What is the right age to freeze your eggs?
Women today are waiting longer to become mothers than previous generations have, some because they haven’t found a partner, others to focus on career or education, still others due to the high cost of living. These reasons, combined with the fact that age increases the risk of infertility for women, has expanded the public interest in fertility preservation. One of the things women, and other people with ovaries, are turning to when looking to delay parenthood is elective egg freezing, otherwise known as oocyte cryopreservation. The procedure to extract eggs for preservation starts with medications that stimulate ovaries to produce multiple eggs. When the eggs have matured, a doctor will extract them and then they will be frozen to temperatures that will suspend all biological activity in the eggs. The eggs are then stored at those sub-zero temperatures until they are needed, after which they are warmed, biological activity resumes for some eggs, and those eggs are inseminated to produce embryos. Successful embryos can be placed in a uterus using in vitro fertilization (IVF).
The number of people electing to freeze their eggs today has significantly increased to 11 times what it was in 2009, and some big tech companies, like Facebook and Google, have been in the news for offering egg freezing benefits for their employees. With the increasing public profile of egg freezing for fertility preservation, big questions are being raised for many people including when is the right time to freeze my eggs?
According to a mathematical model published in Fertility and Sterility, 37 years old is the “best” age to freeze your eggs if you’re worried about age-related infertility. The model shows that if you freeze your eggs at 37, your chances of having a successful pregnancy double when using those eggs vs trying to get pregnant with your own fresh eggs at a later date. In addition, the model shows that the procedure is most cost-effective at that age.
The cost breakdown
It’s no surprise that freezing your eggs is expensive. The initial fertility treatments to mature and retrieve the eggs can cost over $10,000 plus an additional $3,000 to $5,000 for medications. Then, there are the yearly storage fees to think about. These fees, which can be as much as $1,000 per year, depending on the location of the bank, add up the longer the eggs stay preserved. Finally, the in vitro fertilization (IVF) procedure to fertilize the previously frozen egg and, hopefully, implant an embryo, can set you back another $5,000 or more.
These procedures are difficult to access for those who don’t have much disposable income or don’t work for a company that offers egg freezing as a health benefit. The model shows that freezing at 37 defers some of the storage costs that someone would have if they froze their eggs at an earlier age, potentially saving thousands of dollars. The model also considers that eggs retrieved at a younger age are more likely to go unused, since successful pregnancies without intervention are more common before 37, so the costs associated with the procedure and storage would likely not be needed. Similarly, eggs retrieved after 37 are less likely to produce a successful birth according to the model, so the cost would likely be undertaken without achieving the desired outcome. All of these factors contribute to the finding that 37 is age at which elective egg freezing is the most cost effective.
One additional factor that plays a role in cost-effectiveness is the fact that insurance companies won't cover an egg-freezing procedure for ‘social’ reasons. There are many motivations someone can have for wanting to freeze their eggs, but right now the medical community and most health insurance companies designate only two categories: ‘medical’ reasons or ‘social’ reasons. Most reasons considered ‘medical’ are based on diagnosis of disease or treatment for disease that could result in loss of fertility, such as some cancer treatments. It’s rare, but some insurance policies will cover a portion of the costs if you are facing sterility because of an illness. Reasons are considered ‘social’ or ‘elective’ when egg freezing is used for reasons outside those diagnosable diseases, including the anticipation or onset of age-related loss of fertility. Insurance companies don’t cover any costs for the procedure under this category, so the individual or family pursuing egg freezing would have to finance the entire thing themselves.
Some commercial egg banks offer statistics or interviews with fertility specialists that encourage those considering freezing their eggs to do it as young as they possibly can. While true that, on average, the outcomes are better with eggs retrieved at a younger age, what those companies don’t say, that the Fertility and Sterility study does, is that younger people are more likely to conceive using no interventions, so the frozen eggs often go unused. As stated above, freezing at younger ages can result in a massive expense over time for something that may never be needed.
Choosing what's right for you
There are other factors to consider in addition to cost and age when looking at egg freezing, such as: possible feelings of obligation to use banked eggs and IVF, rather than trying to conceive with no intervention or by using less invasive assisted reproductive technologies like intrauterine insemination (IUI); the future of unused frozen eggs; or, if accessing egg freezing through company benefits, the cost of storage in the event of job loss. Statistics and models don’t offer easy answers, but these are just some of the important things to think about when contemplating elective egg freezing.
Hopefully this information will help you or someone you know relax a little if you’re feeling the biological time crunch, but it’s important to keep in mind that this information comes from a mathematical model and doesn’t take into account that every person’s body is unique and people can have fertility challenges at any age. It also doesn’t consider the importance of peace of mind that could come with freezing eggs at an earlier age. As always, if you have questions or concerns about egg freezing or anything else about your fertility check in with your ob-gyn, another trusted healthcare provider, an assisted reproduction professional, and/or your community to talk about what might be right for you.