In an interview with “Allure”, Jennifer Aniston opened up for the first time about her journey with IVF, revealing that trying to conceive was “really hard,” and she was “throwing everything at it” in the midst of intense and cruel public scrutiny. “I would’ve given anything if someone had said to me, ‘Freeze your eggs. Do yourself a favor.’ You just don’t think it. So here I am today. The ship has sailed,” the 53-year-old stated. Aniston’s statement belies what many consider to be the catch 22 of egg freezing: The optimal time to freeze your eggs is in your 20s, but at that point, preserving your fertility for the future is likely the last thing on your mind. 

Or at least it used to be. Now, egg freezing is becoming increasingly popular as an option for fertility preservation in younger demographics. That’s for a couple of reasons, says Lauren Makler, co-founder & CEO of Cofertility, an egg freezing and egg donation startup. “One of the biggest drivers is that women are starting families later than ever. The latest figures show that the average age of women giving birth is now 30 in the U.S., the highest on record,” she notes. 

Related: 8 things to know about egg freezing, from a fertility specialist

Additionally, in 2012, the American Society for Reproductive Medicine (ASRM) removed the “experimental” label from egg freezing procedures. “This really opened the door to clinics beginning to educate and market this service to women nationwide. Since then, hundreds of thousands of women have been through the process and are speaking about it publicly. This has created a snowball effect where egg freezing is now part of the Gen Z zeitgeist.” 

Cofertility was borne out of the reality that the way we build families is more dynamic than ever, Makler adds. “At its core, our platform gives women the opportunity to freeze their eggs for *free* when they donate half of the retrieved eggs to a family who can’t otherwise conceive—like couples with infertility, gay dads, cancer survivors, and more.” 

Though it’s not without limitations, egg freezing is a smart option if you want to give yourself a little more time before having kids, knowing it’s generally accepted that fertility starts declining around age 35. While Makler is very clear that egg freezing is not fertility insurance, “it can increase your chances of having a healthy baby down the road, especially if you intend to have children later in life,” she says. One study shows that for a woman under age 35, freezing nine eggs gives you a 70% chance of at least one child. “As medicine and technology advances, we hope to see this number increase even further.” 

Here’s more information on the benefits, limitations and risks of egg freezing to help inform your decision. 

Benefits of egg freezing

Egg freezing, also known as oocyte cryopreservation, is a process in which eggs are extracted from your ovaries to be frozen and used for future fertilization through assisted reproductive technology (ART), such as in vitro fertilization (IVF). 

“Choosing to preserve your fertility by freezing your eggs is equivalent to stopping your biological clock,” writes Mark P. Leondires, MD, an OB-GYN and reproductive endocrinologist, for Motherly. “Egg freezing is also used to help preserve the fertility of patients undergoing treatment for cancer or those who are planning on transitioning. It’s an option every woman should consider by the age of 35 if they want children but simply aren’t ready yet.” 

A few reasons why people with ovaries may choose to freeze their eggs:

  • Extend fertility into their 40s and beyond
  • Career or educational goals
  • Long-term travel plans
  • Not having found the right partner
  • Before undergoing cancer treatment or other medical treatments
  • In advance of gender-affirming care

Only you and your doctor can determine whether egg freezing is the right move for you, but some experts support the procedure even up to age 40.

“The chances of a healthy pregnancy have much more to do with the age of the eggs at the time frozen than the age of the womb at pregnancy. As we age, our eggs are more likely to contain chromosomal abnormalities which is the main reason for miscarriage,” shares Makler. 

Essentially, egg freezing can buy you time. If you decide not to start trying to get pregnant until your mid-40s, any eggs you froze previously would likely be of higher quality and may be more likely to become fertilized than your existing eggs at that point. It’s like being your own future egg donor.

Related: I’m not done having kids—and I think about my frozen embryos every day

Limitations of egg freezing

Having the option to undergo egg freezing can be life-changing for some, but it’s important to remember that future pregnancy and birth rates aren’t guaranteed. “The pregnancy rate is not as good as I think a lot of women think it will be,” said Dr. Marcelle Cedars, professor and director of the division of reproductive endocrinology at the University of California San Francisco and president of the ASRM, to The New York Times. “I always tell patients, ‘There’s not a baby in the freezer. There’s a chance to get pregnant.’” 

