I recently had a conversation with my 90-year-old grandmother—who had given birth to 4 children between the ages of 23 and 30 years old. She asked me what the average age of my patients was. When I replied that the average age was 37, her surprised response back to me was, “You can help a 37 year old get pregnant?!” Thankfully, the answer is a resounding yes!
As a fertility doctor, I have the great privilege of helping people of all ages to have families. Certainly, many women in their later thirties and early 40s can conceive on their own and don’t need a fertility physician, but one of the most prevalent social trends has been people waiting longer to have children. Looking at census data between 1970 and 2006, the average age for a woman to have her first child increased by 3.6 years nationally; in Massachusetts, that increase was 5.2 years, a huge shift in just over 30 years’ time.
One of the potential downstream effects of this trend is an increase in age-related infertility. Women naturally lose the ability to conceive approximately 5-10 years prior to the onset of menopause (on average, that age is 51 years old). Moreover, both the quantity and quality of a woman’s eggs begins to decline as early as her early-30s and declines rapidly thereafter. The American Society of Reproductive Medicine states that in a healthy 30 year old woman, she has a 20% chance of getting pregnant naturally for each month she tries, compared to a natural fertility rate of only 5% per month for a healthy 40 year old woman. Therefore, for women who are considering starting a family in their mid-thirties, it is important to think about age-related fertility decline, ideal family size and spacing, and pregnancy planning.
But what if your biological clock is about to sound an alarm and you’re not ready? There may be a new answer for you.
Fertility preservation – in particular, “egg freezing” or cryopreservation – was initially reserved for patients who were facing a medical reason for loss of fertility, such as a new cancer diagnosis or a need for medication that could negatively affect fertility. Although there are still some cautions regarding the pursuit of egg freezing for fertility preservation due to concerns about “age-related fertility decline” alone, women are increasingly pursuing this technology.
So if you are wondering about egg freezing and whether it’s right for you, here are some of the basics you should know:
- What do you have to do to freeze eggs? Eggs are resting in the ovaries in an immature stage, and we do not yet have the technology to “mature the eggs” outside of the body. Therefore, women who want to freeze their eggs need to take fertility medications (injections) to stimulate multiple eggs to mature in a single month. On average, this process takes about two weeks, and the eggs are retrieved through a minor procedure under anesthesia. Women who undergo this process should plan for a day off work or a quiet day at home to recuperate.
- How new is egg freezing? Egg freezing was experimental until 2013, but recent technology – specifically, the advent of “vitrification,” or rapid freezing of eggs – has overcome major hurdles and greatly improved the success rates of egg survival after freezing. The Fertility & Reproductive Center at Harvard Vanguard Medical Associates can perform this procedure for our patients.
- What is the ideal age to freeze your eggs? Statistical modeling suggests that egg freezing has the highest success rate in women ages 30-34, although a woman could derive benefit from egg freezing up until the age of 40. Women less than 30 have a high likelihood of getting pregnant on their own, and therefore may have less of a benefit from egg freezing. We typically do not recommend a woman have her eggs frozen past the age of 40, as the likelihood of pregnancy from frozen eggs is lower—although this is something that you could discuss in detail with one of our fertility physicians. Quality of the eggs may have degraded past the point of viability for a pregnancy.
- Does insurance cover egg freezing? Aside from some circumstances where patients are facing a medical loss of fertility like a cancer diagnosis, unfortunately most of this cost is out-of-pocket. The average cost of an egg freezing cycle (including monitoring, medications and the procedure itself) is approximately $8000. In addition, there are annual costs from egg storage.
- Who should I talk to if I have questions or want to consider egg freezing? At Harvard Vanguard’s Department Fertility and Reproductive Health, we have four dedicated fertility specialists, and any of us would be happy to discuss your individual situation and the pros & cons of egg freezing and fertility preservation for you.