Everything You’ve Ever Wondered About Egg Freezing & Taking Control Of Your Fertility
Growing up, safe sex was taught to women from the second they became teenagers. Learning about the pill and condoms so early in life was enough to make young women think that falling pregnant wasn’t just a possibility – it was an inevitability.
But as many women across Australia can attest to, this is not the case. When it comes to fertility, most women aren’t aware how much age can affect their chances of conceiving: a Your Fertility survey of University of Melbourne students found that less than half correctly identified the age at which female fertility declines.
One in six Australian couples of reproductive age experience difficulties conceiving a child. Conceiving through IVF — which begins with egg freezing — is far more common than people might think. Almost one in 20 babies are born through IVF each year in Australia, and for women over the age of 35, this becomes 1 in 10 babies.
Access to egg freezing is a privilege — with the process costing up to $10k — but it’s something that more women are considering. This is especially the case for single women, as they reach a stage in their lives where they might not be ready to get pregnant, but want to do everything they can to ensure they have the best chance to choose if they want to conceive in the future.
The Bachelor’s Brittany Hockley documented her egg freezing journey with Genea Horizon fertility clinic for her podcast Life Uncut. “From my experience, I think women should be freezing well before 40. That comes from research, from chatting with specialists, and from the number of women that personally reached out to me, saying that they wished they didn’t wait so long,” she told Punkee.
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Another former reality star who made recent steps in taking control of her fertility is Married at First Sight’s Jaimie Gardner. “There’s just lots of unknowns about the entire process because it doesn’t get spoken about. Most girlfriends I know who have been through the process have been very private about doing it and then also their results — which doesn’t really help anyone, right?”
Hockley and Gardner’s egg freezing journeys are not uncommon. Clinics have noted a huge increase in women doing egg freezing cycles between 2019 and 2020. So, why is it still rare to hear people talking about the procedure?
Fertility and IVF specialist at Genea, Dr Cheryl Phua, is baffled there isn’t more transparency about women’s fertility. “Unfortunately, all things to do with female health — periods, fertility, egg freezing, all these options — it’s not spoken about widely. I think it’s ridiculous, it’s 2021! We’re in the middle of a pandemic, it’s not the time to pretend that we don’t sometimes need help to fall pregnant,” she told Punkee. “I think it’s great that Britt and Jaimie are coming to the forefront.”
If you’ve contemplated egg freezing or simply want to learn more about fertility, we’ve tried to answer all your questions below.
Everything you’ve ever wondered about egg freezing:
What is egg freezing?
Egg freezing is storing unfertilised eggs for the chance to conceive at a later date. The age that the woman is when her eggs are frozen will be the age that the eggs will remain, which is important as the quality of a woman’s egg supply begins to deteriorate after the age of 25. For women older than 35, their eggs become more fragile and are therefore less likely to survive the freezing and thawing process.
Via Genea Horizon
What are the different stages?
Egg freezing involves several stages: initial fertility testing, hormone stimulation, egg retrieval, and then freezing the eggs for storage with a procedure called vitrification. The tests could range from person-to-person, but will usually at least involve an Anti-Mullerian Hormone blood test (AMH test) and an ultrasound. The AMH test indicates a patient’s ovarian reserve, pointing to overall egg quantity, while the ultrasound gauges how many follicles (where the eggs grow) a patient has, which will advise on how they might respond to the hormone stage.
What do the hormone injections involve?
If the patient decides to go ahead with egg freezing, the next stage will involve the patient self-administering daily hormone injections for between 10 to 14 days. The purpose of the hormone stimulation is to encourage a number of eggs to mature, instead of waiting for your natural cycle. “The premise of egg freezing is that I can’t wait for this one egg to come every month, that’s wasting my patient’s time/money/etc,” said Phua.
“I’m overriding the brain signals with a series of injections pens. This encourages as many of the fluid sacs or follicles to grow as possible, so to optimise how many eggs we can get as possible, to minimise how many times you have to go through it to get a good number of eggs in the freezer.”
During the self-injection phase, patients will visit their clinic for blood tests and ultrasounds to check if the hormone treatment is working, or if their dose needs to be adjusted.
Then what happens when the eggs are collected?
On egg retrieval day, the patient will be put under either local or general anaesthetic and a needle is passed through the top of the vagina into the ovaries to empty the follicles. “Once we retrieve the eggs, the scientist will then check to see how many eggs are suitable to be frozen, because they have to reach a certain level of maturity before they can be frozen. Then you can freeze them and they are snap-frozen at the age that the eggs are collected. The quality of eggs does not decline in the freezer.”
