Treatment Spotlight:

• Egg freezing is a fertility preservation method available to females or those assigned female at birth (AFAB).
• Egg freezing uses strong hormonal medication to grow multiple eggs in a female reproductive cycle, before they are retrieved and frozen in order to be stored.
• In certain cases, the NHS covers egg freezing - but most people pay privately for treatment.
• Social egg freezing - when people freeze their eggs out of personal choice rather than medical necessity - has risen in popularity, but overall numbers of people freezing their eggs remain relatively low in the UK.
• This means there is less data available for egg freezing success rates than for IVF or other fertility treatments.

Egg freezing - more technically known as oocyte cryopreservation - is a method of preserving your fertility if you're female, or AFAB.

A woman is born with all the eggs she will ever have, and these eggs, unlike skin cells, don't regenerate. They age, just like us. Freezing eggs protects them from the effects of further ageing.

There are two main steps involved in egg freezing:

1. Ovarian stimulation

Medication is used to boost the number of mature eggs produced by the ovaries. The eggs are then collected in a surgical procedure.

2. Freezing the eggs

Using an ultra-fast freezing method called 'vitrification', eggs are frozen in liquid nitrogen. At this point, they can be stored for up to 55 years.

Egg freezing is often done before someone tries to conceive, or encounters infertility. It can be particularly useful when:

• Flexibility is key. Many women choose to freeze their eggs to keep their options open, and delay when they start a family. This could be for many reasons, and is commonly known as 'social egg freezing'.

• Facing cancer or other medical conditions. Certain treatments can negatively impact fertility, including therapies for cancer or autoimmune disorders, like rheumatoid arthritis or lupus. You may also be facing surgery on your reproductive organs, such as a laparoscopy for endometriosis. If you are due to undergo any treatment that can impact your fertility in the future, your doctor may recommend egg freezing, and, based on local eligibility criteria, the NHS may cover this.

• Planning gender reassignment. The process of hormonal treatment and gender reassignment can significantly impact fertility, making egg freezing a useful option if considering children in the future.

• Diagnosed with early menopause. Preserving any available eggs for use in future fertility treatment.

• Egg freezing is invasive. Hormone medication can have side effects. You'll also need surgery (under deep sedation or general anaesthetic) to retrieve your eggs. Rest is very important.

• Egg freezing is similar to IVF. Egg freezing involves the same medications and retrieval surgery as IVF. The only difference is that once your eggs are removed, they're frozen rather than fertilised (as with IVF).

• Egg freezing is time consuming. Be prepared to free up your schedule. During ovarian stimulation, for example, you might need weekly or even daily tests to monitor your egg development. 

• One round may not be enough. Your doctor will aim to collect between 7-14 eggs [1], which may not be possible in one treatment cycle. So, you may need to repeat the process - which can be emotionally draining, as well as more expensive.

• Check your clinic's experience. Even if your clinic offers egg freezing, they may not have much experience carrying out the process, as only a few thousand people freeze their eggs each year.

• It's not for everyone. As we age, so do our eggs. Your doctor may not consider egg freezing the best course of action if you're over a certain age.

• When you decide to use your eggs, a live birth isn't guaranteed. There's limited data available on how successful it is to use frozen eggs later. However, one recent study found that the average live birth rate from frozen eggs was around 18% [2].

Time: Varies, but around 2 weeks

Location: Clinic

Your clinic will first run pre-treatment blood tests and ultrasound scans - sometimes referred to as a Fertility MOT. These predict your body's response to treatment and help to understand the number and quality of eggs available (this is known as your ovarian reserve) [3].

Tests include:

• Blood tests for Anti-Müllerian Hormone (AMH) and Follicle Stimulating Hormone (FSH). These are used to understand the number of eggs you have available.

• A pelvic scan, which involves an Antral Follicle Count (AFC). This looks at the number of immature follicles that can be matured (and develop eggs) in the IVF cycle.

• You'll also undergo mandatory screening for blood-borne viruses, like Hepatitis B and C.

Next, you'll need a follow-up consultation with a doctor to discuss the results and prepare for your cycle. You'll be given a treatment plan - or protocol - and a nurse will show you how to administer the medication.

Time: 2-4 weeks

Location: Home, with in-clinic monitoring

Now it's time to begin your treatment - or protocol.

Most protocols start on day 1-2 of your period, directly after your bleed. This is when you will begin stimulation. The process typically takes two weeks, during which you inject medication such as Gonadotrophin into your abdomen. This encourages follicles in your ovaries to grow and develop multiple eggs at the same rate. This is different to a natural cycle, where only a 'lead' follicle develops an egg, and increases your chances of conception.

The size of the follicle is how your doctor determines whether the egg is ready (since eggs are too small to assess otherwise). To monitor the development of your follicles, the doctor will use hormonal blood tests and a trans-vaginal ultrasound.

Sometimes, a protocol includes a period of hormonal down-regulation before you start stimulation. This involves using medication to first shut down your natural cycle. It typically starts at day 21 after your period, just after ovulation, and lasts a few weeks. Oral medication, such as Buserelin, is taken. When your bleed comes on day 1 of your next cycle, you will stop down-regulation and begin stimulation.

Time: 36 hours

Location: Home and clinic

When follicles are the right size, your doctor will advise you to take your 'trigger shot'. This is an injection containing hCG - a hormone that helps your follicles mature, and encourages them to release multiple eggs at the same time.

36 hours after the trigger shot, you'll undergo a 15-30 minute surgery at your clinic to retrieve your eggs. Immediately after retrieval, your doctor will inform you of the number and quality of eggs collected, and whether additional cycles are required.

Time: ASAP, following retrieval

Location: Clinic

Your eggs are frozen as soon as possible after your egg retrieval surgery. The process is very quick, minimising any damage to the eggs.

