When should you freeze your eggs? Your 20s are probably too soon.

Isabel Medina had never thought about freezing her eggs, but she was listening to a personal finance podcast when the hosts brought up the procedure. They called it an insurance policy for your future self. Medina was intrigued: she likes to plan and have peace of mind.

Medina is 25, thriving in her job, and about to start her master’s degree in computer data science. But she doesn’t know if she wants to have children or when it will happen in her life.

“It was the first time I thought it could buy me time to consider all the possibilities,” she says. She’s not the only one her age thinking about it.

Ella Kauter, a 29-year-old Pilates instructor living in Sydney, was told by her mother that she should consider the procedure; she joined a Facebook group on freezing eggs to learn more. And the same thing happened to María Ramírez, a 27-year-old graduate student in New Haven, and a friend of a friend of mine.

Fertility clinics have a clear business case for trying to convince as many people as possible that egg freezing is something every smart woman should do, like saving for retirement or getting car insurance. Some are targeting women in their twenties, with blog posts and social media posts claiming that when it comes to egg freezing, the sooner the better. TikTok influencers, some of whom were only 25 at the time, also shared their “egg freezing journeys”.

Most experts agree that anyone pursuing egg freezing should ideally do so before the age of 35. And although there is no consensus on when Also early to freeze, the benefits of doing it in your twenties probably don’t outweigh the added costs and uncertainty. Freezing before age 30 could, biologically, improve the chances that a frozen egg could successfully develop into an embryo and then into a child. But this improvement would be small and probably not enough to justify paying additional annual storage fees for eggs. In addition, the possibility that the eggs will not be used at all increases considerably.

There are two main reasons a woman’s fertility declines with age, says Dr. Sarah Cascante, a reproductive endocrinology and infertility researcher at NYU Langone Infertility Center. The first is that the number of eggs a woman has begins to decrease as soon as she is born. Each year, this number decreases.

The second reason is egg quality. Younger women are more likely to produce eggs that will form healthy embryos without birth defects. “So if you’re older, you’re more likely to have chromosomal issues that are more likely to result in miscarriage or not producing a baby at all,” Cascante says. The idea of ​​egg freezing is that you can preserve egg quality and potentially have a successful pregnancy later in life.

Although there is consensus that women’s fertility declines with age, the rate of this decline is not constant. “We’re very concerned about aging, but it’s pretty stable around 33 or 34,” says Dr. Avi Tsafrir, a fertility specialist at the Hebrew University of Jerusalem. Before that, your chances of getting pregnant from year to year are pretty even. (Even 35 is not a hard and fast point at which fertility falls off a cliff – the decline varies from person to person.)

“Whether you freeze your eggs at 25 or 32, it doesn’t really matter because you’ll probably get the same number and quality,” says Dr Alex Polyakov, a fertility specialist at the University of Melbourne in Australia.

The egg freezing procedure begins with a woman (or someone with a uterus) being injected with hormones that stimulate her ovaries to produce more eggs. Usually, the patient will have tests and ultrasounds, and when the eggs are ready, the doctor will induce ovulation and collect the eggs from the vagina a few days later. Next, the eggs will be submerged in liquid nitrogen, which will keep them frozen at -350 F.

Once the patient is ready to have a baby, doctors thaw the eggs, fertilize them, and return the embryos to the person’s uterus. “We don’t expect them all to survive,” Tsafrir said. Eggs are discarded at every stage of the process, so egg freezing is never a guarantee and the number of eggs the patient freezes is important.

A study published earlier this year extrapolated data from 520 insemination cycles performed at a fertility clinic in Boston to estimate, based on a patient’s age, the number of eggs a person needs to achieve a live birth. Based on the success rates of those in their sample, the authors predicted that someone who freezes 20 eggs at age 34 has a 92% chance of having a live birth if they undergo in vitro fertilization, while a person who freezes the same amount at age 30 has a 98 percent chance—only a slight improvement. A 2015 paper, titled “Optimal Timing for Elective Egg Freezing,” used data from several sources – a long-term pregnancy study, the National Survey of Family Growth, and the National Summary of Reproductive Technologies. assisted – to examine the question of when people should ideally freeze their eggs. He found that freezing eggs before age 32 generally does not improve your chances of having a live birth.

It should be noted that because egg freezing is typically done by older women, much of the information we have about younger women and egg freezing does not come from actual patient data, but from models. making a better guess. Although most doctors believe that egg freezing is generally not necessary until the early thirties, they would feel more confident with more data.

In addition to unclear advantages, freezing eggs in your twenties has obvious disadvantages. The first is the cost. With egg freezing, you not only pay for egg retrieval but also for how long your eggs are stored. The longer you keep your eggs frozen, the more you will have to pay. At NYU Langone, for example, the cost is $1,000 for each year they remain in storage.

Then there’s the fact that the majority of women who freeze their eggs don’t return them. Some articles and researchers estimate the return rate to be between 9 and 30 percent, although they don’t know the percentage for sure because the procedure hasn’t been around that long. Young women might be even less likely to get their eggs back, Polyakov says.

A small study published in 2021 found that women generally don’t use their frozen eggs for two reasons: they never found a suitable partner (and didn’t want to raise a child without one) or they got pregnant naturally. You could feel, at 28, like you’re single forever, but there’s still plenty of time to find a partner before your fertility starts to decline. Even for women who aren’t heterosexual or who are considering having children through IVF to, say, screen for a particular disease, see if you can wait to have egg retrieval until you’re ready to starting a family can still make the most sense. Egg storage is expensive, embryo testing is more efficient, and plans can always change.

Cascante recommends that women get a good idea of ​​what their 30s and 40s will look like before freezing their eggs. For example, egg freezing might make sense for someone who is 27, wants to be a general surgeon, and is going to put off childbearing for 15 years to get medical training. But the calculation will be different for someone who postpones motherhood for a less certain reason. “If someone says, ‘I’m 27, I really want to have kids as soon as I meet someone’, I might say, ‘Wait until you’re 32 or 33, then let’s see where you are. “.” says Cascante. Early egg freezing may also make sense for women undergoing treatment like chemotherapy or for trans men who are considering having gender-affirming surgery or taking hormones. gender affirmation.

If you are around 30 years old and planning to freeze eggs, doctors recommend getting an ovarian reserve test, which is a blood test that measures hormones to estimate how many eggs you might get during a pregnancy. egg retrieval. This test can tell if there is a reason to hurry. “If you come in and your level is low at 30, and you wait until you’re 35, you’re probably going to be very low level. And at that point, you might not get as many eggs from freezing eggs,” says Cascante. Freezing your eggs is never a guarantee that you will have a baby or that you will consider it money well spent. But it is better to do it with some data in hand, rather than just from to fear.

Leave a comment