can be initiated, provided you have remaining embryos.

What Happens If I Don’t Want To Use My Frozen Eggs or Embryos?

If you freeze eggs or embryos for the future and ultimately decide that you do not want to use them, you will be given a few options: You may donate them to science which enables our embryology team to practice their skills, you may thaw and discard, or you may make arrangements to donate them to an agency of your choice that facilitates embryo/egg donation to infertile couples

We’re happy to be able to offer our patients the ability to control their family building timeline and provide a sense of security for their futures.

Take Control of Your Future Family Planning.

We empower you to take the first step: Contact us to schedule your new patient consultation and discuss your options with one of our board-certified fertility experts.