What to Know Before Freezing Your Eggs: 9 Essential Considerations

7 minutes

Edited for clarity and anonymity: “I'm heartbroken. Six years ago I made the decision to freeze embryos and eggs at the same time. I had 20 eggs and my husband (then boyfriend) and I chose to fertilize half before freezing them. From the 10 fertilized, five became embryos and we chose not to test them. We are now ready to have a baby and decided to fertilize the remaining eggs. The doctor called with devastating news: none of the eggs survived. Eight didn't make it through the thawing process, and the two that did didn’t result in any embryos. I'm struggling to process this. How could this have happened? Was it a clinic mistake? Bad luck? I can’t stop crying.”

Egg freezing is all the buzz, from social media posts to advertisements and even employers offering coverage. It may seem like the perfect insurance policy, but unfortunately, the reality is that it’s not.

Over the years, infertility has shifted from a private struggle to an open topic of conversation, as it should be, given its prevalence—affecting one in six couples, according to the World Health Organization. It's no surprise that you're considering whether to freeze your eggs. While there's no right or wrong answer, knowledge is power. Here are nine important questions to consider as you make your decision.

1. What is my why?

When considering egg freezing, the first question to ask yourself is, "What is my motivation?" While preserving fertility may seem like the obvious reason, it's important to reflect on what that truly means for you. Are you considering egg freezing due to concerns about age, health issues, or advice from a doctor based on diagnostic tests (e.g., PCOS, endometriosis, amenorrhea, low antral follicle count (AMH), or past infertility)? Are external pressures from friends, family, or social media influencing your decision? Perhaps you're looking to take advantage of employer benefits, prioritize your career, or ease the pressure of finding a partner within a specific timeframe. Alternatively, you may be in a relationship that you feel likely won’t lead to parenthood, but you're unsure if that's a dealbreaker. Understanding your motivation will help you make an informed, rather than impulsive, decision, allowing you to enter the process with clear goals and a better chance of achieving your desired outcome.

2. How effective is egg freezing?

The technology behind egg freezing has advanced significantly, offering a form of fertility insurance, but freezing eggs is just one of many factors needed for a successful pregnancy. When evaluating the success of egg freezing, several key factors should be considered:

• Age, health, and reproductive status: Women who freeze their eggs before age 35 generally have better chances of success due to higher egg quality and greater yield. If your body produces fewer eggs in a cycle—whether due to age or reduced ovarian reserve—you may need multiple cycles to store enough eggs.

• Clinic expertise: Fertility clinics vary in their medication protocols, the experience of the doctors performing retrievals, and their methods for freezing and storing eggs. It's important to choose a clinic you've thoroughly researched, know their general success rates, and feel comfortable with. Keep in mind that you may return to the clinic later to create embryos or at least rely on them to safely store or ship your eggs.

• Egg freezing does not guarantee pregnancy: Even if you freeze eggs successfully, it doesn’t mean they will result in viable embryos. When the time comes to use them, the eggs must be thawed, fertilized, and develop into a multicell embryo (three-day embryo) or blastocyst (five-day embryo). You may also opt to have them tested for chromosomal abnormalities. Throughout this process—from thawing to embryo development—there can be significant attrition, and in some cases, none may be viable for transfer into your uterus.

3. What’s the scoop on potential side effects?

Egg freezing can have both physical and emotional side effects. While hormone injections are generally manageable, they can cause bloating, cramping, headaches, and digestive issues. In rare cases, they can lead to ovarian hyperstimulation syndrome (OHSS), which may require emergency medical attention. Emotionally, the process can be taxing due to frequent appointments, concerns about the future, mood swings, or feelings of sadness. It can also lead to frustration, fear, and disappointment if the results don’t meet your expectations. However, for most women, the side effects are manageable and usually short-lived.

4. What’s the price tag on future peace of mind?

Egg freezing involves significant financial considerations. The procedure itself typically costs between $10,000 and $15,000, and most insurance plans do not cover elective egg freezing, meaning these expenses are often out-of-pocket. Additionally, there are ongoing storage fees for keeping the eggs frozen, a cost that is frequently overlooked. Storage fees range from $500 to $1,500 annually, depending on your location, and rates may rise over time—something you should clarify before signing any agreements. If you decide to use the eggs for IVF in the future, there will be additional costs for shipping (if necessary), thawing, fertilizing, possibly testing, and implantation. It's important to understand these expenses upfront, including what happens if a cycle is canceled before retrieval or if you need additional cycles to achieve satisfactory results.

