Right now, all fertility treatment cycles—including egg freezing—are on hold due to the coronavirus COVID-19 pandemic. But there are still things you can do during this time to help optimize your outcome with egg freezing when you (and the world) are ready to move forward.
Here are our suggestions for what you can do now to prepare for a post-pandemic egg freezing cycle.
Think constructively about your reproductive goals.
You may know you want kids—or maybe you’re not sure, and you’re considering egg freezing as a way to make that decision later (no judgement here). But even if you’re 100% certain, there are still questions you can ask yourself now that will allow you to have a more productive conversation with your doctor later, and ensure that their guidance will help you meet your goals. Try to be as honest with yourself as possible as you go through these questions.
- Why am I considering egg freezing? Do I know I definitely want a child (or children), or am I not sure, but want to keep my options open?
- What does my future family look like? How many children do I want, and how far apart?
- Am I planning on using my frozen eggs to conceive, or is this a “back-up plan”?
- When do I think I may want to—or be able to—begin trying to conceive? What has to happen before you’ll feel ready? Finding a partner, finishing school, settling into your career?
- What chance of success (meaning, a pregnancy with your frozen eggs) feels okay for you? 50%? 75%? 90%?
Please remember there are no right or wrong answers here. It’s all simply an exercise to allow you to enter the next phase more in-tune with what you want for your future, and what you want out of the egg freezing process.
Consider stopping your birth control.
We know that birth control does not affect fertility long-term; a study of almost 9,000 planned pregnancies demonstrated that those who had never used oral contraceptives (birth control pills) conceived at the same rates as those who had used oral contraceptives for five years or more.
However, there’s evidence that being on birth control recently may affect not only the results of a fertility assessment, including the anti-Mullerian hormone levels (studies: 1, 2, 3), but can actually suppress the body’s response to egg freezing medication. Use of hormonal birth control directly prior to a “stimulation” cycle (such as egg freezing) can result in a longer egg freezing cycle that requires more medication, according to one study, and can negatively affect the number of eggs that are eventually retrieved, according to another. Our own experience with over 3,000 egg freezing cycles has also shown this to be true.
So, for those who are serious about getting started with egg freezing after COVID-19 restrictions are lifted, stopping birth control 2–3 months before can ensure that you get the most accurate test results as well as the best possible result from your future cycle. One caveat, of course—if you’re having sex and you’re not hoping to get pregnant right now, please make sure to use alternate contraception!
Good news for IUD users—because the IUD doesn’t typically halt ovulation, it doesn’t have the same impact on egg freezing results as birth control pills, patches, or rings. You can actually go through your whole egg freezing process without removing your IUD.
Do an at-home fertility hormone blood test.
The fertility assessment here at Extend Fertility consists of an ultrasound and a blood test for anti-Mullerian hormone (AMH), a hormone created by the follicles (or immature eggs) in the ovaries. The level of AMH in your blood gives doctors a rough estimate of your total egg supply.
Your AMH level can help us estimate how many eggs you’re likely to get in one egg freezing cycle. And alongside your age and data we’ve collected through the many cycles at our center, this test result can also help us understand your chances of pregnancy with the eggs collected in one or more cycles.
Learn more about ovarian reserve testing.
Typically, we offer this complimentary assessment in-person at our offices, but that’s not an option at the moment. We’ve partnered with Modern Fertility, an at-home fertility testing company, to give you the option of collecting some of this information from the safety of your living room. Here’s how it works:
- Order a test kit directly from Modern Fertility.*
- Agree to share the results of your testing with our team through Modern Fertility’s online portal.
- Do a simple finger-prick blood test at home, according to the kit’s directions.
- Pop it in the mail.
- You—along with our team—will get results in about 10 days.
In addition to the AMH test, Modern Fertility’s kit will test for other fertility-related hormones, depending on the type of birth control (if any) you use.
The results of this testing will give you and your doctor some hard data to discuss when it comes time for your consultation. This means we can give you the most accurate and realistic look at how successful your egg freezing cycle may be, and what that means for your future chances of pregnancy.
*Please note: Modern Fertility’s test kit is not yet available in New York, New Jersey, or Rhode Island.
Schedule a free virtual consultation.
