Fertility and Egg Freezing: Know Your Options

For women and all who menstruate, it’s important to understand fertility and reproductive health. At Weill Cornell Medicine, our team includes experts in reproductive medicine who help patients understand their fertility, preserve their fertility and complete their families.  

Isaac Kligman, MD recently shared expert knowledge of egg freezing on the Weill Cornell Medicine Back to Health podcast. Here, you can read Dr. Kligman’s overview about fertility and advice for egg freezing.  

Understand your fertility  

There are a finite number of eggs in the female body for reproduction. “At the beginning of a reproductive cycle,” explained Dr. Kligman, “during the first menses, there are about 400,000 eggs available … those are spent between the initial period and menopause.” Over the years, the number of eggs declines. The quality of the eggs also begins to decline after age 35 to 37.   

Egg freezing to preserve fertility  

Fertility treatments were first developed for younger patients who were receiving treatments that affected their ovarian reserve (number of eggs), such as chemotherapy or radiation therapy, to preserve their fertility. Egg freezing (also called “cryopreservation”) is one of the fertility preservation options developed at that time. Now, this option is widely available. “And I think it’s a very good alternative for women to preserve their fertility,” said Dr. Kligman.  

The first birth from a cryopreserved egg was reported in 1986. During this time, the eggs were frozen with a “slow freeze” technology. Eggs were sometimes damaged if ice crystals developed in the egg.  

“About in 1999,” explained Dr. Kligman, “a new technology came about, which was called vitrification. And vitrification, basically, is a technology where the eggs are very rapidly frozen, so there is no chance for the ice crystals to form in the cytoplasm. That really revolutionized the entire field because the success rates were significantly higher and the technology could be generalized to women who basically did not have any medical condition, but just wanted to preserve their fertility.”  

Egg freezing process  

Many patients are curious about the process for freezing their eggs. When a patient first begins care with a reproductive medicine specialist, such as those at the Weill Cornell Medicine Center for Reproductive Medicine, the first visit includes a discussion of medical history and a physical exam. During that same appointment, the patient receives several tests to understand their hormone levels, fertility and an estimate of the number of eggs and follicles in the ovaries.   

The results from these tests help doctors determine the best medications to stimulate the ovaries. The patient is also asked to monitor their cycle closely. 

Next, “the patient comes to the office every day, every two days, depending on her estrogen levels,” explained Dr. Kligman. “We do an ultrasound, we do blood work, and then we get those results. And in the afternoon, we call the patient with her instructions. We tell her what dose of medication she needs to use, and so on and so forth. We monitor the patient until the follicles that contain the eggs reach a certain size.” 

The patient then receives another medication at this time. Then, 35 hours later, the patient is ready for the egg removal procedure. During this procedure, the patient receives light sedation for comfort. The doctor then uses an ultrasound probe and a needle to remove follicles using suction. The eggs are removed from the follicles, placed into test tubes and sent to labs.  

“And at that point, we clean the eggs and freeze them. There are the special little tubes that are plunged in liquid nitrogen to make those eggs freeze very rapidly and they can actually be conserved for years and years and years. These eggs can be frozen for 10 or 15 or 20 years without having any impact on their chances of turning into a baby, on the chances of being successful,” said Dr. Kligman.  

Advice for those considering egg freezing  

When asked to offer advice for those considering fertility preservation technology, including egg freezing, Dr. Klignman shared that we should all be aware that there are many types of technology available to preserve fertility — including egg freezing — for social and medical reasons.  

“Age is an important factor in women’s reproduction,” he continued. “The optimal age to freeze eggs or to pursue fertility preservation is between 35 and 37 years of age. And women who have no immediate intentions of pursuing parenthood should definitely take advantage of this option because it’s widely available.”  

Be sure to listen to the full podcast featuring Dr. Kligman and learn more about the expert care at the Center for Reproductive Medicine.