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Does Egg Freezing Work?

Course / Does Egg Freezing Work?

The Premise of Egg Freezing

The Core Concept: The fundamental premise of egg freezing (oocyte cryopreservation) is simple yet profound: it is a medical intervention designed to halt the biological aging of a woman’s eggs.

  • The Problem it Solves: A woman’s ovarian reserve—the number and quality of eggs in her ovaries—declines predictably and irreversibly with age. This is the single greatest factor affecting natural fertility. Egg freezing directly addresses this by preserving eggs at their current, younger state.
  • The Technology: The process utilizes vitrification, an ultra-rapid freezing technique that prevents the formation of ice crystals, which historically damaged eggs during slow freezing. Vitrification has revolutionized the field, leading to survival rates, fertilization rates, and subsequent pregnancy rates that are now nearly equivalent to using fresh eggs.
  • Clinical Indication: From a medical standpoint, egg freezing is no longer considered experimental. It is a standard of care for:
    • Elective Fertility Preservation (Social Freezing): For women wishing to delay childbearing for educational, career, or personal reasons.
    • Medical Indications: For patients facing a cancer diagnosis or other medical treatments (like chemotherapy or radiation) that are toxic to the ovaries.
    • Fertility Concerns: For those with a family history of premature ovarian insufficiency or a declining ovarian reserve observed at a young age.

Reduced Number & Quality of Eggs

Understanding the “why” behind egg freezing requires a clear grasp of ovarian aging, which occurs in two critical dimensions:

  1. Quantitative Decline (The Egg Count)
  • A female is born with her lifetime supply of eggs, approximately 1-2 million. This number dwindles to about 300,000 – 500,000 at puberty and continues to decline each month through a process called atresia (natural death).
  • By age 37, a woman has about 25,000 eggs remaining, and by 51 (the average age of menopause), roughly 1,000 remain.
  • Clinical Correlation: We measure this quantitative reserve through blood tests for Anti-Müllerian Hormone (AMH) and an Antral Follicle Count (AFC) via ultrasound. Lower values indicate a diminished ovarian reserve.
  1. Qualitative Decline (The Egg Quality)
  • This is often the more critical and less understood factor. As eggs age within the ovary, they are more susceptible to genetic abnormalities.
  • Older eggs have a higher rate of aneuploidy—an incorrect number of chromosomes. If an aneuploid egg is fertilized, it may fail to implant, result in an early miscarriage, or, in rare cases, lead to a chromosomal disorder like Down syndrome.
  • The Data: While only about 10-20% of a woman’s eggs at age 25 may be aneuploid, this figure rises to over 50% by age 40.
  • The Freezing Implication: By freezing eggs at a younger age (e.g., mid-20s to mid-30s), we preserve not just the quantity available at that time, but more importantly, the superior genetic quality of those eggs.

This Phenomenon Does Not Extend To The Uterus

A Critical Distinction in Reproductive Biology: It is essential to differentiate between ovarian aging and uterine aging. The decline in egg quantity and quality is an ovarian event.

  • Uterine Receptivity: The uterus itself does not “age” in the same way. The endometrial lining remains capable of receiving and supporting an embryo well into a woman’s 40s and 50s, provided it is healthy and receives appropriate hormonal support.
  • The Clinical Significance: This biological fact is the cornerstone of several assisted reproductive technologies, including egg donation and surrogacy. It means that a woman can use her own frozen eggs to create embryos later in life and carry a pregnancy successfully. Conversely, if a uterine issue exists, the embryos created from her young, frozen eggs can be transferred to a gestational surrogate. This principle gives intended parents multiple pathways to build their family.

Egg Donation Works

The efficacy of egg freezing is underpinned by the long-standing and overwhelming success of egg donation.

  • The Model: In an egg donation cycle, a young, healthy donor (typically in her 20s) undergoes ovarian stimulation and egg retrieval. These fresh eggs are then fertilized and transferred to the intended mother or a gestational carrier.
  • The Result: Consistently high success rates, regardless of the recipient’s age. This proves conclusively that the age of the egg is the primary determinant of IVF success, not the age of the uterus receiving the embryo.
  • The Link to Freezing: Egg freezing effectively allows a woman to become her own egg donor. By cryopreserving her own eggs when they are young and of high quality, she is banking the very same biological material that makes third-party egg donation so successful.

Egg Freezing Works

While not a guarantee of a live birth, egg freezing is a statistically robust fertility preservation strategy.

  • Survival Rates: With modern vitrification, over 90% of mature eggs survive the thawing process.
  • Fertilization Rates: Using ICSI (Intracytoplasmic Sperm Injection), approximately 70-80% of thawed eggs will fertilize normally.
  • Live Birth Per Egg: The most critical metric is the cumulative live birth rate per frozen egg. While this varies by the age at freezing, studies suggest:
    • For women freezing eggs under 35, the live birth rate per frozen egg is approximately 5-7%.
    • This means that banking 15-20 mature eggs provides a high statistical probability (often quoted as 70-80%) of achieving at least one live birth.

Conclusion: The technology is proven. The key variables for success are the age of the woman at the time of egg retrieval and the number of mature eggs successfully cryopreserved.

Predicting Success With Egg Freezing

Predicting an individual’s outcome is not guesswork; it is a clinical assessment based on key variables.

  1. Age at Freezing (The Most Critical Factor):
  • <35: Optimal age. Highest egg quality, leading to the best statistical outcomes per egg frozen.
  • 35-37: Good candidates. Success rates remain high, but a larger number of eggs may be recommended to achieve the same cumulative live birth probability.
  • 38-40: Still a viable option, but patients must be counseled that the efficiency per egg is lower, and multiple retrieval cycles are often necessary to bank a sufficient number.
  • >40: Proceed with caution. Success rates drop significantly due to high aneuploidy rates. Thorough counseling on realistic expectations is mandatory.
  1. Ovarian Reserve (AMH & AFC):
  • These tests predict how many eggs a patient is likely to produce in a single cycle. A higher reserve means a potentially higher yield per cycle, reducing the need for multiple expensive retrievals.
  1. Number of Mature Eggs Banked:
  • Success is a numbers game. We do not recommend banking fewer than 10 mature eggs for women under 35, with 15-20 being a more robust goal. For women over 38, 25-30 eggs may be the target to have a realistic chance of one or two children.
  1. Clinic-Specific Expertise:
  • Success is not just about the technology but the team implementing it. Laboratory proficiency in vitrification/thawing protocols and the clinical management of ovarian stimulation are paramount. At Surrogacy4All, we partner only with top-tier IVF clinics whose success metrics and laboratory standards meet our rigorous criteria for the intended parents and surrogates we serve.
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