Your chances of getting pregnant with previously frozen eggs may vary anywhere from 12% to 70%, depending on the number of eggs frozen and your age when the eggs were extracted. A 15-year study published in 2022 found that the average age women froze their eggs was 38.3. The chance of a live birth from their frozen eggs was 39%, but if they were younger than 38 at the time of egg retrieval, the chance of a live birth was 51%. Some eggs won’t survive the freezing process, which is why quantity counts. If women younger than 38 froze at least 20 eggs, their chances of a live birth jumped to 70%.

Success rates vary between different fertility clinics, so it’s important to do thorough research before choosing one in order to ensure your best chance of success, writes Dr. Leondires. 

There’s also the chance that you’ll freeze your eggs and then never use them. At that juncture, you can choose to donate them to another couple looking to get pregnant, dedicate them to scientific research or have them thawed and discarded. In actuality, most people who freeze their eggs never have them fertilized, but surveys suggest that the majority are still likely to be happy with their decision to undergo the egg freezing process. “One study of egg freezing patients at UCSF found that 89% believed they would be glad they froze their eggs, even if they never used them to conceive a child,” cites Makler.

Related: It’s time to stop calling infertility a women’s health issue

Costs of egg freezing

If you’ve ever looked into the process of egg freezing or egg donation, even on a surface level, you know just how confusing—and costly it can seem. While some employers may contribute to covering expenses, insurance is unlikely to cover your costs, unless you have a specific medical condition that will impact your fertility, such as cancer.  

Out of pocket, the costs of egg freezing can be exclusionary. “It’s about $12k to $20k after medication and initial yearly storage fees,” notes Makler. “It’s a great thing when companies offer fertility coverage, but unfortunately this is typically confined to the companies that can afford that cost, which [are usually] larger corporations that generally already have advantaged employees in terms of access and compensation,” she notes. 

With Cofertility, Makler and her co-founders are aiming to demystify the process, promote reproductive choice for all and remove some of the cost barriers. With their Split option, you’ll donate half of the eggs retrieved, and all your medical expenses (plus 10 years of storage) are covered by the family to whom you donate. If you opt to keep all your eggs, you’ll be responsible for the costs incurred. Either way, their Freeze by Co program will batch you in a cohort with others undergoing egg retrieval, so you’ll have a group to lean on. 

Risks of egg freezing

Aside from being traditionally expensive, egg freezing can be a time-consuming process, and one with not insignificant physical and hormonal impacts. 

You’ll need to first undergo testing, including blood draws and ultrasounds, then take synthetic hormones to promote follicular development, plus additional medication to prevent you from ovulating before retrieval happens. To promote egg maturation, you’ll inject yourself with hCG. The retrieval process will likely happen in your doctor’s office, where your physician will use suction to remove the eggs from your ovaries one by one (you’ll first be sedated). 

You might experience side effects from the hormones and medications, but the retrieval procedure itself is considered low-risk. A 2017 study looked at more than 23,000 egg retrieval procedures and found an overall complication rate of just 0.4%, Makler notes. “The greatest risks exist for those who have pre-existing health conditions that put them in a higher risk category. That is why there are a number of steps along the way designed to ensure a patient’s safety before starting the process.” 

Related: How to avoid IVF injection bruising, according to an acupuncturist

A note from Motherly: Is egg freezing right for you?

Freezing your eggs can buy you time when it comes to your fertility, but success rates may vary, so know that it’s not a form of fertility insurance. Your future pregnancy chances will depend on a full fertility assessment, your current age and future fertility goals—it’s an individual decision. Curious if it’s right for you? It’s best to start by setting up a consultation with your doctor. 

Featured expert

Lauren Makler is co-founder & CEO of Cofertility, an egg freezing and egg donation startup.

Sources

Cascante SD, Blakemore JK, DeVore S, et al. Fifteen years of autologous oocyte thaw outcomes from a large university-based fertility center. Fertil Steril. 2022;118(1):158-166. doi:10.1016/j.fertnstert.2022.04.013

Levi-Setti PE, Cirillo F, Scolaro V, Morenghi E, Heilbron F, Girardello D, Zannoni E, Patrizio P. Appraisal of clinical complications after 23,827 oocyte retrievals in a large assisted reproductive technology program. Fertility and Sterility. 2018 Jun 1;109(6):1038-43.

Maslow BS, Guarnaccia MM, Ramirez L, Klein JU. Likelihood of achieving a 50%, 60%, or 70% estimated live birth rate threshold with 1 or 2 cycles of planned oocyte cryopreservation. Journal of assisted reproduction and genetics. 2020 Jul;37(7):1637-43. doi:10.1007/s10815-020-01791-w