You (Probably) Shouldn’t Freeze Your Eggs in Your 20s
Reading Time: 6 minutesDon’t Freeze Your Eggs in Your 20s!, While clinics may suggest that it’s savvy to plan far ahead, experts say the costs of doing the procedure too early outweigh the benefits., When should you freeze your eggs? Your 20s are probably too early.
Isabel Medina had never thought about freezing her eggs, but she was listening to a podcast about personal finance when the hosts brought up the procedure. They referred to it as an insurance policy for your future self. Medina was intrigued: She loves planning and having peace of mind.
Medina is 25, thriving in her job, and about to start her master’s degree in computational data science. But she doesn’t know whether she wants to have children—or when in her life it would happen.
‘That was the first time I thought this might buy me some time to consider all the possibilities,’ she says. She’s not the only one her age thinking about this.
Ella Kauter, a 29-year-old Pilates instructor living in Sydney, was told by her mom she should consider the procedure; she joined an egg-freezing Facebook group to learn more. And the exact 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 up for retirement or having car insurance. Some target women in their twenties, with blog posts and social media posts making the case that when it comes to egg freezing, the earlier the better. TikTok influencers, some as young as 25 at the time, have also shared their ‘egg-freezing journeys.’
Most experts agree that anyone who pursues egg freezing should ideally do so before age 35. And while there is no consensus about when is too early to freeze, the benefits of doing so in your 20s probably don’t outweigh the added costs and uncertainty. Freezing before 30 might, biologically, improve the odds that a frozen egg could successfully turn into an embryo and then a child. But this improvement would be small—and is probably not enough to justify paying additional annual storage fees for the eggs. In addition, the possibility that the eggs will not be used at all goes way up.
There are two main reasons a woman’s fertility declines with age, says Dr. Sarah Cascante, a fellow in reproductive endocrinology and infertility at NYU Langone Infertility Center. The first is that the number of eggs a woman has starts decreasing the moment she’s born. Every year, that number goes down.
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 get chromosomal problems that are more likely to either result in a miscarriage or not produce a baby at all,’ Cascante says. The idea with egg freezing is that you can preserve egg quality, and potentially have a successful pregnancy later in life.
Although there is consensus on the fact that women’s fertility declines with age, the rate of that decline is not constant. ‘We are very concerned about aging, but it’s quite stable towards age 33 or 34,’ says Dr. Avi Tsafrir, a fertility specialist at Hebrew University in Jerusalem. Before then, your chances of getting pregnant from one year to the next 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 the same quality,’ says Dr. Alex Polyakov, a fertility specialist at the University of Melbourne in Australia.
The egg-freezing procedure starts with a woman (or a person with a uterus) getting hormone injections that stimulate her ovaries to produce more eggs. Usually, the patient will go through tests and ultrasounds and, when the eggs are ready, the doctor will induce ovulation and pick up the eggs through the vagina a few days later. Then, the eggs will be immersed in liquid nitrogen, which will keep them frozen at -350 F.
Once the patient is ready to have a baby, doctors will defrost the eggs, fertilize them, and put the embryos back into the person’s uterus. ‘We don’t expect for all of them to survive,’ says Tsafrir. Eggs get discarded at every step of the process, which is why egg freezing is never a guarantee and the number of eggs the patient freezes matters.
A study published earlier this year extrapolated data from 520 insemination cycles performed at a fertility clinic in Boston to estimate, according to a patient’s age, how many eggs a person needs to achieve a live birth. Based on the success rates of those in their sample, the authors predicted that someone freezing 20 eggs at age 34 has a 92 percent chance of achieving a live birth if they undergo in vitro fertilization, while someone freezing the same amount at 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 Assisted Reproductive Technology National Summary—to examine the question of when people should ideally freeze their eggs. It found that egg freezing prior to 32 doesn’t generally improve your chances of having a live birth.
It’s worth noting that because egg freezing is typically done by older women, much of the information we have on younger women and egg freezing is not from actual patients’ data but from models making a best guess. Although most doctors believe that egg freezing isn’t typically necessary before a woman’s early 30s, they would feel more confident with more data.
In addition to unclear benefits, freezing eggs in your 20s comes with some clear disadvantages. The first one is the cost. With egg freezing, you pay not only for the egg retrieval but also for the time your eggs will be in storage. The longer you keep your eggs frozen, the more you will have to pay. At NYU Langone, for instance, the cost is $1,000 for every year they stay in storage.
Then there’s the fact that the majority of women who freeze their eggs don’t go back for them. Some papers and researchers estimate that the return rate is between 9 and 30 percent, though they don’t know the percentage for sure because the procedure hasn’t been around for that long. Younger women might be even less likely to retrieve their eggs, Polyakov says.
A small study published in 2021 found that women typically 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 might feel, at 28, as if you’ll be single forever, but there’s still plenty of time to find a partner before your fertility starts to decline. Even for women who are not heterosexual or who plan to have kids via IVF to, say, screen for a particular disease, seeing if you can wait to undergo egg retrieval until you’re ready to have a family still may make the most sense. Egg storage is expensive, testing embryos is more efficient, and also, plans can always change.
Cascante recommends that women have a good idea of what their 30s and 40s are going to look like before they freeze their eggs. For example, egg freezing might make sense for someone who is 27, wants to be a general surgeon, and is going to postpone childbearing 15 years for medical training. But the calculation will be different for someone postponing motherhood for a less certain reason. ‘If someone says, ‘I’m 27—I really want to have kids as soon as I meet somebody,’ for that person, I might say, ‘Wait until you are 32 or 33, then let’s see where you are,’ ‘ says Cascante. Early egg freezing may also make sense for women who are undergoing a treatment like chemotherapy or for trans men who plan to undergo gender-affirming surgery or take gender-affirming hormones.
If you’re around 30 and considering egg freezing, doctors recommend taking an ovarian reserve test, which is a blood test that measures hormones to estimate how many eggs you might get during an egg retrieval. This test can indicate if there is a reason to hurry. ‘If you come in and your level is low at 30, and you wait until you are 35, you will probably have a very low level. And at that point, you may not get so many eggs from egg freezing,’ Cascante says. Freezing your eggs is never a guarantee that you’ll have a baby or that you’ll consider it money well spent. But it’s better to do it with some data in hand, rather than simply out of fear.
Reference: https://slate.com/technology/2023/05/should-you-freeze-eggs-twenties-early-cost-ivf.html
Ref: slate
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