We’re still here! We’ve simply moved all our consultations to virtual platforms, either phone or video.
Here’s what to expect in your consultation:
- You’ll meet with a reproductive endocrinologist (a fertility specialist doctor).
- Your doctor will start off with an overview of female fertility and how it’s affected by time, among other things.
- You’ll also get a full debriefing of the egg freezing process: how long it takes, what it entails, etc.
- We’ll talk about your medical history and your goals with egg freezing—those questions we asked you to think through above.
- If you’ve shared the results of your blood testing, either through Modern Fertility or another doctor, your doctor can discuss what those results mean for you and for your reproductive goals.
- You’ll have an opportunity to ask any questions you may have about fertility or egg freezing.
This is an amazing opportunity to have an in-depth, one-on-one discussion with a fertility expert. Doing this now can make sure you have your questions answered, and any next steps lined up, for the time when egg freezing cycles are once again an option.
Understand pricing, insurance, and payment plan options.
We know that—even with the lower prices we offer ($6,500 per cycle vs. the national average of $11,000)—egg freezing is expensive for many. This is a great opportunity to take the time to think through this cost and explore your options for payment, including insurance and payment plans.
Make sure you understand what the cost of an egg freezing cycle includes—like monitoring and anesthesia—and what it doesn’t, like medication, long-term frozen egg storage, and using your frozen eggs in IVF later. A cycle here costs $6,500. Medications purchased through a pharmacy can cost $2,000–$6,000. Storage can cost $420–$600 per year, depending on the plan you purchase.
In most cases, insurance is unlikely to cover the cost of the egg freezing procedure, as it’s considered elective. (If you’re freezing your eggs before cancer treatment or surgery that could put your fertility at risk, you may be the exception.) However, now is a great time to figure out whether or not your insurance plan may cover the fertility medications used during egg freezing, and whether or not your plan or employer has other options—like a health savings account—you might be able to use to lower your out-of-pocket cost.
Finally, you can review your financing options. Financing for egg freezing is available through several different companies; it does come with interest (how much depends on your personal credit application), but it offers the option of an easy monthly payment for your cycle, medications, and even storage.
Paying for egg freezing: know your options
Working out the finances of egg freezing now gives you time to plan—and save, if you need to—so you can be ready when we are.
Stop smoking.
Smoking is one of the only lifestyle factors that we know, with very good evidence, negatively affects fertility. Smoking affects how many eggs you have, also known as your egg count; chemicals in cigarette smoke speed up the loss rate of eggs, and smokers experience menopause up to 4 years earlier than non-smokers (according to the American Society for Reproductive Medicine).
Smoking also damages the genetic material of your eggs. ASRM reports that miscarriage and offspring birth-defect rates—both of which are associated with egg quality, or genetic health—are higher among smokers. Finally, smoking can impact your results with ovary-stimulating medications, like those used in egg freezing and IVF. Studies show that female smokers require more medication during IVF, and still end up with fewer eggs at retrieval time.
It’s not clear that you can regain fertility lost to cigarettes, but quitting now can stop any more damage from occurring. Smoking has a huge impact on your fertility and your overall health (including how at-risk you are for COVID-19). If you’re looking for an excuse to quit, let this be it!
Consider starting DHEA and CoQ10.
DHEA and CoQ10 are supplements. DHEA (dehydroepiandrosterone) is a hormone produced by your body’s adrenal glands. Co (coenzyme) Q10 is an antioxidant that protects cells from damage.
There’s some evidence that these supplements can modestly improve the results of fertility treatment, specifically for those with diminished ovarian reserve (or low egg supply). Specifically, use of these supplements together may improve the ovary’s response to medication, according to one study; lower the amount of medication required, according to another, and increase pregnancy rates during IVF according to others (1, 2).
There’s a huge caveat here, in that there have been no studies performed of the effectiveness of DHEA and CoQ10 supplementation on those going through egg freezing cycles, and no evidence that it helps improve fertility in those who don’t have diminished ovarian reserve. But these supplements have very few negative side effects, and are unlikely to be harmful. So if you know that you fall into the “low egg supply” category, starting these supplements may help you get the most out of your egg freezing cycle later.
You can discuss this supplementation—including what kind, how much, and when to take—with your doctor at your consultation.
