Freeze’s “Eggspert” Answers series provides women answers to common, important questions they have when considering to freeze their eggs - answered by world-renowned medical experts. This post is answered by Freeze and Dr. Alison Peck, Reproductive Endocrinologist at HRC Fertility in Los Angeles.
The amount of times a woman “should” cycle depends on (1) her age, (2) the number of eggs retrieved per cycle, and (3) what her end goal is.
I strongly advocate and support women getting informed about egg freezing, the sooner the better, and then acting on it, the sooner the better. Like many things in life, the hardest part is the first step. In this case, that step is making the decision to freeze your eggs. After that, it’s important to consider how many times you will or should do it.
The younger, the better
Most women come to a fertility clinic around age 35 or later to freeze their eggs. Although this is a wonderful step in the right direction and is absolutely worthwhile, the younger you are the more healthy eggs we will retrieve and the less number of cycles you will need to do.
Average eggs per cycle
Here are general numbers. But, it is important to understand, age is not everything! Some women over 40 year can make more eggs in one cycle than a woman less than 20. That is where the fertility markers come in. Age is a factor of quality, whereas the fertility markers are a factor of number.
Checking your fertility markers
Prior to freezing your eggs, you should assess your fertility markers by blood tests and pelvic ultrasound. This is called ovarian reserve testing. The most common tests are:
anti-mullerian hormone (AMH), done on any day of the menstrual cycle
follicle stimulating hormone (FSH) and estradiol (E2), done day 2 or 3 of the menstrual cycle
pelvic ultrasound to count the number of antral follicles in the ovaries, done between day 2 and 5 of the menstrual cycle
These are the most important tests to get to help plan which drugs, in what amounts, you should take. Also, the results help counsel and set expectations. The better the reserve, the more eggs will grow from each cycle. These numbers foreshadow how many times a patient should cycle.
Your goal from freezing
Women choose to freeze their eggs for different reasons. Some want to preserve their “younger, better quality eggs” knowing they want to have children later in life and plan to use the retrieved eggs to create their future children. In this case, the more children they want, the more cycles they should do.
Other women freeze their eggs as a back up plan, hoping not to use them unless they are not successful on their own. If all goes well, these women may be good candidates for one cycle, especially if they get a good yield.
Whatever the reason, I usually recommend women consider up to three cycles.
Why so many eggs for just one baby?
This is because the number of eggs retrieved rarely equals the number of embryos created. And, no one will know how many eggs will be embryos until they are mixed with sperm; so we guestimate.
I explain it like this:
Looking at those numbers with patients help me counsel how many cycles a patient should do. But don’t fret. Like I said, step one is committing to the process. After the first cycle, I always reassess the global plan and that’s when we discuss how many more to do. So it’s baby steps, no pun intended, to find the right number for each patient to get you to your maybe baby.
Dr. Alison Peck, M.D., F.A.C.O.G., Southern California native and practicing since 2006, is board certified in both obstetrics/gynecology and reproductive endocrinology/infertility (REI). Dr.Peck is also fluent in Spanish and Hebrew and has a special interest in Genetic Screening of Embryos and Fertility Preservation in Young Reproductive Age Women. Dr. Peck completed her specialty training in obstetrics and gynecology at the University of Southern California and her fellowship in reproductive endocrinology and infertility at the Albert Einstein College of Medicine, New York.
Dr. Peck helps women freeze their eggs at HRC Fertility, who is a sponsor of this post. Learn about HRC’s egg freezing practice on Freeze.