As we grow up, our conversations tend to evolve from weekend plans and uni classes to home deposits, whatever's going on in the world of TikTok and, naturally, babies.
Whether planned or not, we all get to a point in our lives when it seems that everyone around us is either considering or embracing parenthood. And particularly for those of us that have been locked down for most of the last two years, the idea of starting a family can be confronting. Not only for singles that are unsure of what parenthood might look like for them now, but also for those in relationships who don't quite feel ready to take such a monumental leap. Luckily, we have options.
Oocyte cryopreservation, better known as egg freezing, has been a revolution since its creation in the 1980s. While it began as a way to preserve the child-bearing potential of oncology patients before they underwent treatment, egg freezing has been a miracle for women and AFAB people wanting to pursue parenthood later in life, as our natural egg formulation declines as we get older.
But if you're not completely aware of everything that goes on in the egg freezing process, you're certainly not alone — and schools don't exactly run us through all of our fertility options. For a breakdown of what exactly is involved in the process, as well as the associated costs and success rates, read on for our explainer.
What is egg freezing?
Egg freezing is a method of retrieving and storing a person's unfertilised eggs in order to provide them with an option for conception at a later date.
As Dr Peter Illingworth, Medical Director at IVF Australia explains, “frozen eggs may be stored for many years without significant deterioration. When ready to use the eggs, they are warmed, and then fertilised with sperm. The aim is for the fertilised egg to develop into an embryo, which can then be transferred to the person's uterus giving a chance of pregnancy.”
What is involved in the egg freezing process?
First, patients are prescribed hormonal stimulation to produce more eggs than they naturally do. This usually results in about 6-15 eggs over the one we usually produce during ovulation. There are a variety of stimulation techniques, and your fertility specialist will consult with you on the best fit for you.
The stimulation medications are self-administered by a daily injection using a pen device with a small needle. Patients, or their partners, are taught how to administer these shots.
There are some side effects associated with these hormones, but you should be able to go about your life relatively as normal.
The eggs are eventually collected from the ovaries using an ultrasound-guided probe inserted into the vagina. A needle runs inside the probe and can be gently passed through the vaginal wall into each ovary in turn, allowing the doctor to aspirate eggs from the ovary.
The procedure is usually carried out under light general anaesthetic or sedation in some cases. You can usually go home within hours after the procedure and are advised to rest up.
Overall, there are parts of the experience that can be a bit uncomfortable, but none of it should be painful if carried out properly by a trained clinician.
Once retrieved, the eggs undergo a freezing procedure called vitrification. This involves rapid freezing of the eggs using a process that extracts fluid from the eggs to prevent potentially damaging ice crystal formation.
Once vitrified, your eggs can be stored for years.
How much is egg freezing?
As it stands, egg freezing is only subsidised by Medicare when a person has a condition affecting their fertility, such as severe endometriosis or cancers that require chemotherapy. Even then, the Medicare rebates typically only cover about half of the total costs. And since it can cost anywhere from $7,000-$10,000, that puts many people with little disposable income in the position of making extremely difficult life decisions.
Even for those with private health insurance, the associated costs — including hospital admission, any anesthetist fees, medication, consultant fees and the egg retrieval itself — may not all be covered. Prices also differ according to the chosen clinic.
How successful is egg freezing?
Egg freezing is still a relatively new procedure, and as such, it's hard to give precise figures for success rates. Things like a person's age at the time of freezing can come into play, which is why we're seeing younger women opt for egg freezing earlier on.
Success rates range from 38.8% per embryo transfer for patients under 34, to 5.2% per embryo transfer leading to a healthy birth for patients over 43 years. Although it's worth noting that even if rates are lower for women over 35, it's definitely not impossible.
Currently, the expected success rates of egg freezing for a woman aged 35 or under who has undergone one stimulated cycle would result in the collection of 10-12 eggs, of which 7-9 would be suitable for vitrification and storage, according to IVF Australia.
As noted on their site, approximately 80-90% of eggs survive warming — which is where they are essentially thawed out — with 50-80% of eggs then surviving fertilisation, and 80-90% of fertilised eggs developing into embryos. A single embryo then has a 20-35% chance, on average, of developing into a pregnancy.
Who is eligible for egg freezing?
It's possible to freeze your eggs at any age before menopause, but the quality of the egg can decrease the older we get so specialists recommend beginning the process in your twenties to your early thirties in order to have a better chance of the eggs resulting in pregnancy later on.
How long can eggs be stored?
What isn't so commonly talked about is what comes after you freeze your eggs.
On top of the costs of the egg freezing process, there is indeed a storage fee. While laws vary from state to state, Medicare does not cover any storage, regardless of whether eggs are frozen for medical reasons.
Storage fees can set you back around $500 per year and usually begin after the first six months, which is generally free of charge as part of the process.
Though it doesn't sound like a whole lot when you break it down, it's just one small part of a very lengthy and expensive procedure that is fraught with both physical and emotional exhaustion.
If you, or anyone you know, is considering undergoing egg freezing, you can view your options and read more about costs here.