The egg freezing process uses vitrification, whereby the viable eggs are immersed directly into liquid nitrogen and frozen quickly — then they are ready for storage. “Putting them in liquid nitrogen, or cryo-storing them, means there’s less chance of ice crystal formation, so they are more likely to survive being frozen and thawed out. Based on our data, we are seeing that 80% of our eggs survive coming out of the freezer, ” said Phua. Patients will generally know how many eggs were collected as soon as they wake up from anaesthesia.
Who should consider their fertility options?
It’s important to note that egg freezing is not an insurance policy and won’t ensure you can conceive a baby later in life. However, egg freezing can be a helpful option for women who aren’t ready to have children right now, but want to give themselves the best chance to conceive in the future.
“I have friends who want to send their daughters to me when they’re 21… that’s probably too young,” said Phua. “Whereas by the time we’re in our early to mid-thirties, that’s when I know that I can potentially get a good number of eggs in not many rounds, and theoretically the quality of the eggs should still be good.”
Hockley made the decision to freeze her eggs when she was 33, still single, and “nowhere near” ready to have children yet. “I wasn’t even dating at the time and so deep in my career. I am very career-focused and due to my work in medical imaging, I am more than aware of the difficulties many women face.
“And whether we want to admit it or not, we unfortunately do have a biological clock. I wanted to take the pressure off myself,” she said.
At 35, Gardner hopes to be a mother one day and found herself wanting to take control of her future — rather than wait for a man. “I’ve always thought that I do want to be a mum, which is why I looked into it,” she said. “I might not meet the right person, but I want to give myself options. And if it gets to the point in a few years where I haven’t met the right person and I still decide that I want to have kids and do that on my own, I have the best chance of being able to do that… I’d rather get it done earlier and have a greater chance of having more eggs than not.”
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While egg freezing might not be for everyone, finding out more about your fertility is something that Dr. Phua encourages. “It’s important just to have a chat with either a fertility specialist or even just your GP, just to discuss your options. There’s testing that can be done at the outset just to determine where a woman stands in terms of her egg count number,” she said. “This can be a decision-making tool.”
How bad are the hormone injections?
“It’s like making you have your period on steroids,” said Phua. Side effects to the injections can include headaches, mood swings, insomnia, breast tenderness, and bloating.
However, Phua has found this can vary greatly between patients. “When it comes to the side effects from the injections, I tell my patients that some I’ve taken 20 eggs from and they’ve breezed through it, but others feel like crap. We just don’t know how your body is going to respond to these high hormone levels. Everybody is different, just like everybody’s egg count is different and everybody’s circumstances.”
Two days before retrieval, Hockley said she couldn’t do anything but lay in bed. “The first week of injections was a breeze — besides a pretty bad hormonal headache, I was feeling fine and physically didn’t notice a difference. Week two was a different story. The last two days before my egg collection were in a league of their own. I was in so much pain, I could barely walk anymore, everything hurt and I felt like I was about to burst — you feel so heavy and full.”
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Thankfully, this is not the case for everyone. “I was very lucky,” said Gardner, revealing she suffered side effects including bloating and nausea towards the end of her 12-day plan. “I was thinking the entire time I was like, OK, when are the hormones going to kick in? When am I going to go crazy?”
She did find self-injecting to be confronting at first. “Of course, injecting yourself is really scary for the first time, and I was doing it by myself in lockdown,” she said. “But I guess knowing that there’s an endgame makes it easier.”
What do you feel like after the egg retrieval?
“Afterwards it can be painful, you can get cramping tummy pain, like a bad period for a couple of days — because a needle is going into your ovaries,” said Phua.
Hockley bounced back quickly, stating the day after collection she almost felt back to herself. Gardner had a harder time post-surgery, admitting that, “Post extraction for me, I just had some aches and pains. But it was similar to what you’d get if you were if you had your period — so nothing that I couldn’t handle.”
Can egg freezing hormones have adverse effects on your body?
Phua said that based on decades of IVF data, she didn’t find any evidence of adverse effects from the hormone treatments. “The two-week egg freezing process is exactly the same as IVF. We have more than 40 years of data from IVF and we know it’s very safe. There isn’t any longterm health implications for the women who have undergone IVF, so we can extrapolate this for women who undergo egg freezing — as it’s exactly the same procedure for the two weeks of growing the follicles and collecting the eggs.”
How much does it cost?
