Elective egg freezing for age-related fertility decline
=======================================================

* Jenna Gale
* Aisling A. Clancy
* Paul Claman

**Elective egg freezing is a treatment to help patients increase their chance of pregnancy at a later, more advanced age**

Elective egg freezing, or oocyte cryopreservation, involves controlled ovarian stimulation, followed by an egg retrieval procedure. Patients considering this treatment are referred to a fertility specialist for evaluation and counselling regarding risks, benefits and alternative options.

**Patients aged ≤ 35 years with normal ovarian reserve have the highest chance of later success, but future live birth cannot be guaranteed**

Ovarian reserve testing (ultrasound and blood work) assists in helping to predict the number of retrievable eggs and allows counselling of patients at risk of very low egg yield.1 For patients aged 35 years or younger, about 14 mature eggs are needed for an anticipated 80% chance of future live birth, with more eggs required as patients age.2 Multiple egg freezing cycles may be recommended to achieve the desired number of eggs.

**The process typically takes 10–14 days**

Ovarian stimulation typically involves 8–12 days of injection medications and ultrasound monitoring. Two days later, a 5- to 10-minute ultrasound-guided transvaginal needle aspiration procedure is performed, at which time 1–2 days of rest are required. Eggs are stored at the fertility clinic and can be transferred to another location if needed.

**Fees for this elective treatment are not covered by government health insurance**

Total costs range from $9000 to $17 000 per cycle (private insurance may cover $3000–$8000 medication costs) with an additional $300–$500 annual storage fee.3 Additional costs are incurred when patients return to use the frozen eggs to cover the thawing, fertilization and subsequent embryo transfer(s).

**There is no “expiry date” on frozen eggs**

Many patients do not use their frozen eggs. If used, eggs are thawed and fertilized with sperm to create embryos that are transferred into the uterus. Pregnancy rates are tied to the woman’s age at the time of egg freezing. Advanced maternal age is associated with greater risk in pregnancy4 and many clinics have an age limit after which they will not provide embryo transfer treatment.

## Footnotes

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*   **Competing interests:** None declared.

*   This article has been peer reviewed.

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## References

1.  Saumet J, Petropanagos A, Buzaglo K, et al. No. 356 — Egg freezing for age-related fertility decline. J Obstet Gynaecol Can 2018;40:356–68.
    
    

2.  Goldman RH, Racowsky C, Farland LV, et al. Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients. Hum Reprod 2017;32:853–9.
    
    

3.  Petropanagos A, Cattapan A, Baylis F, et al. Social egg freezing: risk, benefits and other considerations. CMAJ 2015;187:666–9.
    
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4.  Johnson JA, Tough SSOGC Genetics Committee. Delayed child-bearing. J Obstet Gynaecol Can 2012;34:80–93.
    
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