Your eggs are then stored for however long you require them (up to 55 years) at the clinic, or a third party storage facility.

Typical timeline: 4-6 weeks

This is based on one round, from pre-treatment tests to freezing the eggs.

The length of your treatment depends on the protocol used, and whether your doctor needs to carry out any additional tests before starting treatment. Many people also choose to take a break after their pretreatment testing, which can add to the timeline overall.

Due to the relatively small number of egg freezing cycles that happen each year in the UK (just 4,215 in 2021 [4]), there isn't a lot of reliable data on how successfully frozen eggs lead to a live birth. Egg freezing success rates also vary from clinic to clinic, because there are only a small number of cycles performed at each.

Just like IVF, though, collecting enough good quality eggs is key. Data on IVF suggests that people who had 15 eggs collected during treatment had the highest chances of success [5]. A recent study, which looked specifically at egg freezing cycles, confirmed this - finding that a higher birth rate was achieved if 15 or more eggs had been frozen [6] (45%, compared to 13% if fewer than 15 eggs were retrieved).

This is because egg freezing - like IVF - involves many steps, and not all eggs will survive being thawed, or lead to a live birth.

As more people choose egg freezing, and methods and reporting improve, we'll be able to get a better picture of success rates. In the meantime, remember lots of factors can affect your chances of having a child and your doctor should recommend the best protocol for your needs.

Once you've frozen your eggs, what happens next is up to you. Remember that for each year you store your eggs, an annual charge applies.

If you need to do another round of treatment, you may opt to start the process again - or take a break between rounds.

For social egg freezers, when you're ready to start a family, your doctor may first advise you to try and conceive naturally before using your frozen eggs..

If you decide to use your frozen eggs, your clinic will thaw them, using ICSI to fertilise them. Your egg will develop into an embryo in the lab, and be transferred to your uterus following a surgical procedure at your clinic. You'll need to wait about 2 weeks to find out whether you’re pregnant. 

If you don’t use all your eggs, or decide you no longer want to keep them, you have a number of options. You can:

• Donate your eggs to others (not everyone is eligible to do this, however)

• Donate them to fertility treatment training

• Donate them to research

• Allow them to naturally perish

Overall, egg freezing is considered safe. However, it's important to be aware of the risks involved.

• Mental wellbeing. From medication side effects to money worries, many people often underestimate the toll egg freezing can have on your mental and emotional wellbeing. It's important you have appropriate support throughout your treatment journey.

• Ovarian Hyperstimulation Syndrome (OHSS). OHSS occurs when your ovaries become overactive in response to hormonal medication, and start releasing their own chemicals. However, this is rare and, if it does occur, can usually be treated at home. In rare cases, it can lead to hospitalisation and pregnancy complications.

• Surgical risk. As with any surgical procedure, egg retrieval surgery carries a small risk of infection and complications from the sedation administered.

• Using frozen eggs. Currently, there isn't enough reliable data on the health outcomes of pregnancies and live births derived from frozen eggs. However, many people who choose to freeze their eggs do so to delay pregnancy until later in life. There's evidence to suggest that pregnancy among older women carries a higher risk of various conditions, including gestational diabetes, preeclampsia, caesarean delivery and preterm delivery of a baby with low birth weight. These risks vary considerably depending on a woman's individual health.

Social egg freezing is not covered by the NHS so people pay for it out of pocket. There are however certain situations in which the NHS will fund egg freezing. One example is when undergoing treatment for a medical condition - like cancer - that could negatively impact fertility.

However, even if you are covered by the NHS funding might not be available for the full length of time you wish to store your eggs - so always double check the length of time funding will cover.

The cost of egg freezing varies a lot between private clinics, as does what's actually included in a package. The average advertised price of an egg freezing package is £3,715 - but most packages don't usually include the cost of:

• Preliminary tests

• Your initial consultation

• In-treatment blood tests

• Medication

• Egg storage

And that's just the freezing. Bear in mind that if you wish to use your eggs, you'll also have to pay for the egg thaw cycle, with ICSI to fertilise them and other associated costs.

As the name suggests, “Freeze and Share” programmes enable you to freeze and donate half of your eggs to offset the cost of egg freezing. These programmes are becoming popular amongst people who are trying to save money on egg freezing and are interested in helping others who might not be able to conceive using their own eggs. In the ‘Freeze and Share’ programme your clinic will cover the costs of treatment, medication and, often, initial storage. You can find out more about the process in our "Understanding the Cost of Egg Freezing" guide.

Whilst you will go through the same treatment process as standard egg freezing, “Freeze and Share” programmes are not for everyone. There are additional clinical requirements in order to qualify, such as being under the age of 35 and passing certain health tests. In addition, your clinic will want to make sure that sufficient eggs have been collected for you and the recipient of your donated eggs, and so they may advise multiple rounds of egg freezing. This can be emotionally and physically demanding. Finally, there are important legal considerations to take into account to be able to donate your eggs, which your clinic will take you through. 

For those who can donate, it can be a rewarding experience. Read about Sienna’s story of using an Egg "Freeze and Share" programme here.

Egg freezing is one of the fastest growing fertility treatments in the UK, thanks to advances in the technology used to freeze eggs and a growing awareness of issues surrounding female fertility.

As a treatment, egg freezing provides people with the flexibility to delay parenthood until it's right for them. It also gives people the option to start a family using their own eggs, even when facing a serious medical condition or procedure.

But it's not a fail-safe insurance policy. Success rates are unclear, and it's important to remember that it's not for everyone - with age playing a significant factor. The NHS also only covers it in certain cases. For most people, egg freezing is paid for privately, and you will need to pay an annual storage fee for as long as you choose to store your frozen eggs.