Prices can vary greatly between individuals. As a rough guide at Genea, the first cycle cost is $4600 — which includes six months storage — and the subsequent cycles are $3950. In addition to this, the medication (aka hormones) is around $1500 per cycle, along with $1529 for the procedure of day surgery under local anaesthetic. After the first six months, storage of the eggs costs $45.10 per month.
Different clinics offer slightly different prices, but all up to freeze your eggs will generally cost between $7,000 to $10,000 per cycle.
Is a rebate offered?
Sadly, not really. In Australia, Medicare only provides a rebate for egg freezing if there is a medical need for the treatment — which will reduce the out-of-pocket costs. However, “medical need” is limited to only certain conditions. “If you’re having cancer surgery, like having an ovary removed, or having chemotherapy, or things that will impact your future fertility then you get a Medicare rebate for egg freezing,” said Phua.
“Endometriosis is not covered, unless they’ve had an ovary removed.”
If you don’t fall under this criteria, unfortunately, you won’t be eligible to receive any Medicare assistance. “It’s quite a significant investment for a backup plan,” said Gardner. “I think that’s why it’s so important that people go and do those first checks and speak to their doctor.”
What is the success rate?
“There is no guarantee of pregnancy,” warned Phua.
“I tell my patients that the only insurance policy that egg freezing provides is insurance against regret. It’s not an insurance policy against babies. As women, the problem is that we are born with as many eggs as we have in our ovaries. Nobody tells you this.”
Dr. Phua told Punkee that each egg frozen has around 5-10% of leading to a live birth — which is why multiple eggs need to be collected — but this statistic is dependent on what female age the eggs were frozen at. The data around success rates is limited, as IVF statistics don’t always differentiate between whether fresh or frozen eggs were used. According to Monash IVF’s 2019 study for frozen embryos created via IVF or ICSI, there’s a 35.4% chance of a live birth for women aged 30-34, however this drops to 21.7% for those aged 40-44.
It’s also important to acknowledge that eggs are just one aspect of a woman’s fertility — egg freezing isn’t going to be viable for everyone because fertility health isn’t only defined by having healthy eggs. “Other issues that we can’t overcome with egg freezing are things like sometimes some women have issues in the lining of the womb that prevent the embryo from implanting or sticking. Egg freezing is only one part of the equation, the womb itself is important, the lining is important, and also the sperm,” said Phua.
There’s a range of other medical conditions that can affect fertility, from ovulation problems to issues with a woman’s fallopian tubes.
How many people actually use their eggs?
As it turns out, not many. “Only 5% to 10% of women come back to use their eggs,” said Phua.
“Not many people come back to use their eggs and it’s for a variety of reasons. It could be that they’re not ready to go at it alone, they could have fallen pregnant themselves, or they could be keeping the eggs for future pregnancies,” she said. “A lot of the women who see me also don’t know if they want children and a lot of things need to fall into place before they’re able to in their life circumstances. They want the house, the job, their ducks all aligned before they bring a being into the world.”
If women rarely use their eggs, then what’s the point?
While the amount of women returning to use their eggs after the costly process is relatively low, Phua said that the peace of mind that egg freezing offers women is priceless. “The number of women who regret doing it is a different story. Why they do it, and whether or not they use it are two different things.”
Despite enduring a bit of pain during the process, Brittany Hockley has no regrets and is even contemplating doing another cycle in the future. “I feel like a weight was lifted off my shoulders,” she said.
“Honestly, I am unsure if I will have children. I am really enjoying life and not ready for that commitment. It is more about giving myself a chance in the future, making sure I have the option. For me, that was so important. I know it is not a guarantee, but I have put myself in a better position by putting some mini-mes on ice.”
Jaime Gardner doesn’t plan on doing another cycle any time soon, but she also has zero regrets. “I’m still hopeful that within the next couple of years, I can meet someone and my aim would still be to try and have [a baby] naturally. But at least I know that if that’s not possible for any reason — either not meeting someone or that I just physically can’t anymore — that I have some backup plans,” she said.
“I would recommend it to absolutely everybody.”
Whether women use their eggs or not, egg freezing is just as much about taking control of your own fertility, as it is about making plans to try and start a family. “It’s about empowerment,” said Phua. “A lot of the people who do egg freezing say ‘I don’t think I’m ever going to use them’ in the first consult. It’s about making yourself feel like you’ve done everything you can – at 32, 33, 34 – so that in the future, if you decide you want a baby, at least you know you’ve done everything you can to optimise your chances.”