5. What to put on ice–eggs or embryos?

If you’re certain you will use a donor—whether you’re planning for single parenthood, are a same-sex couple with a known donor, or are in a heterosexual relationship where your partner cannot contribute sperm—or if you and your partner plan to have children but aren’t ready to take that step, you might want to consider freezing embryos rather than just eggs. Freezing embryos typically offers higher success rates compared to freezing eggs alone, as embryos generally survive the freezing and thawing process better. This approach also ensures that your eggs will be used to create embryos, which can then be assessed for chromosomal normality (at an additional cost) and graded by the embryologist. This information can help determine whether additional cycles are warranted. Keep in mind that creating embryos that may never be used has its own implications, which won’t be covered in this post.

6. Could freezing eggs lead me to unrealistic expectations about conceiving later?

Consider what you truly want for your future and whether egg freezing aligns with those goals. While it can offer a sense of security, potentially allowing you to stay in a relationship that may not have a future or approach dating with less urgency, it’s important to assess whether this sense of security is genuinely beneficial for you. Relying too heavily on egg freezing as a safety net could lead to complacency, which might backfire later. For example, you might find that when you attempt to use your frozen eggs in your 40s, they do not yield viable embryos, or you could discover a condition like endometriosis that impacts your ability to carry a pregnancy—issues that might have been addressed earlier with a more proactive approach. While egg freezing can provide reassurance, be cautious not to let it become a crutch that leads to oversights or missed opportunities for addressing underlying health issues or relationship concerns.

7. What will be the fate of my frozen eggs if they never see the light of day?

If you decide not to use your frozen eggs, it's important to at least consider their eventual disposition. Your options typically include continuing to store them (at a yearly cost), donating them to science or to another individual or couple, or opting for their destruction. Research indicates that a significant number of frozen eggs are never used, with only about 16% of women who freeze their eggs eventually using them for a future pregnancy. However, this percentage may change over the next decade as egg freezing becomes more popular and done at younger ages. This low utilization rate highlights the need to carefully consider your long-term plans and the reasons for freezing your eggs.

8. How does your state play by the legal rules?

Understanding the laws and regulations regarding egg and, particularly, embryo storage in your state is important for planning their future use. Different states have varying rules about how embryos are classified, which can impact your long-term plans. While current regulations may not apply to eggs, new laws are continually being established, making it essential to stay informed as we navigate this uncharted territory. For example, you might one day be required to ship your eggs before fertilization, adding both cost and potential risks to their viability. If you currently live in a state with less favorable fertility regulations, it’s important to factor this into your decision-making process, as the legal landscape can change over time.

9. Private equity – Wait what does that have to do with it?

There is a growing trend of egg freezing that may not be entirely warranted. Recent investments by private equity firms into fertility clinics have led to the consolidation of smaller clinics into larger conglomerates. The primary goal of these firms is to increase their profits year after year. As traditional IVF and other common fertility treatments reach their limits, those seeking to impress shareholders have shifted their focus to promoting egg freezing—often targeting younger women who may never need to use frozen eggs. While egg freezing can be beneficial for some, the aggressive marketing campaigns and advertisements on subways and social media may not always reflect the true necessity of the procedure. This underscores the importance of conducting thorough research and understanding your own reasons for considering it.

What’s the bottom line?

If you’re in your 20s and have concerns about your future fertility—whether due to irregular periods from athletic activity, intense menstrual symptoms possibly indicating endometriosis, suspected PCOS based on symptoms, or intuition—the first step is to discuss it with your OBGYN. Request blood tests like AMH and Follicle-Stimulating Hormone (FSH); these are typically covered by insurance. If you want a more comprehensive evaluation, consider visiting a reputable fertility clinic for additional testing, such as a follicle count or something more invasive if recommended based on your symptoms or initial results. This will likely be an out-of-pocket expense, but it’s significantly less costly than egg freezing and could give you peace of mind that time ‘is’ on your side. Again, be aware that some clinics might promote fear tactics as a strategy to boost their revenue and satisfy investors. In the end, there’s nothing wrong with choosing to freeze your eggs in your 20s; in fact, egg donors are often recruited in their 20s because younger eggs typically yield better results. However, if you come to find there is no immediate rush, consider whether it's necessary at this point in your life or if it's something you can revisit in a few years.

If you’re in your early 30s and have compelling reasons to consider egg freezing—such as being single or feeling that trying to conceive isn’t in your immediate plans—this may be a more suitable time to seriously consider it. However, if everything looks good and the cost is a concern, it might still be unnecessary. Finally, once you are 35 and have no near-term clear plans for trying to conceive, egg freezing should absolutely be on your radar if you know you want children in the future.