At Northwell Health Fertility, our egg preservation program—led by Dr. Nicole Noyes—allows patients to preserve their fertility for a later time when they might feel ready to start a family. When a woman seeks fertility preservation, she can do so through egg freezing (oocyte cryopreservation) or embryo banking (when eggs are fertilized by sperm prior to storage).
Previously, egg freezing was not very successful due to the relatively high water content of gametes (our reproductive cells). Earlier freezing techniques caused the egg to expand with ice crystal formation, which is known to be detrimental to internal proteins and DNA. Improved freezing methods, such as vitrification (also known as ultra-fast freezing) avoids ice crystals, offering better protection against damage. Vitrification is also associated with excellent warming survival rates when the time comes for implantation. At Northwell Health, vitrification is used exclusively in the egg freezing process.
Egg freezing process
The actual egg freezing cycle takes about two weeks. Here’s what you can expect.
You will first meet with one of our physicians for a consultation to discuss the egg freezing process. At that appointment, a physical examination, a pelvic ultrasound and some bloodwork that includes ovarian reserve testing will be done. You will also be asked to sign a consent form. Feel free to ask questions during this appointment; a coordinator who specializes in egg freezing will be available to answer any you may have. After this visit, you’ll be asked to watch some educational videos at home to prepare you, and when ready, you’ll make an appointment to come back for your procedure.
The egg freezing process is composed of the following steps:
- Step 1: Ovarian stimulation. You will self-administer fertility drugs for about 10 days, during which you will be monitored with blood tests and vaginal ultrasound exams (for approximately five days out of the 10-day cycle).
- Step 2: Trigger shot. When the eggs are ready, a different medication will be used to help your eggs achieve final maturation prior to retrieval.
- Step 3: Egg retrieval. Approximately 34 to 35 hours following the trigger shot, your eggs will (usually) be retrieved vaginally in an office-procedure suite. The egg removal is directed using ultrasound guidance and the procedure is performed under mild sedation. It is short, typically less than 10 minutes. The procedure is usually followed by a one-hour stay in the recovery room prior to going home.
- Step 4: Egg freezing. Immediately after extraction, your eggs are examined by a laboratory specialist and then placed in an incubator. All viable, mature eggs will be cryopreserved approximately one hour after removal from the body and will remain frozen until you decide to use them. Sometimes, frozen oocytes are discarded, but this is only done at your direction.
- Step 5: Embryo freezing. If you are having your eggs fertilized before freezing (thereby creating embryos), the eggs are first placed with sperm, and any viable embryos that result are cultured and then frozen before being placed in liquid nitrogen.
Frequently asked questions
There are multiple reasons women choose to freeze their eggs. An egg freezing candidate may be someone who is trying to earn an advanced degree, who is climbing the ranks in her career, or who has a condition that may impact her chances of conceiving, such as certain types of cancer, endometriosis or ovarian cysts. It could also be someone who simply wants to be proactive and press pause on her biological clock if she's not ready to become a mother right now.
Birthdays have become one of the biggest factors in fertility because the quantity and quality of eggs decrease with age. So, when considering what age to freeze your eggs, in general, the younger the better. Most women freeze eggs in their 30s. We recommend beginning to think about egg freezing in your mid- to late-20s and, ideally, to freeze before age 35.
One of the reasons it’s beneficial to have your eggs frozen at a young age is that you’re more likely to have a robust ovarian reserve when younger—which is important. It’s hard to give the absolute number one should have frozen, but numbers in the teens to 20s have been associated with the highest pregnancy outcomes. The older you are at the time of freezing, the more eggs will be needed.
If you freeze your eggs before the age of 35, approximately 14 mature eggs retrieved is a good number; after the age of 35, that number increases to 20 to 25 mature eggs and goes up from there. Depending on your age and the vitality of your ovarian reserve, your doctor may recommend multiple retrieval cycles, often two to three.
Patients are often surprised by the short length of the egg freezing process. While some may think it takes months, it’s actually about a two-week commitment. After consulting with your physician, the preparation for the procedure—which includes the administration of fertility drugs and a trigger shot along with serial ultrasound and blood testing—usually takes approximately 10 days. Following the retrieval, you can also anticipate another week of mild symptoms, most often bloating. That’s because your ovaries are often enlarged after producing upward of a dozen more eggs than they’re used to in a month. All in all, the average patient only needs to take a day off work–the day of the egg retrieval.
Once frozen in liquid nitrogen, the eggs can be stored indefinitely. Due to the innate, extremely cold temperature of the nitrogen (-321 degrees Fahrenheit), the viability of your eggs won’t decrease over time.
It’s always beneficial to consult your doctor about whether egg freezing is right for you, but it is important to remember that the procedure is not guaranteed to be successful. It could result in no eggs being retrieved; alternatively, the eggs retrieved may not be viable, particularly if you’re having the procedure later in life. Even when the procedure is considered successful, some women may choose not to use their eggs for a number of reasons.